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CN-122003272-A - ICE optimized left atrium and left auricle pacing

CN122003272ACN 122003272 ACN122003272 ACN 122003272ACN-122003272-A

Abstract

A pacing system configured to sense cardiac activity and deliver pacing therapy to a patient's heart. The pacing system may include a first electrode configured to be positioned in a first chamber of the heart and configured to deliver a first pacing therapy to the first chamber of the heart and a second electrode configured to be positioned in the left atrial appendage and configured to deliver a second pacing therapy to the left atrial appendage. The processing module of the pacing system may be configured to time delivery of the first pacing therapy based on the first timing reference and to time delivery of the second pacing therapy based on the determined pacing delay between the first pacing therapy and the second pacing therapy. The determined pacing delay may be configured to maximize blood flow into and/or out of the left atrial appendage.

Inventors

  • JERRY KING
  • Joshua mark Enoch
  • JAMES M. ANDERSON

Assignees

  • 波士顿科学医学有限公司

Dates

Publication Date
20260508
Application Date
20240801
Priority Date
20230810

Claims (15)

  1. 1. A pacing system configured to sense cardiac activity and deliver pacing therapy to a patient's heart, the pacing system comprising: a first electrode configured to be positioned in a first chamber of the heart and configured to deliver a first pacing therapy to the first chamber of the heart; A second electrode configured to be positioned adjacent to a left atrial appendage of the heart and configured to deliver a second pacing therapy to the left atrial appendage of the heart; Wherein the processing module of the pacing system is configured to time delivery of at least a portion of a first pacing therapy for the first electrode based at least in part on a first timing reference, and the processing module of the pacing system is configured to time delivery of at least a portion of a second pacing therapy for the second electrode based at least in part on a determined pacing delay between the first pacing therapy and the second pacing therapy, and Wherein the determined pacing delay is configured to maximize blood flow into and/or out of the left atrial appendage.
  2. 2. The pacing system of claim 1, wherein the first electrode is coupled to a first lead extending from a pacemaker and the second electrode is coupled to a second lead extending from the pacemaker.
  3. 3. The pacing system of claim 2, wherein the second lead comprises: A puncture needle; Adhering a growth pad; the second electrode, and An electrical conductor extending proximally from the second electrode.
  4. 4. The pacing system of claim 3, wherein the puncture needle and the adhesive growth pad are configured to be punctured through and compressed against an outer surface of the left atrial appendage.
  5. 5. The pacing system of claim 1, wherein the first electrode is coupled to a first lead extending from a pacemaker and the second electrode is coupled to a leadless cardiac pacemaker.
  6. 6. The pacing system of claim 5, wherein the pacemaker communicates with the leadless cardiac pacemaker.
  7. 7. The pacing system of any one of claims 1-6, wherein the first timing criterion comprises heart sounds.
  8. 8. The pacing system of any one of claims 1-6, wherein the first timing criterion includes a flap opening.
  9. 9. The pacing system of any one of claims 1-6, wherein the first timing criterion comprises a pressure drop.
  10. 10. The pacing system of any one of claims 1-7, wherein the determined pacing delay is configured to be customized during implantation of the pacing system.
  11. 11. The pacing system of any one of claims 1-8, wherein the first chamber of the heart is the left atrium.
  12. 12. The pacing system of any one of claims 1-11, wherein the second electrode is configured to be positioned in the left atrial appendage.
  13. 13. The pacing system of any one of claims 1-11, wherein the second electrode is configured to be positioned outside of the left atrial appendage.
  14. 14. The pacing system of any one of claims 1-13, wherein the determined pacing delay is in accordance with the first timing reference.
  15. 15. The pacing system of any one of claims 1-13, wherein the determined pacing delay is in accordance with the first pacing therapy.

Description

ICE optimized left atrium and left auricle pacing Cross Reference to Related Applications The present application claims priority from U.S. provisional patent application Ser. No. 63/531,884 filed 8/10 at 2023, which is incorporated herein by reference. Technical Field The present disclosure relates generally to implantable medical devices, and more particularly to implantable cardiac pacemakers. Background The Left Atrial Appendage (LAA) is a small organ attached to the left atrium of the heart as a saccular extension. In patients with atrial fibrillation, the left atrial appendage fails to properly contract with the left atrium, causing stagnant blood to pool within its interior, which may lead to undesirable thrombosis in the left atrial appendage. Thrombus formed in the left atrial appendage may detach from the region and enter the blood stream. Thrombus migrating through a blood vessel may eventually occlude a smaller blood vessel downstream and thereby cause a stroke or heart attack. Clinical studies have shown that most blood clots in patients with atrial fibrillation are found in the left atrial appendage. There is a continuing need for improved medical devices and methods for controlling left atrial appendage thrombosis in patients with atrial fibrillation. Disclosure of Invention The present disclosure provides designs, materials, manufacturing methods, and alternatives for use in medical devices. In a first example, a pacing system configured to sense cardiac activity and deliver pacing therapy to a patient's heart may include a first electrode configured to be positioned in a first chamber of the heart and configured to deliver a first pacing therapy to the first chamber of the heart and a second electrode configured to be positioned adjacent to a left atrial appendage of the heart and configured to deliver a second pacing therapy to the left atrial appendage of the heart. The processing module of the pacing system may be configured to time delivery of at least a portion of the first pacing therapy for the first electrode based at least in part on the first timing reference, and the processing module of the pacing system may be configured to time delivery of at least a portion of the second pacing therapy for the second electrode based at least in part on the determined pacing delay between the first pacing therapy and the second pacing therapy. The determined pacing delay may be configured to maximize blood flow into and/or out of the left atrial appendage. Alternatively or additionally to any of the examples above, in another example, the first electrode may be coupled to a first lead extending from the pacemaker and the second electrode may be coupled to a second lead extending from the pacemaker. Alternatively or additionally to any of the examples above, in another example, the second lead may include a puncture needle, an adhesive growth pad, a second electrode, and an electrical conductor extending proximally from the second electrode. Alternatively or additionally to any of the examples above, in another example, the puncture needle and the adhesive growth pad may be configured to be punctured through and compressed against an outer surface of the left atrial appendage. Alternatively or additionally to any of the examples above, in another example, the first electrode may be coupled to a first lead extending from the pacemaker and the second electrode may be coupled to a leadless cardiac pacemaker. Alternatively or additionally to any of the examples above, in another example, the pacemaker may communicate with a leadless cardiac pacemaker. Alternatively or additionally to any of the examples above, in another example, the first timing criterion may include heart sounds. Alternatively or additionally to any of the examples above, in another example, the first timing criterion may include a flap opening. Alternatively or additionally to any of the examples above, in another example, the first timing criterion may include a pressure drop. Alternatively or additionally to any of the examples above, in another example, the determined pacing delay may be configured to be customized during implantation of the pacing system. Alternatively or additionally to any of the examples above, in another example, the first chamber of the heart may be the left atrium. Alternatively or additionally to any of the examples above, in another example, the second electrode may be configured to be positioned in the left atrial appendage. Alternatively or additionally to any of the examples above, in another example, the second electrode may be configured to be positioned outside of the left atrial appendage. Alternatively or additionally to any of the examples above, in another example, the determined pacing delay may be calibrated according to a first timing. Alternatively or additionally to any of the examples above, in another example, the determined pacing delay may be according to a first pacing therapy. In