Systems and methods for controlling paired pacing interpulse intervals to reduce contractility disequilibrium using an implantable medical device

摘要

Techniques are provided for use with implantable medical devices equipped to deliver paired postextrasystolic potentiation (PESP) pacing within a patient having an intact ventricle and a weakened ventricle. A first interpulse interval is determined for use with paired PESP pacing of the intact ventricle sufficient to achieve only relatively minimal potentiation within the intact ventricle. A second interpulse interval is determined for use with paired PESP pacing of the weakened ventricle sufficient to achieve relatively more significant potentiation within the weakened ventricle. Then, paired PESP pacing is delivered to the intact ventricle using the first interpulse interval while paired PESP is also delivered to the weakened ventricle using the second interpulse interval to reduce contractility disequilibrium within the heart caused by the weakened ventricle to achieve a matching of natural contractilities. In this manner, dual ventricular, independently timed, continuous PESP is provided.

主权项

1. A method for use with an implantable cardiac stimulation device equipped to deliver paired post-extrasystolic (PESP) pacing within a patient having an intact ventricle and a weakened ventricle, the method comprising:
determining a first interpulse interval for use with paired PESP pacing of the intact ventricle sufficient to achieve only relatively minimal potentiation within the intact ventricle; determining a second interpulse interval for use with paired PESP pacing of the weakened ventricle sufficient to achieve relatively more significant potentiation within the weakened ventricle, wherein the determining comprises delivering test pulses at varying intervals, assessing the degree of potentiation achieved with each interval, and selecting the interval corresponding to a maximum potentiation; and delivering paired PESP pacing to the intact ventricle using the first interpulse interval while delivering paired PESP to the weakened ventricle using the second interpulse interval to reduce contractility disequilibrium within the heart caused by the weakened ventricle.