Apparatus and method for analyzing patient tolerance to a stimulation mode favoring a spontaneous atrioventricular conduction
First Claim
1. An active implantable medical device for stimulation, resynchronization and/or defibrillation of a patient, comprising:
- means for detecting spontaneous atrial and ventricular events;
means for delivering ventricular and atrial stimulation;
means for detecting spontaneous ventricular depolarization after an atrial pacing;
means for measuring an atrioventricular delay between the atrial pacing and the corresponding ventricular depolarization;
means for operating the device in a dual chamber mode with ventricular sensing and ventricular pacing in the absence of spontaneous ventricular depolarization detected after an atrioventricular delay;
means for mode switching, to control conditionally, according to a predetermined criteria, the switching of the device between a dual chamber mode and a pacing mode favoring a spontaneous atrioventricular conduction;
a hemodynamic sensor having an output signal;
means for deriving from the output signal a hemodynamic index representative of a patient'"'"'s tolerance to the atrioventricular delay, wherein the means for deriving utilizes output data from the hemodynamic sensor associated with a single cardiac cycle to derive the hemodynamic index, wherein the means for deriving the hemodynamic index is configured to derive the hemodynamic index when the atrioventricular delay exceeds a threshold value; and
means for inhibiting or forcing said conditional switching of the device to the dual chamber mode based on said hemodynamic index derived from the output data from the hemodynamic sensor associated with the single cardiac cycle.
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Accused Products
Abstract
An implantable cardiac prosthesis device conducting an analysis of a patient tolerance to a pacing mode favoring the spontaneous atrioventricular conduction is disclosed. The device operates in a dual chamber (DDD or biventricular) mode and in a pacing mode favoring the spontaneous atrioventricular conduction such as an AAI mode (10) with a ventricular sensing or a mode with hysteresis of the atrioventricular delay. The device controls (10-18) the conditional switching from one mode to the other. The device comprises a hemodynamic sensor, including an endocardial acceleration sensor, derives a hemodynamic index representative of the hemodynamic tolerance of the patient to the spontaneous atrioventricular conduction. The device controls inhibiting or (20) forcing the conditional switching of the device to the DDD (or biventricular) mode according to the evolution of the hemodynamic index.
21 Citations
22 Claims
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1. An active implantable medical device for stimulation, resynchronization and/or defibrillation of a patient, comprising:
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means for detecting spontaneous atrial and ventricular events; means for delivering ventricular and atrial stimulation; means for detecting spontaneous ventricular depolarization after an atrial pacing; means for measuring an atrioventricular delay between the atrial pacing and the corresponding ventricular depolarization; means for operating the device in a dual chamber mode with ventricular sensing and ventricular pacing in the absence of spontaneous ventricular depolarization detected after an atrioventricular delay; means for mode switching, to control conditionally, according to a predetermined criteria, the switching of the device between a dual chamber mode and a pacing mode favoring a spontaneous atrioventricular conduction; a hemodynamic sensor having an output signal; means for deriving from the output signal a hemodynamic index representative of a patient'"'"'s tolerance to the atrioventricular delay, wherein the means for deriving utilizes output data from the hemodynamic sensor associated with a single cardiac cycle to derive the hemodynamic index, wherein the means for deriving the hemodynamic index is configured to derive the hemodynamic index when the atrioventricular delay exceeds a threshold value; and means for inhibiting or forcing said conditional switching of the device to the dual chamber mode based on said hemodynamic index derived from the output data from the hemodynamic sensor associated with the single cardiac cycle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. An implantable medical device comprising:
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a hemodynamic sensor configured to generate an output signal, wherein the hemodynamic sensor comprises an electronic sensor configured to measure a value representative of a property of at least one of heart tissue and blood flowing through a heart or blood vessels proximate to the heart; and one or more circuits configured to; switch the implantable medical device between a single chamber mode and a dual chamber mode, wherein, in the single chamber mode, the one or more circuits are configured to stimulate the atrium and prompt spontaneous atrioventricular conduction, and wherein, in the dual chamber mode, the one or more circuits are configured to stimulate the ventricle in the absence of spontaneous ventricular depolarization detected after an atrioventricular delay, measure the atrioventricular delay between an atrial pacing event and a spontaneous ventricular depolarization after the atrial pacing event, determine whether the atrioventricular delay exceeds a threshold atrioventricular delay, in response to the atrioventricular delay exceeding the threshold atrioventricular delay; derive from the output signal of the hemodynamic sensor a hemodynamic index representative of a patient'"'"'s tolerance to the atrioventricular delay that exceeds the threshold atrioventricular delay, and determine whether to activate or deactivate the dual chamber mode based on the hemodynamic index. - View Dependent Claims (20, 21)
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22. An implantable medical device comprising:
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a hemodynamic sensor configured to generate an output signal; and one or more circuits configured to; switch the implantable medical device between a single chamber mode and a dual chamber mode, wherein, in the single chamber mode, the one or more circuits are configured to stimulate the atrium and prompt spontaneous atrioventricular conduction, and wherein, in the dual chamber mode, the one or more circuits are configured to stimulate the ventricle in the absence of spontaneous ventricular depolarization detected after an atrioventricular delay, determine, over a plurality of atrial events, whether an amount of atrial events that are not followed by a detected ventricular event exceeds a threshold, in response to the number of atrial events that are not followed by a detected ventricular event exceeding the threshold, activate the dual chamber mode, in response to the number of atrial events that are not followed by a detected ventricular event not exceeding the threshold, determine whether to activate or deactivate the dual chamber mode using the hemodynamic sensor by; deriving from the output signal of the hemodynamic sensor a hemodynamic index representative of a patient'"'"'s tolerance to the atrioventricular delay when the atrioventricular delay exceeds a threshold value, and determining whether to activate or deactivate the dual chamber mode based on the hemodynamic index.
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Specification