US 11,654,288 B2
Systems and methods for managing atrial-ventricular delay adjustments
Wenwen Li, San Jose, CA (US); Nima Badie, Berkeley, CA (US); Luke C. McSpadden, Los Angeles, CA (US); Yun Qiao, Sunnyvale, CA (US); Avi Fischer, New Rochelle, NY (US); and Kyungmoo Ryu, Palmdale, CA (US)
Assigned to Pacesetter, Inc., Sylmar, CA (US)
Filed by Pacesetter, Inc., Sylmar, CA (US)
Filed on Aug. 10, 2020, as Appl. No. 16/988,821.
Prior Publication US 2022/0040484 A1, Feb. 10, 2022
Int. Cl. A61N 1/368 (2006.01); A61N 1/05 (2006.01)
CPC A61N 1/3682 (2013.01) [A61N 1/0587 (2013.01); A61N 1/36843 (2017.08)] 30 Claims
OG exemplary drawing
 
1. A system for managing atrial-ventricular (AV) delay adjustments, the system comprising:
an implantable medical device (IMD) having a header that includes a right atrial (RA) header port, a right ventricular (RV) header port and a left ventricular (LV) header port;
a first lead having a first electrode configured to be located proximate to an atrial (A) site, the first lead having a proximal end with a first lead terminal connected to the RA header port; and
a second lead having a second electrode configured to be located proximate to at least one of a left bundle branch (LBB) site or a HIS bundle, the second lead having a proximal end with a second lead terminal connected to the RV or LV header port,
memory configured to store program instructions;
one or more processors that, when configured to execute the program instructions:
measure an AV interval corresponding to an interval between Lan atrial paced (Ap) event or an atrial sensed (As) event, paced or sensed at the first electrode, and La sensed ventricular (Vs) event sensed at the second electrode;
set a candidate AV delay based on the AV interval and based on a bundle branch adjustment (BBA) value, wherein the BBA value represents an adjustment to the AV interval to account for sensing the Vs event at the second electrode which is located proximate to at least one of the LBB site or the HIS bundle but connected to the RV or LV header port;
measure a QRS characteristic of interest (COI) while utilizing the candidate AV delay in connection with delivering a pacing therapy by the IMD;
adjust the BBA value and reset the candidate AV delay based on the AV interval and the BBA value as adjusted;
repeat the adjust, reset and measure to obtain a collection of QRS COIs and corresponding candidate AV delays;
select one of the candidate AV delays, that corresponds to a select one of the QRS COIs, as a BBA AV delay; and
manage the pacing therapy, utilized by the IMD, based on the BBA AV delay.