System and method for cardiac rhythm management with synchronized pacing protection period
First Claim
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1. 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;
pacing the rate chamber upon expiration of an escape interval;
pacing the synchronized chamber at a pacing instant defined to occur prior to expiration of the escape interval by a specified offset interval;
resetting the escape interval after a rate chamber pace;
resetting the escape interval after a rate chamber sense; and
, initiating a synchronized chamber protection period of predetermined duration after a synchronized chamber sense during which a pace to the synchronized chamber is inhibited.
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Abstract
A device and method for cardiac rhythm management in which a heart chamber is paced in accordance with a pacing mode that employs sense signals from the opposite chamber. A protection period triggered by the sensing of intrinsic activity in the paced chamber is used to inhibit pacing without otherwise disturbing the pacing algorithm.
86 Citations
20 Claims
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1. A method for operating a cardiac rhythm management device, comprising:
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sensing rate and synchronized heart chambers through separate channels and generating sense signals upon detection of depolarization occurring in a chamber;
pacing the rate chamber upon expiration of an escape interval;
pacing the synchronized chamber at a pacing instant defined to occur prior to expiration of the escape interval by a specified offset interval;
resetting the escape interval after a rate chamber pace;
resetting the escape interval after a rate chamber sense; and
,initiating a synchronized chamber protection period of predetermined duration after a synchronized chamber sense during which a pace to the synchronized chamber is inhibited. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
sensing an atrium and generating an atrial sense upon detection of depolarization occurring in the atrium;
restarting the atrio-ventricular escape interval after an atrial sense; and
,resetting the atrio-ventricular escape interval after a rate chamber sense and a rate chamber pace such that the atrio-ventricular escape interval is stopped but not restarted.
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7. The method of claim 1 further comprising pseudo-pacing the rate chamber with a virtual pace prior to expiration of the escape interval so as to reset the escape interval and result in synchronized chamber-only pacing.
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8. The method of claim 7 further comprising delivering a safety pace to the rate chamber if the synchronized chamber pace is inhibited by the synchronized chamber protection period.
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9. The method of claim 7 further comprising pacing the synchronized chamber in a triggered synchronized pacing mode.
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10. The method of claim 9 wherein a pace to the synchronized chamber may be triggered by the synchronized chamber sense and wherein the synchronized chamber protection period starts only after a specified delay from the synchronized chamber sense, which allows triggered pacing but prevents pacing during the vulnerable period of the synchronized chamber.
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11. A cardiac rhythm management device, comprising:
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sensing channels for sensing depolarizations from heart chambers designated as a rate chamber and a synchronized chamber;
pacing channels for pacing the synchronized and rate chambers;
a controller for controlling the delivery of paces in accordance with a programmed pacing mode;
wherein the controller is programmed to;
pace the rate chamber upon expiration of an escape interval;
pace the synchronized chamber at a pacing instant defined to occur prior to expiration of the escape interval by a specified offset interval;
reset the escape interval after a rate chamber pace;
reset the escape interval after a rate chamber sense; and
,initiate a synchronized chamber protection period of predetermined duration after a synchronized chamber sense during which a pace to the synchronized chamber is inhibited. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
sense an atrium and generating an atrial sense upon detection of depolarization occurring in the atrium;
restart the atrio-ventricular escape interval after an atrial sense; and
,reset the atrio-ventricular escape interval after a rate chamber sense and a rate chamber pace such that the atrio-ventricular escape interval is stopped but not restarted.
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17. The device of claim 11 wherein the controller is programmed to pseudo-pace the rate chamber with a virtual pace prior to expiration of the escape interval so as to reset the escape interval and result in synchronized chamber-only pacing.
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18. The device of claim 17 wherein the controller is programmed to deliver a safety pace to the rate chamber if the synchronized chamber pace is inhibited by the synchronized chamber protection period.
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19. The device of claim 17 wherein the controller is programmed to further pace the synchronized chamber in a triggered synchronized pacing mode.
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20. The device of claim 19 wherein a pace to the synchronized chamber may be triggered by the synchronized chamber sense and wherein the synchronized chamber protection period starts only after a specified delay from such a triggering event, which allows triggered pacing but prevents pacing during the vulnerable period of the synchronized chamber.
Specification