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Methods for promoting intrinsic activation in single chamber implantable cardiac pacing systems

  • US 8,478,407 B2
  • Filed: 07/28/2011
  • Issued: 07/02/2013
  • Est. Priority Date: 07/28/2011
  • Status: Active Grant
First Claim
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1. A method for rate adaptive cardiac pacing that employs implanted electrodes for single chamber pacing and sensing and one or more rate response sensors;

  • and the method comprising the steps of;

    establishing a baseline rate for pacing stimulation according to input from the one or more rate response sensors;

    establishing an offset rate for pacing stimulation, the offset rate being lower than the baseline rate and generally tracking therewith such that a difference between the baseline rate and the offset rate remains substantially constant over time;

    sensing for intrinsic events by means of the implanted electrodes;

    applying a pacing stimulation pulse by means of the implanted electrodes, when an intrinsic event is not detected within a time interval necessary to at least maintain the offset rate, the applied pacing stimulation pulse creating a paced event to maintain the offset rate;

    switching from the offset rate to the baseline rate and pacing at the baseline rate over a predetermined period of time, when x of y successive events are paced events, x being greater than one and y being greater than or equal to x; and

    at the end of the predetermined period of time, again sensing for intrinsic events, and repeating the above last two steps;

    wherein the offset rate is established according to a predetermined decrement of one of;

    the baseline rate; and

    a greater of the baseline rate and an intrinsic rate, the intrinsic rate being determined by the sensing for intrinsic events; and

    further comprising;

    establishing a preference rate that falls between the baseline rate and the offset rate; and

    switching from the offset rate to the baseline rate and pacing at the baseline rate over the predetermined period of time, when the rates of successive intrinsic events, over a predetermined interval, even if greater than the offset rate, meet a criterion with respect to the preference rate, the criterion being one of;

    x of y successive intrinsic events falling below the preference rate over the predetermined interval, x being greater than one and y being greater than or equal to x; and

    a measure of central tendency of the rates of successive intrinsic events falling below the preference rate over the predetermined interval.

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