Atrial rate based programmable pacemaker with automatic mode switching means
First Claim
1. An improved dual chamber pacemaker having programmable modes of operation, said pacemaker being capable of stimulating the atrial and the ventricular chambers of the heart, said pacemaker including programming means for selectively allowing the pacemaker to be programmed to operate in an atrial rate based mode of operation, and atrial sensing means for sensing atrial activity occurring in the atrial chamber, including atrial rate of said atrial activity, wherein the improvement comprises:
- first sensing means for monitoring said atrial rate and sensing whether said atrial rate exceeds a first prescribed threshold;
means for providing a stimulating pulse to a selected chamber of the heart at a maximum upper rate in the event said atrial rate sensed by said first sensing means exceeds said first prescribed threshold;
second sensing means for monitoring said atrial rate above said first prescribed threshold and sensing whether said atrial rate exceeds a second prescribed threshold, said second threshold being at a higher rate than said first threshold; and
means for automatically switching the mode of operation of said pacemaker from said atrial rate based mode of operation to a selected alternate mode of operation in the event said atrial rate exceeds said second prescribed threshold.
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Reexamination
Accused Products
Abstract
An atrial rate based programmable pacemaker including means for preventing the heart from being paced at an upper rate limit for prolonged periods of time is disclosed which paces the heart at a rate that follows or tracks the atrial rate up to the upper rate limit of the pacemaker, at which point the pacemaker stimulates the heart at the upper rate limit, but also continues to monitor the atrial rate. If the monitored atrial rate exceeds a second upper rate limit, a fast atrial arrhythmia or tachycardia condition is deemed to exist, and the pacemaker automatically switches from its existing mode of operation to an alternate mode of operation in an attempt to break or terminate the fast atrial condition. Alternate embodiments include using an external activity or physiological sensor to control the pacing rate in the new pacing mode, and the inclusion of means for periodically verifying that atrial sensing is occurring, and means for automatically adjusting the sensitivity of the atrial channel as required.
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Citations
20 Claims
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1. An improved dual chamber pacemaker having programmable modes of operation, said pacemaker being capable of stimulating the atrial and the ventricular chambers of the heart, said pacemaker including programming means for selectively allowing the pacemaker to be programmed to operate in an atrial rate based mode of operation, and atrial sensing means for sensing atrial activity occurring in the atrial chamber, including atrial rate of said atrial activity, wherein the improvement comprises:
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first sensing means for monitoring said atrial rate and sensing whether said atrial rate exceeds a first prescribed threshold; means for providing a stimulating pulse to a selected chamber of the heart at a maximum upper rate in the event said atrial rate sensed by said first sensing means exceeds said first prescribed threshold; second sensing means for monitoring said atrial rate above said first prescribed threshold and sensing whether said atrial rate exceeds a second prescribed threshold, said second threshold being at a higher rate than said first threshold; and means for automatically switching the mode of operation of said pacemaker from said atrial rate based mode of operation to a selected alternate mode of operation in the event said atrial rate exceeds said second prescribed threshold. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A dual chamber pacemaker having first and second channels, said first and second channels including sensing means for sensing cardiac activity and pulse generating means for providing pacing pulses in the absence of cardiac activity in the atrial and the ventricular chambers of the heart, respectively, said pacemaker comprising:
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control means for controlling said sensing means and said pulse generating means of said first and second channels in a prescribed mode of operation, said control means comprising; means for detecting a rate of cardiac activity as sensed by said sensing means in said first channel; and means for triggering said pulse generating means to provide pacing pulses in said second channel at a rate which is the lesser of said rate of cardiac activity detected in said first channel or a maximum tracking rate; and means for automatically changing said prescribed mode of operation in the event said rate of cardiac activity detected in said first channel exceeds a specified threshold level, said specified threshold level comprising a rate which is greater than said maximum tracking rate. - View Dependent Claims (12, 13, 14)
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15. A method of operating a dual chamber programmable pacemaker, said pacemaker being capable of operating in a variety of modes of operation and being initially programmed to operate in an atrial rate based mode of operation, said pacemaker comprising means for sensing cardiac activity in the atrial and the ventricular chambers of a heart, and means for selectively providing a stimulating pulse to either chamber of the heart at prescribed times and under prescribed conditions, the method comprising the steps of:
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(a) sensing when the atrial rate exceeds a first rate threshold; (b) providing a stimulating pulse to a selected chamber of the heart at a maximum upper rate in the event the atrial rate sensed in step (a) exceeds said first rate threshold; (c) monitoring the atrial rate above said first rate threshold up to a second rate threshold; and (d) automatically switching the mode of operation of said pacemaker from said atrial rate based mode of operation to a selected alternate mode of operation in the event the atrial rate exceeds said second rate threshold. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification