Cardiac rhythm management system with maximum tracking rate (MTR) hysteresis
First Claim
1. A method, including:
- sensing a first cardiac signal from a ventricular location;
detecting ventricular depolarizations from the first cardiac signal;
determining a heart rate based on the ventricular depolarizations;
comparing the heart rate to a first predetermined value and a second predetermined value, the second value larger than the first value;
setting a maximum ventricular pacing rate to the first predetermined value when the heart rate exceeds the second predetermined value; and
setting the maximum ventricular pacing rate to the second predetermined value when the heart rate falls below a predetermined threshold.
1 Assignment
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Accused Products
Abstract
A cardiac rhythm management system provides both a safe maximum pacing rate limit and a physiological maximum pacing rate limit. The present subject matter provides a solution to problems associated with the use of a single maximum tracking rate (MTR). In one embodiment, the present subject matter utilizes two MTRs, where the first is a normal MTR and the second is a hysteresis MTR. In one embodiment, the hysteresis MTR is set higher than the normal MTR. The hysteresis MTR functions as a maximum pacing rate limit while tracking an atrial rate until the atrial rate exceeds the hysteresis MTR limit. When the atrial rate exceeds the hysteresis MTR limit, the maximum pacing rate limit is set to the normal MTR. Once the atrial rate falls below a predetermined threshold, the maximum pacing rate limit is set to the hysteresis MTR. The predetermined threshold may be set to the normal MTR, the hysteresis MTR, or other rates. In one embodiment, changing the maximum pacing rate limit in this fashion allows for uninterrupted pacing treatment for patients, such as congestive heart failure (CHF) patients, who may display fast but physiologically normal heart rates and need cardiac resynchronization therapy (CRT) at such fast heart rates. Such a pacing treatment provides for a more rapid and natural maximum pacing rate limit for the patient, while still protecting the patient from being paced at abnormally high rates.
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Citations
22 Claims
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1. A method, including:
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sensing a first cardiac signal from a ventricular location;
detecting ventricular depolarizations from the first cardiac signal;
determining a heart rate based on the ventricular depolarizations;
comparing the heart rate to a first predetermined value and a second predetermined value, the second value larger than the first value;
setting a maximum ventricular pacing rate to the first predetermined value when the heart rate exceeds the second predetermined value; and
setting the maximum ventricular pacing rate to the second predetermined value when the heart rate falls below a predetermined threshold. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A cardiac rhythm management system, including:
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a first lead adapted to sense a first cardiac signal in or about a ventricle of a heart;
a first sensing circuit, coupled to the first lead, including;
a first sense amplifier, coupled to the first lead, to receive the first cardiac signal; and
a first cardiac depolarization detector, coupled to the first sense amplifier, to detect ventricular depolarizations in the first cardiac signal;
a controller, coupled to the first sensing circuit, including;
a rate detector, coupled to the first cardiac depolarization detector, to determine a heart rate from detected ventricular depolarizations, a comparator, coupled to the rate detector, including inputs representative of the heart rate and at least one of a first predetermined value, a second predetermined value, and a predetermined threshold and one or more outputs representative of whether the heart rate exceeds the second predetermined value and whether heart rate falls below the predetermined threshold;
a storage medium, coupled to the comparator, including the first predetermined value, the second predetermined value, and the predetermined threshold; and
a pacing algorithm module, coupled to the comparator, to set a maximum ventricular pacing rate to the first predetermined value when the heart rate exceeds the second predetermined value, and set the maximum ventricular pacing rate to the second predetermined value when the heart rate falls below a predetermined threshold. - View Dependent Claims (18, 19, 20, 21, 22)
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Specification