System and method for conditional biventricular pacing
First Claim
1. A medical device, comprising:
- an atrial pacing lead;
a right ventricular lead;
a left ventricular lead; and
a microprocessor operably coupled with the atrial pacing lead, the right ventricular lead and the left ventricular lead and configured to provide pacing stimuli according to a minimal bi-ventricular pacing protocol in the absence of both sensed atrioventricular (AV) decoupling and sensed AV uncoupling and to provide pacing stimuli according to a conditional triple chamber pacing protocol if one of AV decoupling and AV uncoupling is sensed.
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Accused Products
Abstract
An implantable pacing system with single, double and triple chamber pacing capabilities, provided individually or in concert on a conditional or continuous basis depending upon ongoing analyses of atrial rhythm status, atrioventricular conduction status and ventricular rate. A mode is selected to reduce the occurrence of any ventricular pacing in favor of intrinsic atrioventricular and ventricular conduction. If excessively long PR intervals are occurring too frequently or atrioventricular conduction is unreliable or absent, the implantable pulse generator is operated in a conditional triple chamber pacing mode that provides atrial-synchronous biventricular pacing in every cardiac cycle for a period of time as necessary to restore and maintain AV synchrony, while minimizing ventricular asynchrony otherwise associated with monochamber RV pacing as in conventional dual chamber pacing systems. Similarly, biventricular pacing is provided in every cardiac cycle when ventricular rates are undesirably slow during atrial fibrillation, where AV synchronization is excluded.
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Citations
23 Claims
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1. A medical device, comprising:
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an atrial pacing lead; a right ventricular lead; a left ventricular lead; and a microprocessor operably coupled with the atrial pacing lead, the right ventricular lead and the left ventricular lead and configured to provide pacing stimuli according to a minimal bi-ventricular pacing protocol in the absence of both sensed atrioventricular (AV) decoupling and sensed AV uncoupling and to provide pacing stimuli according to a conditional triple chamber pacing protocol if one of AV decoupling and AV uncoupling is sensed. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method of operating a medical device, comprising:
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operating the device in an atrial based mode of a minimal bi-ventricular pacing mode (MVBP); sensing ventricular activity; determining atrioventricular (AV) intervals in response to the sensed ventricular activity; determining the presence of AV decoupling based on the determined AV intervals; determining the presence of AV uncoupling in response to the sensed ventricular activity; and operating the device in a conditional triple chamber pacing (CTCP) mode if one of AV decoupling and AV uncoupling is determined to be present. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A non-transitory computer readable medium having computer executable instructions for performing a method in a medical device, the method comprising:
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operating the device in a minimal bi-ventricular pacing (MVBP) mode; sensing ventricular activity; determining atrioventricular (AV) intervals in response to the sensed ventricular activity; determining the presence of AV decoupling based upon the determined AV intervals; determining the presence of AV uncoupling based upon the sensed ventricular activity; and operating the device in a conditional triple chamber pacing (CTCP) mode if one of AV decoupling and AV uncoupling is determined to be present.
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Specification