Method and apparatus for differentiating antegrade from retrograde P-waves and for preventing pacemaker generated tachycardia
OwnerLawrence J. Gessmaninventor
Life of this patent
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Abstract
An improved dual chamber cardiac pacing apparatus detects retrograde P-waves conduction by either determining polarity of the P-wave at a location in the right atrium adjacent the A-V node; or the sequence of signals which appear at this predetermined location and at a second predetermined location in the atrium in proximity to the sinus node. The pacing apparatus will ignore retrograde P-waves when initiating sequential pacing in the ventricle. In addition, the pacing apparatus will provide a burst of high rate atrial pacing pulses upon detection of the simultaneous occurrence of retrograde P-wave conduction, high rate heart beat and narrow QRS complexes.
Claims33
A method for detecting retrograde P-wave conduction from an A-V node through an atrium of a human heart, said method comprising the steps of:
- (a) sensing a P-wave signal at a first location in said atrium;
- (b) sensing said P-wave signal at a second location in said atrium, said second location being intermediate said first location and said A-V node;
- (c) comparing the time at which said P-wave is sensed at said first location with the time at which said P-wave is sensed at said second location;
- and
- (d) indicating the occurrence of a retrograde P-wave whenever said P-wave is sensed at said second location before it is sensed at said first location.
An apparatus for detecting retrograde P-wave conduction from an A-V node through an atrium of a human heart, said apparatus comprising:
- (a) means for sensing a P-wave signal at a first location in said atrium;
- (b) means for sensing said P-wave signal at a second location in said atrium, said second location being intermediate said first location and said A-V node;
- (c) means for comparing the time at which said P-wave is sensed at said first location with the time at which said P-wave is sensed at said second location;
- and
- (d) means for indicating the occurrence of a retrograde P-wave whenever said P-wave is sensed at said second location before it is sensed at said first location.
A method for inhibiting tachycardia initiated by a pacemaker having means for sensing the occurrence of a P-wave within an atrium of a human heart and means for generating a pacing pulse to a ventricle of said heart at a predetermined time following the occurrence of said P-wave, said method comprising the steps of:
- (a) sensing the occurrence of said P-wave at a first location in said atrium;
- (b) sensing the occurrence of said P-wave at a second location in said atrium, said second location being intermediate said first location and said ventricle;
- (c) comparing the time at which said P-wave occurs at said first location with the time at which said P-wave occurs at said second location;
- and
- (d) inhibiting the generation of said ventricular pacing pulse whenever said P-wave occurs at said second location before it occurs at said first location.
In a cardiac pacemaker including means for sensing occurrence of a P-wave within an atrium of a human heart and means for generating pacing pulse to a ventricle of said heart at a predetermined time following the occurrence of said P-wave;
- an improvement for inhibiting tachycardia initiated by said pacemaker, said improvement comprising:
- (a) means for sensing the occurrrence of said P-wave at a first location in said atrium;
- (b) means for sensing the occurrence of said P-wave at a second location in said atrium, said second location being intermediate said first location and said ventricle;
- (c) means for comparing the time at which said P-wave occurs at said first location with the time at which said P-wave occurs at said second location;
- and
- (d) means for inhibiting the generation of said ventricular pacing pulse whenever said P-wave occurs at said second location before it occurs at said first location.
An apparatus for differentiating between retrograde P-wave conduction from an A-V node through an atrium of a heart and antegrade P-wave conduction through said atrium, said apparatus comprising:
- (a) first means for sensing the occurrence of a P-wave, said first means adapted to be operatively connected to the heart at a first location on or in the atrium;
- (b) second means for sensing the occurrence of said P-wave, said second means adapted to be operatively connected to the heart at a second location on or in the atrium, said second location being intermediate said first location and said A-V node;
- (c) means, responsive to said first and second P-wave sensing means, for comparing the time of occurrence of said P-wave at said first location with the time of occurrence of said P-wave at said second location;
- and
- (d) means for providing a signal indicating the occurrence of a retrograde P-wave whenever said P-wave is sensed at said second location before it is sensed at said first location.
A cardiac pacemaker including first means for sensing the occurrence of a P-wave in an atrium of a heart, said first means adapted to be operatively connected to the heart at a first location on or in the atrium, and means for generating a pacing pulse at a predetermined time following the occurrence of said P-wave, said pacing pulse generating means adapted to be operatively connected to the heart on or in the ventricle thereof, said improvement comprising:
- (a) second means for sensing the occurrence of said P-wave, said second means adapted to be operatively connected to the heart at a second location on or in the atrium, said second location being intermediate said first location and an A-V node;
- (b) means, responsive to said first and second P-wave sensing means, for comparing the time of occurrence of said P-wave at said first location with the time of occurrence of said P-wave at said second location;
- (c) means for inhibiting the generation of said ventricular pacing pulse whenever said P-wave occurs at said second location before it occurs at said first location;
- and
- (d) means for enabling the generation of said ventricular pacing pulse whenever said P-wave occurs at said first location before it occurs at said second location.
Dependencies are inferred from the claim text.