Duke University

The United States Government As Represented by the Department of Veterans Affairs

Medtronic, Inc.

Brett D Atwater

Nathan A Grenz

Daniel Friedman

John F Beshai

Systems and methods for selecting, positioning, and controlling cardiac resynchronization therapy (CRT) electrodes are disclosed. According to an aspect, a CRT system includes one or more electrodes configured to be positioned on or in proximity to a subject's heart for receiving electrical signals carrying EGM data. The system also includes a CRT device operatively connected to the electrode(s). The CRT device is configured to receive the electrical signals from the electrode(s) when the one or more electrodes are positioned in a first arrangement with respect to the subject's heart. Further, the CRT device is configured to determine a second arrangement of the electrode(s) with respect to the subject's heart based on the carried EGM data. The CRT device is configured to present the second arrangement of the electrode(s).

Systems and methods for selecting, positioning, and controlling cardiac resynchronization therapy (CRT) electrodes

Systems and methods for optimizing CRT are disclosed. According to an aspect, a method includes receiving, during at least two time periods of a cardiac cycle, electrical signals communicated by two or more electrodes of a CRT device positioned one or more of on a surface of a body, within a thorax of the body, a heart of the body, a surrounding venous structure of the body, and a surrounding subcutaneous structure of the body. The method also includes calculating, based on the received electrical signals, spacing between the two or more electrodes during the at least two time periods of the cardiac cycle. Further, the method includes controlling output of the CRT device to the electrodes based on the calculated spacing between the two or more electrodes.

Systems and methods for optimizing cardiac resynchronization therapy (CRT)

Techniques for identifying abnormal cardiac substrate, e.g., scar substrate, may be implemented, as an example, during implantation of a left-ventricular (LV) lead, e.g., for cardiac resynchronization therapy (CRT), which may enable placement of the LV lead to avoid the abnormal cardiac substrate. An example system for identifying abnormal cardiac substrate comprises at least one implantable LV lead comprising at least one bipolar electrode pair configured to sense a LV bipolar cardiac electrogram signal of LV tissue proximate the bipolar electrode pair. The system delivers cardiac pacing pulses to a left ventricle via at least one electrodes of the LV lead, which may be different then the electrodes of the bipolar pair, and which may be spaced at least a threshold distance from the bipolar pair of electrodes. The amplitude of paced depolarizations in the bipolar electrogram indicates whether tissue proximate the bipolar electrode pair comprises abnormal cardiac substrate.

Growing community of inventors

Durham, NC, United States of America

Brett D Atwater