Stimulation mode determination
First Claim
1. An active implantable medical device for stimulation, resynchronization and/or defibrillation of a patient, comprising:
- 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 of stimulation and a dual chamber mode of stimulation;
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; and
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, wherein the one or more circuits are configured to utilize output data from the hemodynamic sensor associated with a single cardiac cycle to derive the hemodynamic index; and
determine whether to activate or deactivate the dual chamber mode based on the hemodynamic index.
1 Assignment
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Accused Products
Abstract
Devices and methods for providing pacing in multiple modes are provided. One 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.
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Citations
27 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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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 of stimulation and a dual chamber mode of stimulation; 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; and 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, wherein the one or more circuits are configured to utilize output data from the hemodynamic sensor associated with a single cardiac cycle to derive the hemodynamic index; and determine whether to activate or deactivate the dual chamber mode based on the hemodynamic index. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An implantable medical device comprising:
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;
orblood 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 of stimulation and a dual chamber mode of stimulation; 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; and 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 (14, 15, 16, 17, 18, 19, 20)
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21. A method comprising:
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switching an implantable medical device between a single chamber mode of stimulation and a dual chamber mode of stimulation; determining whether an atrioventricular delay between an atrial pacing event and a spontaneous ventricular depolarization after the atrial pacing event exceeds a threshold atrioventricular delay; and in response to the atrioventricular delay exceeding the threshold atrioventricular delay, determining whether to activate or deactivate the dual chamber mode using a hemodynamic sensor comprising an electronic sensor configured to measure a value representative of a property of at least one of heart tissue or blood flowing through a heart or blood vessels proximate to the heart, the step of determining whether to activate or deactivate the dual chamber mode comprising; deriving from an output signal of the hemodynamic sensor a hemodynamic index representative of a patient'"'"'s tolerance to the atrioventricular delay; and determining whether to activate or deactivate the dual chamber mode based on the hemodynamic index. - View Dependent Claims (22, 23, 24, 25, 26, 27)
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Specification