Arrhythmia and fibrillation prevention pacemaker using ratchet up and decay modes of operation
First Claim
1. A method for controlling the rate of pacing pulse delivery in an atrium of a heart wherein at least two modes for changing the rate of pacing delivered to said chamber are included in said method, a first of said two modes being a decay mode during which the rate of pacing delivered to the atrium is reduced and a second being a ratchet up mode during which the pacing rate is increased, said method comprising,determining by means of detected atrial events whether there is natural, nonpacemaker induced depolarization or contraction of the atrium,maintaining the pacing rate until it is determined that one such natural atrial event has occurred,switching to a ratchet up mode when natural atrial depolarizations are detected during a period of atrial pacing such that the pacing rate is increased until no further such natural atrial depolarizations or contractions are detected and for a period thereafter maintaining said increased pacing rate,after said period expires, switching to a decay mode until a safety level is reached or a natural atrial depolarization or contraction is detected, if said safety level is reached, continuing to pace at the safety rate, but if natural depolarization or contraction is determined prior to reaching the safety rate in said decay mode, then pacing at an increment above the rate at which the natural depolarization or contraction was found.
1 Assignment
0 Petitions
Accused Products
Abstract
New pacing algorithm defines faster than indicated pacing rate during detection of PAC'"'"'s/PVC'"'"'s and reduces rate after awhile to a safety rate unless natural depolarizations are detected.
224 Citations
47 Claims
-
1. A method for controlling the rate of pacing pulse delivery in an atrium of a heart wherein at least two modes for changing the rate of pacing delivered to said chamber are included in said method, a first of said two modes being a decay mode during which the rate of pacing delivered to the atrium is reduced and a second being a ratchet up mode during which the pacing rate is increased, said method comprising,
determining by means of detected atrial events whether there is natural, nonpacemaker induced depolarization or contraction of the atrium, maintaining the pacing rate until it is determined that one such natural atrial event has occurred, switching to a ratchet up mode when natural atrial depolarizations are detected during a period of atrial pacing such that the pacing rate is increased until no further such natural atrial depolarizations or contractions are detected and for a period thereafter maintaining said increased pacing rate, after said period expires, switching to a decay mode until a safety level is reached or a natural atrial depolarization or contraction is detected, if said safety level is reached, continuing to pace at the safety rate, but if natural depolarization or contraction is determined prior to reaching the safety rate in said decay mode, then pacing at an increment above the rate at which the natural depolarization or contraction was found.
-
9. An apparatus for controlling a pacing system for delivering pacing pulses to the atrium of a heart comprising:
-
Timing control means for controlling the rate of delivery of pacing pulses to said atrium, said timing control means capable of at least two modes of adjustment, one of said at least two being a decay mode and the other of said at least two being a ratchet up mode, atrial contraction sense means for detecting atrial events and producing a signal therefrom, and for distinguishing between natural and induced contractions or depolarizations, switching means for signaling said timing control means to change to a ratchet up mode when natural atrial depolarizations are detected such that the pacing rate is increased until no further such natural atrial contractions are detected and for a period thereafter maintaining said increased pacing rate, and after said period expires, switching to a decay mode until either a safety pacing rate level is reached or a natural atrial contraction is detected, if said safety level is reached, continuing to pace at the safety rate, but if natural atrial contraction is detected prior to reaching the safety rate in said decay mode, then signaling said timing control means to pace at a rate greater by an increment than a rate at which the natural depolarization or contraction was found. - View Dependent Claims (10, 11, 12, 13, 14, 15)
-
-
16. A method for controlling the rate of pacing pulse delivery in a heart so as wherein at least two modes for changing the rate of pacing delivered to a ventricle are included in said method, a first of said two modes being a decay mode during which the rate of pacing delivered to the ventricle is reduced and a second being a ratchet up mode during which the pacing rate to the ventricle is increased, said method comprising,
determining by means of detected ventricular events whether there is natural, nonpacemaker induced depolarization or contraction of the ventricle, maintaining the pacing rate until it is determined that one such natural ventricular event has occurred, switching to a ratchet up mode when natural ventricular depolarizations are detected during a period of ventricular pacing such that the pacing rate is increased until no further such natural depolarizations or contractions are detected and for a period thereafter maintaining said increased pacing rate, after said period expires, switching to a decay mode until a safety level is reached or a natural ventricular depolarization or contraction is detected, if said safety level is reached, continuing to pace at the safety rate, but if natural depolarization or contraction is determined prior to reaching the safety rate in said decay mode, then pacing at an increment above the rate at which the natural depolarization or contraction was found.
-
23. An apparatus for controlling a pacing system for delivering pacing pulses to a ventricle of a heart comprising:
-
Timing control means for controlling the rate of delivery of pacing pulses to said atrium, said timing means capable of at least two modes of adjustment, one of said at least two being a decay mode and the other of said at least two being a ratchet up mode, ventricular contraction sense means for detecting ventricular events and producing a signal therefrom, and for distinguishing between natural and induced contractions or depolarizations of a ventricle, switching means for signaling said timing control means to change to a ratchet up mode when natural ventricular depolarizations are detected such that the pacing rate is increased until no further such natural ventricular contractions are detected and for a period thereafter maintaining said increased pacing rate, and after said period expires, switching to a decay mode until either a safety pacing rate level is reached or a natural ventricular contraction is detected, if said safety level is reached, continuing to pace at the safety rate, but if natural ventricular contraction is detected prior to reaching the safety rate in said decay mode, then signaling said timing control means to pace at a rate greater by an increment than a rate at which the natural depolarization or contraction was found. - View Dependent Claims (24, 25, 26, 27, 28, 29)
-
-
30. A method for controlling the rate of pacing pulse delivery in a ventricle and an atrium of a heart wherein at least two modes for changing the rate of pacing delivered to a ventricle are included in said method, a first of said two modes being a decay mode during which the rate of pacing delivered to the ventricle is reduced and a second being a ratchet up mode during which the pacing rate to the ventricle is increased, said method comprising,
determining by means of detected ventricular events whether there is natural, nonpacemaker induced depolarization or contraction of the ventricle, maintaining the pacing rate until it is determined that one such natural ventricular event has occurred, switching to a ratchet up mode when natural non-paced ventricular depolarizations are detected during a period of atrial pacing such that the pacing rate is increased until no further such natural depolarizations or contractions are detected and for a period thereafter maintaining said increased pacing rate, after said period expires, switching to a decay mode until a safety level is reached or a natural nonpacemaker induced depolarization or contraction is detected, if said safety level is reached, continuing to pace at the safety rate, but if nonpacemaker induced depolarization or contraction is detected prior to reaching the safety rate in said decay mode, then pacing at an increment above the rate at which the natural depolarization or contraction was found.
-
39. An apparatus for controlling a pacing system for delivering pacing pulses to an atrium and a ventricle of a heart comprising:
-
Timing control means for controlling the rate of delivery of pacing pulses to said atrium, said timing means capable of at least two modes of adjustment, one of said at least two being a decay mode and the other of said at least two being a ratchet up mode, ventricular contraction sense means for detecting ventricular events, and for distinguishing between natural non-pace induced and induced contractions or depolarizations of a ventricle, switching means for signaling said timing control means to change to a ratchet up mode when natural ventricular depolarizations are detected such that the pacing rate is increased until no further such natural ventricular contractions are detected and for a period thereafter maintaining said increased pacing rate, and after said period expires, switching to a decay mode until either a safety pacing rate level is reached or a natural ventricular contraction is detected, if said safety level is reached, continuing to pace at the safety rate, but if natural ventricular contraction is detected prior to reaching the safety rate in said decay mode, then signaling said timing control means to pace at a rate greater by an increment than a rate at which the natural non-pace induced ventricular depolarization or contraction was found. - View Dependent Claims (40, 41, 42, 43, 44, 45, 46, 47)
-
Specification