Dual chamber pacing system and method with continual adjustment of the AV escape interval so as to maintain optimized ventricular pacing for treating cardiomyopathy
First Claim
1. A dual chamber pacemaker, having atrial sense means for sensing atrial signals from a patient, ventricular sense means for sensing ventricular signals from a patient, ventricular pace means for generating and delivering ventricular pace pulses to said patient'"'"'s right ventricle, and sync control means for controlling said ventricular pace means to generate and deliver a ventricular pace pulse at a controlled AV escape interval following a sensed atrial signal, said sync control means having AVesc means for setting said AV escape interval, said AVesc means comprising:
- fusion means for detecting occurrence of fusion beats, rate means for determining a rate of occurrence of fusion beats over a plurality of pacemaker cycles, and adjustment means for adjusting said AV escape interval as a function of said determined rate.
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Abstract
A dual chamber pacemaker is provided having capability for adjusting the AV escape interval so as to optimize the timing of delivered ventricular pace pulses for therapy of patients with cardiomyopathy. The pacemaker system continually monitors to determine when a delivered pace pulse results in a fusion beat, and periodically adjusts the AV escape interval in accordance with the percentage or rate of incidence of such fusion beats. In one specific embodiment, the pacing system determines the percentage of delivered ventricular pace pulses which are followed by fusion beats over a predetermined number of intervals, and decrements AV escape interval when such percentage is not below a predetermined minimum. The pacing system also periodically increments AV escape interval when the rate of fusion beats is acceptable, thereby providing a closed loop system for maintaining the AV interval at an optimally long value consistent with maximizing full capture by delivered ventricular pace pulses. In another embodiment, the V--V escape interval of a non-tracking mode pacemaker is controlled to optimize pre-excitation of the ventricle.
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Citations
13 Claims
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1. A dual chamber pacemaker, having atrial sense means for sensing atrial signals from a patient, ventricular sense means for sensing ventricular signals from a patient, ventricular pace means for generating and delivering ventricular pace pulses to said patient'"'"'s right ventricle, and sync control means for controlling said ventricular pace means to generate and deliver a ventricular pace pulse at a controlled AV escape interval following a sensed atrial signal, said sync control means having AVesc means for setting said AV escape interval, said AVesc means comprising:
fusion means for detecting occurrence of fusion beats, rate means for determining a rate of occurrence of fusion beats over a plurality of pacemaker cycles, and adjustment means for adjusting said AV escape interval as a function of said determined rate. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method of pacing therapy using a dual chamber pacemaker system, comprising
delivering a ventricular pace pulse upon the time out of an AV escape interval following an atrial event, determining whenever a delivered ventricular pace pulse results in a fusion beat, determining a measure of a rate of occurrence of fusion beats, and adjusting said AV escape interval as a function of said measure of the rate of occurrence.
Specification