Apparatus and method for ventricular rate regularization with biventricular sensing
First Claim
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1. A method for operating a cardiac pacemaker, comprising:
- sensing right and left ventricular depolarizations through separate ventricular sensing channels and generating ventricular sense signals in accordance therewith;
pacing a ventricle upon expiration of a ventricular escape interval without receiving a ventricular sense from either ventricular sensing channel, wherein the ventricular escape interval starts with either a ventricular pace or a ventricular sense, the reciprocal of the ventricular escape interval being the lower rate limit of the pacemaker;
measuring an R-R interval associated with each ventricular sense, wherein an R-R interval is the time between a ventricular sense and the preceding ventricular sense or ventricular pace, the reciprocal of the R-R interval thus being the measured intrinsic ventricular rate; and
, adjusting the ventricular escape interval in accordance with a measured R-R interval so that the lower rate limit adjusts in accordance with changes in the measured intrinsic ventricular rate.
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Abstract
A method and system for operating a cardiac pacemaker which employs pacing therapy to regularize the ventricular rhythm together with biventricular sensing. Biventricular sensing allows the ventricular rate regularization to be accomplished with greater hemodynamic stability.
30 Citations
26 Claims
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1. A method for operating a cardiac pacemaker, comprising:
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sensing right and left ventricular depolarizations through separate ventricular sensing channels and generating ventricular sense signals in accordance therewith;
pacing a ventricle upon expiration of a ventricular escape interval without receiving a ventricular sense from either ventricular sensing channel, wherein the ventricular escape interval starts with either a ventricular pace or a ventricular sense, the reciprocal of the ventricular escape interval being the lower rate limit of the pacemaker;
measuring an R-R interval associated with each ventricular sense, wherein an R-R interval is the time between a ventricular sense and the preceding ventricular sense or ventricular pace, the reciprocal of the R-R interval thus being the measured intrinsic ventricular rate; and
,adjusting the ventricular escape interval in accordance with a measured R-R interval so that the lower rate limit adjusts in accordance with changes in the measured intrinsic ventricular rate. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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17. A cardiac pacemaker, comprising:
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ventricular sensing channels for sensing right and left ventricular depolarizations and generating ventricular sense signals in accordance therewith;
a ventricular pacing channel for pacing a ventricle;
a controller for controlling operation of the pacemaker such that a ventricular pace is delivered upon expiration of a ventricular escape interval without receiving a ventricular sense from either ventricular sensing channel, wherein the ventricular escape interval starts with either a ventricular pace or a ventricular sense, the reciprocal of the ventricular escape interval being the lower rate limit of the pacemaker;
wherein the controller is configured to measure an R-R interval associated with each ventricular sense, wherein an R-R interval is the time between a ventricular sense and the preceding ventricular sense or ventricular pace, the reciprocal of the R-R interval thus being the measured intrinsic ventricular rate; and
,wherein the controller is configured to adjust the ventricular escape interval in accordance with a measured R-R interval so that the lower rate limit adjusts in accordance with changes in the measured intrinsic ventricular rate.
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Specification