Rate responsive pacing using the ventricular gradient
First Claim
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1. A cardiac pacing method which comprises the steps of:
- applying electrical stimulus pulses to the heart;
detecting a cardiac event potential;
integrating the detected potential over time to obtain the depolarization gradient and a repolarization gradient;
sensing the peak of the depolarization gradient;
sensing the peak of the repolarization gradient;
determining the peak to peak time interval from the depolarization gradient peak to the repolarization gradient peak;
storing said peak to peak time interval;
comparing said peak to peak time interval with a corresponding peak to peak time interval of at least one previous cardiac cycle that has been stored; and
controlling the rate of said electrical stimulus pulses in response to said comparison.
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Abstract
A rate responsive cardiac pacing system is provided. In the illustrative embodiment, electrical stimulus pulses are applied to the heart ventricle and the evoked potential of the applied electrical stimulus pulses is detected. The detected potential is integrated over time to obtain a depolarization gradient and a repolarization gradient. A peak to peak time interval is determined from the peak of the depolarization gradient to the peak of the repolarization gradient. The peak to peak time interval is compared to the peak to peak time interval of at least one previous cardiac cycle. The rate of the electrical stimulus pulses is controlled in response to this comparison.
231 Citations
16 Claims
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1. A cardiac pacing method which comprises the steps of:
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applying electrical stimulus pulses to the heart; detecting a cardiac event potential; integrating the detected potential over time to obtain the depolarization gradient and a repolarization gradient; sensing the peak of the depolarization gradient; sensing the peak of the repolarization gradient; determining the peak to peak time interval from the depolarization gradient peak to the repolarization gradient peak; storing said peak to peak time interval; comparing said peak to peak time interval with a corresponding peak to peak time interval of at least one previous cardiac cycle that has been stored; and controlling the rate of said electrical stimulus pulses in response to said comparison. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A cardiac pacing method which comprises the steps of:
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applying electrical stimulus pulses to the heart; detecting a cardiac event potential; integrating the detected potential over time to obtain a depolarization gradient and a repolarization gradient; sensing the peak of the depolarization gradient; sensing the peak of the repolarization gradient; determining the peak to peak time interval from the depolarization gradient peak to the repolarization gradient peak; comprising said peak to peak time interval with a target value; and controlling the rate of said electrical stimulus pulses in response to said comparison. - View Dependent Claims (10, 11, 12, 13, 14, 15)
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16. A cardiac pacing method which comprises the steps of:
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applying electrical stimulus pulses to the heart; detecting a cardiac event potential; integrating the detected potential over time to obtain a depolarization gradient and a repolarization gradient; sensing the peak of the depolarization gradient; sensing the peak of the repolarization gradient; determining the peak to peak time interval from the depolarization gradient to the repolarization gradient peak; comparing the peak to peak time interval with a target value; controlling the rate of said electrical stimulus pulses in response to said comparison, said controlling step including the steps of not changing the pacing rate if the compared values are equal, increasing the pacing rate if the time interval is less than the target value, and decreasing the pacing rate if the time interval is greater than the target value; if the time interval is less than the target value, then determining if the pacing rate is at a predetermined maximum; and
if the pacing rate is at a predetermined maximum, then not changing the pacing rate, but if the pacing rate is less than said predetermined maximum then increasing the pacing rate; and
if the time interval is greater than the target value, then determining whether the pacing rate is at a predetermined minimum value; and
if the pacing rate is at a predetermined minimum value, then not changing the pacing rate, but if the pacing rate is greater than said predetermined minimum then decreasing the pacing rate; andinhibiting the application of a stimulus pulse if a natural ventricular event is sensed within a predetermined time period.
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Specification