Dual-chamber implantable pacemaker having negative AV/PV hysteresis and ectopic discrimination
First Claim
1. A dual-chamber programmable pacemaker for enhancing cardiac performance of a patient suffering from hypertrophic obstructive cardiomyopathy, comprising:
- sensing means for sensing P-waves and R-waves, associated with natural atrial and ventricular contractions, respectively;
means for storing a morphology signal for a naturally-conducted selected reference R-wave resulting from a natural ventricular depolarization;
means for comparing the reference R-wave and a current R-wave and for verifying, based on such comparison, whether the current R-wave has the morphology of a naturally-conducted R-wave or is the result of an ectopic R-wave;
processing means for adjusting an AV/PV interval in accordance with a predetermined strategy when it is verified that a current R-wave has the morphology of a selected reference R-wave and wherein the current R-wave is considered an ectopic R-wave when the current R-wave does not have the morphology of a selected reference R-wave.
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Abstract
A dual-chamber implantable pacemaker is configured to operate in the DDD or DDDR mode with its AV (or PV) interval automatically set to be a small time interval less than the natural conduction time of a patient. The pacemaker shortens the AV (or PV) interval in response to a verified R-wave occurring within the AV (PV) interval, which it discriminates from an ectopic R-wave by requiring the occurrence of at least three consecutive R-waves or, alternatively, the occurrence of an R-wave having a morphology that matches the morphology of a reference R-wave stored in the pacemaker'"'"'s memory. When the AV (or PV) interval is set to a value that is less than the natural conduction time, preemptive ventricular pacing.
95 Citations
15 Claims
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1. A dual-chamber programmable pacemaker for enhancing cardiac performance of a patient suffering from hypertrophic obstructive cardiomyopathy, comprising:
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sensing means for sensing P-waves and R-waves, associated with natural atrial and ventricular contractions, respectively; means for storing a morphology signal for a naturally-conducted selected reference R-wave resulting from a natural ventricular depolarization; means for comparing the reference R-wave and a current R-wave and for verifying, based on such comparison, whether the current R-wave has the morphology of a naturally-conducted R-wave or is the result of an ectopic R-wave; processing means for adjusting an AV/PV interval in accordance with a predetermined strategy when it is verified that a current R-wave has the morphology of a selected reference R-wave and wherein the current R-wave is considered an ectopic R-wave when the current R-wave does not have the morphology of a selected reference R-wave. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method of operating a dual-chamber programmable pacemaker for enhancing cardiac performance of a patient suffering from hypertrophic obstructive cardiomyopathy, comprising the steps of:
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sensing an R-wave; storing morphology signals for a naturally-conducted selected reference R-wave; comparing the morphology of a current sensed R-wave with the morphology of a stored reference R-wave to verify that the sensed R-wave has the morphology of a conducted ventricular contraction and is not the result of an ectopic ventricular contraction; setting an AV/PV interval in accordance with a predetermined strategy when a sensed R-wave is verified as resulting from a conducted ventricular contraction. - View Dependent Claims (10, 11, 12, 13, 14, 15)
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Specification