Back to results
US 5,292,340 AGranted
Physiologically-calibrated rate adaptive, dual chamber pacemaker
AssigneeTelectronics Pacing Systems, Inc.
InventorsPeter A. Crosby, John R. Hamilton, Anthony J. Ujhazy
Life of this patent
Estimating the term…
Abstract
A dual-chamber metabolic demand, rate adaptive pacemaker that automatically calibrates the correlation between a metabolic demand measurement and an appropriate metabolic demand pacing rate according to the true physiological needs of the body, as determined by a patient's sinus rate when the natural sinus rate is functioning in a reliable manner in the absence of cardiac arrhythmia.
Claims50
A dual-chamber rate-responsive pacemaker, comprising:
- means for generating ventricular pacing pulses;
- means for measuring metabolic indicator values;
- means for determining metabolic indicator rates as a function of said metabolic indicator values and a predetermined rate response factor;
- means for sensing atrial heartbeats;
- means responsive to said atrial heartbeat sensing means for determining intrinsic atrial rate values;
- means for ascertaining whether sensed atrial heartbeats are occurring at rates which are pathological, on one hand, and non-pathological, on the other hand;
- means for storing at least one intrinsic atrial rate value and at least one metabolic indicator value when said ascertaining means has determined that the rate of atrial heartbeats is non-pathological;
- and
- means for controlling said generating and sensing means to operate normally in a first mode in which ventricular pacing pulses are generated in synchrony with atrial heartbeats sensed by said sensing means but to switch to a second mode in which ventricular pacing pulses are generated at a rate which is a function of said metabolic indicator rates, with timing independent of said atrial heartbeats sensed by said sensing means, when said ascertaining means has determined that the rates of atrial heartbeats are pathological, said controlling means, upon switching from said first mode to said second mode, operating to update said rate response factor as a function of said stored at least one intrinsic atrial rate value and said stored at least one metabolic indicator value, and said controlling means, thereafter functioning in said second mode, operating to update said metabolic indicator rates as a function of said updated rate response factor and said stored metabolic indicator values.
6 more elements
A dual-chamber rate-responsive pacemaker, comprising:
- means for generating atrial and ventricular pacing pulses;
- means for sensing atrial and ventricular heartbeats;
- means responsive to said sensing means for determining intrinsic atrial rate values;
- means for measuring metabolic indicator values;
- means for determining metabolic indicator rates as a function of said metabolic indicator values and a predetermined rate response factor;
- means for ascertaining whether sensed atrial heartbeats are occurring at a rate which is pathological, on one hand, and non-pathological, on the other hand;
- means for storing at least one intrinsic atrial rate value and at least one metabolic indicator parameter when said ascertaining means has determined that the rate of atrial heartbeats is non-pathological;
- and
- means for controlling said generating and sensing means to operate normally in a DDDR mode but to switch to a VVIR mode when the rate of atrial heartbeats is pathological, said controlling means, upon switching from the DDDR mode to the VVIR mode, operating to update said rate response factor as a function of said stored at least one intrinsic atrial rate value and said stored at least one metabolic indicator parameter, and said controlling means, thereafter functioning in the VVIR mode, operating to update said metabolic indicator rates as a function of said updated rate response factor and said stored metabolic indicator parameter.
6 more elements
A dual-chamber rate-responsive pacemaker, comprising:
- means for generating ventricular pacing pulses;
- means for sensing atrial heartbeats;
- means responsive to said atrial heartbeat sensing means for determining an intrinsic atrial rate;
- means for measuring metabolic indicator values;
- means for determining a metabolic indicator rate as a function of said metabolic indicator values and a predetermined, continuously updating, rate response factor;
- means for comparing said metabolic indicator rate to said intrinsic atrial rate to determine whether said intrinsic atrial rate is pathological;
- means for controlling said generating and sensing means to operate in a first, synchronous, mode in which said ventricular pacing pulse generating means generates paces in synchrony with the atrial heartbeats sensed by said sensing means when said intrinsic atrial rate is non-pathological, and otherwise controlling said generating and sensing means to operate in a second, nonsynchronous, mode in which said ventricular pacing pulse generating means generates paces at said metabolic indicator rate;
- means, operational when said controlling means changes the operating mode from said first mode to said second mode, for correlating the metabolic indicator values measured by said measuring means and the intrinsic atrial rate determined by said intrinsic atrial rate determining means while the pacemaker is operating in said first mode;
- and
- means responsive to said correlating means for updating said rate response factor.
7 more elements
A method of operating a dual-chamber rate-responsive pacemaker, comprising the steps of:
- generating ventricular pacing pulses;
- sensing atrial heartbeats;
- determining an intrinsic atrial rate in response to said atrial heartbeat sensing step;
- measuring metabolic indicator values;
- determining a metabolic indicator rate as a function of the metabolic indicator values and a predetermined, continuously updating, rate response factor;
- comparing said metabolic indicator rate to said intrinsic atrial rate to determine whether said intrinsic atrial rate is pathological;
- controlling said generating and sensing steps to operate in a first, synchronous, mode in which said generating step generates ventricular pacing pulses in synchrony with the atrial heartbeats sensed by said sensing step when the intrinsic atrial rate is non-pathological, and otherwise controlling said generating and sensing steps to operate in a second, nonsynchronous, mode in which said generating step generates ventricular pacing pulses at the metabolic indicator rate;
- when said controlling step changes the operating mode from said first mode to said second mode, correlating the metabolic indicator values measured by said measuring step and the intrinsic atrial rate determined by said intrinsic atrial rate determining step while the pacemaker was operating in said first mode;
- and
- updating said rate response factor in response to the result of said correlating step.
7 more elements
A method of operating a dual-chamber rate-responsive pacemaker, comprising the steps of:
- generating atrial and ventricular pacing pulses;
- sensing atrial and ventricular heartbeats;
- determining intrinsic atrial rate values in response to said sensing step;
- measuring metabolic indicator values;
- determining metabolic indicator rates as a function of said metabolic indicator values and a predetermined rate response factor;
- ascertaining whether sensed atrial heartbeats are occurring at a rate which is pathological, on one hand, and non-pathological, on the other hand;
- storing at least one intrinsic atrial rate value and at least one metabolic indicator parameter when said ascertaining step has determined that the rate of atrial heartbeats is non-pathological;
- and
- controlling said generating and sensing steps to operate normally in a DDDR mode but to switch to a VVIR mode when the rate of atrial heartbeats is pathological, said controlling step, upon switching from the DDDR mode to the VVIR mode, operating to update said rate response factor as a function of said stored at least one intrinsic atrial rate value and said stored at least one metabolic indicator parameter, and said controlling step, thereafter functioning in the VVIR mode, operating to update said metabolic indicator rates as a function of said updated rate response factor and said stored metabolic indicator parameter.
6 more elements
A method of operating a dual-chamber rate-responsive pacemaker, comprising the steps of:
- generating ventricular pacing pulses;
- measuring metabolic indicator values;
- determining metabolic indicator rates as a function of said metabolic indicator values and a predetermined rate response factor;
- sensing atrial heartbeats;
- determining intrinsic atrial rate values in response to said atrial heartbeat sensing step;
- ascertaining whether sensed atrial heartbeats are occurring at rates which are pathological, on one hand, and non-pathological;
- storing at least one intrinsic atrial rate value and at least one metabolic indicator value when said ascertaining step has determined that the rate of atrial heartbeats is non-pathological;
- and
- controlling said generating and sensing steps to operate normally in a first mode in which ventricular pacing pulses are generated in synchrony with atrial heartbeats sensed in said sensing step but to switch to a second mode in which ventricular pacing pulses are generated at a rate which is a function of said metabolic indicator rates, with timing independent of said atrial heartbeats sensed by said sensing step, when said ascertaining step has determined that the rates of atrial heartbeats are pathological, said controlling step, upon switching from said first mode to said second mode, operating to update said rate response factor as a function of said stored at least one intrinsic atrial rate value and said stored at least one metabolic indicator value, and said controlling step, thereafter functioning in said second mode, operating to update said metabolic indicator rates as a function of said updated rate response factor and said stored metabolic indicator values.
6 more elements
Dependencies are inferred from the claim text.