Variable rate pacemaker having upper rate limit governor based on hemodynamic performance
First Claim
1. In a rate adaptive pacemaker of the type including a variable rate pulse generating means for producing cardiac stimulating pulses, means for sensing a change in a patient'"'"'s physiologic demand, mans responsive to said sensed change in physiologic demand for providing a control signal to said variable rate pulse generating means to thereby alter the rate at which said stimulating pulses are produced by said variable rate pulse generating means, the improvement comprising:
- (a) means for sensing changes in the hemodynamic performance of the heart in response to said stimulating pulses; and
(b) means responsive to said means for sensing changes in the hemodynamic performance for preventing said control signal from altering the rate at which said stimulating pulses are produced by said pulse generating means when to do so will compromise said hemodynamic performance of the heart.
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Abstract
A rate adaptive pacemaker of the type having a variable rate cardiac stimulating pulse generator and a sensor for monitoring some physiologic parameter whereby the pulse generator stimulating rate can be adjusted to meet physiologic demand is further provided with a hemodynamic sensor which is operative to provide an output signal representing the pumping performance of the heart in response to the pacing stimulation. The signal from the hemodynamic sensor is processed and then used in an algorithm to determine whether further rate increase should be permitted based upon whether the rate increase would be accompanied by a further increase in cardiac output, a plateau or a decrease in cardiac output. Hence, the adaptive rate pacemaker is provided with a real-time, hemodynamic maximum pacing rate instead of a preprogrammed, fixed, maximum rate.
169 Citations
13 Claims
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1. In a rate adaptive pacemaker of the type including a variable rate pulse generating means for producing cardiac stimulating pulses, means for sensing a change in a patient'"'"'s physiologic demand, mans responsive to said sensed change in physiologic demand for providing a control signal to said variable rate pulse generating means to thereby alter the rate at which said stimulating pulses are produced by said variable rate pulse generating means, the improvement comprising:
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(a) means for sensing changes in the hemodynamic performance of the heart in response to said stimulating pulses; and (b) means responsive to said means for sensing changes in the hemodynamic performance for preventing said control signal from altering the rate at which said stimulating pulses are produced by said pulse generating means when to do so will compromise said hemodynamic performance of the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. In a rate adaptive pacemaker of the type including a variable rate pulse generating means for producing cardiac stimulating pulses, means for sensing a change in physiologic demand, means responsive to said sensed change for providing a first control signal to said variable rate pulse generating means for varying the rate at which said stimulating pulses are produced thereby, the improvement comprising:
(a) means coupled to said pulse generating means and automatically responsive to the hemodynamic performance of the heart for limiting the upper rate to which said stimulating pulses can be driven by said first control signal. - View Dependent Claims (9, 10, 11, 12, 13)
Specification