System for inducing tachycardia utilizing near field T-wave sensing
First Claim
1. An implantable pacing system, comprising:
- a pacing pulse generator for generating pacing pulses;
a lead with at least one electrode for delivery of pacing pulses at a location of a predetermined one of the patient'"'"'s heart chambers, said lead having a conductor for conducting said pacing pulses from said generator to said electrode;
near field means electrically connected to said electrode for sensing repolarization waves from near said location and for determining the timing of a predetermined portion of each said repolarization wave; and
control means for controlling the timing of generation of pacing pulses by said generator, said control means having series means for controlling generation of a first series of pacing pulses for evoking heartbeats, and inducing means for controlling generation of an inducing pacing pulse as a function of the timing of each said repolarization portion evoked by a pacing pulse of said first series.
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Accused Products
Abstract
A system and method are provided for inducing ventricular tachycardia in a patient to enable testing to determine the optimum parameters for anti-tachycardia stimulation. The implantable device provides for overdrive pacing of the heart for a short sequence, followed by delivery of a series of pulse pairs. Each pulse pair has a first stimulus pulse delivered at the same or similar overdrive rate, and an inducing pulse which is delivered in timed relation to the evoked T-wave, preferably during the falling edge portion of the T-wave. In this way, each cycle the inducing pulse is timed for efficaciously inducing tachycardia. The timing of the inducing pulse is enhanced by near field sensing of the T-wave at about the location where the pulses are delivered, preferably using bipolar sensing and/or sense circuitry designed to recover the signal with an optimum time response. In one preferred embodiment, near field sensing is enabled by use of an FDC circuit. In another preferred embodiment, near field sensing is provided by a pacing lead having bipolar electrodes where the ring electrode is spaced less than 1 mm proximal to the tip electrode.
34 Citations
21 Claims
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1. An implantable pacing system, comprising:
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a pacing pulse generator for generating pacing pulses; a lead with at least one electrode for delivery of pacing pulses at a location of a predetermined one of the patient'"'"'s heart chambers, said lead having a conductor for conducting said pacing pulses from said generator to said electrode; near field means electrically connected to said electrode for sensing repolarization waves from near said location and for determining the timing of a predetermined portion of each said repolarization wave; and control means for controlling the timing of generation of pacing pulses by said generator, said control means having series means for controlling generation of a first series of pacing pulses for evoking heartbeats, and inducing means for controlling generation of an inducing pacing pulse as a function of the timing of each said repolarization portion evoked by a pacing pulse of said first series. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A system for inducing an abnormally high rate in a patient'"'"'s ventricle, comprising:
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pacing pulse means for generating a series of pacing pulses at about a predetermined rate; lead means for delivering said pacing pulses to a location of said ventricle; near field means for obtaining near field T wave signals from near said location, and determining means for determining a falling edge portion of each said near field T wave signal; and inducing means for triggering said pacing pulse means to generate an inducing pulse following each said determined falling edge portion, said inducing means comprising timing means for timing an inducing pulse in a predetermined time relation to each said near field T wave signal, whereby a series of inducing pulses are delivered to said patient'"'"'s ventricle. - View Dependent Claims (8, 9, 10, 11, 12, 13)
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14. A system for inducing an abnormally high rate in a patient'"'"'s ventricle, comprising:
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pacing pulse means for generating a series of pacing pulses at about a predetermined rate; lead means for delivering said pacing pulses to a location of said ventricle and for sensing cardiac signals, said lead means having a tip electrode for positioning at about said location and a ring electrode spaced proximally from said tip electrode by an inter-electrode distance of less than about 1 mm, whereby near field T wave signals are obtained between said electrodes; and inducing means for triggering said pacing pulse means to generate an inducing pulse following each said obtained near field T wave signal, said inducing means comprising timing means for timing an inducing pulse in a predetermined time relation to each said near field T wave signal, whereby a series of inducing pulses are delivered to said patient'"'"'s ventricle. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21)
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Specification