Device and method for providing atrial-synchronized ventricular pacing with selective atrial tracking

• US 8,332,030 B2
• Filed: 04/27/2005
• Issued: 12/11/2012
• Est. Priority Date: 04/27/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Hess, Michael F., Warman, Eduardo N.
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US11/115,597
• Publication Number:
  US 20060247690A1
• Time in Patent Office: 2,785 Days
• Field of Search: 607/4, 607/9, 607/11
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

A device for delivering pacing therapy includes an atrial and ventricular leads, sensing circuitry connected to the leads for detecting depolarizations, and pulse generation circuitry for delivering ventricular pacing pulses based on sensed atrial depolarizations. The device includes control circuitry for controlling the pulse generation circuitry in a first mode in which the pulse generation circuitry delivers atrial synchronized pulses to both the right and left ventricular leads in response to each atrial depolarization sensed. In response to a detected atrial arrhythmia, the control circuitry causes the pulse generation circuitry to deliver atrial synchronized ventricular pacing pulses in response only to selected atrial depolarizations.

Claims

1. A device for providing pacing therapy, the device comprising:

an atrial lead for sensing electrical activity in an atrium;

a ventricular lead for sensing electrical activity in a ventricle and for delivering electrical pulses to the ventricle;

sensing circuitry connected to the atrial and ventricular leads for sensing depolarizations in the atrium and ventricle, respectively;

pulse generation circuitry connected to the ventricular lead for delivering pacing pulses to the ventricle, respectively; and

control circuitry responsive to sensed atrial depolarizations, for detecting atrial arrhythmias and for controlling the pulse generation circuitry in a mode in which the pulse generation circuitry delivers an atrial synchronized pulse to the ventricular lead in response to each atrial depolarization and causing the pulse generation circuitry, in response to a detected atrial arrhythmia, to deliver atrial synchronized pacing pulses to the ventricular lead in response only to selected atrial depolarizations, wherein the control circuitry determines a desired ratio of atrial depolarizations to ventricular paced pulses based on a beat rate of the atrial arrhythmia and a preferred ventricular beat rate and causes the pulse generation circuitry to deliver atrial synchronized pulses to the ventricular lead in response to detection of a number of atrial depolarizations corresponding to the desired ratio.

2. The device of claim 1, wherein if the desired ratio of atrial depolarizations to ventricular paced pulses is determined to be N-to-one, where N is an integer, then the control circuitry causes the pulse generation circuitry to deliver the atrial synchronized pulse to the ventricular lead in response to each Nth atrial depolarization detected.

3. A device for providing pacing therapy, the device comprising:

an atrial lead for sensing electrical activity in an atrium;

a right ventricular lead for sensing electrical activity in a right ventricle and for delivering electrical pulses to the right ventricle;

a left ventricular lead for sensing electrical activity in a left ventricle and for delivering electrical pulses to the left ventricle;

sensing circuitry connected to the atrial, right ventricular and left ventricular leads for sensing atrial and ventricular depolarizations;

pulse generation circuitry connected to the right ventricular and left ventricular leads for delivering pacing pulses to the right ventricle and left ventricle, respectively; and

control circuitry responsive to sensed atrial depolarizations, for detecting atrial arrhythmias and for controlling the pulse generation circuitry in a mode in which the pulse generation circuitry delivers atrial synchronized pulses to both the right and left ventricular leads in response to each atrial depolarization and causing the pulse generation circuitry, in response to a detected atrial arrhythmia, to deliver atrial synchronized pacing pulses to both the right and left ventricular leads in response only to selected atrial depolarizations, wherein the control circuitry determines a desired ratio of atrial depolarizations to ventricular paced pulses based on a beat rate of the atrial arrhythmia and a preferred ventricular beat rate and causes the pulse generation circuitry to deliver atrial synchronized pulses to the right and left ventricular leads in response to detection of a number of atrial depolarizations corresponding to the desired ratio.

4. The device of claim 3, wherein if the desired ratio of atrial depolarizations to ventricular paced pulses is determined to be N-to-one, where N is an integer, then the control circuitry causes the pulse generation circuitry to deliver the atrial synchronized pulse to the right and left ventricular leads in response to each Nth atrial depolarization sensed.