Pacing system and method for cardiac pacing as a function of determined myocardial contractility
First Claim
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1. A pacemaker system for rate-adaptive pacing of a patient, comprising:
- pulse means for generating pacing pulses;
timing means for generating timing signals controlling the timing and rate of said pacing pulses, and connected to deliver said timing signals to said pulse means so as to control the rate of generated pacing pulses;
lead means for delivering said pacing pulses to the heart of said patient, said lead means being connected to said pulse means and having electrode means for delivering said pacing pulses to said patient heart, said lead means also having sensing means for sensing patient heart beats and for generating heart signals representative thereof,myocardial contractile state means for generating signals representative of the myocardial contractile state of said patient'"'"'s heart, said myocardial contractile state means comprising(a) intramyocardial pressure sensing means for sensing intramyocardial pressure within the heart wall and for generating signals representative of intramyocardial pressure, said intramyocardial pressure sensing means being positioned on said lead means for generating signals representative of intramyocardial pressure,(b) signal processing means connected to receive said intramyocardial pressure signals and for processing same, and(c) controller means connected to said signal processing means for generating contractility signals continuously representative of said myocardial contractile state and for determining a desired pacing rate as a function of said contractility signals,said controller means having an output connected to said timing means for controlling operation of same, whereby pacing pulses are delivered at a rate which corresponds to said patient contractile state.
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Abstract
A cardiac pacing system and method provides rate control as a function of sensed myocardial contractility. A signal representative of short term, e.g. cycle-to-cycle, heart contractility is derived from a sensor which measures intramyocardial pressure. A microprocessor-band controller provides logic and memory capacity for carrying out a signal processing algorithm for determining and selecting optimum pacing rate as a function of sensed intensity of the active state of the cardiac muscle.
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Citations
30 Claims
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1. A pacemaker system for rate-adaptive pacing of a patient, comprising:
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pulse means for generating pacing pulses; timing means for generating timing signals controlling the timing and rate of said pacing pulses, and connected to deliver said timing signals to said pulse means so as to control the rate of generated pacing pulses; lead means for delivering said pacing pulses to the heart of said patient, said lead means being connected to said pulse means and having electrode means for delivering said pacing pulses to said patient heart, said lead means also having sensing means for sensing patient heart beats and for generating heart signals representative thereof, myocardial contractile state means for generating signals representative of the myocardial contractile state of said patient'"'"'s heart, said myocardial contractile state means comprising (a) intramyocardial pressure sensing means for sensing intramyocardial pressure within the heart wall and for generating signals representative of intramyocardial pressure, said intramyocardial pressure sensing means being positioned on said lead means for generating signals representative of intramyocardial pressure, (b) signal processing means connected to receive said intramyocardial pressure signals and for processing same, and (c) controller means connected to said signal processing means for generating contractility signals continuously representative of said myocardial contractile state and for determining a desired pacing rate as a function of said contractility signals, said controller means having an output connected to said timing means for controlling operation of same, whereby pacing pulses are delivered at a rate which corresponds to said patient contractile state. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A demand pacing system having controllable means for generating pacing pulses on demand and lead means implantable in a patient'"'"'s heart and connected to said controllable means for delivering said pacing pulses to said heart and for detecting the occurrence of natural heart beats in said heart, characterized by
said lead means having sensor means for sensing within the patient myocardium a measure of patient myocardial contractility and for generating and delivering signals representative thereof to said controllable means, and said controllable means having rate control means for controlling the rate of said pacing pulses as a function of said representative signals.
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22. In a demand pacing system, a method of controlling the rate of delivered pacing pulses to a patient over a plurality of consecutive pacing cycles, comprising:
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sensing within the patient myocardium a measure of myocardial contractility of said patient'"'"'s heart each of said pacing cycles, and determining desired pacing rate as a predetermined function of said sensed contractility and pacing said patient as a function of said determined rate. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30)
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Specification