SYSTEMS AND METHODS FOR PREVENTING, DETECTING, AND TERMINATING PACEMAKER MEDIATED TACHYCARDIA IN BIVENTRICULAR IMPLANTABLE CARDIAC STIMULATION SYSTEMS
First Claim
1. In an implantable cardiac stimulation device having a biventricular pacing system and a pacemaker mediated tachycardia (PMT) prevention system, a method comprising:
- delivering a pair of biventricular pacing pulses to left and right ventricles of a heart using the biventricular pacing system, the pair of biventricular pacing pulses comprising a first ventricular pacing pulse and a second ventricular pacing pulse; and
triggering a post ventricular atrial refractory period (PVARP) upon delivery of the second ventricular pacing pulse to prevent onset of PMT.
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Abstract
Various techniques are described for preventing pacemaker mediated tachycardia (PMT) within biventricular pacing systems and for detecting and terminating PMT should it nevertheless arise. In a first prevention technique, refractory periods applied to the atrial channel are synchronized to begin with a second of a pair of ventricular pacing pulses to more effectively prevent T-wave oversensing on the atrial channel. In a second prevention technique, the sensitivity of the atrial channel is reduced during T-waves also to prevent T-wave oversensing. In a third prevention technique, template matching is performed on the ventricular channels to prevent T-wave oversensing. In a fourth prevention technique, T-wave detection windows are applied to both the ventricular and atrial channels subsequent to any paced or sensed events. In a first detection technique, PMT is detected based upon a degree of variation within V-pulse to P-wave pacing intervals. In a second detection technique, PMT is detected based upon a degree variation within ventricular pacing intervals. In either case, if the degree of variation is too low, indicative of PMT, ventricular refractory periods are expanded to terminate the PMT.
81 Citations
24 Claims
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1. In an implantable cardiac stimulation device having a biventricular pacing system and a pacemaker mediated tachycardia (PMT) prevention system, a method comprising:
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delivering a pair of biventricular pacing pulses to left and right ventricles of a heart using the biventricular pacing system, the pair of biventricular pacing pulses comprising a first ventricular pacing pulse and a second ventricular pacing pulse; and
triggering a post ventricular atrial refractory period (PVARP) upon delivery of the second ventricular pacing pulse to prevent onset of PMT. - View Dependent Claims (2, 3, 4, 5, 6)
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7. In an implantable cardiac stimulation device having a biventricular pacing system and a pacemaker mediated tachycardia (PMT) detection and termination system, a method comprising:
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determining a sequence for delivery of a pair of biventricular pacing pulses to a first ventricle and a second ventricle using the biventricular pacing system, the pair of biventricular pacing pulses comprising a first ventricular pacing pulse to the first ventricle and a second ventricular pacing pulse to the second ventricle;
delivering the first ventricular pacing pulse to the first ventricle in accordance with the sequence determined by the biventricular pacing system;
delivering the second ventricular pacing pulse to the second ventricle in accordance with the sequence determined by the biventricular pacing system; and
triggering a post ventricular atrial refractory period (PVARP) upon delivery of the second ventricular pacing pulse using the PMT detection and termination system to prevent onset of PMT. - View Dependent Claims (8, 9, 10, 11, 12)
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13. An implantable cardiac stimulation device comprising:
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a pulse generator delivering a pair of biventricular pacing pulses to left and right ventricles of a heart, the pair of biventricular pacing pulses comprising a first ventricular pacing pulse and a second ventricular pacing pulse;
an atrial sensing channel sensing atrial activity;
a controller that is operative to control the pulse generator to deliver the pair of biventricular pacing pulses; and
a pacemaker mediated tachycardia (PMT) prevention system to trigger a post ventricular atrial refractory period (PVARP) upon delivery of the second ventricular pacing pulse to prevent onset of PMT. - View Dependent Claims (14, 15, 16, 17, 18, 24)
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19. An implantable cardiac stimulation device comprising:
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a biventricular pacing system determining a sequence for delivery of a pair of pacing pulses to a first ventricle and a second ventricle, the pair of biventricular pacing pulses comprising a first ventricular pacing pulse to the first ventricle and a second ventricular pacing pulse to the second ventricle; and
a pacemaker mediated tachycardia (PMT) detection and termination system triggering a post ventricular atrial refractory period (PVARP) upon delivery of the second ventricular pacing pulse to prevent onset of PMT. - View Dependent Claims (20, 21, 22, 23)
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Specification