System and method for promoting intrinsic conduction through atrial timing
First Claim
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1. A method comprising:
- operating an implantable medical device according to a ventricular pacing protocol (VPP) wherein ventricular pacing is precluded in a given cardiac cycle where a ventricular event occurred in a cardiac cycle immediately prior to the given cardiac cycle;
establishing an A-A interval;
initiating a first AV interval timer having a duration that is shorter than the A-A interval at the initiation of the given cardiac cycle;
sensing for ventricular events;
scheduling an atrial pacing pulse prior to the termination of the A-A interval if no ventricular event is sensed within the duration of the AV interval timer; and
delivering the atrial pacing pulse subsequent to the expiration of the first AV interval timer and prior to termination of the A-A interval if no ventricular activity is sensed within the first AV interval timer.
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Abstract
An atrial based pacing protocol promotes intrinsic conduction. An entire cardiac cycle is monitored for ventricular activity and permitted to lapse with ventricular activity. Ventricular pacing is available in a cardiac cycle immediately subsequent to such a skipped beat. When monitoring for intrinsic ventricular events, an event is expected within a given window. If no such event is detected, the cardiac cycle in truncated, leading to a shorter cycle that is devoid of ventricular activity. The subsequent cycle has a high likelihood of a ventricular sensed event and a greater than normal AV interval is provided prior to pacing.
119 Citations
20 Claims
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1. A method comprising:
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operating an implantable medical device according to a ventricular pacing protocol (VPP) wherein ventricular pacing is precluded in a given cardiac cycle where a ventricular event occurred in a cardiac cycle immediately prior to the given cardiac cycle; establishing an A-A interval; initiating a first AV interval timer having a duration that is shorter than the A-A interval at the initiation of the given cardiac cycle; sensing for ventricular events; scheduling an atrial pacing pulse prior to the termination of the A-A interval if no ventricular event is sensed within the duration of the AV interval timer; and delivering the atrial pacing pulse subsequent to the expiration of the first AV interval timer and prior to termination of the A-A interval if no ventricular activity is sensed within the first AV interval timer. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. An implantable medical device comprising:
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means for operating an implantable medical device (IMD) according to a ventricular pacing protocol (VPP) wherein ventricular pacing is precluded in a given cardiac cycle wherein a ventricular event occurred in a cardiac cycle immediately subsequent to the given cardiac cycle; means for establishing an A-A interval; means for initiating a first AV interval timer having a duration that is shorter than the A-A interval at the initiation of the given cardiac cycle; means for sensing for ventricular events; means for scheduling an atrial pacing pulse prior to the termination of the A-A interval if no ventricular event is sensed within the duration of the AV interval timer; and means for delivering the atrial pacing pulse subsequent to the expiration of the first AV interval timer and prior to termination of the A-A interval if no ventricular activity is sensed within the first AV interval timer. - View Dependent Claims (11, 12, 13, 14, 15, 16)
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17. A computer readable medium having instructions that when executed on a processor of an implantable medical device have cardiac pacing capabilities cause the IMD to:
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establish an A-A interval for a first cardiac cycle; initiate an AV interval timer having a duration that is shorter than the A-A interval concurrent with the initiation of the A-A interval; sense for a conducted ventricular event; schedule an atrial pace to shorten the A-A interval if no conducted ventricular event occurs prior to the expiration of the AV interval timer; and deliver the atrial pacing pulse subsequent to the expiration of the first AV interval timer and prior to termination of the A-A interval if no ventricular activity is sensed within the first AV interval timer. - View Dependent Claims (18, 19, 20)
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Specification