System and method for preventing recurrence of atrial tachyarrhythmia

• US 20080319494A1
• Filed: 08/25/2008
• Published: 12/25/2008
• Est. Priority Date: 09/14/2000
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Morris, Milton M., Seim, Gary T., Chen, Victor T.
• Granted Patent: US 8,046,061 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.

Claims

1. A method, comprising:

providing pacing pulses at an initial value that is well above an intrinsic rate;

incrementally decreasing a pacing rate from the initial value until at least one intrinsic atrial contraction is detected;

increasing the pacing rate to an adjusted value just above an intrinsic atrial rate;

incrementally decreasing the pacing rate from the adjusted value until at least one intrinsic atrial contraction is detected; and

increasing the pacing rate to another adjusted value just above the intrinsic atrial rate.

2. The method of claim 1, wherein providing pacing pulses at the initial value is initiated in response to an atrial defibrillation shock.

3. The method of claim 1, wherein providing pacing pulses at the initial value is initiated at a first time delay after an atrial defibrillation shock.

4. The method of claim 1, wherein providing pacing pulses at the initial value is initiated in response to a cardioversion pulse.

5. The method of claim 1, wherein providing pacing pulses at the initial value is initiated at a first time delay after a cardioversion pulse.

6. The method of claim 1, comprising repeating:

incrementally decreasing the pacing rate from the adjusted value until at least one intrinsic atrial contraction is detected; and

increasing the pacing rate to another adjusted value just above the intrinsic atrial rate.

7. The method of claim 6, wherein repeating is continued for a desired time period.

8. The method of claim 6, wherein repeating is continued until a desired number of intrinsic atrial contractions is detected.

9. The method of claim 1, comprising determining the intrinsic atrial rate from the at least one intrinsic atrial contraction.

10. The method of claim 9, wherein determining the intrinsic atrial rate includes determining the intrinsic atrial rate from at least two intrinsic atrial contractions.

11. The method of claim 1, wherein incrementally decreasing the pacing rate includes increasing an interval between the pacing pulses by a value in the range of 7.5 to 10 milliseconds.

12. The method of claim 1, wherein providing pacing pulses at the initial value includes providing pacing pulses at a pacing rate in a range of 100 to 200 pacing pulses per minute.

13. A method, comprising:

providing pacing pulses at a pacing rate that is well above an intrinsic rate; and

repeating;

incrementally decreasing the pacing rate until at least one intrinsic contraction is detected;

determining an adjusted intrinsic rate from the at least one intrinsic contraction; and

setting the pacing rate to an adjusted value just above the determined adjusted intrinsic rate.

14. The method of claim 13, wherein repeating is continued for a desired time period.

15. The method of claim 13, wherein repeating is continued until a desired number of intrinsic contractions is detected.

16. The method of claim 13, wherein providing pacing pulses at the pacing rate is initiated in response to a cardioversion pulse.

17. The method of claim 13, wherein providing pacing pulses at the pacing rate is initiated at a first time delay after a cardioversion pulse.

18. The method of claim 13, wherein determining the intrinsic rate includes determining the intrinsic rate from at least two intrinsic contractions.

19. The method of claim 13, wherein determining the adjusted intrinsic rate includes determining the adjusted intrinsic rate from at least one intrinsic atrial contraction.

20. The method of claim 13, wherein determining the adjusted intrinsic rate includes determining the adjusted intrinsic rate from two consecutive intrinsic contractions.