METHODS FOR SETTING CARDIAC PACING PARAMETERS IN RELATIVELY HIGH EFFICIENCY PACING SYSTEMS
First Claim
1. In an implanted cardiac pacing system, a method for setting pacing parameters comprising:
- conducting periodic pacing threshold searches, wherein at least one of the periodic pacing threshold searches comprises;
applying a series of test pacing pulses at incremented and/or decremented levels of pulse energy;
adjusting an initial evoked response amplitude threshold for evoked response signal detection to a lower value when, upon applying a test pacing pulse, no evoked response signal is detected at the initial threshold; and
restarting the pacing threshold search with the lower value for the evoked response amplitude threshold;
setting an operational pacing pulse energy greater than or equal to a predetermined maximum desirable pulse energy, if no evoked response signal is detected with the lower evoked response amplitude threshold when another test pulse is applied at or above the predetermined maximum desirable pulse energy during the pacing threshold search; and
reducing a pacing rate following the pacing threshold search of the periodic pacing threshold searches, if the operational pacing pulse energy is set greater than the predetermined maximum desirable pulse energy.
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Accused Products
Abstract
According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.
7 Citations
25 Claims
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1. In an implanted cardiac pacing system, a method for setting pacing parameters comprising:
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conducting periodic pacing threshold searches, wherein at least one of the periodic pacing threshold searches comprises; applying a series of test pacing pulses at incremented and/or decremented levels of pulse energy; adjusting an initial evoked response amplitude threshold for evoked response signal detection to a lower value when, upon applying a test pacing pulse, no evoked response signal is detected at the initial threshold; and restarting the pacing threshold search with the lower value for the evoked response amplitude threshold; setting an operational pacing pulse energy greater than or equal to a predetermined maximum desirable pulse energy, if no evoked response signal is detected with the lower evoked response amplitude threshold when another test pulse is applied at or above the predetermined maximum desirable pulse energy during the pacing threshold search; and reducing a pacing rate following the pacing threshold search of the periodic pacing threshold searches, if the operational pacing pulse energy is set greater than the predetermined maximum desirable pulse energy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. An implantable cardiac pacing system configured to be wholly implanted against an endocardial or epicardial surface, the system including a pulse generator having a microprocessor element being preprogrammed to direct the pulse generator to carry out a method comprising the following steps:
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conducting periodic pacing threshold searches, wherein at least one of the periodic pacing threshold search comprises; applying a series of test pacing pulses at incremented and/or decremented levels of pulse energy; adjusting an initial evoked response amplitude threshold to a lower value, if, upon applying a test pacing pulse, no evoked response signal is detected at the initial threshold; and restarting the pacing threshold search with the lower value for the evoked response amplitude threshold, if the initial threshold is adjusted; generating a first command signal to set an operational pacing pulse energy greater than or equal to the predetermined maximum desirable pulse energy, if no evoked response signal is detected with the lower evoked response amplitude threshold, when another test pulse is applied at or above a predetermined maximum desirable pulse energy during the pacing threshold search; and generating a second command signal to reduce a pacing rate following a pacing threshold search of the periodic pacing threshold searches, if the operational pacing pulse energy is set greater than the predetermined maximum desirable pulse energy. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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Specification