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Automatic programming of rate-adaptive therapy via activity monitoring

  • US 8,538,526 B2
  • Filed: 12/16/2010
  • Issued: 09/17/2013
  • Est. Priority Date: 12/17/2009
  • Status: Active Grant
First Claim
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1. A pacemaker, comprising:

  • pacing circuitry for generating pacing pulses to be delivered to one or more atrial or ventricular sites;

    a minute ventilation sensor for measuring minute ventilation (MV);

    an activity level sensor for measuring activity level; and

    ,a controller for controlling the delivery of pacing pulses in accordance with a programmed mode, wherein the controller is further programmed to;

    deliver pacing pulses at a rate determined by a rate-adaptive algorithm as a function of the sensed minute ventilation, termed the sensor-indicated rate (SIR);

    compute the sensor-indicated rate by mapping a measured ventilation value equaling a specified baseline minute ventilation value (BMV) to a specified minimum pacing rate, termed the lower rate limit (LRL), and mapping a measured minute ventilation value greater than the baseline minute ventilation value to a pacing rate calculated as the LRL added to the amount by which the measured minute ventilation value exceeds the baseline minute ventilation value multiplied by a rate response factor; and

    ,enter a parameter adjustment mode for calculating the value of the rate response factor by;

         1) monitoring the measured activity level,

         2) when the measured activity level is maintained within a specified target activity level range for a specified length of time, measuring a corresponding target minute ventilation value (TMV), and

         3) calculating the rate response factor (RF) as;


    RF=(THR−

    LRL
    )/(TMV−

    BMV
    )where the target heart rate THR is a specified value corresponding to a desired pacing rate for the target activity level range and wherein the target activity level range is selected such that the TMV is less than a minute ventilation value that is mapped by the rate-adaptive algorithm to a maximum sensor-indicated rate.

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