Criteria for optimal electrical resynchronization derived from multipolar leads or multiple electrodes during biventricular pacing

摘要

Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

主权项

1. A method of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes, comprising:
a) pacing using the right ventricular electrode and measuring activation times at a plurality of the left ventricular electrodes; b) pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes; c) computing a first electrical dyssynchrony (ED1) based on activation times in step b); d) pacing using the right ventricular electrode and a second one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes; e) computing a second electrical dyssynchrony (ED2) based on the activation times in step d); f) determining whether a difference between ED1 and ED2 is less than a predetermined threshold; and g) eliminating one of the left ventricular electrodes for delivery of subsequent pacing pulses if the difference between ED1 and ED2 is greater than a predetermined threshold,wherein ED1 and ED2 are each determined from one of a set of equations comprising:
ED(1)=AT(1)+AT(2)+AT(3)/2+AT(4)/3; ED(2)=AT(1)+AT(2)+AT(3)+AT(4)/2; ED(3)=AT(1)/2+AT(2)+AT(3)+AT(4)/2; and ED(4)=AT(1)/3+AT(2)/2+AT(3)+AT(4).