Atrial capture management during atrial and ventricular pacing
First Claim
1. In a pacing system adapted to be implanted in a patient'"'"'s body to provide atrial pacing at an atrial pacing rate exceeding a slow intrinsic atrial heart rate insufficient to provide adequate cardiac output comprising an implantable pulse generator, an atrial lead extending from the implantable pulse generator having at least one active atrial pace/sense electrode adapted to be disposed in operative relation to an atrial heart chamber, and an indifferent atrial pace/sense electrode adapted to be implanted in the patient'"'"'s body, the implantable pulse generator further comprising:
- atrial pace pulse generator means coupled to the active and indifferent atrial pace sense electrodes for delivering an atrial pace (A-PACE) pulse having an A-PACE pulse width and an A-PACE pulse amplitude to the atrial heart chamber;
atrial sensing means coupled to the active and indifferent atrial pace/sense electrodes for sensing intrinsic atrial depolarizations and declaring an A-EVENT;
A-A escape interval timing means for timing out an A-A escape interval following generation of an A-PACE pulse by said atrial pulse generator means and following an A-EVENT declared by the atrial sensing means; and
means for triggering said atrial pulse generator means to generate an A-PACE pulse at the expiration of the A-A escape interval whereby the atrial heart chamber is paced in the absence of an A-EVENT declared during the A-A escape interval, an atrial capture management (ACM) method for periodically determining an A-PACE pulse energy sufficient to reliably capture the atrium without being wasteful of battery energy from a test A-PACE pulse energy at atrial loss of capture (ALOC) further comprising;
defining an ACM test window exceeding a prevailing A-A escape interval and correlated to the slow intrinsic atrial heart rate;
setting the A-PACE pulse energy of a test A-PACE pulse;
triggering the atrial pace pulse generator means to deliver at least one test A-PACE pulse at the test A-PACE pulse energy during the ACM test window;
timing out the ACM test window;
declaring ALOC by the delivered test A-PACE pulse at the test A-PACE pulse energy if an A-EVENT is declared during the time-out of an ACM test window;
declaring atrial capture by the delivered test A-PACE pulse at the test A-PACE pulse energy in the absence of an A-EVENT declared during the ACM test window; and
setting the prevailing A-PACE pulse energy as a function of the test A-PACE pulse energy at ALOC.
1 Assignment
0 Petitions
Accused Products
Abstract
In an atrial pacing system, the A-PACE pulse energy, defined by the pulse width and pulse amplitude, sufficient to reliably capture the atrium without being wasteful of battery energy is periodically determined in accordance with atrial capture management (ACM) algorithms. The ACM algorithms allow a slow intrinsic atrial heart rate that is suppressed by delivered A-PACE pulses resulting in A-CAPTURE and that occurs when delivered test A-PACE pulses result in ALOC to be detected. ALOC is declared if an A-EVENT of the slow intrinsic atrial heart rate is detected either during an ACM test window timed from the last delivered test A-PACE pulse or during delivery of a sequence of test A-PACE pulses delivered within or defining the ACM test window correlated to the slow intrinsic atrial heart rate.
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Citations
22 Claims
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1. In a pacing system adapted to be implanted in a patient'"'"'s body to provide atrial pacing at an atrial pacing rate exceeding a slow intrinsic atrial heart rate insufficient to provide adequate cardiac output comprising an implantable pulse generator, an atrial lead extending from the implantable pulse generator having at least one active atrial pace/sense electrode adapted to be disposed in operative relation to an atrial heart chamber, and an indifferent atrial pace/sense electrode adapted to be implanted in the patient'"'"'s body, the implantable pulse generator further comprising:
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atrial pace pulse generator means coupled to the active and indifferent atrial pace sense electrodes for delivering an atrial pace (A-PACE) pulse having an A-PACE pulse width and an A-PACE pulse amplitude to the atrial heart chamber; atrial sensing means coupled to the active and indifferent atrial pace/sense electrodes for sensing intrinsic atrial depolarizations and declaring an A-EVENT; A-A escape interval timing means for timing out an A-A escape interval following generation of an A-PACE pulse by said atrial pulse generator means and following an A-EVENT declared by the atrial sensing means; and means for triggering said atrial pulse generator means to generate an A-PACE pulse at the expiration of the A-A escape interval whereby the atrial heart chamber is paced in the absence of an A-EVENT declared during the A-A escape interval, an atrial capture management (ACM) method for periodically determining an A-PACE pulse energy sufficient to reliably capture the atrium without being wasteful of battery energy from a test A-PACE pulse energy at atrial loss of capture (ALOC) further comprising; defining an ACM test window exceeding a prevailing A-A escape interval and correlated to the slow intrinsic atrial heart rate; setting the A-PACE pulse energy of a test A-PACE pulse; triggering the atrial pace pulse generator means to deliver at least one test A-PACE pulse at the test A-PACE pulse energy during the ACM test window; timing out the ACM test window; declaring ALOC by the delivered test A-PACE pulse at the test A-PACE pulse energy if an A-EVENT is declared during the time-out of an ACM test window; declaring atrial capture by the delivered test A-PACE pulse at the test A-PACE pulse energy in the absence of an A-EVENT declared during the ACM test window; and setting the prevailing A-PACE pulse energy as a function of the test A-PACE pulse energy at ALOC. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. In a pacing system adapted to be implanted in a patient'"'"'s body to provide atrial pacing at an atrial pacing rate exceeding a slow intrinsic atrial heart rate insufficient to provide adequate cardiac output comprising an implantable pulse generator, an atrial lead extending from the implantable pulse generator having at least one active atrial pace/sense electrode adapted to be disposed in operative relation to an atrial heart chamber, and an indifferent atrial pace/sense electrode adapted to be implanted in the patient'"'"'s body, the implantable pulse generator further comprising:
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atrial pace pulse generator means coupled to the active and indifferent atrial pace sense electrodes for delivering an atrial pace (A-PACE) pulse having an A-PACE pulse width and an A-PACE pulse amplitude to the atrial heart chamber; atrial sensing means coupled to the active and indifferent atrial pace/sense electrodes for sensing intrinsic atrial depolarizations and declaring an A-EVENT; A-A escape interval timing means for timing out an A-A escape interval following generation of an A-PACE pulse by said atrial pulse generator means and following an A-EVENT declared by the atrial sensing means; and means for triggering said atrial pulse generator means to generate an A-PACE pulse at the expiration of the A-A escape interval whereby the atrial heart chamber is paced in the absence of an A-EVENT declared during the A-A escape interval, atrial capture management (ACM) means for periodically determining an A-PACE pulse energy sufficient to reliably capture the atrium without being wasteful of battery energy from a test A-PACE pulse energy at atrial loss of capture (ALOC) further comprising; ACM test window defining means for defining an ACM test window exceeding the A-A escape interval and correlated to the slow intrinsic atrial heart rate; means for setting the A-PACE pulse energy of a test A-PACE pulse; means for triggering the atrial pace pulse generator means to deliver at least one test A-PACE pulse at the test A-PACE pulse energy; means for timing out the ACM test window; means responsive to an A-EVENT declared during the time-out of the ACM test window for declaring ALOC by the delivered test A-PACE pulse at the test A-PACE pulse energy; means responsive to the absence of an A-EVENT declared during the ACM test window for declaring atrial capture by the delivered test A-PACE pulse at the test A-PACE pulse energy; and means for setting the prevailing A-PACE pulse energy as a function of the test A-PACE pulse energy at ALOC. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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Specification