Devices and method for accelerometer-based characterization of cardiac synchrony and dyssynchrony

摘要

Systems and methods according to the invention employ an acceleration sensor to characterize the synchrony or dyssynchrony of the left ventricle. Patterns of acceleration related to myocardial contraction can be used to assess synchrony or dyssynchrony. Time-frequency transforms and coherence are derived from the acceleration. Information and numerical indices determined from the acceleration time frequency transforms and coherence can be used to find the optimal pacing location for cardiac resynchronization therapy. Similarly, the information can be used to optimize timing intervals including V to V and A to V timing.

主权项

1. A method for identifying an optimal pacing location, comprising:
a. introducing an acceleration-measuring catheter into a coronary sinus of a patient; b. measuring a baseline pattern of left ventricular myocardial acceleration; c. placing a right ventricular pacing device in a right ventricle of the patient; d. placing a left ventricular pacing device in or on the left ventricle of the patient; e. moving the left ventricular pacing device to a plurality of locations in or on the left ventricle; f. performing biventricular or left ventricular pacing at each of the plurality of locations with the left ventricular pacing device; g. measuring an acceleration pattern at each of the plurality of locations caused by the biventricular or left ventricular pacing; and h. determining a location within the left ventricle having a least dyssynchronous acceleration pattern; and i. selecting the location with the least dyssynchronous acceleration pattern to implant a CRT pacing lead.