Forced atrioventricular synchrony dual chamber pacemaker
First Claim
1. A dual-chamber pacemaker comprising:
- means for sensing an atrial heartbeat (A-sense);
means for sensing a ventricular heartbeat (V-sense);
means for generating an atrial pacing pulse (A-pace);
means for generating a ventricular pacing pulse (V-pace);
timer means for timing(i) a ventricular event to ventricular event interval (VV), such VV interval beginning with either a V-sense or a V-pace,(ii) an atrial event to V-pace interval (AV delay), such AV delay interval beginning with either an A-sense or an A-pace,(iii) an atrial protection interval (API),(iv) a post ventricular atrial refractory period (PVARP), and(v) an Alert interval (Alert); and
controller means for providing a normal loop timing sequence of AV delay, PVARP, API, and Alert, with minimum time values for AV delay and API, and a maximum time value for AV delay;
said controller means operating such that if an A-sense occurs during said API or PVARP and the remaining time in the VV interval is longer than said maximum AV delay, then an API is timed, at the end thereof an Apace is generated, and thereafter an appropriate AV delay is timed so as to stabilize the VV interval.
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Accused Products
Abstract
A dual chamber cardiac pacemaker is adapted to operate in a forced synchrony pacing mode. The pacemaker senses atrial heartbeats and determines whether the rate of sensed atrial heartbeats is pathological or physiological. For physiological atrial heartbeat rates, the pacemaker functions in an AV synchronous pacing mode. For pathological atrial rates, atrial heartbeats occur too frequently for safe AV synchronous pacing so the heart is paced in the forced synchrony mode. In the forced synchrony mode, the pacemaker, upon sensing a natural atrial heartbeat, waits a predetermined atrial protection interval, paces the atria with an atrial stimulation pulse, waits a physiologically appropriate AV delay interval, and then delivers a ventricular pacing pulse at a time which maintains a stable ventricular rate.
60 Citations
40 Claims
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1. A dual-chamber pacemaker comprising:
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means for sensing an atrial heartbeat (A-sense); means for sensing a ventricular heartbeat (V-sense); means for generating an atrial pacing pulse (A-pace); means for generating a ventricular pacing pulse (V-pace); timer means for timing (i) a ventricular event to ventricular event interval (VV), such VV interval beginning with either a V-sense or a V-pace, (ii) an atrial event to V-pace interval (AV delay), such AV delay interval beginning with either an A-sense or an A-pace, (iii) an atrial protection interval (API), (iv) a post ventricular atrial refractory period (PVARP), and (v) an Alert interval (Alert); and controller means for providing a normal loop timing sequence of AV delay, PVARP, API, and Alert, with minimum time values for AV delay and API, and a maximum time value for AV delay;
said controller means operating such that if an A-sense occurs during said API or PVARP and the remaining time in the VV interval is longer than said maximum AV delay, then an API is timed, at the end thereof an Apace is generated, and thereafter an appropriate AV delay is timed so as to stabilize the VV interval. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A dual-chamber pacemaker comprising:
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means for sensing an atrial heartbeat (A-sense); means for sensing a ventricular heartbeat (V-sense); means for generating an atrial pacing pulse (A-pace); means for generating a ventricular pacing pulse (V-pace); timer means for timing (i) an atrial event to V-pace interval (AV delay), such AV delay interval bet;
inning with either an A-sense or an A-pace,(ii) an atrial protection interval (API), (iii) a post ventricular atrial refractory period (PVARP), and (iv) an Alert interval (Alert); and controller means for providing a normal loop timing sequence of AV delay, PVARP, API, and Alert;
said controller means operating such that if an A-sense occurs during said API and the remaining time in the loop timing sequence is sufficient, then an API is timed, at the end thereof an A-pace is generated, and thereafter an AV delay is timed. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A method of operating a dual-chamber pacemaker comprising the steps of:
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sensing an atrial heartbeat (A-sense); sensing a ventricular heartbeat (V-sense); generating an atrial pacing pulse (A-pace); generating a ventricular pacing pulse (V-pace); timing (i) a ventricular event to ventricular event interval (VV), such VV interval beginning with either a V-sense or a V-pace, (ii) an atrial event to V-pace interval (AV delay), such AV delay interval beginning with either an A-sense or an A-pace, (iii) an atrial protection interval (API), (iv) a post ventricular atrial refractory period (PVARP), and (v) an Alert interval (Alert); and providing a normal loop timing sequence of AV delay, PVARP, API, and Alert, with minimum time values for AV delay and API, and a maximum time value for AV delay;
wherein if an A-sense occurs prior to the Alert interval and the remaining time in the VV interval is longer than said maximum AV delay, then an API is timed, at the end thereof an A-pace is generated, and thereafter an AV delay is timed. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29)
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30. A method of operating a dual-chamber pacemaker comprising the steps of:
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sensing an atrial heartbeat (A-sense); sensing a ventricular heartbeat (V-sense); generating an atrial pacing pulse (A-pace); generating a ventricular pacing pulse (V-pace); timing (i) an atrial event to V-pace interval (AV delay), such AV delay interval beginning with either an A-sense or an A-pace, (ii) an atrial protection interval (API), (iii) a post ventricular atrial refractory period (PVARP), and (iv) an Alert interval (Alert); and providing a normal loop timing sequence of AV delay, PVARP, API, and Alert;
wherein if an A-sense occurs prior to the Alert interval and the remaining time in the loop tinting sequence is sufficient, then an API is timed, at the end thereof an Apace is generated, and thereafter an AV delay is timed. - View Dependent Claims (31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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Specification