System and method for timing synchronized pacing

• US 6,574,506 B2
• Filed: 12/26/2000
• Issued: 06/03/2003
• Est. Priority Date: 12/26/2000
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Kramer, Andrew P.
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US09/748,736
• Publication Number:
  US 20020082654A1
• Time in Patent Office: 889 Days
• Field of Search: 607/15, 607/9, 607/4, 607/14
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

A device and method for cardiac rhythm management in which a heart chamber is paced in accordance with sense signals from the opposite chamber or other distant cardiac site. In an exemplary embodiment, a rate chamber and a synchronized chamber are defined. The synchronized chamber is then paced in accordance with a synchronized pacing mode such that a synchronized chamber pace is delivered at a specified pacing instant defined with respect to expiration of a rate chamber escape interval based upon rate chamber events. The method is particularly useful in delivering cardiac resynchronization therapy.

Claims

1. A method for operating a cardiac rhythm management device, comprising:

sensing a heart chamber designated as a rate chamber and generating a rate chamber sense upon detection of depolarization occurring in the rate chamber;

sensing a heart chamber contralateral to the rate chamber designated as a synchronized chamber and generating a synchronized chamber sense upon detection of depolarization occurring in the synchronized chamber;

pacing the synchronized chamber upon expiration of an escape interval;

restarting the escape interval after a synchronized chamber pace;

restarting the escape interval after a rate chamber sense; and

,

wherein the escape interval is not restarted after a synchronized chamber sense.

2. The method of claim 1 further comprising:

starting a synchronized chamber protection period of specified duration after a synchronized chamber sense; and

,

inhibiting pacing of the synchronized chamber for the duration of the synchronized chamber protection period.

3. The method of claim 2 wherein the escape interval is restarted upon expiration if the synchronized chamber pace is inhibited.

4. The method of claim 1 wherein the paired ventricles are the rate and synchronized chambers.

5. The method of claim 1 wherein the paired atria are the rate and synchronized chambers.

6. The method of claim 1 further comprising pacing one or more additional synchronized pacing sites in the synchronized chamber at pacing instants defined with respect to expiration of the escape interval.

7. The method of claim 1 wherein a rate chamber pace is inhibited by a rate chamber pseudo-pace coincident with a synchronized chamber pace.

9. The method of claim 2 further comprising pacing the rate chamber upon expiration of the escape interval if the synchronized chamber is inhibited wherein the rate chamber pace restarts the escape interval.

8. A method for operating a cardiac rhythm management device, comprising:

sensing rate and synchronized heart chambers through separate channels and generating sense signals upon detection of depolarization occurring in a chamber; and

,

pacing the synchronized chamber in accordance with a synchronized pacing mode wherein a synchronized chamber pace is delivered at a specified pacing instant defined with respect to expiration of a rate chamber escape interval based upon rate chamber events, wherein the rate chamber escape interval is reset upon a rate chamber sense and upon delivery of a pace to either chamber.

10. A cardiac rhythm management device, comprising:

means for sensing a heart chamber designated as a rate chamber and generating a rate chamber sense upon detection of depolarization occurring in the rate chamber;

means for sensing a heart chamber contralateral to the rate chamber designated as a synchronized chamber and generating a synchronized chamber sense upon detection of depolarization occurring in the synchronized chamber;

means for pacing the synchronized chamber upon expiration of an escape interval; and

,

means for restarting the escape interval after a synchronized chamber pace and after a rate chamber sense but not after a synchronized chamber sense.

11. The device of claim 10 further comprising:

means for sensing the synchronized chamber and generating a synchronized chamber sense upon detection of depolarization occurring in the synchronized chamber; and

,

means for starting a synchronized chamber protection period of specified duration after a synchronized chamber sense; and

,

means for inhibiting pacing of the synchronized chamber for the duration of the synchronized chamber protection period.

12. The device of claim 11 further comprising means for restarting the escape interval upon expiration if the synchronized chamber pace is inhibited.

13. The device of claim 11 further comprising means for pacing the rate chamber upon expiration of the escape interval if the synchronized chamber is inhibited wherein the rate chamber pace restarts the escape interval.

14. The device of claim 10 wherein the device is configured with the paired ventricles as the rate and synchronized chambers.

15. The device of claim 10 wherein the device is configured with the paired atria as the rate and synchronized chambers.

16. The device of claim 10 further comprising means for pacing one or more additional sites in the synchronized chamber at pacing instants defined with respect to expiration of the escape interval.

17. The device of claim 10 further comprising means for inhibiting a rate chamber pace by a rate chamber pseudo-pace coincident with a synchronized chamber pace.

18. A cardiac rhythm management device, comprising:

means for sensing rate and synchronized heart chambers through separate channels and generating sense signals upon detection of depolarization occurring in a chamber; and

,

means for pacing the synchronized chamber in accordance with a synchronized pacing mode wherein a synchronized chamber pace is delivered at a specified pacing instant defined with respect to expiration of a rate chamber escape interval based upon rate chamber events, wherein the rate chamber escape interval is reset upon a rate chamber sense and upon delivery of a pace to either chamber.