System and method for preventing false pacemaker PVC response
First Claim
1. In an implantable pacemaker having means for sensing atrial and ventricular events, means for generating an atrial stimulation pulse, means for generating an atrial refractory time interval having a relative refractory portion wherein sensed atrial activity is considered as atrial noise and not as a valid atrial event, and means for detecting apremature ventricular contraction (PVC) and responding thereto in a prescribed manner, electornic circuit means for preventing said PVC detecting means from responding to a false PVC comprising:
- means for generating a latched signal in the event atrial noise is sensed during said relative refractory portion of said atrial refractory time interval;
means responsive to said latched signal for causing said PVC detecting means to assume a disabled state, said disabled state continuing until the first occurrence thereafter of a prescribed re-enabling event; and
means responsive to said prescribed re-enabling event for enabling said PVC detecting means;
a PVC thereby not being detectable by said PVC detecting means subsequent to the occurrence of atrial noise until said re-enabling event occurs.
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Accused Products
Abstract
An implantable pacemaker having means for detecting and responding to a premature ventricular contraction (PVC), also includes circuit means for minimizing the likelihood of sensing a PVC when in fact a PVC has not occurred. The circuit means latches the occurrence of any atrial events sensed during the relative atrial refractory period of the pacemaker, whether such atrial events are noise or an early P-wave; and, in response to such latching, disables the PVC detection circuit until certain prescribed events occur, whereupon the PVC detection circuit is re-enabled. The prescribed events that re-enable the PVC detection circuit after it has been disabled include, e.g., the occurrence of a ventricular pulse or sensed R-wave. Further, in the event a PVC is detected and a desired PVC response is invoked, an additional circuit means automatically terminates the PVC response in the event the PVC response becomes stuck.
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Citations
21 Claims
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1. In an implantable pacemaker having means for sensing atrial and ventricular events, means for generating an atrial stimulation pulse, means for generating an atrial refractory time interval having a relative refractory portion wherein sensed atrial activity is considered as atrial noise and not as a valid atrial event, and means for detecting apremature ventricular contraction (PVC) and responding thereto in a prescribed manner, electornic circuit means for preventing said PVC detecting means from responding to a false PVC comprising:
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means for generating a latched signal in the event atrial noise is sensed during said relative refractory portion of said atrial refractory time interval; means responsive to said latched signal for causing said PVC detecting means to assume a disabled state, said disabled state continuing until the first occurrence thereafter of a prescribed re-enabling event; and means responsive to said prescribed re-enabling event for enabling said PVC detecting means; a PVC thereby not being detectable by said PVC detecting means subsequent to the occurrence of atrial noise until said re-enabling event occurs. - View Dependent Claims (2, 3, 4)
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5. A system for detecting premature ventricular contractions for use in an implantable, programmable, pacemaker comprising:
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detection means for detecting first and second ventricular events without an intervening atrial event; first means for testing the second detected ventricular event to determine if said second detected ventricular event exhibits a first specified criterion of a premature ventricular contraction (PVC); second means for testing the second detected ventricular event to determine if said second detected ventricular event exhibits a second specified criterion of a PVC; decision means coupled to said first and second test means for determining whether a selected one of said first or second specified criterion is exhibited in said second detected ventricular event, and if so for generating a PVC detection signal indicating that a PVC has occurred; PVC response means responsive to said PVC detection signal for triggering a selected PVC response of said pacemaker; and means for disabling said detection means upon the occurrence of prescribed atrial activity and re-enabling said detection means upon the occurrence of a prescribed enabling event. - View Dependent Claims (6, 7)
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8. A method for preventing a false premature ventricular contraction (PVC) response of an implantable pacemaker, said pacemaker including means for detecting a PVC and providing a prescribed PVC response, said method comprising the steps of:
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(a) disabling said PVC detecting means upon the occurrence of any atrial event that might possibly be a valid atrial event; and (b) re-enabling said PVC detecting means only upon the occurrence of a prescribed enabling event. - View Dependent Claims (9, 10, 11, 12)
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13. A method for automatically terminating a stuck premature ventricular contraction (PVC response of an implantable pacemaker comprising:
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(a) sensing a PVC with PVC detection means; (b) disabling said PVC detection means in the event an atrial event occurs early in a cardiac cycle at a time that only invalid atrial events are expected to occur, and re-enabling said PVC detection means upon the occurrence of a prescribed enabling event; (c) enabling a PVC response mode of said pacemaker in response to the sensing of a PVC with said PVC detection means; (d) monitoring the number of cardiac cycles that occur while said PVC response mode is enabled; and (e) disabling said PVC response mode if the number of cardiac cycles occurring during said PVC response mode reaches n, where n is an integer greater than two. - View Dependent Claims (14, 15, 16)
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17. In an implantable programmable pacemaker having means for sensing a premature ventricular contraction (PVC) and responding thereto with a prescribed response, PVC response termination means for terminating the prescribed response of said PVC sensing means in the event said prescribed response becomes stuck, said PVC response termination means comprising:
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means for enabling a PVC response mode of said pacemaker in response to the sensing of a PVC by said PVC sensing means, said means for enabling a PVC response mode including means for disabling said PVC sensing means in the event an atrial event occurs early in the cardiac cycle at a time that only invalid atrial events, such as noise, are expected to occur, thereby minimizing the likelihood that a false PVC will be detected by the PVC sensing means of the pacemaker; means for monitoring the number of cardiac cycles that occur while said PVC response mode is enabled; and means for disabling said PVC response mode if the number of cardiac cycles occurring during said PVC response mode reaches n, where n is an integer greater than two. - View Dependent Claims (18, 19, 20, 21)
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Specification