Accurate identification of intrinsic atrial activity during overdrive pacing

• US 20040215255A1
• Filed: 04/25/2003
• Published: 10/28/2004
• Est. Priority Date: 04/25/2003
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Vries, Janneke de
• Application Number:
  US10/424,579
• Publication Number:
  US 20040215255A1
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions

Abstract

In general, the invention is directed to the determination of an intrinsic heart rate based on detection of two or more consecutive intrinsic atrial activities to more accurately apply an overdrive pacing therapy in response to pathological events, such as premature atrial contractions (PACs). In this manner, the invention can more accurately identify intrinsic atrial activity as pathological or physiological events, and thus more accurately avoid undue increases in a pacing rate of the overdriving pacing therapy in response to pathological events.

Claims

1. A method comprising:

sensing an intrinsic atrial activity and a subsequent intrinsic atrial activity within a heart;

determining an intrinsic heart rate based on the sensed intrinsic atrial activity and the subsequently sensed atrial activity; and

delivering an overdrive pacing therapy to the heart based on the intrinsic heart rate.

2. The method of claim 1, further comprising determining a coupling interval between the sensed intrinsic atrial activity and the subsequently sensed intrinsic atrial activity to aid in determining the intrinsic heart rate.

3. The method of claim 1, wherein the overdrive pacing therapy comprises delivering pacing pulses at a pacing rate slightly above than the intrinsic heart rate.

4. The method of claim 3, further comprising increasing the pacing rate based on the intrinsic heart rate.

5. The method of claim 4, wherein increasing the pacing rate depends on whether the intrinsic heart rate lies within a range of rates.

6. The method of claim 3, wherein the range of rates comprises a range of rates, where a maximum rate of the range is a set increment of the pacing rate and a minimum rate of the range is a set decrement of the pacing rate.

7. The method of claim 5, wherein the increase is an initial increase and the pacing rate decreases after the initial increase in a manner proportional to the magnitude of the pacing rate after the initial increase.

8. The method of claim 2, wherein the pacing rate increases to a maximum pacing rate limit, which comprises a maximum pacing rate above which the pacing rate cannot increase.

9. The method of claim 7, wherein the pacing rate decreases continually to a minimum pacing rate limit, which comprises a minimum pacing rate below which the pacing rate cannot decrease.

10. The method of claim 1, wherein the intrinsic atrial activity comprises a premature atrial contraction.

11. The method of claim 1, further comprising sensing additional intrinsic atrial activities, determining additional coupling intervals between two consecutive additional intrinsic atrial activities and determining the intrinsic heart rate based on a plurality of additional coupling intervals.

12. A device comprising:

at least one electrode to sense an intrinsic atrial activity and a subsequent intrinsic atrial activity within a heart; and

a processor that determines an intrinsic heart rate based on the sensed intrinsic atrial activity and the subsequently sensed atrial activity and delivers an overdrive pacing therapy based on the intrinsic heart rate.

13. The device of claim 12, wherein the processor further determines a coupling interval between the sensed intrinsic atrial activity and the subsequently sensed intrinsic atrial activity to aid in determining the intrinsic heart rate.

14. The device of claim 12, wherein the overdrive pacing therapy comprises delivering pacing pulses at a pacing rate slightly above the intrinsic heart rate.

15. The device of claim 14, wherein the electrode comprises an electrode to deliver the pacing pulses.

16. The device of claim 14, wherein the processor further increases the pacing rate based on the intrinsic heart rate.

17. The device of claim 16, wherein the processor further determines a range of rates and increases the pacing rate based on whether the intrinsic heart lies within the range of rates.

18. The device of claim 17, wherein the processor further determines a maximum rate of the range by incrementing the pacing rate by a set increment and a minimum rate of the range by decrementing the pacing interval by a set decrement.

19. The device of claim 16, wherein the increase is an initial increase and the processor further decreases the pacing rate after the initial increase in a manner proportional to the magnitude of the pacing rate after the initial increase.

20. The device of claim 16, wherein the processor further increases the pacing rate up to the maximum pacing rate limit, which comprises the maximum pacing rate above which the processor cannot increase the pacing rate.

21. The device of claim 19, wherein the processor further decreases the pacing rate continually until the pacing rate reaches the minimum pacing rate limit, which comprises the minimum pacing rate below which the processor cannot decrease the pacing rate.

22. The device of claim 20, further comprising a memory to store the maximum pacing rate, coupling interval, intrinsic heart rate, and characteristics of the sensed intrinsic atrial activity and subsequently sensed intrinsic atrial activity.

23. The device of claim 13, wherein the intrinsic atrial activity comprises a premature atrial contraction.

24. The device of claim 12, wherein the electrode senses additional intrinsic atrial activities and the processor determines additional coupling intervals between two consecutive additional sensed intrinsic atrial activities and the intrinsic heart rate based on a plurality of additional coupling intervals.

25. A computer-readable medium comprising instructions to cause a processor to:

sense an intrinsic atrial activity and a subsequent intrinsic atrial activity within a heart;

determine an intrinsic heart rate based on the sensed intrinsic atrial activity and the subsequently sensed atrial activity; and

deliver an overdrive pacing therapy to the heart based on the intrinsic heart rate.

26. The computer-readable medium of claim 25, further comprising instructions to cause the processor to determine a coupling interval between the sensed intrinsic atrial activity and the subsequently sensed intrinsic atrial activity to aid in determining the intrinsic heart rate.

27. The computer-readable medium of claim 25, wherein the overdrive pacing therapy comprises delivering pacing pulses at a pacing rate slightly greater than the intrinsic heart rate.

28. The computer-readable medium of claim 27, further comprising instructions to cause the processor to increase the pacing rate based on the intrinsic heart rate.

29. The computer-readable medium of claim 28, further comprising instructions to cause the processor to determine a range of rates based on the pacing rate and increase the pacing rate based on whether the intrinsic heart lies within the range of rates.

30. The computer-readable medium of claim 29, further comprising instruction to cause the processor to determine a maximum rate of the range by incrementing the pacing rate by a set increment and a minimum rate of the range by decrementing the pacing rate by a set decrement.

31. The computer-readable medium of claim 28, wherein the increase is an initial increase and the instructions further cause the processor to decrease the pacing rate after the initial increase in a manner proportional to the magnitude of the pacing rate after the initial increase.

32. The computer-readable medium of claim 28, wherein the instructions further cause the processor to increase the pacing rate to a maximum pacing rate limit, which comprises a maximum pacing rate above which the processor cannot increase the pacing rate.

33. The computer-readable medium of claim 31, wherein the instructions further cause the processor to decrease the pacing rate continually to a minimum pacing rate limit, which comprises a minimum pacing rate above which the processor cannot decrease the pacing rate.

34. The computer-readable medium of claim 25, wherein the intrinsic atrial activity comprises a premature atrial contraction.

35. The computer-readable medium of claim 25, further comprising instructions to cause the processor to sense additional intrinsic atrial activities, determine additional coupling intervals between two consecutive additional intrinsic atrial activities and determine the intrinsic heart rate based on a plurality of additional coupling intervals.