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 method of operating a pacemaker in a non-tracking mode adapted to apply when said pacemaker is implanted in a patient with a heart having atrial events, comprising:
- (a) delivering ventricular pace pulses to a patient without a timed relationship to atrial events,(b) lengthening a V--V escape interval of delivered ventricular pace pulses, and determining when one or more said lengthened interval delivered ventricular pace pulses fail to result in fall capture of the ventricle, and(c) shortening said V--V escape interval in response to a determination of such a failure.
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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
11 Claims
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1. A method of operating a pacemaker in a non-tracking mode adapted to apply when said pacemaker is implanted in a patient with a heart having atrial events, comprising:
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(a) delivering ventricular pace pulses to a patient without a timed relationship to atrial events, (b) lengthening a V--V escape interval of delivered ventricular pace pulses, and determining when one or more said lengthened interval delivered ventricular pace pulses fail to result in fall capture of the ventricle, and (c) shortening said V--V escape interval in response to a determination of such a failure. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method of operating a pacemaker in a non-tracking mode adapted to apply when said pacemaker is implanted in a patient with a heart having atrial events, comprising:
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detecting a rate of the patient'"'"'s spontaneous atrial beats, detecting when the atrial rate is above a predetermined atrial high rate limit, and upon detecting an atrial rate above said high rate limit; (a) delivering ventricular pace pulses to a patient without a timed relationship to detected atrial events, (b) changing a V--V escape interval of delivered ventricular pace pulses, and determining when one or more said changed interval delivered ventricular pace pulses fail to result in full capture of the ventricle, and (c) shortening said V--V escape interval in response to a determination of such a failure.
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Specification