Rate scanning demand pacemaker and method for treatment of tachycardia
First Claim
1. The method of controlling a tachycardia condition comprising the steps of:
- (a) sensing natural heart depolarizations and providing sense signals in response thereto;
(b) confirming a tachycardia condition;
(c) generating a burst of a plurality of spaced heart stimulating pulses which potentially allow tachycardia to be terminated;
(d) establishing escape intervals between each of said plurality of spaced heart stimulating pulses; and
(e) restarting an escape interval in the event that a sense signal is provided during an escape interval in response to a natural heart depolarization during the provision of said burst of heart stimulating pulses, whereby the provision of a stimulating pulse in the vulnerable phase of the heart cycle is avoided.
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Accused Products
Abstract
A self-adapting demand pacemaker that recognizes the tachycardia from the intrinsic signals and initiates treatment in the following manner: First, the escape interval of the demand pacemaker is shortened to be identical to the cycle length of the tachycardia, then to overdrive the tachycardia the pacemaker escape interval is continuously shortened with each subsequent beat, for a predetermined number of beats, by a small programmable decrement. Thereafter, the escape interval is restored to its original value and protects against a potential bradycardia. It has to be emphasized that the pacemaker remains in demand mode all of the time; thus stimulation in a vulnerable zone is prevented and some of the hazards that accompany overdrive pacing are reduced. An additional advantage of this treatment is that since each stimulus is delivered only a few milliseconds before the next intrinsic depolarization is expected to arrive at the site of the electrode, it facilitates capture even when the excitable interval is extremely short.
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Citations
29 Claims
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1. The method of controlling a tachycardia condition comprising the steps of:
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(a) sensing natural heart depolarizations and providing sense signals in response thereto; (b) confirming a tachycardia condition; (c) generating a burst of a plurality of spaced heart stimulating pulses which potentially allow tachycardia to be terminated; (d) establishing escape intervals between each of said plurality of spaced heart stimulating pulses; and (e) restarting an escape interval in the event that a sense signal is provided during an escape interval in response to a natural heart depolarization during the provision of said burst of heart stimulating pulses, whereby the provision of a stimulating pulse in the vulnerable phase of the heart cycle is avoided. - View Dependent Claims (2, 3, 4, 5, 6, 18)
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7. The apparatus for controlling a tachycardia condition comprising:
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(a) means for sensing natural heart depolarizations and providing sense signals in response thereto; (b) means for confirming a tachycardia condition; (c) means for generating a burst of a plurality of spaced heart stimulating pulses which potentially allow tachycardia to be terminated; (d) means for establishing escape intervals between each of said plurality of spaced heart stimulating pulses; and (e) means for restarting an escape interval in the event that a sense signal is provided during an escape interval in response to a natural heart depolarization during the provision of said burst of heart stimulating pulses, whereby the provision of a stimulating pulse in the vulnerable phase of the heart cycle is avoided. - View Dependent Claims (8, 9, 10, 11, 12)
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13. The method of detecting and treating a tachycardia condition comprising the steps of:
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(a) sensing natural heart depolarizations and providing sense signals in response thereto; (b) measuring the intervals between successive sense signals and confirming tachycardia as a function of the measured intervals; (c) in response to a confirmed tachycardia, generating a stimulating pulse at the end of a first escape interval measured from a preceding sense signal and applying the pulse to the heart; (d) generating at least one further stimulating pulse at the end of a further escape interval measured from the generation of the preceding stimulating pulse; (e) delivering said stimulating pulses to the patient'"'"'s heart; and (f) restarting said first and further escape intervals in response to a sense signal provided during at least a portion of the first or further escape interval or intervals. - View Dependent Claims (14, 15, 16, 17, 19)
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20. A tachycardic control pacer comprising:
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(a) sensing means for sensing natural heart depolarizations; (b) means for confirming a tachycardia condition; (c) pulse generating means responsive to said confirming means for generating a burst of a plurality of spaced heart stimulating pulses which potentially allows tachycardia to be terminated, said pulse generating means comprising timing means for establishing the escape intervals between the plurality of spaced heart stimulating pulses; and (d) reset means responsive to said sensing means for resetting said timing means to restart the escape interval in the event that a natural heartbeat is sensed during the provision of said burst of heart stimulating pulses, whereby the provision of a stimulating pulse into a vulnerable phase of the heart is avoided. - View Dependent Claims (21, 22)
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23. Apparatus for detecting and treating a tachycardia condition comprising:
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(a) means for sensing natural heart depolarizations and providing sense signals in response thereto; (b) means for measuring the intervals between successive sense signals and confirming tachycardia as a function of the measured intervals; (c) means responsive to a confirmed tachycardia for generating a stimulating pulse at the end of a first escape interval measured from a preceding sense signal and applying the pulse to the heart; (d) means for generating at least one further stimulating pulse at the end of a further escape interval measured from the generation of the preceding stimulating pulse; (e) means for delivering said stimulating pulses to the patient'"'"'s heart; and (f) means for restarting said first and further escape intervals in response to a sense signal provided during at least a portion of the first or further escape interval or intervals. - View Dependent Claims (24, 25, 26, 27, 28, 29)
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Specification