Variable length scanning burst tachycardia control pacer

• US 4,406,287 A
• Filed: 07/17/1981
• Issued: 09/27/1983
• Est. Priority Date: 07/17/1981
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Telectronics Incorporated
• Inventors: Swift, Stephen J., Nappholz, Tibor A., Camm, Alan J.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Shein, Mitchell J.
• Application Number:
  US06/284,348
• Time in Patent Office: 802 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 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 number of pulses in a burst is similarly scanned, a complete rate scan taking place for each pulse number in a scan. The rate of a burst and the number of pulses in it which are successful in terminating tachycardia are stored, and following the next tachycardia confirmation the stored rate and pulse number are 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 and pulse number are used. Only if success is not achieved does scanning of the burst rate and pulse number ensue, starting with the previously successful rate and pulse number.

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 scanning of heart stimulating pulse bursts with respect to both their numbers of pulses and their rates.

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

3. A tachycardia control pacer in accordance with claim 2 wherein said generating means generates the same number of pulses during successive pulse bursts as the burst rate is scanned, the number of pulses in successive bursts being changed only after completion of each scan of burst rate.

4. A tachycardia control pacer in accordance with claim 3 wherein said controlling means causes the burst rate to be scanned in the direction of increasing rate, with the minimum burst rate following the maximum burst rate.

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

6. A tachycardia control pacer in accordance with claim 3 wherein said controlling means causes the number of pulses in a burst to be scanned in the direction of increasing number, with the minimum number following the maximum number.

7. A tachycardia control pacer in accordance with claim 3 further including means under external control for setting the maximum number of pulses in a burst.

8. 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.

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

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

11. A tachycardia control pacer in accordance with claim 3 wherein said controlling means causes the numbers of pulses in successive bursts which have different numbers of pulses to differ by unity.

12. 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.

13. A tachycardia control pacer in accordance with claim 12 wherein said controlling means changes the number of pulses in or the rate of a burst, or both, only following tachycardia confirmation, and operation of said normal heartbeat detecting means causes said governing means to inhibit any pulse-number or rate change by said controlling means during the cycle of operation which follows the next tachycardia confirmation.

14. 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.

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

16. 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.

17. A tachycardia control pacer in accordance with claim 3 further including means under external control for adjusting the range through which the numbers of pulses in a burst vary.

18. A tachycardia control pacer in accordance with claim 17 further including means under external control for adjusting the range through which the pulse burst rates vary.

19. 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.

20. A tachycardia control pacer in accordance with claim 2 wherein said controlling means causes the burst rate to be scanned in the direction of increasing rate, with the minimum burst rate following the maximum burst rate.

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

22. A tachycardia control pacer in accordance with claim 2 wherein said controlling means causes the number of pulses in a burst to be scanned in the direction of increasing number, with the minimum number following the maximum number.

23. A tachycardia control pacer in accordance with claim 2 further including means under external control for setting the maximum number of pulses in a burst.

24. 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.

25. A tachycardia control pacer in accordance with claim 24 wherein said confirming means includes means to adjust said predetermined time period under external control such that heartbeats occuring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

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

27. A tachycardia control pacer in accordance with claim 2 wherein said controlling means causes the numbers of pulses in successive bursts which have different numbers of pulses to differ by unity.

28. 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.

29. A tachycardia control pacer in accordance with claim 28 wherein said controlling means changes the number of pulses in or the rate of a burst, or both, following tachycardia confirmation, and operation of said normal heartbeat detecting means causes said governing means to inhibit any pulse-number or rate change by said controlling means during the cycle of operation which follows the next tachycardia confirmation.

30. 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.

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

32. 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.

33. A tachycardia control pacer in accordance with claim 2 further including means under external control for adjusting the range through which the numbers of pulses in a burst vary.

34. A tachycardia control pacer in accordance with claim 33 further including means under external control for adjusting the range through which the pulse burst rates vary.

35. 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.

36. A tachycardia control pacer in accordance with claim 1 wherein said generating means generates the same number of pulses during successive pulse bursts as the burst rate is scanned, the number of pulses in successive bursts being changed only after completion of each scan of burst rate.

37. A tachycardia control pacer in accordance with claim 1 wherein said controlling means causes the burst rate to be scanned in the direction of increasing rate, with the minimum burst rate following the maximum burst rate.

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

39. A tachycardia control pacer in accordance with claim 1 wherein said controlling means causes the number of pulses in a burst to be scanned in the direction of increasing number, with the minimum number following the maximum number.

40. A tachycardia control pacer in accordance with claim 1 further including means under external control for setting the maximum number of pulses in a burst.

41. 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.

42. A tachycardia control pacer in accordance with claim 41 whrein said confirming means includes means to adjust said predetermined time period under external control such that heartbeats occuring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

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

44. A tachycardia control pacer in accordance with claim 1 wherein said controlling means causes the numbers of pulses in successive bursts which have different numbers of pulses to differ by unity.

45. 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.

46. A tachycardia control pacer in accordance with claim 45 wherein said controlling means changes the number of pulses in or the rate of a burst, or both, only following tachycardia confirmation, and operation of said normal heartbeat detecting means inhibits any pulse-number or rate change by said controlling means during the cycle of operation which follows the next tachycardia confirmation.

47. 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.

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

49. 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.

50. A tachycardia control pacer in accordance with claim 1 further including means under external control for adjusting the range through which the numbers of pulses in a burst vary.

51. A tachycardia control pacer in accordance with claim 50 further including means under external control for adjusting the range through which the pulse burst rates vary.

52. 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.

53. A tachycardia control pacer comprising means for confirming tachycardia, means responsive to said confirming means for generating a burst of heart-stimulating pulses at a constant rate which potentially allows tachycardia to be terminated, means for scanning the number of pulses in a burst during sequential 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 number of pulses which was successful in terminating tachycardia for first use in the next burst which follows tachycardia confirmation.

54. A tachycardia control pacer in accordance with claim 53 wherein the pulses in each burst are generated at a constant rate, and further including means for scanning the rates of the pulses in sequential bursts.

55. A tachycardia control pacer in accordance with claim 54 wherein said generating means generates the same number of pulses during successive pulse bursts as the burst rate is scanned, the number of pulses in successive bursts being changed only after completion of each scan of burst rate.

56. A tachycardia control pacer in accordance with claim 55 wherein said registering means further registers the last-used pulse rate which was successful in terminating tachycardia for first use in the next burst which follows tachycardia confirmation.

57. A tachycardia control pacer in accordance with claim 56 further including means under external control for setting the minimum pulse burst rate.

58. A tachycardia control pacer in accordance with claim 56 further including means under external control for setting the maximum number of pulses in a burst.

59. A tachycardia control pacer in accordance with claim 54 wherein said registering means further registers the last-used pulse rate which was successful in terminating tachycardia for first use in the next burst which follows tachycardia confirmation.

60. A tachycardia control pacer in accordance with claim 54 further including means under external control for setting the minimum pulse burst rate.

61. A tachycardia control pacer in accordance with claim 54 further including means under external control for setting the maximum number of pulses in a burst.

62. A tachycardia control pacer in accordance with claim 53 further including means under external control for setting the maximum number of pulses in a burst.

63. A tachycardia control pacer in accordance with claim 62 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.

64. A tachycardia control pacer in accordance with claim 63 wherein said confirming means includes means to adjust said predetermined time period under external control such that heartbeats occuring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

65. A tachycardia control pacer in accordance with claim 53 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.

66. A tachycardia control pacer in accordance with claim 65 wherein said confirming means includes means to adjust said predetermined time period under external control such that heartbeats occuring at sinus rhythm result in tachycardia confirmation, said pulse generating means thereupon automatically operating in order to induce tachycardia.

67. A tachycardia control pacer in accordance with claim 53 wherein said controlling means causes the numbers of pulses in successive bursts which have different numbers of pulses to differ by unity.

68. A tachycardia control pacer in accordance with claim 53 wherein said tachycardia confirming means operates the same way whether the preceding heartbeats were in sinus rhythm or part of a tachycardia episode.

69. A tachycardia control pacer in accordance with claim 53 further including externally controlled means for programming said pulse generating means off.

70. A tachycardia control pacer in accordance with claim 53 further including means under external control for adjusting the range through which the numbers of pulses in a burst vary.