# US 2014/0194940 A1 · Heart stimulation device and respective control system

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- Number: US 2014/0194940 A1
- Document ID: US20140194940A1
- Status: Published application
- Kind: A1
- Application number: 14/237,627
- Filed: 2012-07-24
- Published: 2014-07-10
- Earliest claimed: 2011-08-08
- Assignees: P.A. &M Partecipazioni Azionarie & Management S.P.A.
- Inventors: Ferruccio De Bellis
- Web page: https://patentgrep.com/patent/US20140194940A1

## CPC

- A61N 1/368: comprising more than one electrode co-operating with different heart regions {(A61N1/3622, A61N1/3627 take precedence)}
- A61N 1/3628: {using sub-threshold or non-excitatory signals}
- A61N 1/3987: {characterised by the timing or triggering of the shock}
- 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

Pacemaker for the stimulation of the human heart having three electrodes or two electrodes, with the first electrode connected to the right atrium, the second electrode connected to the right ventricle and the third electrode connected to the said right ventricle. The pacemaker is programmed so that there is first stimulation of the right atrium by means of the first electrode, then there is second stimulation of the right ventricle by means of the second electrode with an interval function of the programmed AV delay (50-400 msec) and with a voltage not exceeding 80-90% of the threshold potential, and finally there is third stimulation, again of the right ventricle by means of the third electrode with a voltage that conforms with Safety Margin rules and at a second stimulation time interval comprised between 50 msec and 300 msec.

## Claims

### Claim 1

Stimulation device, in particular a pacemaker or defibrillator, comprising an atrial electrode adapted to be connected to the right atrium of the human heart of a patient, at least one first ventricular electrode adapted to be connected to the right ventricle of the human heart and provided with a control system that has been arranged to emit, in the course of each cardiac stimulation cycle:
a first impulse for the stimulation of the right atrium by means of the atrial electrode,
a second impulse for a first stimulation of the right ventricle, said first stimulation being defined below-threshold pre-stimulation, by means of the at least one first ventricular electrode, said second impulse being emitted after a time interval T1 from the emission of the first impulse, this second impulse having a voltage comprised between 0.5 and −3 Volt and which is not in excess of 80-90% of the cardiac stimulation threshold potential of the patient,
a third impulse for a second stimulation of the right ventricle, emitted after a time interval T2 from the predefined pre-stimulation second impulse, said time interval T2 being comprised between 50 and 400 msec, said third impulse having a voltage adapted to provoke the cardiac stimulation of the patient

### Claim 2 (depends on 1)

Stimulation device according to claim 1 , wherein said third impulse for the second stimulation of the right ventricle is emitted by means of the at least one first ventricular electrode.

### Claim 3 (depends on 1)

Stimulation device according to claim 1, provided with a second ventricular electrode adapted to be connected to the right ventricle and wherein said second stimulation of the right ventricle occurs by means of the second ventricular electrode.

### Claim 4 (depends on 1)

Stimulation device according to claim 1, wherein said time interval T2 from the first stimulation of the right ventricle is equal to 70 msec.