Programmable automatic implantable cardioverter/defibrillator and pacemaker system
First Claim
1. A programmable cardioverter/defibrillator system comprising:
- (a) an automatic implantable cardioverter/ defibrillator (AICD), said AICD comprising;
high/low rate sensing means for sensing when a heart is beating above a fixed high threshold rate or below a fixed low threshold rate; and
means for delivering a high energy cardioversion/defibrillation pulse to the heart whenever said high/low rate sensing means senses that the heart is beating above the fixed high threshold rate or below the fixed low threshold rate;
(b) an implantable programmable pacemaker, said pacemaker comprising;
heart-rate sensing means for sensing the rate at which the heart is beating;
means for processing the sensed heart rate to determine whether the sensed heart rate lies within a programmed range of acceptable heart rates and for triggering the generation of said cardioversion/defibrillation pulse from said AICD so that the fixed high and low threshold rates of said AICD are replaced by the programmed range of heart rates of said implantable programmable pacemaker, said triggering occurring whenever the heart rate sensed by said heart rate sensing means of said pacemaker does not fall within said prescribed range of acceptable heart rates; and
programming means for allowing said programmed range of acceptable heart rates to be programmed into said processing means; and
(c) coupling means for coupling the operation of said AICD to said pacemaker.
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Accused Products
Abstract
A non-programmable automatic implantable cardioverter/defibrillator (AICD) capable of providing programmable thresholds for triggering high energy stimulation pulse(s) from the AICD is coupled to an implantable programmable pacemaker which preferably includes bradycardia support and/or tachycardia support using low enery output pulses. When the low energy antitachycardia pulse(s) from the pacemaker fail to terminate a tachycardia, or whenever other various thresholds, as sensed by programmable sensing circuits of the pacemaker, are exceeded, the high enery pulses from the AICD may be selectively invoked by an AICD trigger circuit included within the pacemaker. Coupling between the AICD and pacemaker is by either a direct electrical connection, or by an indirect connection, such as through the use of narrow pulse sequences generated by the pacemaker which are of insufficient energy to invoke a cardiac response but are of sufficient energy to be sensed by the AICD sensing circuits.
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Citations
20 Claims
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1. A programmable cardioverter/defibrillator system comprising:
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(a) an automatic implantable cardioverter/ defibrillator (AICD), said AICD comprising; high/low rate sensing means for sensing when a heart is beating above a fixed high threshold rate or below a fixed low threshold rate; and means for delivering a high energy cardioversion/defibrillation pulse to the heart whenever said high/low rate sensing means senses that the heart is beating above the fixed high threshold rate or below the fixed low threshold rate; (b) an implantable programmable pacemaker, said pacemaker comprising; heart-rate sensing means for sensing the rate at which the heart is beating; means for processing the sensed heart rate to determine whether the sensed heart rate lies within a programmed range of acceptable heart rates and for triggering the generation of said cardioversion/defibrillation pulse from said AICD so that the fixed high and low threshold rates of said AICD are replaced by the programmed range of heart rates of said implantable programmable pacemaker, said triggering occurring whenever the heart rate sensed by said heart rate sensing means of said pacemaker does not fall within said prescribed range of acceptable heart rates; and programming means for allowing said programmed range of acceptable heart rates to be programmed into said processing means; and (c) coupling means for coupling the operation of said AICD to said pacemaker. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A programmable implantable medical system for delivering high energy stimulation pulses to a heart whenever the heart rate exceeds a programmable threshold rate value, said system comprising:
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an automatic implantable cardioverter/defibrillator (AICD) device, said AICD device comprising; AICD sensing means for sensing when a heart rate is above a fixed high threshold rate value; and means for delivering a high energy stimulation pulse to the heart whenever said AICD sensing means senses that the heart rate exceeds said fixed high threshold rate value; and an implantable pacemaker device, said pacemaker device comprising; pacemaker sensing means for sensing the heart rate; means for processing the sensed heart rate to determine if it exceeds programmed criteria; programming means for programming said specified criteria into said processing means; and means for generating and delivering a sequence of very low energy pulses to the heart at a rate which exceeds the AICD fixed threshold rate in response to a determination by said processing means that the heart rate exceeds said programmed criteria, said very low energy pulses having an energy level sufficient to be detected by the AICD sensing means, but insufficient to stimulate the heart, said sequence of very low energy pulses being detectable by the AICD sensing means, whereby said delivery means of said AICD device responds by delivering said high energy stimulation pulse to the heart. - View Dependent Claims (11, 12)
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13. In combination, an automatic implantable cardioverter/defibrillator (AICD) device and an implantable programmable pacemaker device, said pacemaker device comprising:
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heart-rate sensing means for sensing the rate at which the heart is beating; means for processing the sensed heart rate to determine whether said heart rate is within a specified range of acceptable heart rates; programming means for allowing said specified range to be programmed into said processing means; and signaling means within said pacemaker device for sending a trigger signal to said AICD device upon a determination by said processing means that the sensed heart rate is not within said specified range of acceptable heart rates; said AICD device comprising; AICD sensing means for sensing when a heart is beating above a fixed high threshold rate or below a fixed low threshold rate; means for delivering a high energy stimulation pulse to the heart in response to receiving said trigger signal or in response to said AICD sensing means sensing that the heart is beating above the fixed high threshold rate or below the fixed low threshold rate; and receiving means within said AICD device for receiving said trigger signal; said trigger signal sent by said signaling means comprising a series of pulses having a frequency at least as great as said fixed high threshold rate of said AICD device, said series of pulses being sent directly to said AICD receiving means when the heart rate sensed by said heart-rate sensing means of said pacemaker is above said specified range of acceptable heart rates; and said trigger signal comprising an inhibiting of all pulses sent directly to the AICD receiving means for a prescribed period of time when the heart rate sensed by said heart-rate sensing means of said pacemaker is below said specified range of acceptable heart rates. - View Dependent Claims (14)
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15. A method of converting fixed high or low rate threshold values of an automatic implantable cardioverter/defibrillator (AICD) device to programmable high or low rate threshold values, said AICD including means for generating a high energy cardioversion/defibrillation pulse whenever the heart rate sensed by sensing means within said AICD device either exceeds the fixed high rate threshold value or is less than the fixed low rate threshold value, said method comprising the steps of:
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coupling a programmable pacemaker to said AICD device by way of a direct electrical connection between a sensing electrode of said AICD device and a trigger circuit of said pacemaker, said pacemaker further including heart rate sensing means for sensing when the heart rate exceeds a programmable upper limit and is less than a programmable lower limit; and triggering the generation of said high energy cardioversion/defibrillation pulse whenever the heart rate sensing means of said pacemaker senses a rate which exceeds the programmable upper limit or is less than the programmable lower limit.
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16. A method of converting fixed high or low rate threshold values of an automatic implantable cardioverter/defibrillator (AICD) device to programmable high or low rate threshold values, said AICD including means for generating a high energy cardioversion/defibrillation pulse whenever the heart rate sensed by sensing means within said AICD device either exceeds the fixed high rate threshold value or is less than the fixed low rate threshold value, said method comprising the steps of:
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coupling a programmable pacemaker to said AICD device, said pacemaker including heart rate sensing means for sensing when the heart rate exceeds a programmable upper limit and is less than a programmable lower limit; and triggering the generation of said high energy cardioversion/defibrillation pulse whenever the heart rate sensing means of said pacemaker senses a rate which exceeds the programmable upper limit or is less than the programmable lower limit; said coupling step comprising; generating a low energy pulse within said pacemaker, said low energy pulse having insufficient energy to stimulate the heart, but sufficient energy to be sensed by the sensing means of said AICD device; applying said low energy pulse to said heart at a rate that exceeds said fixed high rate threshold; and detecting the presence of said low energy pulse within the sensing circuits of said AICD.
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17. In combination, an automatic implantable cardioverter/defibrillator (AICD) device and an implantable programmable pacemaker device, said pacemaker device comprising:
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heart-rate sensing means for sensing the rate at which the heart is beating; means for processing the sensed heart rate to determine whether said heart rate is within a specified range of acceptable heart rates; programming means for allowing said specified range to be programmed into said processing means; and signaling means within said pacemaker device for sending a trigger signal to said AICD device upon a determination by said processing means that the sensed heart rate is not within said specified range of acceptable heart rates; means for generating and delivering low energy stimulation pulses as controlled by said processing means; said AICD device comprising; AICD sensing means for sensing when a heart is beating above a fixed high threshold rate or below a fixed low threshold rate; means for delivering a high energy stimulation pulse to the heart in response to receiving said trigger signal or in response to said AICD sensing means sensing that the heart is beating above the fixed high threshold rate or below the fixed low threshold rate; and receiving means within said AICD device for receiving said trigger signal; said signaling means of said pacemaker device comprising a series of very low energy pulses which are generated and delivered to the heart by said stimulation pulse delivery means of said pacemaker device at a rate which exceeds said fixed high threshold rate of said AICD sensing means, and wherein said receiving means within said AICD device comprises said AICD sensing means, said very low energy pulses having an energy level sufficient to be detected by said AICD sensing means, but insufficient to stimulate the heart, whereby said AICD sensing means senses the series of very low energy pulses and interprets the same to be the heart beating at a rate which exceeds said fixed high rate threshold, whereby said delivery means of said AICD device responds by delivering said high energy stimulation pulse to the heart. - View Dependent Claims (18, 19, 20)
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Specification