Implantable medical device with adaptive operation
First Claim
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1. An implantable medical device (IMD) comprising:
- means for operating the IMD with a Ventricular Pacing Protocol (VPP);
means for providing cardiac pacing;
means for selectively operating the IMD to inhibit or provide asynchronous pacing when noise is detected by the IMD, based upon a patient classification.
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Abstract
An implantable medical device operates with an algorithm that promotes intrinsic conduction and reduces ventricular pacing. The IMD monitors the occurrence of necessary ventricular pacing and takes certain actions based upon whether this occurrence has been relatively high or relatively low. When noise is detected, asynchronous pacing is provided when the occurrence is relatively high and is not provided when relatively low. When atrial threshold testing is performed, the incidence will determine which methodology is utilized.
162 Citations
18 Claims
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1. An implantable medical device (IMD) comprising:
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means for operating the IMD with a Ventricular Pacing Protocol (VPP);
means for providing cardiac pacing;
means for selectively operating the IMD to inhibit or provide asynchronous pacing when noise is detected by the IMD, based upon a patient classification. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method comprising:
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operating an implantable medical device (IMD) having pacing capabilities according to a Ventricular Pacing Protocol (VPP);
classifying an AV conduction status based upon the performance of the IMD while operating according to the VPP, wherein the status is a first classification or a second classification and an occurrence of ventricular pacing is lower for the first classification than for the second classification;
determining the presence of a condition allowing for the selection of a first response or a second response; and
selecting the first response when the first classification indicates the AV conduction status and the second response when the second status indicates the AV conduction status. - View Dependent Claims (9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A method comprising:
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operating an implantable medical device (IMD) according to a Ventricular Pacing Protocol (VPP) which causes the IMD to operate in an atrial based pacing mode and monitor for intrinsic AV conduction over an entire cardiac cycle and provide ventricular backup pacing in a cardiac cycle subsequent to a first cardiac cycle devoid of sensed ventricular activity, operate in a dual chamber based pacing mode upon a detected loss of AV conduction satisfying VPP criteria, and periodically performing conduction checks during operation in the dual chamber based pacing mode;
monitoring the operation of the IMD and recording data indicative of the occurrence of ventricular pacing;
classifying an AV conduction status based upon the data, wherein a first status is indicative of a lower occurrence of ventricular pacing than a second status;
monitoring for the presence of noise;
providing asynchronous pacing if noise is detected and the AV Conduction status is classified as the second status; and
inhibiting asynchronous pacing if noise is detected and the AV conduction statues is classified as the first status.
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Specification