# US 12,303,697 B2 · Cardiac pacing sensing and control > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,303,697 B2 - Document ID: US12303697B2 - Status: Granted - Kind: B2 - Application number: 17/944,951 - Filed: 2022-09-14 - Published: 2023-01-19 - Granted: 2025-05-20 - Earliest claimed: 2014-11-24 - Assignees: AtaCor Medical, Inc. - Applicants: AtaCor Medical, Inc. - Inventors: Rick Sanghera; Alan Marcovecchio; Sean P. McGeehan - Web page: https://patentgrep.com/patent/US12303697B2 ## CPC - A61B 5/1116: {Determining posture transitions} - A61N 1/36585: {controlled by two or more physical parameters} - A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition - A61B 5/686: {Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence)} - A61N 1/0504: {Subcutaneous electrodes} - A61N 1/0587: {Epicardial electrode systems; Endocardial electrodes piercing the pericardium} - A61N 1/059: {Anchoring means} - A61N 1/362: Heart stimulators (heart defibrillators A61N1/39) - A61N 1/3627: {for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy} - A61N 1/36514: {controlled by a physiological quantity other than heart potential, e.g. blood pressure (controlled by two or more physical parameters A61N1/36585)} - A61N 1/36557: {controlled by chemical substances in blood} - A61N 1/36564: {controlled by blood pressure} - A61N 1/3752: {Details of casing-lead connections} - A61B 2562/0219: Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches - A61N 1/36535: {controlled by body position or posture} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract A cardiac pacing system having a pulse generator for generating therapeutic electric pulses, a lead electrically coupled with the pulse generator having an electrode, a first sensor configured to monitor a physiological characteristic of a patient, a second sensor configured to monitor a second physiological characteristic of a patient and a controller. The controller can determine a pacing vector based on variables including a signal received from the second sensor, and cause the pulse generator to deliver the therapeutic electrical pulses according to the determined pacing vector. The controller can also modify pacing characteristics based on variables including a signal received from the second sensor. ## Claims ### Claim 1 A system comprising: a pulse generator including a housing, the pulse generator configured to generate therapeutic electrical pulses; a sensor configured to detect electrical signals from a heart of a patient; and a controller configured for: receiving a signal from the sensor; obtaining an average heart rate of the patient based on the signal; obtaining an instant heart rate of the patient based on the signal; determining a P-wave expectation window based on the average heart rate and the instant heart rate; and finding a P-wave in the P-wave expectation window utilizing a template. ### Claim 2 (depends on 1) The system of claim 1, wherein the instant heart rate is based on a preceding P-P interval. ### Claim 3 (depends on 1) The system of claim 1, the controller further configured for finding the P-wave by: sweeping the template through expectation window data from the signal; and comparing the template to the signal to find a best match between the template and the expectation window data. ### Claim 4 (depends on 1) The system of claim 1, the controller further configured for initiating an atrioventricular (AV) delay based on timing of the P-wave. ### Claim 5 (depends on 4) The system of claim 4, the controller further configured for adjusting the AV delay based on the timing of the P-wave. ### Claim 6 (depends on 1) The system of claim 1, the controller further configured for: identifying an irregular P-wave interval utilizing the P-wave expectation window; and altering the generation of the therapeutic electrical pulses based on the identifying of the irregular P-wave interval. ### Claim 7 (depends on 6) The system of claim 6, the controller further configured for reverting the generation the therapeutic electrical pulses to settings prior to the altering when a regular P-wave interval is identified. ### Claim 8 A system comprising: a pulse generator including a housing, the pulse generator configured to generate therapeutic electrical pulses; a sensor configured to detect electrical signals from a heart of a patient; and a controller configured to: receive a signal from the sensor; obtaining an average heart rate of the patient based on the signal; obtaining an instant heart rate of the patient based on the signal; determine an R-wave expectation window based on the average heart rate and the instant heart rate; and find an R-wave in the R-wave expectation window utilizing a template. ### Claim 9 (depends on 8) The system of claim 8, wherein the instant heart rate is based on a preceding R-R interval. ### Claim 10 (depends on 8) The system of claim 8, the controller further configured for finding the R-wave by: sweeping the template through expectation window data from the signal; and comparing the template to the signal to find a best match between the template and the expectation window data. ### Claim 11 (depends on 8) The system of claim 8, the controller further configured for initiating an atrioventricular (AV) delay based on timing of the R-wave. ### Claim 12 (depends on 11) The system of claim 11, the controller further configured for adjusting the AV delay based on the timing of the R-wave. ### Claim 13 (depends on 8) The system of claim 8, the controller further configured for: identifying an irregular R-wave interval utilizing the R-wave expectation window; and altering the generation of the therapeutic electrical pulses based on the identifying of the irregular R-wave interval. ### Claim 14 (depends on 13) The system of claim 13, the controller further configured for reverting the generation the therapeutic electrical pulses to settings prior to the altering when a regular R-wave interval is identified.