Cardiac rhythm management system with maximum tracking rate (MTR) hysteresis
First Claim
1. A cardiac rhythm management system, including:
- a first sensing circuit to sense a first cardiac signal, the first sensing circuit including;
a first sense amplifier to receive the first cardiac signal; and
a first cardiac depolarization detector, coupled to the first sense amplifier, to detect ventricular depolarizations in the first cardiac signal; and
a controller coupled to the first sensing circuit, the controller including;
a rate detector, coupled to the first cardiac depolarization detector, to determine a ventricular rate from the detected ventricular depolarizations;
a comparator, coupled to the rate detector, including inputs representative of the ventricular rate and at least one of a first predetermined value, a second predetermined value, and a predetermined threshold and one or more outputs representative of whether the ventricular rate exceeds the second predetermined value and whether the ventricular rate falls below the predetermined threshold;
a storage medium, coupled to the comparator, including the first predetermined value, the second predetermined value, and the predetermined threshold; and
a pacing algorithm module, coupled to the comparator, to set a maximum ventricular pacing rate to the first predetermined value when the ventricular rate exceeds the second predetermined value, and set the maximum ventricular pacing rate to the second predetermined value when the ventricular rate falls below the predetermined threshold.
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Abstract
A cardiac rhythm management system provides both a safe maximum pacing rate limit and a physiological maximum pacing rate limit. In one embodiment, a normal maximum tracking rate (MTR) and a hysteresis MTR are provided. The hysteresis MTR is set higher than the normal MTR and functions as a maximum pacing rate. When an atrial rate exceeds the hysteresis MTR limit, the maximum pacing rate limit is set to the normal MTR. Once the atrial rate falls below a predetermined threshold, the maximum pacing rate limit is set to the hysteresis MTR. This provides for a more rapid and natural maximum pacing rate limit for a patient, while still protecting the patient from being paced at abnormally high rates.
41 Citations
20 Claims
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1. A cardiac rhythm management system, including:
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a first sensing circuit to sense a first cardiac signal, the first sensing circuit including; a first sense amplifier to receive the first cardiac signal; and a first cardiac depolarization detector, coupled to the first sense amplifier, to detect ventricular depolarizations in the first cardiac signal; and a controller coupled to the first sensing circuit, the controller including; a rate detector, coupled to the first cardiac depolarization detector, to determine a ventricular rate from the detected ventricular depolarizations; a comparator, coupled to the rate detector, including inputs representative of the ventricular rate and at least one of a first predetermined value, a second predetermined value, and a predetermined threshold and one or more outputs representative of whether the ventricular rate exceeds the second predetermined value and whether the ventricular rate falls below the predetermined threshold; a storage medium, coupled to the comparator, including the first predetermined value, the second predetermined value, and the predetermined threshold; and a pacing algorithm module, coupled to the comparator, to set a maximum ventricular pacing rate to the first predetermined value when the ventricular rate exceeds the second predetermined value, and set the maximum ventricular pacing rate to the second predetermined value when the ventricular rate falls below the predetermined threshold. - View Dependent Claims (2, 3, 4, 5)
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6. A method, including:
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sensing a first cardiac signal from a ventricular location; detecting ventricular depolarizations from the first cardiac signal; determining a ventricular rate based on the ventricular depolarizations; comparing the ventricular rate to a predetermined threshold and a second predetermined value; setting a maximum ventricular pacing rate in a cardiac rhythm management device using a result of the comparing, the setting including; setting the maximum ventricular pacing rate to a first predetermined value when the ventricular rate exceeds the second predetermined value, the second predetermined value larger than the first predetermined value; and setting the maximum ventricular pacing rate to the second predetermined value when the ventricular rate falls below the predetermined threshold. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A cardiac rhythm management system, including:
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a first sensing circuit to sense a first cardiac signal, the first sensing circuit including; a first sense amplifier to receive the first cardiac signal; and a first cardiac depolarization detector, coupled to the first sense amplifier, to detect atrial depolarizations in the first cardiac signal; and a controller coupled to the first sensing circuit, the controller including; a rate detector, coupled to the first cardiac depolarization detector, to determine an atrial rate from the detected atrial depolarizations; a comparator, coupled to the rate detector, including inputs representative of the atrial rate and at least one of a first predetermined value, a second predetermined value, and a predetermined threshold and one or more outputs representative of whether the atrial rate exceeds the second predetermined value and whether the atrial rate falls below the predetermined threshold; a storage medium, coupled to the comparator, including the first predetermined value, the second predetermined value, and the predetermined threshold; and a pacing algorithm module, coupled to the comparator, to set a maximum ventricular pacing rate to the first predetermined value when the atrial rate exceeds the second predetermined value, and set the maximum ventricular pacing rate to the second predetermined value when the atrial rate falls below the predetermined threshold. - View Dependent Claims (17, 18, 19, 20)
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Specification