Systems and methods for packed pacing using bifurcated pacing pulses of opposing polarity generated by an implantable medical device
First Claim
1. A method for use with an implantable cardiac stimulation device equipped for delivering output pulses via a plurality of electrodes, the method comprising:
- during a first cardiac cycle, generating a first plurality of closely spaced single-phase primary stimulation pulses for delivery to the heart of the patient during the first cardiac cycle with each pulse of the plurality of primary pulses being delivered using a different pair of electrodes wherein an amplitude of the primary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse; and
during a second cardiac cycle, generating a corresponding second plurality of closely spaced single-phase secondary stimulation pulses for delivery to the heart of the patient during the second cardiac cycle with each pulse of the plurality of secondary stimulation pulses being delivered using a different pair of electrodes, the secondary pulses being opposite in polarity to corresponding primary pulses delivered with a corresponding pair of electrodes and configured as recharge pulses in relation to the corresponding primary pulses, wherein an amplitude of the secondary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse.
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Abstract
Techniques are provided for use with implantable medical devices to deliver packed pacing using split or bifurcated pulses of opposing polarity in different cardiac cycles. In one example, packed single-phase pulses are delivered by the device during a first cardiac cycle that serve to stimulate heart tissue. During the next cardiac cycle, packed single-phase stimulation pulse of opposing polarity are delivered that serve to recharge the pacing capacitors and also serve to stimulate heart tissue. By separating the pulses into separate cardiac cycles, near simultaneous multisite packed stimulation can be achieved within each cardiac cycle while providing for charge balancing and without interfering with sensing. Non-packed pacing with bifurcated pulses is also described.
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Citations
16 Claims
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1. A method for use with an implantable cardiac stimulation device equipped for delivering output pulses via a plurality of electrodes, the method comprising:
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during a first cardiac cycle, generating a first plurality of closely spaced single-phase primary stimulation pulses for delivery to the heart of the patient during the first cardiac cycle with each pulse of the plurality of primary pulses being delivered using a different pair of electrodes wherein an amplitude of the primary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse; and during a second cardiac cycle, generating a corresponding second plurality of closely spaced single-phase secondary stimulation pulses for delivery to the heart of the patient during the second cardiac cycle with each pulse of the plurality of secondary stimulation pulses being delivered using a different pair of electrodes, the secondary pulses being opposite in polarity to corresponding primary pulses delivered with a corresponding pair of electrodes and configured as recharge pulses in relation to the corresponding primary pulses, wherein an amplitude of the secondary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A system for use with an implantable cardiac stimulation device equipped for delivering output pulses via a plurality of electrodes, the system comprising:
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a single-phase primary pulse packed pacing system operative during a first cardiac cycle to generate a plurality of closely spaced single-phase primary stimulation pulses for delivery to the heart of the patient with each pulse of the plurality of primary pulses being delivered using a different pair of electrodes during the first cardiac cycle, wherein an amplitude of the primary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse; and a single-phase secondary pulse packed pacing system operative during a second cardiac cycle to generate a plurality of closely spaced single-phase secondary stimulation pulses for delivery to the heart of the patient during the second cardiac cycle with each pulse of the plurality of secondary stimulation pulses being delivered using a different pair of electrodes, the secondary pulses being opposite in polarity to the primary pulses and configured as recharge pulses in relation to corresponding primary pulses, wherein an amplitude of the secondary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse.
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16. A system for use with an implantable cardiac stimulation device equipped for delivering output pulses via a plurality of electrodes, the system comprising:
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means, operative during a first cardiac cycle, for generating a plurality of closely spaced single-phase primary stimulation pulses for delivery to the heart of the patient with each pulse of the plurality of primary pulses being delivered using a different pair of electrodes during the first cardiac cycle, wherein an amplitude of the primary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single pulse; and means, operative during a second cardiac cycle, for generating a plurality of closely spaced single-phase secondary stimulation pulses for delivery to the heart of the patient with each pulse of the plurality of secondary stimulation pulses being delivered using a different pair of electrodes during the second cardiac cycle, the secondary pulses being opposite in polarity to the primary pulses and configured as recharge pulses in relation to corresponding primary pulses, wherein an amplitude of the secondary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single pulse.
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Specification