Fully inhibited dual chamber pacing mode
First Claim
1. A method of selectively providing cardiac pacing with an implantable medical device comprising:
- setting a flag during a given cardiac cycle in response to ventricular activity; and
precluding a ventricular pacing pulse during a current cardiac cycle if the flag is present at the onset of the current cardiac cycle.
1 Assignment
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Accused Products
Abstract
A pacing mode is provided, in one embodiment, that permits missed or skipped ventricular beats. The mode monitors a full cardiac cycle (A-A interval) for the presence of intrinsic ventricular activity. If ventricular activity is present, a flag is set that is valid for the next cardiac cycle. At the beginning of the next cardiac cycle, the device determines if the flag is present. So long as the flag is present, the device will not deliver a ventricular pacing pulse in that cycle, even if there is no intrinsic ventricular activity. If there is no flag present at the start of a given cardiac cycle, a ventricular pacing pulse is delivered and this ventricular activity sets a flag for the subsequent cardiac cycle.
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Citations
54 Claims
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1. A method of selectively providing cardiac pacing with an implantable medical device comprising:
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setting a flag during a given cardiac cycle in response to ventricular activity; and
precluding a ventricular pacing pulse during a current cardiac cycle if the flag is present at the onset of the current cardiac cycle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. An implantable medical device comprising:
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means for sensing cardiac depolarizations;
means for pacing; and
means for controlling the means for pacing according to a selected mode, wherein one selectable mode is a fully inhibited DDI (FIDDI) mode. - View Dependent Claims (19, 20, 21, 22, 23)
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24. An implantable medical device comprising:
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means for sensing cardiac depolarizations;
means for pacing according to a selectable mode;
means for mode switching to an atrial based pacing mode upon the sensing of ventricular activity in a given cardiac cycle; and
means for mode switching from the atrial based pacing mode to a dual chamber mode at the completion of the given cardiac cycle, wherein the dual chamber mode includes a first set of parameters that are implemented for a first cardiac cycle while operating in the dual chamber mode such that the implemented parameters preclude the delivery of a ventricular pacing pulse during the first cardiac cycle and a second set of parameters implemented in a second consecutive cardiac cycle while operating in the dual chamber mode such that ventricular pacing is delivered unless inhibited. - View Dependent Claims (25)
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26. An implantable medical device comprising:
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a controller;
a ventricular lead operably coupled to the controller and configured to deliver ventricular pacing pulses and sense ventricular depolarizations;
an atrial lead operable coupled to the controller and configured to deliver atrial pacing pulses and sense atrial depolarizations; and
a memory including a plurality of algorithms defining pacing modalities selectable by the controller, wherein one of the pacing modalities is fully inhibited DDI.
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27. A computer readable medium including instructions that define a pacing mode that when implemented on an implantable medical device cause the implantable medical device to:
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set a flag in response to ventricular activity occurring in a current cardiac cycle, wherein the flag is valid for a subsequent cardiac cycle;
determine if a flag is present at the start of a given cardiac cycle;
initiate an atrial escape interval if the flag is present at the start of the given cardiac cycle;
initiate an AV interval if no flag is present at the start of the given cardiac cycle;
deliver a ventricular pacing pulse at the completion of the AV interval; and
initiate a VA interval at the completion of the AV interval. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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39. A method of operating an implantable medical device in a mode, the method comprising:
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setting a flag during a first cardiac cycle if a pre-established criteria is met during the first cardiac cycle;
determining whether the flag has been set at the initiation of a second cardiac cycle that is consecutive to the first cardiac cycle;
acting in a first manner during the second cardiac cycle and while remaining in the mode if the flag has been set;
acting in a second manner during the second cardiac cycle and while remaining in the mode if the flag has not been set. - View Dependent Claims (40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52)
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53. A method of operating an implantable medical device for delivering pacing therapy in a given mode, the method comprising:
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initiating an atrial escape interval to start a cardiac cycle;
monitoring for intrinsic ventricular activity during the entirety of the atrial escape interval;
setting a flag if a first occurrence of ventricular activity is sensed during the atrial escape interval;
terminating the atrial escape interval and initiating a VA interval if a second occurrence of ventricular activity is sensed during the atrial escape interval and restarting the VA interval with each subsequent occurrence of ventricular activity sensed during the VA interval;
identifying an end of the cardiac cycle, wherein the end is defined by either an expiration of the atrial escape interval, an expiration of the VA interval, or a sensed atrial event;
delivering an atrial pacing pulse at the end of the cycle unless inhibited by the sensed atrial event;
determining whether the flag is present at the end of the cardiac cycle;
returning to step a if the flag is present at the end of the cardiac cycle;
initiating an AV interval if the flag is not present at the end of the current cardiac cycle;
delivering a ventricular pacing pulse at the completion of the AV interval, unless inhibited;
setting another flag;
initiating a VA interval;
restarting the VA interval if ventricular activity is sensed;
returning to step a upon completion of the VA interval, wherein completion of the VA interval includes either expiration of the VA interval or sensing an intrinsic atrial event.
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54. A method of selectively providing cardiac pacing with an implantable medical device comprising:
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setting a flag during a given cardiac cycle in response to ventricular activity; and
delivering a ventricular pacing pulse during a current cardiac cycle only if a flag is absent at the onset of the current cardiac cycle.
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Specification