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Automatic determination of chronotropic incompetence using atrial pacing at rest

  • US 9,132,275 B2
  • Filed: 11/07/2011
  • Issued: 09/15/2015
  • Est. Priority Date: 11/18/2010
  • Status: Active Grant
First Claim
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1. An apparatus comprising:

  • an implantable cardiac signal sensing circuit configured to provide an electrical cardiac signal representative of cardiac activity of a subject;

    an implantable therapy circuit configured to deliver electrical pacing stimulation energy to a heart of a subject; and

    a controller circuit, communicatively coupled to the cardiac signal sensing circuit and the therapy circuit, including a chronotropic incompetence detection circuit configured to;

    initiate pacing of an atrium of the subject at a rate higher than a device-indicated rate or a sensed intrinsic rate;

    monitor a time interval between a paced event in the atrium and a sensed intrinsic event in the ventricle (paced AV interval);

    initiate an increase in the pacing rate while continuing the monitoring of the paced AV interval;

    calculate a change in paced AV intervals between a highest paced rate used in the monitoring and a lowest paced rate used in the monitoring;

    indicate that the paced AV intervals are evidence of chronotropic incompetence when the calculated change in the paced AV intervals exceeds a specified threshold AV interval change value; and

    provide an indication of chronotropic incompetence to a user or process.

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