METHODS FOR SETTING CARDIAC PACING PARAMETERS IN RELATIVELY HIGH EFFICIENCY PACING SYSTEMS
First Claim
1. In an implanted cardiac pacing system, a method for setting pacing parameters comprising:
- defining an evoked response amplitude threshold for evoked response signal detection;
conducting periodic pacing threshold searches, wherein at least one of the periodic pacing threshold searches comprises;
applying a series of test pacing pulses at incremented and/or decremented levels of pulse energy;
setting an operational pacing pulse energy greater than or equal to a predetermined maximum desirable pulse energy, in response to no evoked response signal being detected using the evoked response amplitude threshold following a test pulse applied at or above the predetermined maximum desirable pulse energy during the pacing threshold search; and
reducing a pacing rate following the pacing threshold search of the periodic pacing threshold searches, responsive to the operational pacing pulse energy being set greater than or equal to the predetermined maximum desirable pulse energy.
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Abstract
According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.
89 Citations
8 Claims
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1. In an implanted cardiac pacing system, a method for setting pacing parameters comprising:
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defining an evoked response amplitude threshold for evoked response signal detection; conducting periodic pacing threshold searches, wherein at least one of the periodic pacing threshold searches comprises; applying a series of test pacing pulses at incremented and/or decremented levels of pulse energy; setting an operational pacing pulse energy greater than or equal to a predetermined maximum desirable pulse energy, in response to no evoked response signal being detected using the evoked response amplitude threshold following a test pulse applied at or above the predetermined maximum desirable pulse energy during the pacing threshold search; and reducing a pacing rate following the pacing threshold search of the periodic pacing threshold searches, responsive to the operational pacing pulse energy being set greater than or equal to the predetermined maximum desirable pulse energy. - View Dependent Claims (2, 3, 4, 7, 8)
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5. An implantable cardiac pacing system configured to be wholly implanted against an endocardial or epicardial surface, the system including a pulse generator having a microprocessor element being preprogrammed to direct the pulse generator to carry out a method comprising the following steps:
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defining an evoked response amplitude threshold for evoked response signal detection; conducting periodic pacing threshold searches, wherein at least one of the periodic pacing threshold searches comprises; applying a series of test pacing pulses at incremented and/or decremented levels of pulse energy; setting an operational pacing pulse energy greater than or equal to a predetermined maximum desirable pulse energy, in response to no evoked response signal being detected using the evoked response amplitude threshold following a test pulse applied at or above the predetermined maximum desirable pulse energy during the pacing threshold search; and reducing a pacing rate following the pacing threshold search of the periodic pacing threshold searches, responsive to the operational pacing pulse energy being set greater than or equal to the predetermined maximum desirable pulse energy. - View Dependent Claims (6)
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Specification