REVERSE HYSTERESIS AND MODE SWITCHING FOR INTERMITTENT PACING THERAPY
First Claim
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1. A cardiac device, comprising:
- one or more sensing amplifiers for sensing electrical cardiac activity through one or more sensing channels;
one or more pulse generators for delivering pacing pulses to one or more myocardial sites through one or more pacing channels;
a controller programmed to operate the device in either a normal operating mode or an intermittent pacing therapy (IPT) mode;
wherein, in the IPT mode, the controller is programmed to deliver paces to the one or more myocardial sites using a pacing mode that results in some degree of dyssynchrony as compared with the normal operating mode;
wherein the controller is programmed to intermittently switch to the IPT mode and, upon switching to the IPT mode, adjust the value of an escape interval used to deliver pacing pulses to the one or more myocardial sites to an IPT value; and
,wherein, when operating in the IPT mode, the controller is further programmed to monitor for senses that inhibit pacing pulses to the one or more myocardial sites and shorten the escape interval used to deliver pacing pulses to the one or more myocardial sites if a specified number of such senses have occurred.
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Abstract
Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.
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Citations
20 Claims
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1. A cardiac device, comprising:
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one or more sensing amplifiers for sensing electrical cardiac activity through one or more sensing channels; one or more pulse generators for delivering pacing pulses to one or more myocardial sites through one or more pacing channels; a controller programmed to operate the device in either a normal operating mode or an intermittent pacing therapy (IPT) mode; wherein, in the IPT mode, the controller is programmed to deliver paces to the one or more myocardial sites using a pacing mode that results in some degree of dyssynchrony as compared with the normal operating mode; wherein the controller is programmed to intermittently switch to the IPT mode and, upon switching to the IPT mode, adjust the value of an escape interval used to deliver pacing pulses to the one or more myocardial sites to an IPT value; and
,wherein, when operating in the IPT mode, the controller is further programmed to monitor for senses that inhibit pacing pulses to the one or more myocardial sites and shorten the escape interval used to deliver pacing pulses to the one or more myocardial sites if a specified number of such senses have occurred. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cardiac device, comprising:
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one or more sensing amplifiers for sensing electrical cardiac activity through one or more sensing channels; one or more pulse generators for delivering pacing pulses to one or more myocardial sites through one or more pacing channels; a controller programmed to operate the device in either a normal operating mode or an intermittent pacing therapy (IPT) mode; wherein, in the IPT mode, the controller is programmed to deliver paces to the one or more ventricular sites using a pacing mode that results in some degree of ventricular dyssynchrony as compared with the normal operating mode; wherein the controller is programmed to intermittently switch to the IPT mode in accordance with a predetermined duty cycle; wherein the controller is programmed to measure a present normal sinus rhythm (NSR); wherein the controller is programmed to initially use a non-atrial tracking ventricular pacing mode with an IPT LRL set above the NSR for the IPT mode unless the NSR is above a specified limit value, in which case an atrial tracking ventricular pacing mode is used for the IPT mode. - View Dependent Claims (12)
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13. A method for operating a cardiac device, comprising:
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sensing electrical cardiac activity through one or more sensing channels; delivering pacing pulses to one or more myocardial sites through one or more pacing channels; operating the device in either a normal operating mode or an intermittent pacing therapy (IPT) mode; in the IPT mode, delivering paces to the one or more myocardial sites using a pacing mode that results in some degree of dyssynchrony as compared with the normal operating mode; intermittently switching to the IPT mode and, upon switching to the IPT mode, adjusting the value of an escape interval used to deliver pacing pulses to the one or more myocardial sites to an IPT value; and
,when operating in the IPT mode, monitoring for senses that inhibit pacing pulses to the one or more myocardial sites and shortening the escape interval used to deliver pacing pulses to the one or more myocardial sites if a specified number of such senses have occurred. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20)
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Specification