IMPLANTABLE MEDICAL DEVICE FOR IDENTIFYING AND MANAGING INTRINSIC REENTRANT TACHYCARDIA
First Claim
1. An implantable medical device, comprising:
- a pulse generator configured to provide atrial and ventricular pacing pulses on demand, the pulse generator timing delivery of the ventricular pacing pulses based on an AV pacing interval;
an AV hysteresis module that extends an AV interval from a base AV interval to an extended AV interval to promote intrinsic heart activity;
a refractory module that establishes a PVARP interval equal to a base PVARP interval following at least one of the ventricular pacing pulses, the refractory module lengthening the PVARP interval by adding a PVARP extension to the base PVARP interval to provide an extended PVARP interval; and
a reentrant conduction detector identifying an intrinsic reentrant tachycardia based, in part, on a retrograde P wave occurring during the PVARP extension of the extended PVARP interval.
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Abstract
An implantable medical device is provided that comprises a pulse generator that provides atrial and ventricular pacing pulses on demand. The pulse generator times delivery of the ventricular pacing pulses based on an AV pacing interval. The device also includes an AV hysteresis module that extends the AV interval from a base AV interval to an extended AV interval to promote intrinsic heart activity. A refractory module establishes a PVARP interval equal to base PVARP interval following at least one of the ventricular pacing pulses. The refractory module lengthens the PVARP interval by adding a PVARP extension to a base PVARP interval to provide an extended PVARP interval. The device further includes a reentrant conduction detector that identifies an intrinsic reentrant tachycardia having a retrograde P wave occurring during the PVARP extension, based on one or more of i) a retrograde P wave, ii) intrinsic R waves sensed over N cardiac cycles at an R to R interval above a rate threshold and iii) one or more of PR and RP intervals that exceed PR and RP thresholds.
42 Citations
21 Claims
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1. An implantable medical device, comprising:
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a pulse generator configured to provide atrial and ventricular pacing pulses on demand, the pulse generator timing delivery of the ventricular pacing pulses based on an AV pacing interval; an AV hysteresis module that extends an AV interval from a base AV interval to an extended AV interval to promote intrinsic heart activity; a refractory module that establishes a PVARP interval equal to a base PVARP interval following at least one of the ventricular pacing pulses, the refractory module lengthening the PVARP interval by adding a PVARP extension to the base PVARP interval to provide an extended PVARP interval; and a reentrant conduction detector identifying an intrinsic reentrant tachycardia based, in part, on a retrograde P wave occurring during the PVARP extension of the extended PVARP interval. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method for managing an arrhythmia, comprising:
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providing atrial and ventricular pacing pulses on demand, the ventricular pacing pulses being delivered based on an AV pacing interval; extending an AV interval from a base AV interval to an extended AV interval; establishing a PVARP interval equal to a base PVARP interval following at least one of the ventricular pacing pulses; lengthening the PVARP interval by adding a PVARP extension to the base PVARP interval to provide an extended PVARP interval; and identifying an intrinsic reentrant tachycardia based on a retrograde P wave occurring during the PVARP extension of the extended PVARP interval. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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Specification