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US 12,746,394 B2Granted
Atrial tracking confirmation in an intracardiac ventricular pacemaker
AssigneeMedtronic, Inc.
InventorsTodd J. Sheldon, Wade M. Demmer, Greggory R. Herr
Life of this patent
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Abstract
A pacemaker having a motion sensor delivers atrial-synchronized ventricular pacing by detecting events from a signal produced by the motion sensor and delivering ventricular pacing pulses at a rate that tracks the rate of the detected events. The pacemaker is configured to confirm atrial tracking of the ventricular pacing pulses by determining if detected events from the motion sensor signal are atrial events. The pacemaker is configured to adjust a control parameter used for detecting events from the motion sensor signal if atrial tracking is not confirmed.
Claims20
A medical device comprising:
- a pulse generator configured to deliver ventricular pacing pulses;
- a motion sensor configured to sense a motion signal;
- a control circuit in communication with the motion sensor and the pulse generator and configured to:
- apply a first post-ventricular atrial refractory period to the motion signal in response to a delivered ventricular pacing pulse of the ventricular pacing pulses delivered by the pulse generator;
- determine that a rate of the delivered ventricular pacing pulses is greater than a threshold rate;
- apply a second post-ventricular atrial refractory period to the motion signal in response to determining that the rate of the delivered ventricular pacing pulses is greater than the threshold rate, the second post-ventricular atrial refractory period being greater than the first post-ventricular atrial refractory period;
- sense a non-refractory atrial event signal from the motion signal after the second post-ventricular atrial refractory period;
- and
- based on a time of the non-refractory atrial event signal sensed after the second post-ventricular atrial refractory period, select one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period;
- the pulse generator further configured to deliver a first subsequent ventricular pacing pulse in response to the non-refractory atrial event signal being sensed after the second post-ventricular atrial refractory period;
- the control circuit further configured to:
- apply the selected one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period to the motion signal following the first subsequent ventricular pacing pulse;
- and
- sense a second non-refractory atrial event signal from the motion signal after the selected one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period;
- and
- the pulse generator further configured to deliver a second subsequent ventricular pacing pulse in response to the second non-refractory atrial event signal being sensed by the control circuit.
13 more elements
A method comprising:
- delivering ventricular pacing pulses;
- sensing a motion signal;
- applying a first post-ventricular atrial refractory period to the motion signal in response to a delivered ventricular pacing pulse;
- determining that a rate of the delivered ventricular pacing pulses is greater than a threshold rate;
- applying a second post-ventricular atrial refractory period to the motion signal in response to determining that the rate of the delivered ventricular pacing pulses is greater than the threshold rate, the second post-ventricular atrial refractory period being longer than the first post-ventricular atrial refractory period;
- sensing a non-refractory atrial event signal from the motion signal after the second post-ventricular atrial refractory period;
- based on a time of the sensed non-refractory atrial event signal after the second post-ventricular atrial refractory period, selecting one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period;
- delivering a first subsequent ventricular pacing pulse in response to the non-refractory atrial event signal being sensed after the second post-ventricular atrial refractory period;
- applying the selected one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period to the motion signal following the first subsequent ventricular pacing pulse;
- sensing a second non-refractory atrial event signal from the motion signal after the selected one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period;
- and
- delivering a second subsequent ventricular pacing pulse in response to the second non-refractory atrial event signal being sensed.
9 more elements
A non-transitory computer readable medium storing a set of instructions that, when executed by a control circuit of a medical device, cause the device to:
- deliver ventricular pacing pulses;
- sense a motion signal;
- apply a first post-ventricular atrial refractory period to the motion signal in response to a delivered ventricular pacing pulse;
- determine that a rate of the delivered ventricular pacing pulses is greater than a threshold rate;
- apply a second post-ventricular atrial refractory period to the motion signal in response to determining that the rate of the delivered ventricular pacing pulses is greater than the threshold rate, the second post-ventricular atrial refractory period being longer than the first post-ventricular atrial refractory period;
- sense a non-refractory atrial event signal from the motion signal after the second post-ventricular atrial refractory period;
- based on a time of the sensed non-refractory atrial event signal after the second post-ventricular atrial refractory period, select one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period;
- deliver a first subsequent ventricular pacing pulse in response to the non-refractory atrial event signal being sensed after the second post-ventricular atrial refractory period;
- apply the selected one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period to the motion signal following the first subsequent ventricular pacing pulse;
- sense a second non-refractory atrial event signal from the motion signal after the selected one of the first post-ventricular atrial refractory period or the second post-ventricular atrial refractory period;
- and
- deliver a second subsequent ventricular pacing pulse in response to the second non-refractory atrial event signal being sensed.
9 more elements
Dependencies are inferred from the claim text.