Dual chamber, multi-mode external pacemaker

A simplified method of changing the pacing mode of a dual chamber, rate-responsive pacemaker pulse generator adapted to be attached with atrial and ventricular pacing and sensing leads of the type comprising:

• atrial sense amplifier means adapted to be coupled to an atrial pacing and sensing lead for sensing natural atrial depolarizations as atrial sensed events;
• ventricular sense amplifier means adapted to be coupled to a ventricular pacing and sensing lead for sensing natural ventricular depolarizations as ventricular sensed events;
• atrial pulse generator means adapted to be coupled to said atrial pacing and sensing lead for providing atrial pacing pulses to the patient's atrium at a selected atrial pace pulse amplitude;
• atrial pace pulse amplitude adjusting means for adjusting said atrial pace pulse amplitude to amplitude settings in an operating range of delivered atrial pace pulse amplitude and to a no atrial output setting;
• ventricular pulse generator means adapted to be coupled to said ventricular pacing and sensing lead for providing ventricular pacing pulses to the patient's ventricle at a selected ventricular pace pulse amplitude;
• ventricular pace pulse amplitude adjusting means for adjusting said ventricular pace pulse amplitude to amplitude settings in an operating range of delivered ventricular pace pulse amplitude and to a no ventricular output setting;
• and
• timing and control means coupled to said atrial and ventricular sense amplifier means and pulse generator means for responding to atrial and ventricular sensed events for timing intervals and for triggering said atrial and ventricular pulse generators to provide atrial and ventricular pacing pulses having pulse amplitudes in the adjusted operating ranges thereof, and wherein said method comprises the steps of:
• switching the pacing mode of said timing and control means to a dual chamber pacing mode when said atrial and ventricular pace pulse amplitudes are set to said operative ranges;
• switching the pacing mode of said timing and control means to an atrial pacing mode when said ventricular pace pulse amplitued setting means is set to said no ventricular output setting;
• and
• switching the pacing mode of said timing and control means to a ventricular pacing mode when said atrial pace pulse amplitude setting means is set to said no atrial output setting.

A multi-mode, dual chamber pacemaker pulse generator operable in at least the DDD, VVI and AAI pacing and sensing modes, comprising:

• atrial sense amplifier means coupled to an atrial pacing and sensing lead for sensing natural atrial depolarizations as atrial sensed events;
• ventricular sense amplifier means coupled to a ventricular pacing and sensing lead for sensing natural ventricular depolarizations as ventricular sensed events;
• atrial pulse generator means coupled to the atrial lead for providing atrial pacing pulses to the atrium at a selected atrial pace pulse amplitude;
• atrial pace pulse amplitude selection means adjustable to one of an operative range setting and a no atrial output setting;
• ventricular pulse generator means coupled to the ventricular lead for providing ventricular pacing pulses to the ventricle at a selected ventricular pace pulse amplitude;
• ventricular pace pulse amplitude selection means adjustable to one of an operative range ventricular pace pulse amplitude setting and a no ventricular output setting;
• and
• timing and control means, coupled to the atrial and ventricular sense amplifier and pulse generator means, for triggering the pulse generators to provide pacing pulses in accordance with the pacing and sensing modes, and having first means for switching the pacing and sensing mode to:
• (i) the DDD or DDI mode when the atrial or ventricular pace pulse amplitude selection means is adjusted to the operative range amplitude setting;
• (ii) the VVI mode when the atrial pace pulse amplitude selection means is adjusted to the no atrial output setting, and
• (iii) the AAI mode when the ventricular pace pulse amplitude selection means is adjusted to the no ventricular output setting.

An external multi-mode, dual chamber pacemaker pulse generator operable in at least the DDD and AAI pacing and sensing modes, comprising:

• (a) ventricular pulse generator amplitude controlling means adjustable to at least one of an operable range setting where the pulse generator delivers pacing pulses to the ventricle through a ventricular pacing and sensing lead and a no ventricular output setting where the pulse generator delivers no pacing pulses to the ventricle;
• (a) timing and control means, coupled to atrial and ventricular sense amplifier and pulse generator means, for providing pacing pulses according to at least the DDD and AAI pacing and sensing modes;
• (b) mode switching means, connected to the timing and control means, for switching the pacing and sensing mode to:
• (i) the DDD or DDI mode when the atrial or ventricular pace pulse amplitude is adjusted to the operative range amplitude setting, and
• (ii) the AAI mode when the ventricular pace pulse amplitude is adjusted to the no ventricular output setting.

An external multi-mode, dual chamber pacemaker pulse generator operable in at least the DDD and VVI pacing and sensing modes, comprising:

• (a) atrial pulse generator amplitude controlling means adjustable to at least one of an operable range setting where the pulse generator delivers pacing pulses to the atrium through an atrial pacing and sensing lead and a no atrial output setting where the pulse generator delivers no pacing pulses to the atrium;
• (a) timing and control means, coupled to atrial and ventricular sense amplifier and pulse generator means, for providing pacing pulses according to at least the DDD and VVI pacing and sensing modes;
• (b) mode switching means, connected to the timing and control means, for switching the pacing and sensing mode to:
• the DDD or DDI mode when the atrial or ventricular pace pulse amplitude is adjusted to the operative range amplitude setting, and
• (ii) the VVI mode when the atrial pace pulse amplitude is adjusted to the no atrial output setting.

An external multi-mode, dual chamber pacemaker pulse generator operable in at least the DDD and AAI pacing and sensing modes, comprising:

• (a) ventricular pulse generator amplitude controlling means adjustable to at least one of an operable range setting where the pulse generator delivers pacing pulses to the ventricle through a ventricular pacing and sensing lead and a no ventricular output setting where the pulse generator delivers no pacing pulses to the ventricle;
• (b) mode switching means, responsive to the ventricular pulse generator amplitude controlling means, for switching the pacing and sensing mode of the pacemaker to:
• (i) the DDD or DDI mode when the ventricular pace pulse amplitude is adjusted to the operable range setting, and
• (ii) the AAI mode when the ventricular pace pulse amplitude is adjusted to the no ventricular output setting.

An external multi-mode, dual chamber pacemaker pulse generator operable in at least the DDD and VVI pacing and sensing modes, comprising:

• (a) atrial pulse generator amplitude controlling means adjustable to at least one of an operable range setting where the pulse generator delivers pacing pulses to the atrium through an atrial pacing and sensing lead and a no atrial output setting where the pulse generator delivers no pacing pulses to the atrium;
• (b) mode switching means, responsive to the atrial pulse generator amplitude controlling means, for switching the pacing and sensing mode of the pacemaker to:
• (i) the DDD or DDI mode when the atrial pace pulse amplitude is adjusted to the operable range setting, and
• the VVI mode when the atrial pace pulse amplitude is adjusted to the no atrial output setting.