Scanning burst tachycardia control pacer

• US 4,398,536 A
• Filed: 07/17/1981
• Issued: 08/16/1983
• Est. Priority Date: 07/17/1981
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Telectronics Incorporated
• Inventors: Swift, Stephen J., Nappholz, Tibor A.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Shein, Mitchell J.
• Application Number:
  US06/284,349
• Time in Patent Office: 760 Days
• Field of Search: 128/419 P, 128/419 PG, 128/419 D, 128/702, 128/703, 128/705, 128/706, 128/795, 128/796
• US Class Current: 607/15
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate

Abstract

There is disclosed an improved pacer for controlling tachycardia. Following each tachycardia confirmation, a burst of a programmed number (e.g., 15) of stimulating pulses is generated. The rates of the bursts increase from cycle to cycle; thus following each tachycardia confirmation, a pulse burst at a different rate is generated. The rate of a burst which is successful in terminating tachycardia is stored, and following the next tachycardia confirmation the stored rate is used for the first burst which is generated. In this manner, there is a greater likelihood that tachycardia will be terminated following the first burst since a previously successful rate is used. Only if success is not achieved does scanning of the burst rate ensue, starting with the previously successful rate.

Claims

1. A tachycardia control pacer comprising means for confirming tachycardia, means responsive to each operation of said confirming means for generating a burst of heart stimulating pulses at a constant rate, and means for controlling successive heart stimulating pulse bursts to be generated at different constant rates.

2. A tachycardia control pacer in accordance with claim 1 wherein the rate of the last burst which is successful in terminating tachycardia is retained, and further including means for governing the rate of the next burst following operation of said tachycardia confirming means to equal the retained rate.

3. A tachycardia control pacer in accordance with claim 2 wherein said generating means generates the same number of pulses during each pulse burst.

4. A tachycardia control pacer in accordance with claim 3 wherein said controlling means controls successive pulse bursts to have increasing rates, with the minimum pulse burst rate following the maximum pulse burst rate.

5. A tachycardia control pacer in accordance with claim 4 including means under external control for setting the minimum pulse burst rate.

6. A tachycardia control pacer in accordance with claim 3 further including means under external control for setting the number of pulses generated in each burst.

7. A tachycardia control pacer in accordance with claim 3 wherein said confirming means operates to confirm tachycardia responsive to a predetermined number of heartbeats occurring in succession, each of which occurs after the preceding heartbeat within a predetermined time period.

8. A tachycardia control pacer in accordance with claim 7 wherein said confirming means includes means to adjust said predetermined time period under external control such that heartbeats occurring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

9. A tachycardia control pacer in accordance with claim 3 wherein said generating means generates pulses with the time intervals between pulses in successive bursts differing by the same value.

10. A tachycardia control pacer in accordance with claim 3 further including means for detecting a normal heartbeat which occurs after a predetermined time interval which follows the preceding heartbeat to indicate tachycardia termination.

11. A tachycardia control pacer in accordance with claim 10 wherein said controlling means changes the value of burst rate following tachycardia confirmation, and further including means responsive to operation of said normal heartbeat detecting means for inhibiting any rate change by said controlling means during the cycle of operation which follows the next tachycardia confirmation.

12. A tachycardia control pacer in accordance with claim 3 wherein said tachycardia confirming means operates the same way whether the preceding heartbeats were in sinus rhythm or part of a tachycardia episode.

13. A tachycardia control pacer in accordance with claim 3 further including externally controlled means for programming said pulse generating means off.

14. A tachycardia control pacer in accordance with claim 3 further including means under external control for adjusting the range through which the pulse burst rates vary.

15. A tachycardia control pacer in accordance with claim 3 wherein said generating means controls the time interval between operation of said tachycardia confirming means and the first pulse in any ensuing burst to equal the time interval between any two pulses in the burst.

16. A tachycardia control pacer in accordance with claim 2 wherein said controlling means controls successive pulse bursts to have increasing rates, with the minimum pulse burst rate following the maximum pulse burst rate.

17. A tachycardia control pacer in accordance with claim 2 further including means under external control for setting the minimum pulse burst rate.

18. A tachycardia control pacer in accordance with claim 2 further including means under external control for setting the number of pulses generated in each burst.

19. A tachycardia control pacer in accordance with claim 2 wherein said confirming means operates to confirm tachycardia responsive to a predetermined number of heartbeats occurring in succession, each of which occurs after the preceding heartbeat within a predetermined time period.

20. A tachycardia control pacer in accordance with claim 19 wherein said confirming emans includes means to adjust said predetermined time period under external control such that heartbeats occurring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

21. A tachycardia control pacer in accordance with claim 2 wherein said generating means generates pulses with the time intervals between pulses in successive bursts differing by the same value.

22. A tachycardia control pacer in accordance with claim 2 further including means for detecting a normal heartbeat which occurs after a predetermined time interval which follows the preceding heartbeat to indicate tachycardia termination.

23. A tachycardia control pacer in accordance with claim 22 wherein said controlling means changes the value of burst rate following tachycardia confirmation, and further including means responsive to operation of said normal heartbeat detecting means for inhibiting any rate change by said controlling means during the cycle of operation which follows the next tachycardia confirmation.

24. A tachycardia control pacer in accordance with claim 2 wherein said tachycardia confirming means operates the same way whether the preceding heartbeats were in sinus rhythm or part of a tachycardia episode.

25. A tachycardia control pacer in accordance with claim 2 further including externally controlled means for programming said pulse generating means off.

26. A tachycardia control pacer in accordance with claim 2 further including means under external control for adjusting the range through which the pulse burst rates vary.

27. A tachycardia control pacer in accordance with claim 2 wherein said generating means controls the time interval between operation of said tachycardia confirming means and the first pulse in any ensuing burst to equal the time interval between any two pulses in the burst.

28. A tachycardia control pacer in accordance with claim 1 wherein said generating means generates the same number of pulses during each pulse burst.

29. A tachycardia control pacer in accordance with claim 1 wherein said controlling means controls successive pulse bursts to have increasing rates, with the minimum pulse burst rate following the maximum pulse burst rate.

30. A tachycardia control pacer in accordance with claim 1 further including means under external control for setting the minimum pulse burst rate.

31. A tachycardia control pacer in accordance with claim 1 further including means under external control for setting the number of pulses generated in each burst.

32. A tachycardia control pacer in accordance with claim 1 wherein said confirming means operates to confirm tachycardia responsive to a predetermined number of heartbeats occurring in succession, each of which occurs after the preceding heartbeat within a predetermined time period.

33. A tachycardia control pacer in accordance with claim 32 wherein said confirming means includes means to adjust said predetermined time period under external control such that heartbeats occurring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

34. A tachycardia control pacer in accordance with claim 1 wherein said generating means generates pulses with the time intervals between pulses in successive bursts differing by the same value.

35. A tachycardia control pacer in accordance with claim 1 further including means for detecting a normal heartbeat which occurs after a predetermined time interval which follows the preceding heartbeat to indicate tachycardia termination.

36. A tachycardia control pacer in accordance with claim 35 wherein said controlling means changes the value of burst rate following tachycardia confirmation, and further including means responsive to operation of said normal heartbeat detecting means for inhibiting any rate change by said controlling means during the cycle of operation which follows the next tachycardia confirmation.

37. A tachycardia control pacer in accordance with claim 1 wherein said tachycardia confirming means operates the same way whether the preceding heartbeats were in sinus rhythm or part of a tachycardia episode.

38. A tachycardia control pacer in accordance with claim 1 further including externally controlled means for programming said pulse generating means off.

39. A tachycardia control pacer in accordance with claim 1 further including means under external control for adjusting the range through which the pulse burst rates vary.

40. A tachycardia control pacer in accordance with claim 1 wherein said generating means controls the time interval between operation of said tachycardia confirming means and the first pulse in any ensuing burst to equal the time interval between any two pulses in the burst.

41. A tachycardia control pacer comprising means for confirming tachycardia, means responsive to said confirming means for generating a burst of at least three heart-stimulating pulses at a constant rate which potentially allows tachycardia to be terminated, means for scanning said rate during successive cycles of operation of said pulse burst generating means, means for detecting tachycardia termination, said pulse burst generating means ceasing to operate following tachycardia termination, and means for registering the last-used pulse rate which was successful in terminating tachycardia for first use in the next scan which follows tachycardia confirmation.

42. A tachycardia control pacer in accordance with claim 41 wherein said generating means generates the same number of pulses during each pulse burst.

43. A tachycardia control pacer in accordance with claim 41 wherein said scanning means causes successive pulse bursts to have increasing rates, with the minimum pulse burst rate following the maximum pulse burst rate.

44. A tachycardia control pacer in accordance with claim 41 further including means under external control for setting the minimum pulse burst rate.

45. A tachycardia control pacer in accordance with claim 41 further including means under external control for setting the number of pulses generated in each burst.

46. A tachycardia control pacer in accordance with claim 41 wherein said confirming means operates to confirm tachycardia responsive to a predetermined number of heartbeats occurring in succession, each of which occurs after the preceding heartbeat within a predetermined time period.

47. A tachycardia control pacer in accordance with claim 46 wherein said confirming means includes means to adjust said predetermined time period under external control such that heartbeats occurring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

48. A tachycardia control pacer in accordance with claim 41 wherein said scanning means causes the time intervals between pulses in successive bursts to differ by the same value.

49. A tachycardia control pacer in accordance with claim 41 further including means for detecting a normal heartbeat which occurs after a predetermined time interval which follows the preceding heartbeat to indicate tachycardia termination.

50. A tachycardia control pacer in accordance with claim 49 wherein said scanning means changes the value of burst rate following tachycardia confirmation, and further including means responsive to operation of said normal heartbeat detecting means for inhibiting any rate change by said controlling means during the cycle of operation which follows the next tachycardia confirmation.

51. A tachycardia control pacer in accordance with claim 41 wherein said tachycardia confirming means operates the same way whether the preceding heartbeats were in sinus rhythm or part of a tachycardia epidode.

52. A tachycardia control pacer in accordance with claim 41 further including externally controlled means for programming said pulse generating means off.

53. A tachycardia control pacer in accordance with claim 41 further including means under external control for adjusting the range through which the pulse burst rates vary.

54. A tachycardia control pacer in accordance with claim 41 wherein said generating means controls the time interval between operation of said tachycardia confirming means and the first pulse in any ensuing burst to equal the time interval between any two pulses in the burst.