Methods and apparatus for preventing atrial arrhythmias by overdrive pacing multiple heart tissue sites using an implantable cardiac stimulation device
First Claim
1. A method for overdrive pacing a patient'"'"'s heart using an implantable cardiac stimulation device connected to a plurality of electrodes implanted in a patient'"'"'s heart, the method comprising:
- sensing intrinsic atrial depolarizations of the patient'"'"'s heart;
determining an overdrive pacing rate based on the intrinsic atrial depolarizations; and
overdrive pacing the heart via the plurality of electrodes at the overdrive pacing rate, wherein the plurality of electrodes define at least two independent electrode configurations, and wherein each of the electrode configurations independently stimulates the heart;
wherein sensing comprises individually sensing depolarizations from the plurality of electrodes and determining comprises determining the overdrive pacing rate according to the highest sensed depolarization rate.
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Abstract
Techniques are described for pacing multiple sites in a patient'"'"'s heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
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Citations
18 Claims
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1. A method for overdrive pacing a patient'"'"'s heart using an implantable cardiac stimulation device connected to a plurality of electrodes implanted in a patient'"'"'s heart, the method comprising:
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sensing intrinsic atrial depolarizations of the patient'"'"'s heart; determining an overdrive pacing rate based on the intrinsic atrial depolarizations; and overdrive pacing the heart via the plurality of electrodes at the overdrive pacing rate, wherein the plurality of electrodes define at least two independent electrode configurations, and wherein each of the electrode configurations independently stimulates the heart; wherein sensing comprises individually sensing depolarizations from the plurality of electrodes and determining comprises determining the overdrive pacing rate according to the highest sensed depolarization rate. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. An implantable cardiac stimulation device configured for overdrive pacing a patient'"'"'s heart via a plurality of electrodes that are adapted to be implanted in a patient'"'"'s heart, the device comprising:
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at least one sensing circuit that is operative to sense intrinsic atrial depolarizations of the Patient'"'"'s heart via one or more of the plurality of electrodes; a controller that is operative to determine an overdrive pacing rate based on the sensed atrial depolarizations; and at least one pulse generator that is controlled by the controller to generate pacing pulses at the overdrive pacing rate for delivery to the heart via the plurality of electrodes; wherein the plurality of electrodes define at least two independent electrode sets, and wherein each of the electrode sets comprises at least one electrode and wherein each of the electrode sets receives the pacing pulses from the pulse generator and independently stimulates the heart; wherein the at least one sensing circuit comprises a first and second sensing circuit for individually sensing depolarizations from the plurality of electrodes; and wherein the controller determines the overdrive pacing rate according to the highest sensed depolarization rate. - View Dependent Claims (9, 10, 11, 12, 13, 14, 15, 16)
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17. An implantable cardiac stimulation device configured for overdrive pacing a patient'"'"'s heart via a plurality of electrodes that are adapted to be implanted in a patient'"'"'s heart, the device comprising:
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at least one sensing circuit that is operative to sense intrinsic atrial depolarizations of the patient'"'"'s heart via one or more of the plurality of electrodes; a controller that is operative to determine an overdrive pacing rate based on the sensed atrial depolarizations; and at least one pulse generator that is controlled by the controller to generate pacing pulses at the overdrive pacing rate for delivery to the heart via the plurality of electrodes; and wherein the plurality of electrodes define at least two independent electrode sets, and wherein each of the electrode sets comprises at least one electrode and wherein each of the electrode sets receives the pacing pulses from the pulse generator and independently stimulates the heart; and wherein the controller further comprises means for determining a sinus rate and means for setting the overdrive pacing rate to be equal to the sinus rate.
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18. A system for controlling overdrive pacing of a patient'"'"'s heart, the system comprising:
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means for sensing intrinsic atrial depolarizations; means for determining an overdrive pacing rate based on the intrinsic atrial depolarizations; means for overdrive pacing the heart at the overdrive pacing rate and at a plurality of independent stimulation sites; means for determining a sinus rate; and means for setting the overdrive pacing rate to be equal to the sinus rate.
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Specification