Systems and methods for use by an implantable medical device for controlling multi-site CRT pacing in the presence of atrial tachycardia

摘要

Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to single-site LV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish organized atrial tachycardias (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold that is set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes.