Physiologic demand driven pacing
First Claim
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1. An apparatus comprising:
- a first data input configured to receive an intrinsic electric cardiac signal produced by the heart and to measure a duration of an intrinsic electrical QRS complex using the electric cardiac signal;
a second data input configured to receive a subject heart rate;
ventricular pacing circuitry configured to provide ventricular pacing pulses in response to expiration of a specified atrioventricular (AV) delay; and
control circuitry configured to use information about the duration of the QRS complex to;
determine a first specified threshold value using information about the intrinsic electrical QRS complex;
compare a subject'"'"'s heart rate to the first specified threshold value; and
when the subject'"'"'s heart rate is less than the first specified threshold value, intermittently extend the specified AV delay by an amount that obtains respective intrinsic ventricular contractions; and
when the subject'"'"'s heart rate is greater than or equal to the first specified threshold value, shorten the specified AV delay to provide a shortened AV delay, wherein the shortened AV delay is less than the specified AV delay.
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Abstract
Physiologic demand driven pacing can be used to maintain cardiac synchrony and improve hemodynamic function in patients with heart failure.
119 Citations
20 Claims
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1. An apparatus comprising:
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a first data input configured to receive an intrinsic electric cardiac signal produced by the heart and to measure a duration of an intrinsic electrical QRS complex using the electric cardiac signal; a second data input configured to receive a subject heart rate; ventricular pacing circuitry configured to provide ventricular pacing pulses in response to expiration of a specified atrioventricular (AV) delay; and control circuitry configured to use information about the duration of the QRS complex to; determine a first specified threshold value using information about the intrinsic electrical QRS complex; compare a subject'"'"'s heart rate to the first specified threshold value; and when the subject'"'"'s heart rate is less than the first specified threshold value, intermittently extend the specified AV delay by an amount that obtains respective intrinsic ventricular contractions; and when the subject'"'"'s heart rate is greater than or equal to the first specified threshold value, shorten the specified AV delay to provide a shortened AV delay, wherein the shortened AV delay is less than the specified AV delay. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A non-transitory device-readable medium including instructions that, when performed by the device, comprise:
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receiving an intrinsic electric cardiac signal produced by the heart; measuring a duration of an intrinsic electrical QRS complex using the intrinsic electric cardiac signal produced by the heart; providing a first specified threshold value using information about the intrinsic electrical QRS complex; receiving a subject heart rate; providing ventricular pacing pulses in response to expiration of a specified atrioventricular (AV) delay; and using information about the duration of the QRS complex and the subject heart rate to; intermittently extend the specified AV delay that obtains respective intrinsic ventricular contractions when the subject'"'"'s heart rate is less than the first specified threshold; and shorten the specified AV delay to provide a shortened AV delay when the subject'"'"'s heart rate is greater than or equal to the first specified threshold value, wherein the shortened AV delay is less than the specified AV delay. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification