Method and apparatus for dynamically adjusting overdrive pacing parameters
First Claim
1. In an implantable cardiac stimulation device having a pulse generator for generating pacing pulses for applying to a heart of a patient and having a control circuit for controlling the pulse generator to apply overdrive pacing pulses to the heart using a set of control parameters, a method, performed by the control circuit, for automatically adjusting the control parameters comprising:
- acquiring an initial set of control parameters;
controlling the pulse generator, based on the set of control parameters, to overdrive pace the heart;
determining a degree of overdrive pacing achieved using the selected set of control parameters; and
adjusting the set of control parameters so as to improve the degree of overdrive pacing to be achieved during further overdrive pacing.
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Abstract
Dynamic overdrive pacing adjustment techniques are described for use in implantable cardiac stimulation devices. In a first technique, an overdrive pacing unit of a microcontroller of the implantable device operates to optimize various control parameters that affect overdrive pacing so as to achieve a desired degree of overdrive pacing for the particular patient in which the stimulation device is implanted. Parameters to be optimized include the number of overdrive beats paced once overdrive pacing is trigged, the overdrive pacing response function, the recovery rate, and various base rates. The control parameters are adjusted in a hierarchical order of priority until the desired degree of overdrive pacing is achieved. Adjustment of the number of overdrive beats, the recovery rate, and various base rates is iteratively performed by using incremental numerical adjustments. Adjustment of the overdrive pacing response function may be performed by selecting among a set of fixed predetermined linear response functions. In a second technique, the overdrive pacing unit operates to optimize the shape of a single non-linear dynamic overdrive pacing response function so as to achieve the desired degree of overdrive pacing for the patient. The second technique may either be employed alone or in combination with the first, hierarchical optimization technique.
43 Citations
29 Claims
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1. In an implantable cardiac stimulation device having a pulse generator for generating pacing pulses for applying to a heart of a patient and having a control circuit for controlling the pulse generator to apply overdrive pacing pulses to the heart using a set of control parameters, a method, performed by the control circuit, for automatically adjusting the control parameters comprising:
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acquiring an initial set of control parameters;
controlling the pulse generator, based on the set of control parameters, to overdrive pace the heart;
determining a degree of overdrive pacing achieved using the selected set of control parameters; and
adjusting the set of control parameters so as to improve the degree of overdrive pacing to be achieved during further overdrive pacing. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. An implantable cardiac stimulation device comprising:
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a pulse generator that is operative to generate pacing pulses to be applied to a heart of a patient; and
a control circuit that is operative to control the pulse generator to apply overdrive pacing pulses to the heart using a set of control parameters and for dynamically and automatically adjusting the control parameters so that a degree of overdrive pacing exceeds a predefined threshold. - View Dependent Claims (22, 23, 24, 25, 26)
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27. An implantable cardiac stimulation device comprising:
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means for generating pacing pulses for applying to the heart of a patient;
means for acquiring an initial set of control parameters for use in overdrive pacing the heart;
means for controlling the means for generating pulses, based on the initial set of control parameters, to overdrive pace the heart;
means for determining the degree of overdrive pacing achieved using the initial set of control parameters; and
means for adjusting the initial set of control parameters so as to improve the degree of overdrive pacing to be achieved during further overdrive pacing. - View Dependent Claims (28)
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29. In an implantable cardiac stimulation device, a method comprising:
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pacing a heart at an overdrive pacing rate specified by a set of control parameters;
determining whether a degree of overdrive pacing achieved using the set of control parameters falls below a threshold;
adjusting one or more of the control parameters if the degree of overdrive pacing falls below the threshold; and
using the adjusted set of control parameters for further overdrive pacing.
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Specification