Suppression of high rate pacing for reducing myocardial ischemic irritability
First Claim
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1. A method of controlling delivery of therapy in a medical device, comprising:
- sensing physiologic signals of a patient;
delivering the therapy in response to the sensed signals;
determining the presence of increased myocardial irritability that occurs in response to the delivered therapy; and
adjusting an upper pacing rate limit associated with the delivering of the therapy to an adjusted upper pacing rate limit below a programmed upper pacing rate limit in response to determining the presence of increased myocardial irritability occurring in response to the delivered therapy, wherein determining the presence of increased myocardial irritability comprises detecting one of a non-sustained ventricular tachycardia event that spontaneously reverts to normal sinus rhythm, a non-sustained ventricular fibrillation event that spontaneously reverts to normal sinus rhythm, a minimum rate of premature ventricular contractions, and prediction of a ventricular tachycardia cluster.
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Abstract
A medical device capable of delivering automatic rate-adjusting pacing therapies is provided having an adjustable upper rate limit responsive to an indication of myocardial irritability. The device, which may be embodied as a pacemaker, a pacemaker/cardioverter/defibrillator, or the like, responds to the detection of an arrhythmia as an indicator of myocardial irritability by adjusting an upper rate limit. The adjusted upper rate limit is applied as the maximum allowable pacing rate during delivery of any pacing therapies previously defined as “long-term” pacing therapies.
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Citations
20 Claims
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1. A method of controlling delivery of therapy in a medical device, comprising:
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sensing physiologic signals of a patient; delivering the therapy in response to the sensed signals; determining the presence of increased myocardial irritability that occurs in response to the delivered therapy; and adjusting an upper pacing rate limit associated with the delivering of the therapy to an adjusted upper pacing rate limit below a programmed upper pacing rate limit in response to determining the presence of increased myocardial irritability occurring in response to the delivered therapy, wherein determining the presence of increased myocardial irritability comprises detecting one of a non-sustained ventricular tachycardia event that spontaneously reverts to normal sinus rhythm, a non-sustained ventricular fibrillation event that spontaneously reverts to normal sinus rhythm, a minimum rate of premature ventricular contractions, and prediction of a ventricular tachycardia cluster. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A medical device for delivering therapy to a patient, comprising:
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a plurality of electrodes configured to sense physiologic signals of a patient and deliver the therapy; a control unit, coupled to the plurality of electrodes, configured to control delivery of the therapy in response to the sensed signals; a microprocessor, coupled to the control unit, configured to determine the presence of increased myocardial irritability that occurs in response to the delivered therapy, wherein the control unit is further configured to adjust an upper pacing rate limit associated with the delivery of the therapy to an adjusted upper pacing rate limit below a programmed upper pacing rate limit in response to the microprocessor determining the presence of increased myocardial irritability that occurs in response to the delivered therapy, wherein determining the presence of increased myocardial irritability comprises detecting one of a non-sustained ventricular tachycardia event that spontaneously reverts to normal sinus rhythm, a non-sustained ventricular fibrillation event that spontaneously reverts to normal sinus rhythm, a minimum rate of premature ventricular contractions, and prediction of a ventricular tachycardia cluster. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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19. A method of controlling delivery of therapy in a medical device, comprising:
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sensing physiologic signals of a patient; determining the presence of a cardiac event in response to the sensed signals; delivering the therapy at a predetermined pacing rate in response to the determined cardiac event; determining whether the delivered therapy is one of a short term therapy having a first duration and a long term therapy having a second duration greater than the first duration; continuing delivery of the therapy at the predetermined pacing rate in response to the delivered therapy being a short term therapy; determining, in response to the delivered therapy being a long term therapy, whether an increase in myocardial irritability occurs in response to the delivered therapy; and reducing an upper pacing rate limit associated with the delivering of the therapy to an adjusted upper pacing rate limit below a programmed upper rate limit in response to an increase myocardial irritability occurring in response to the delivered therapy, wherein determining whether an increase in myocardial irritability occurs comprises detecting one of a non-sustained ventricular tachycardia event that spontaneously reverts to normal sinus rhythm, a non-sustained ventricular fibrillation event that spontaneously reverts to normal sinus rhythm, a minimum rate of premature ventricular contractions, and prediction of a ventricular tachycardia cluster. - View Dependent Claims (20)
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Specification