Patent ID: 6708061
Filing Date: 2004-03-16
Classification: A61N

Abstract:
A method of optimizing the pacing mode and inter-site delay configuration of a dual chamber pacemaker of the type having means for sensing atrial depolarization events, means for sensing ventricular depolarization events and means for applying cardiac stimulating pulses selectively to the right, left or both ventricular chambers at a plurality of sites at predetermined delay intervals following detection of atrial depolarization events, comprising the steps of:(a) determining a patient's intrinsic AV delay; (b) generating randomized list of configurations, each having a specific pacing mode and AV delay, said AV delay being a function of the intrinsic AV delay; (c) measuring a selected cardiac performance parameter selected from a group indicative of the performance of a patient's heart during multi-site pacing for a first number of beats to establish a baseline using a first setting comprising a first pacing mode and first inter-site delay interval; (d) varying the setting in accordance with a configuration from step (b); (e) measuring said parameter during pacing for a second number of beats; (f) calculating and storing a performance parameter feature value obtained in steps (C) and (e); (g) repeating steps (c)-(f) which define a trial until said randomizer list is exhausted; (h) re-randomizing list of configurations in (b) a predetermined number of times (N) and repeating steps (c)-(g) for each randomization that each configuration is repeated for N trials; (i) determining that data confirms that all configurations are valid and wherein any invalid configuration results in ending of the optimization and return of the pacemaker to permanent settings; (j) determining an optimal inter-site delay interval and pacing mode configuration based on measurements of said parameter at said plurality of configuration, each having a plurality of trials; and (k) setting the inter-site delays and pacing mode configuration of the pacemaker to the optimal inter-site delays and pacing mode configuration established in step (j).