METHOD OF ADJUSTING THE CARDIAC CONTRACTILITY MODULATION SYSTEM IN PATIENTS WITH A WIDE QRS COMPLEX ON THE ECG Russian patent published in 2023 - IPC A61N1/362 A61B5/349 A61B5/366 

FIELD: medicine.

SUBSTANCE: invention relates to a method of adjusting a cardiac contractility modulation system in patients with a wide QRS complex on an ECG. The patient is implanted a pacemaker (ECS) and two endocardial bipolar electrodes with active fixation under local anesthesia. The electrodes are implanted in the interventricular septum with a minimum diastasis of 2 cm and are labeled as LS electrode and RV electrode, which correspond to the LS channel and RV channel, respectively. The electrodes are connected to an external programmer for verification, and if the parameters on the electrodes correspond to the specified values, the ECS is connected to them. The ECS is set up with the help of an external programmer. The confirmation of the correct setting is stable ventricular stimulation, which is evaluated immediately after setting the pacemaker using the programmer, where the events on the LS-channel are recorded in the "Alert" interval, and the ECG by confirmation in ≥90% of cases of application of therapy after cardiac contraction. Confirmation of an incorrect setting is confirmation in <90% of cases of application of therapy after a heartbeat, as well as both an event of not falling into the Alert interval, and more than 1 event of falling into the Alert interval, which qualify the contraction as abnormal and inhibit therapy until the next event on any of the electrodes. After that, reconfiguration is carried out. In case of the correct setting of the ECS-system, the subsequent evaluation of the work is carried out again a day after the initial setting. At ≥90% of effective stimulation it is recommended to abstain from the correction of system operation parameters. At <90% effective stimulation, re-adjustment or correction of the parameters of the pacemaker is performed.

EFFECT: optimization of the process of setting up the system of discrimination of normal and abnormal heart beats and an increase in the frequency of successful application of pacing therapy is achieved.

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