Patent ID: 8886306
Filing Date: 2014-11-11
Classification: A61N

Abstract:
1. A cardiac rhythm management device, comprising: pulse generation circuitry for delivering electrical stimulation to one or more electrodes; a switching matrix for connecting the pulse generation circuitry to one or more of a plurality of available electrodes disposed at a plurality of stimulation sites; a hemodynamic response sensor for sensing a physiological variable reflective of myocardial contractility; a controller programmed to, in a normal mode, deliver pacing pulses to a selected stimulation site using a bradycardia pacing mode; wherein the controller is programmed to, in a high-output pacing (HOP) mode, deliver pacing pulses to an optimal HOP stimulation site using a bradycardia pacing mode with a pacing pulse energy greater than in the normal mode; wherein the controller is programmed to cycle through a plurality of different stimulation sites by operating the switch matrix to connect the pulse generator to different ones of the available electrodes in order to deliver HOP stimulation to the different stimulation sites, compare the hemodynamic response sensor outputs of each of the different stimulation sites white HOP stimulation is delivered thereto, and select the optimal HOP stimulation site based upon the comparison; sensing circuitry for detecting cardiac decompensation; wherein the controller is programmed to operate in the normal mode and to intermittently enter and exit the HOP mode in accordance with specified entry and exit conditions; and, wherein the device is programmed to use detection of cardiac decompensation as an entry condition for triggering delivery of HOP stimulation in the HOP mode.