PVC response-triggered blanking in a cardiac pacing system
AssigneeMedtronic, Inc.
InventorChester Struble
Life of this patent
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Abstract
A biventricular pacing system incorporates a premature ventricular contraction (PVC) response. The biventricular pacing system also includes a programmable ventricular blanking period (VBP) that is initiated with the PVC response. During the programmed VBP, ventricular events are effectively blanked out. This prevents both ventricular leads from each independently initiating a dual PVC response, based on the same PVC event.
Claims65
An implantable cardiac pacemaker, comprising:
- a first ventricular lead;
- a second ventricular lead;
- and
- a controller that controls the implantable cardiac pacemaker based in part on signals received from the first and second ventricular leads, and initiates an extended post ventricular atrial refractory period of between about 350-450 ms, during which sensed atrial events are ignored, and a programmable ventricular blanking period in response to a premature ventricular contraction.
The implantable cardiac pacemaker of 7, wherein the margin of error is equal to approximately 10-30% of the interventricular conduction delay.
An implantable medical device, comprising;
- biventricular pacing and sensing leads;
- and
- a programmable cardiac pacing system coupled to the biventricular pacing and sensing leads, and having a preprogrammed premature ventricular contraction response function that initiates an extended post ventricular atrial refractory period for a first predetermined period of time of between about 350-450 ms, during which sensed atrial events are ignored, and initiates a programmed ventricular blanking period for a second predetermined period of time, following the detection of a premature ventricular contraction.
A method of preventing pacemaker mediated tachycardia in a biventricular cardiac pacing system, the method comprising:
- detecting a premature ventricular contraction;
- initiating an extended post ventricular atrial refractory period of between about 350-450 ms during which atrial events are not sensed by the cardiac pacing system;
- and
- initiating a programmable ventricular blanking period, during which ventricular events are not sensed by the cardiac pacing system.
A method of utilizing a biventricular cardiac pacing system, the method comprising:
- providing a first ventricular lead and a second ventricular lead;
- sensing atrial and ventricular events;
- classifying a sensed ventricular event following another ventricular event without an intervening atrial event as a premature ventricular contraction;
- initiating a first time period, during which atrial events are blanked out by the cardiac pacing system so that pacemaker mediated tachycardia is avoided;
- and
- initiating a second time period, during which ventricular events are blanked out by the cardiac pacing system, wherein the second time period is at least as long as an interventricular conduction delay so that an event sensed by the first ventricular lead and classified as the premature ventricular contraction is not subsequently classified as another premature ventricular contraction when sensed by the second ventricular lead, so that an extended ventricular sensing cycle is avoided.
An implantable programmable biventricular cardiac pacing system, comprising:
- an atrial lead;
- a first ventricular lead;
- a second ventricular lead;
- a microprocessor coupled to the atrial lead and the first and second ventricular leads, the microprocessor being configured to monitor sensed ventricular and atrial events so that a ventricular event sensed after another ventricular event without an intervening atrial sense is determined to be a premature ventricular contraction;
- and
- a programmable microcomputer circuit coupled to the microprocessor and including an algorithm for responding to a determined premature ventricular contraction by initiating an extended post ventricular atrial refractory period, during which atrial events are blanked for a period of between about 350-450 ms, and initiating a programmable ventricular blanking period having a duration equal to a measured value of an interventricular conduction delay plus a margin of error equal to about 10-30% of the interventricular conduction delay, during which ventricular events sensed by the first or the second ventricular lead are ignored so that both pacemaker mediated tachycardia and extended ventricular sensing are avoided by the cardiac pacing system.
An implantable cardiac pacemaker, comprising:
- means for sensing biventricular events;
- and
- means for controlling the implantable cardiac pacemaker based in part on signals received from the means for sensing biventricular events, and initiating an extended post ventricular atrial refractory period of between about 350-450 ms, during which sensed atrial events are ignored, and a programmable ventricular blanking period in response to a premature ventricular contraction.
The implantable cardiac pacemaker of 49, wherein the margin of error is equal to approximately 10-30% of the interventricular conduction delay.
A biventricular cardiac pacing system configured to prevent pacemaker mediated tachycardia, comprising:
- means for detecting a premature ventricular contraction;
- means for initiating an extended post ventricular atrial refractory period of between about 350-450 ms during which atrial events are not sensed by the cardiac pacing system;
- and
- means for initiating a programmable ventricular blanking period, during which ventricular events are not sensed by the cardiac pacing system.
A biventricular cardiac pacing system, comprising:
- means for sensing atrial and biventricular events;
- means for classifying a sensed ventricular event following another ventricular event without an intervening atrial event as a premature ventricular contraction;
- means for initiating a first time period, during which atrial events are blanked out by the cardiac pacing system so that pacemaker mediated tachycardia is avoided;
- and
- means for initiating a second time period, during which ventricular events are blanked out by the cardiac pacing system, wherein the second time period is at least as long as an interventricular conduction delay so that an event sensed by the first ventricular lead and classified as the premature ventricular contraction is not subsequently classified as another premature ventricular contraction when sensed by the second ventricular lead, so that an extended ventricular sensing cycle is avoided.
Dependencies are inferred from the claim text.