Implantable cardiac stimulation device with detection and therapy for patients with vasovagal syncope
First Claim
1. An implantable cardiac stimulation device having a mode for responding to vasovagal syncope, comprising:
- means for defining a programmable Base Rate, a Hysteresis Escape Rate below the Base Rate, and a Vasovagal Syncope Response Rate above the Base Rate;
pulse generating means for generating stimulation pulses at one of the Base Rate, the Hysteresis Escape Rate, and the Vasovagal Syncope Response Rate based on a mode of operation;
sensing means for sensing ventricular cardiac signals and for determining an intrinsic ventricular heart rate;
means for operating the pulse generating means in a Hysteresis Mode using the Hysteresis Escape Rate whenever a ventricular cardiac signal is sensed; and
control means for controlling a rate of stimulation pulses to the heart at the Vasovagal Syncope Response Rate whenever the intrinsic heart rate falls below the Hysteresis Escape Rate.
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Abstract
A pacemaker or other implantable cardiac stimulation device is configured with both a rate hysteresis mode and a vasovagal syncope prevention mode. Within the rate hysteresis mode, the pacemaker detects when the intrinsic heart rate of the patient is below an escape rate, then paces the heart at a Base Rate until an intrinsic beat is detected. When programmed in the vasovagal syncope prevention mode, upon detecting the intrinsic rate falling below the Hysteresis Escape Rate, the pacemaker paces the heart at a Vasovagal Syncope Response Rate, which is considerably higher than the Base Rate. The pacemaker is preferably set to the syncope prevention mode for patients prone to recurrent vasovagal syncope. By pacing the heart at the higher Vasovagal Syncope Response Rate, the pacemaker thereby helps prevent a significant drop in blood pressure which might otherwise cause a loss of consciousness in the patient. System and method embodiments are described.
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Citations
21 Claims
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1. An implantable cardiac stimulation device having a mode for responding to vasovagal syncope, comprising:
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means for defining a programmable Base Rate, a Hysteresis Escape Rate below the Base Rate, and a Vasovagal Syncope Response Rate above the Base Rate;
pulse generating means for generating stimulation pulses at one of the Base Rate, the Hysteresis Escape Rate, and the Vasovagal Syncope Response Rate based on a mode of operation;
sensing means for sensing ventricular cardiac signals and for determining an intrinsic ventricular heart rate;
means for operating the pulse generating means in a Hysteresis Mode using the Hysteresis Escape Rate whenever a ventricular cardiac signal is sensed; and
control means for controlling a rate of stimulation pulses to the heart at the Vasovagal Syncope Response Rate whenever the intrinsic heart rate falls below the Hysteresis Escape Rate. - View Dependent Claims (2, 3, 11)
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4. A method for stimulating the heart using an implantable cardiac stimulation device, the method comprising the steps of:
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monitoring an intrinsic heart rate of the patient;
determining whether the intrinsic rate falls below a predetermined Hysteresis Escape Rate below a programmed minimum Base Rate; and
generating stimulation pulses in a vasovagal syncope prevention mode whenever the intrinsic rate falls below the predetermined Hysteresis Escape Rate such that the stimulation pulses are delivered to the heart at a predetermined Vasovagal Syncope Response Rate which is greater than the Base Rate. - View Dependent Claims (5, 6, 7, 8, 9, 10)
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12. An implantable cardiac stimulation device, comprising:
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a sensing circuit that senses an intrinsic heart rate of the patient;
a pulse generator that generates stimulation pulses to the patient'"'"'s heart at a predetermined stimulation rate corresponding to a Base Rate;
a detector capable of detecting when the intrinsic rate falls below a predetermined rate threshold below the Base Rate; and
a controller, responsive to the detector, that triggers the pulse generator to increase the stimulation rate to a Vasovagal Syncope Response Rate when the intrinsic rate falls below a predetermined rate threshold, the Vasovagal Syncope Response Rate being greater than the Base Rate. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21)
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Specification