System and method for alleviating the effects of pacemaker crosstalk
DCFirst Claim
1. In an dual-chamber implantable stimulation device having an atrial and a ventricular channel, each channel having pulse generating means for generating stimulation pulses and sensing means for sensing cardiac signals in a respective chamber of the heart, an improved system for preventing crosstalk from potentially inhibiting a ventricular stimulation pulse, the improvement comprising:
- control circuitry, coupled to the pulse generating means and the sensing means on each channel, for controlling the application of stimulation pulses to both chambers of the heart, wherein the control circuitry includes;
means for triggering generation of an atrial stimulation pulse at an initial time and for initiating an absolute blanking interval on the ventricular channel by disabling the ventricular sensing means for an absolute blanking interval beginning at the initial time and ending at a final time; and
means for initiating, beginning at the final time, a retriggerable relative blanking interval on the ventricular channel during which the ventricular sensing means is enabled, such that if a signal is detected by the ventricular sensing means during one of the relative blanking intervals, then the control circuitry immediately initiates a successive relative blanking interval.
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Abstract
Methods and apparatus are provided for alleviating the effects of crosstalk in an implantable stimulation device. An autoblanking approach is provided whereby the total blanking interval is made up of an absolute blanking interval followed by a retriggerable relative blanking interval. The implantable stimulation device sensing circuitry is disabled during the absolute blanking interval and enabled during the relative blanking intervals. If a signal is detected during a relative blanking interval, a successive relative blanking interval is initiated. If no signal is detected, then relative blanking terminates. Further, an approach for combining safety standby pacing with autoblanking is provided. If autoblanking terminates before the crosstalk sensing interval reaches a maximum blanking interval, then safety standby pacing is cancelled. Another aspect of the invention relates to monitoring the amount of time in a safety standby sensing window during which signals are detected. If signals are detected longer than a predetermined time, then a safety standby stimulation pulse is provided, otherwise, safety standby pacing is inhibited.
124 Citations
22 Claims
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1. In an dual-chamber implantable stimulation device having an atrial and a ventricular channel, each channel having pulse generating means for generating stimulation pulses and sensing means for sensing cardiac signals in a respective chamber of the heart, an improved system for preventing crosstalk from potentially inhibiting a ventricular stimulation pulse, the improvement comprising:
control circuitry, coupled to the pulse generating means and the sensing means on each channel, for controlling the application of stimulation pulses to both chambers of the heart, wherein the control circuitry includes; means for triggering generation of an atrial stimulation pulse at an initial time and for initiating an absolute blanking interval on the ventricular channel by disabling the ventricular sensing means for an absolute blanking interval beginning at the initial time and ending at a final time; and means for initiating, beginning at the final time, a retriggerable relative blanking interval on the ventricular channel during which the ventricular sensing means is enabled, such that if a signal is detected by the ventricular sensing means during one of the relative blanking intervals, then the control circuitry immediately initiates a successive relative blanking interval. - View Dependent Claims (2, 3, 4)
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5. A method for autoblanking for preventing crosstalk from potentially inhibiting a ventricular stimulation pulse, the implantable stimulation device comprising a first and second channel coupled to a first and second chamber of the heart, respectively, the first channel including first pulse generating means for generating stimulation pulses and first sensing means for sensing cardiac signals, the second channel including second pulse generating means for generating stimulation pulses and second sensing means for sensing cardiac signals, the method comprising the steps of:
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generating of a first stimulation pulse on the first channel at an initial time; initiating an absolute blanking interval by disabling the second sensing means for an absolute blanking interval beginning at the initial time and ending at a final time; initiating at the final time a retriggerable relative blanking interval on the second channel during which the second sensing means is enabled; monitoring the second sensing means for signals on the second channel during the relative blanking interval; and initiating a successive relative blanking interval on the second channel immediately following one of the relative blanking intervals if a signal is detected by the second sensing means during one of the relative blanking intervals. - View Dependent Claims (6, 7, 8)
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9. An implantable stimulation device for alleviating crosstalk, the implantable device including a first and a second channel, each channel having pulse generating means for generating stimulation pulses and sensing means for sensing cardiac signals in a respective chamber of the heart, comprising:
control circuitry, coupled to the pulse generating means and the sensing means on each channel, for controlling the application of stimulation pulses to both chambers of the heart, wherein the control circuitry includes; means for initiating the generation of a stimulation pulse on the first channel at an initial time; means for initiating a retriggerable crosstalk sensing interval on the second channel beginning at the initial time, the crosstalk sensing interval having a total length which may be varied up to a predetermined maximum blanking interval; means for initiating a safety standby sensing window immediately following the crosstalk sensing interval when the crosstalk sensing interval reaches the predetermined maximum blanking interval before terminating; and means for enabling the sensing means on the second channel during the safety standby sensing window, so that when a signal is detected on the second channel during the safety standby sensing window the control circuit initiates generation of a safety standby stimulation pulse on the second channel. - View Dependent Claims (10)
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11. A method of safety standby pacing in a implantable stimulation device in which implantable stimulation device pulses applied to patient'"'"'s heart on a first channel can result in crosstalk on a second channel, comprising the steps of:
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initiating generation of a stimulation pulse on the first channel at an initial time; initiating a retriggerable crosstalk sensing interval on the second channel beginning at the initial time, the crosstalk sensing interval having a total length which may be varied up to a predetermined maximum blanking interval; initiating a safety standby sensing window immediately following the crosstalk sensing interval when the crosstalk sensing interval reaches the predetermined maximum blanking interval before terminating; monitoring signals on the second channel during the safety standby sensing window; and initiating application of a safety standby stimulation pulse on the second channel whenever a signal is detected during the safety standby sensing window. - View Dependent Claims (12)
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13. An implantable stimulation device for alleviating crosstalk which occurs when implantable stimulation device pulses applied to a patient'"'"'s heart on a first implantable stimulation device channel result in signals on a second implantable stimulation device channel, comprising:
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first pulse generating means for generating stimulation pulses on the first channel; sensing means for detecting cardiac signals on the second channel; and second pulse generating means for generating stimulation pulses on the second channel; and control circuitry for controlling application of stimulation pulses, wherein the control circuitry includes; means for initiating generation of a stimulation pulse on the first channel at an initial time; means for initiating a blanking interval on the second channel beginning at the initial time; and means for initiating a safety standby sensing window immediately following the termination of the blanking interval; means for enabling the sensing means during the safety standby sensing window; means for determining an amount of time for which a signal is detected on the second channel during the safety standby sensing window; means for initiating generation of a safety standby stimulation pulse on the second channel with the second pulse generating means when the amount of time is greater than a predetermined time interval; and means for inhibiting application of the safety standby stimulation pulse when the amount of time is less than the predetermined time interval. - View Dependent Claims (14, 15, 16, 17)
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18. A method of safety standby pacing in an implantable stimulation device in which implantable stimulation device pulses applied to a patient'"'"'s heart on a first channel can result in crosstalk on a second channel, comprising the steps of:
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initiating the generation of a stimulation pulse on the first channel at an initial time; initiating a blanking interval on the second channel beginning at the initial time; initiating a safety standby sensing window immediately following the blanking interval; detecting signals on the second channel during the safety standby sensing window; determining an amount of time for which the signals are detected; initiating the application of a safety standby stimulation pulse on the second channel when the amount of time is greater than a predetermine time interval; and inhibiting the application of a safety standby stimulation pulse on the second channel when the amount of time is less than the predetermined time interval. - View Dependent Claims (19, 20, 21, 22)
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Specification