Pressure regulated atrio-ventricular delay for multi-site pacing
The hemodynamic operation of certain heart disease patient can be improved using pressure regulated atrio-ventricular delay. The pressure regulated atrio-ventricular delay involves recording atrial activation and ventricle activation, identifying a maximum diastolic pressure, identifying a declination pressure, calculating a percent decrease, and adjusting atrio-ventricular delay. The declination pressure occurs at the beginning of an isovolumetric contraction. The percent decrease is calculated between the maximum diastolic pressure and the declination pressure. The atrio-ventricular delay is adjusted according to the percent decrease between the maximum diastolic pressure and the declination pressure.
1. A cardiac pacemaker for pressure regulated atrio-ventricular delay for multi-site pacing, comprising:
a housing having a power supply carried in the housing and a feedthrough;
a controller carried in the housing coupled to the power supply;
memory coupled to the controller;
pacing electronics coupled to the controller and the feedthrough;
sensing electronics coupled to the controller and the feedthrough;
a first electrical lead coupled to the feedthrough and configured for positioning in an atrium;
a second electrical lead coupled to the feedthrough and configured for positioning in a ventricle a pressure sensor carried on the third electrical lead;
a second electrical lead coupled to the feedthrough and configured for positioning in the left ventricle; and,
software stored in memory containing instructions including,
a first sequence of instructions when executed by the controller, causes the controller to record atrial activation and ventricle activation,
a second sequence of instructions when executed by the controller, causes the controller to identify a maximum diastolic pressure,
a third sequence of instructions when executed by the controller, causes the controller to identify a declination pressure occurring at an isovolumetric contraction beginning,
a fourth sequence of instructions when executed by the controller, causes the controller to calculate the percent decrease between the maximum diastolic pressure and the declination pressure, and,
a fifth sequence of instructions when executed by the controller, causes the controller to adjust atrio-ventricular delay according to the percent decrease between the maximum diastolic pressure and the declination pressure.
2. A method for pressure regulated atrio-ventricular delay in multi-site pacing, comprising:
recording atrial activation and ventricle activation,
identifying a maximum diastolic pressure,
identifying a declination pressure occurring at an isovolumetric contraction beginning,
calculating a percent decrease between the maximum diastolic pressure and the declination pressure, and,
adjusting atrio-ventricular delay according to the percent decrease between the maximum diastolic pressure and the declination pressure.