Pacemaker system with automatic event-programmed switching between unipolar and bipolar operation
First Claim
1. Pacemaker apparatus having an implantable pacemaker, said pacemaker having stimulus means for generating stimulus pulses, sensing means for sensing heart signals, and cyclic means for controlling said pacemaker to carry out cyclic operation, a lead with at least two spaced lead electrodes thereon, and an indifferent electrode, comprising:
- connection means for controllably connecting said sensing means and said stimulus means to respective selected ones of a plurality of combinations of said lead electrodes and said indifferent electrode;
selection means for selecting respective first and second ones of said combinations for sensing of respective heart signals at different times during a cycle of pacemaker operation; and
control means for controlling said connection means in accordance with said selected combinations
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Accused Products
Abstract
A pacemaker system incorporates an implantable pacemaker and a plurality of electrodes, electrodes preferably being on a pacing lead for a single chamber pacemaker, or a pair of such leads for a dual chamber pacemaker. Programmable connection means are provided for connecting the pacemaker output to a selected combination of lead electrodes, the selection being changed during each pacer cycle to optimize the choice of unipolar and bipolar operation for given pacemaker events. In one mode, the system employs bipolar QRS sensing and unipolar pacing and T-wave sensing. In another mode, the system employs bipolar QRS sensing and pacing, and unipolar T-wave sensing.
225 Citations
15 Claims
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1. Pacemaker apparatus having an implantable pacemaker, said pacemaker having stimulus means for generating stimulus pulses, sensing means for sensing heart signals, and cyclic means for controlling said pacemaker to carry out cyclic operation, a lead with at least two spaced lead electrodes thereon, and an indifferent electrode, comprising:
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connection means for controllably connecting said sensing means and said stimulus means to respective selected ones of a plurality of combinations of said lead electrodes and said indifferent electrode; selection means for selecting respective first and second ones of said combinations for sensing of respective heart signals at different times during a cycle of pacemaker operation; and control means for controlling said connection means in accordance with said selected combinations - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 15)
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9. Pacemaker apparatus for delivering stimulus pulses, said apparatus having pacing means for generating said stimulus pulses and sensing means for sensing patient heartbeat signals, a housing which houses at least said pacing means, at least a portion of which housing comprises an indifferent electrode, and a lead having at least two electrodes, said pacing means having program means for carrying out cyclical operation, characterized further by
connecting means for selectively connecting said pacing means to two of said lead electrodes for bipolar operation or to said indifferent electrode and one of said lead electrodes for unipolar operation, first control means operable each pacemaker cycle to control said connection means to make a selected connection during delivery of a stimulus pulse, and second control means operable twice each pacemaker cycle to control said connection means to make predetermined selected connections for sensing of patient heartbeat signals at two respective times during said each cycle.
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12. Pacemaker apparatus for delivering stimulus pulses, said apparatus having pacing means for generating said stimulus pulses and sensing means for sensing patient heartbeat signals, a housing which houses at least said pacing means, at least a portion of which housing comprises an indifferent electrode, and a lead having at least two electrodes, said pacing means having program means for carrying out cyclical operation, characterized further by
connection means for selectively connecting said pacing means to two of said lead electrodes for bipolar operation or to said indifferent electrode and one of said lead electrodes for unipolar operation, monitoring means for monitoring the occurrence and absence of occurrence of at least one said sensed heartbeat signal during each pacemaker cycle, and control means for controlling said connection means during each said cycle as a function of said monitoring.
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14. Pacemaker apparatus having a pacemaker with program means for controlling repetitive cycles of pacemaker operation and a plurality of electrodes for delivering stimulus pulses and sensing heart activity, said pacemaker comprising:
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connection means for controllably connecting said pacemaker to a selected combination of said electrodes; determining means for determining pacemaker data over a plurality of said cycles, and control means for controlling said connection means as a function of said determined pacemaker data.
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Specification