Implantable cardiac stimulation device with detection and therapy for patients with vasovagal syncope

An implantable cardiac stimulation device comprising:

• means for defining a programmable Base Rate, a Hysteresis Escape Rate below the Base Rate, and a Vasovagal Syncope Response Rate above the Base Rate;
• pulse generating means for generating stimulation pulses at one of the Base Rate, the Hysteresis Escape Rate, and the Vasovagal Syncope Response Rate based on a mode of operation;
• vasovagal syncope detecting means for detecting a non-rate-based parameter corresponding to vasovagal syncope;
• and
• control means for operating in a Vasovagal Syncope mode whenever the non-rate-based parameter indicates that vasovagal syncope is present, wherein the rate of stimulation pulses are immediately adjusted to the Vasovagal Syncope Response Rate whenever the non-rate-based parameter indicates that vasovagal syncope is present.

An implantable cardiac stimulation device comprising:

• means for defining a programmable Base Rate, a Hysteresis Escape Rate below the Base Rate, and a Vasovagal Syncope Response Rate above the Base Rate;
• pulse generating means for generating stimulation pulses at one of the Base Rate, the Hysteresis Escape Rate, and the Vasovagal Syncope Response Rate based on a mode of operation;
• vasovagal syncope detecting means for detecting a non-rate-based parameter corresponding to vasovagal syncope;
• control means for operating in a Vasovagal Syncope mode whenever the non-rate-based parameter indicates that vasovagal syncope is present, wherein the rate of stimulation pulses are adjusted to the Vasovagal Syncope Response Rate;
• sensing means for sensing ventricular cardiac signals and for determining an intrinsic ventricular heart rate;
• rate detecting means for detecting a sudden drop in the intrinsic heart rate as a secondary indication of vasovagal syncope;
• wherein the control means further comprises means for operating in the Vasovagal Syncope mode when the rate detecting means confirms the occurrence of vasovagal syncope;
• and
• means for disabling the vasovagal syncope detecting means upon detecting at least one episode of vasovagal syncope and for operating in the Vasovagal Syncope mode for each subsequent detection of a sudden drop in the intrinsic heart rate.

An implantable cardiac stimulation device comprising:

• means for defining a programmable Base Rate, a Hysteresis Escape Rate below the Base Rate, and a Vasovagal Syncope Response Rate above the Base Rate;
• pulse generating means for generating stimulation pulses at one of the Base Rate, the Hysteresis Escape Rate, and the Vasovagal Syncope Response Rate based on a mode of operation;
• vasovagal syncope detecting means for detecting a non-rate-based parameter corresponding to vasovagal syncope;
• control means for operating in a Vasovagal Syncope mode whenever the non-rate-based parameter indicates that vasovagal syncope is present, wherein the rate of stimulation pulses are adjusted to the Vasovagal Syncope Response Rate;
• sensing means for sensing ventricular cardiac signals and for determining an intrinsic ventricular heart rate;
• rate detecting means for detecting a sudden drop in the intrinsic heart rate as a secondary indication of vasovagal syncope;
• wherein the control means further comprises means for operating in the Vasovagal Syncope mode when the rate detecting means confirms the occurrence of vasovagal syncope;
• and
• hysteresis means for selectively extending a minimum stimulation pulse escape interval by adding a prescribed hysteresis value upon sensing a ventricular cardiac signal to produce a Hysteresis Escape Rate below the Base Rate;
• and
• means for determining when the intrinsic rate falls below the Hysteresis Escape Rate.

A method to stimulate a heart of a patient using an implantable cardiac stimulation device, the method comprising:

• defining a programmable Base Rate, a Hysteresis Escape Rate below the Base Rate, and a Vasovagal Syncope Response Rate above the Base Rate;
• generating stimulation pulses at one of the Base Rate, the Hysteresis Escape Rate, and the Vasovagal Syncope Response Rate based on a mode of operation;
• detecting a non-rate-based parameter corresponding to vasovagal syncope;
• and
• operating in a Vasovagal Syncope mode when the non-rate-based parameter indicates that vasovagal syncope is present, wherein the rate of stimulation pulses are immediately adjusted to the Vasovagal Response Rate when the non-rate-based parameter indicates that vasovagal syncope is present.