IMPLANTABLE MEDICAL DEVICE FOR CARDIAC ELECTRICAL STIMULATION

• US 20100298901A1
• Filed: 04/30/2010
• Published: 11/25/2010
• Est. Priority Date: 05/19/2009
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Urban, Jon Frederic, Xiao, Yong-Fu, Zhou, Xiaohong, Sommer, John Louis, Brabec, Scott J.
• Application Number:
  US12/771,217
• Publication Number:
  US 20100298901A1
• Time in Patent Office: Days
• US Class Current: 607/14
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

A method and apparatus for reducing a patient'"'"'s heart rate or blood pressure. The apparatus provides stimulation to the patient'"'"'s atrial and/or nodal tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial an/or nodal tissue, responsive to detecting an occurrence of a ventricular depolarization following a preceding atrial depolarization.

The apparatus may define a time window following the ventricular depolarization, following the atrial depolarization or determined based upon the timing of both the atrial and ventricular depolarizations. The stimulus may be delivered during or on expiration of the defined time window. The duration of the time window may be pre-set or determined based upon measurements of the patient'"'"'s refractory periods.

Claims

1. A method of reducing a patient'"'"'s heart rate or blood pressure, comprising:

detecting the patient'"'"'s atrial and ventricular depolarizations having associated refractory periods thereafter;

responsive to detecting an occurrence of a ventricular depolarization following a preceding atrial depolarization, delivering a stimulus pulse to the patient'"'"'s atrial and/or nodal tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial an/or nodal tissue.

2. A method according to claim 1, comprising defining a time window following the ventricular depolarization and wherein the stimulus pulse is delivered during the defined window.

3. A method according to claim 1, comprising defining a time window following the ventricular depolarization and wherein the stimulus pulse is delivered on expiration of the defined time window.

4. A method according to claim 1, comprising defining a time window following the preceding atrial depolarization and wherein the stimulus pulse is delivered during the defined time window.

5. A method according to claim 1, comprising defining a time window following the preceding atrial depolarization and wherein the stimulus pulse is delivered on expiration of the defined interval.

6. A method according to any of claims 2-5 wherein the time window is defined based upon a predetermined value

7. A method according to any of claims 2-5 wherein the time window is defined based upon a measured parameter.

8. A method according to claims 7 wherein the time window is defined based upon a measured refractory period.

9. A method according to claim 1, comprising defining time windows following the detected atrial and ventricular depolarizations and wherein the stimulus pulse is delivered within an overlap of the defined time windows.

10. A method according to claim 9 wherein the time window is defined based upon a predetermined value

11. A method according to claim 10 wherein the time window is defined based upon a measured parameter.

12. A method according to claim 11 wherein the time window is defined based upon a measured refractory period.

13. An apparatus for reducing a patient'"'"'s heart rate or blood pressure, comprising:

means for detecting the patient'"'"'s atrial and ventricular depolarizations having associated refractory periods thereafter;

means responsive to detecting an occurrence of a ventricular depolarization following a preceding atrial depolarization, for delivering a stimulus pulse to the patient'"'"'s atrial and/or nodal tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial an/or nodal tissue.

14. An apparatus according to claim 13, comprising means for defining a time window following the ventricular depolarization and wherein the stimulus pulse is delivered during the defined window.

15. An apparatus according to claim 13, comprising means for defining a time window following the ventricular depolarization and wherein the stimulus pulse is delivered on expiration of the defined time window.

16. An apparatus according to claim 13, comprising means for defining a time window following the preceding atrial depolarization and wherein the stimulus pulse is delivered during the defined time window.

17. An apparatus according to claim 13, comprising means for defining a time window following the preceding atrial depolarization and wherein the stimulus pulse is delivered on expiration of the defined interval.

18. An apparatus according to any of claims 14-17 wherein the time window is defined based upon a predetermined value

19. An apparatus according to any of claims 14-17 wherein the time window is defined based upon a measured parameter.

20. An apparatus according to claim 19 wherein the time window is defined based upon a measured refractory period.

21. An apparatus according to claim 13, comprising means for defining time windows following the detected atrial and ventricular depolarizations and wherein the stimulus pulse is delivered within an overlap of the defined time windows.

22. An apparatus according to claim 21 wherein the time window is defined based upon a predetermined value

23. An apparatus according to claim 21 wherein the time window is defined based upon a measured parameter.

24. An apparatus according to claim 23 wherein the time window is defined based upon a measured refractory period.

26. An apparatus according to claim 24, comprising timing circuitry defining a time window following the ventricular depolarization and wherein the stimulus pulse is triggered during the defined window.

27. An apparatus according to claim 24, comprising timing circuitry defining a time window following the ventricular depolarization and wherein the stimulus pulse is triggered on expiration of the defined time window.

25. An apparatus for reducing a patient'"'"'s heart rate or blood pressure, comprising:

Sense amplifiers responsive to atrial and ventricular depolarizations having associated refractory periods thereafter;

a generator providing stimulus pulses; and

circuitry triggering the pulse generator responsive to detection of an occurrence of a ventricular depolarization following a preceding atrial depolarization, to deliver a stimulus pulse to the patient'"'"'s atrial and/or nodal tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial an/or nodal tissue.