Patent ID: 8219210
Filing Date: 2012-07-10
Classification: A61B,A61N

Abstract:
1. An implantable device, comprising: pulse generation circuitry for generating pacing pulses; sensing circuitry for receiving electrogram signals; a switch matrix for connecting the pulse generation circuitry and/or sensing circuitry to electrodes selected from a plurality of electrodes adapted for disposition at a plurality of sites near different myocardial regions; a controller interfaced to the sensing circuitry that is programmed to derive one or more characteristics from electrogram signals generated by a plurality of electrodes connected to the sensing circuitry by the switch matrix, wherein the one or more characteristics are locally affected by myocardial ischemia or infarction such that the magnitude of a characteristic derived from a particular electrode varies in relation to the proximity of the particular electrode to an ischemic or infarcted myocardial region; wherein the controller is programmed to measure the one or more characteristics over time and establish baseline values for the measured characteristics; wherein the controller is programmed to detect myocardial ischemia/infarction when a deviation from the baseline in one or more characteristics occurs above a specified threshold; wherein the controller is further programmed to localize an ischemic/infarcted region(s) by analyzing the magnitudes of the measured characteristics as derived from differently located electrodes; wherein the controller is further programmed to, among the plurality of electrodes connected to the sensing circuitry, identify electrodes in a zone around the ischemic/infarcted region and operate the switch matrix to configure a pacing channel with the electrode having the largest change in characteristics above the baseline; and, wherein the controller is further programmed to deliver pre-excitation pacing through the configured pacing channel to a pacing site in proximity to the ischemic/infarcted region.