Dual chamber pacing with interchamber delay
First Claim
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1. A method for determining the origin of a cardiac signal in a heart, comprising the steps of:
- providing first and second electrodes connected to said heart, and a third electrode referenced outside said heart;
providing said first electrode for sensing a first chamber of said heart;
providing said second electrode for sensing a second chamber of said heart;
sensing for said cardiac signal while said first and second electrodes are in a bipolar configuration;
detecting said cardiac signal with said first and second electrodes;
switching both said first and second electrodes to a unipolar configuration after detecting said cardiac signal; and
sensing for said cardiac signal between said first and second electrodes and said third electrode in said unipolar configuration; and
determining the origin of said cardiac signal in one of said first and second chambers.
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Abstract
A method and apparatus for determining the origin of a cardiac signal in the heart of a patient. A cardiac stimulator includes a multiple-chamber electrode arrangement having at least two electrodes positioned to sense and/or pace different chambers of the heart. The electrodes switch from a bipolar configuration to a unipolar configuration in order to verify the point of origin for the cardiac signal and in order to determine whether propagation of the cardiac signal occurs. The apparatus allows simultaneous and timed pacing of left and right chambers.
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Citations
16 Claims
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1. A method for determining the origin of a cardiac signal in a heart, comprising the steps of:
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providing first and second electrodes connected to said heart, and a third electrode referenced outside said heart; providing said first electrode for sensing a first chamber of said heart; providing said second electrode for sensing a second chamber of said heart; sensing for said cardiac signal while said first and second electrodes are in a bipolar configuration; detecting said cardiac signal with said first and second electrodes; switching both said first and second electrodes to a unipolar configuration after detecting said cardiac signal; and sensing for said cardiac signal between said first and second electrodes and said third electrode in said unipolar configuration; and determining the origin of said cardiac signal in one of said first and second chambers. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A method for verifying propagation of a cardiac signal in a heart, comprising the steps of:
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providing a first electrode electrically connected with a first atrial chamber of said heart; providing a second electrode electrically connected with a second atrial chamber of said heart; providing a ground electrode outside said heart; providing said first and second electrodes in a bipolar configuration in which one of pacing and sensing occur between said first and second electrodes; pacing said first chamber to induce a cardiac signal; commencing a conduction time interval; switching both said first and second electrodes to a unipolar configuration in which sensing occurs between said second electrode and said ground electrode; sensing for said cardiac signal in said second chamber with said ground and second electrodes in said unipolar configuration; and verifying propagation of said signal if said cardiac signal is sensed in said second chamber. - View Dependent Claims (8, 9, 10)
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11. An implantable medical device for determining the origin of a cardiac signal in a heart, comprising:
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a conductive housing; control circuitry enclosed within said housing; a first electrode electrically connected to said control circuitry, and electrically connectable with a first chamber of said heart; a second electrode electrically connected to said control circuitry, and electrically connectable with a second chamber of said heart; an indifferent electrode electrically connected to said housing; means for connecting said first and second electrodes in a bipolar configuration, wherein sensing for said cardiac signal occurs between said first and second electrodes; means for switching said first and second electrodes to a unipolar configuration after said cardiac signal is sensed in said bipolar configuration, wherein sensing for said cardiac signal occurs between said indifferent and second electrodes; and means responsive to a detected signal at one said first or second electrodes in unipolar configuration for determining the origin of said signal in said first or second chamber of said heart. - View Dependent Claims (12, 13, 14, 15, 16)
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Specification