Systems and methods for ranking and selection of pacing vectors

摘要

Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds.

主权项

1. A method of operating a cardiac device to rank potential Left Ventricular (LV) cardiac pacing vectors, comprising:
measuring one or more parameter values indicative of pacing viability for a plurality of cathode electrodes of a cardiac chamber; identifying each of the plurality of cathode electrodes as a viable cathode electrode or an eliminated cathode electrode based on the one or more measured parameter values for that particular cathode electrode, wherein the viable cathode electrodes are subject to further testing and the eliminated cathode electrodes are eliminated from further testing; after identifying the viable cathode electrodes for the cardiac chamber:
measuring a value of a parameter indicating hemodynamic function of pacing for at least some of the viable cathode electrodes; andmeasuring one or both of a cardiac capture threshold and a phrenic nerve activation threshold for potential LV pacing vectors of the cardiac chamber, each potential LV pacing vector defined between a viable cathode electrode and an anode electrode; ranking the potential LV pacing vectors based on the measured hemodynamic function parameter value and the one or both measured thresholds; and generating an output of the cardiac device indicating the ranking.