Biatrial triple-chamber cardiac pacemaker with multi-conditional inhibition of second atrial stimulation

A biatrial triple-chamber pacemaker for use with a heart having a first and a second atrium and a first and a second ventricle, said pacemaker comprising:

• at least one sensing unit for sense events of the first atrium and the first ventricle;
• at least one stimulation unit which is adapted to produce stimulation pulses to the second atrium and the first ventricle;
• and
• a control unit which is connected to the sensing unit and the stimulation unit and which is adapted to evaluate, for actuating the stimulation unit, at least the atrial sense events (AR-Sense) associated with the first atrium and the ventricular sense events (V-Sense) associated with the first ventricle;
• wherein the stimulation unit is actuated with regard to a ventricular escape interval and a postatrial ventricular blanking time such that an occurrence of the atrial sense event (AR-Sense) triggers the ventricular escape interval, at the end of which a ventricular stimulation pulse is triggered if same is not inhibited by an occurrence of the ventricular sense event within the ventricular escape interval and outside the postatrial ventricular blanking time,
• wherein the stimulation unit is actuated with regard to an interatrial conduction time such that an occurrence of the atrial sense event (AR-Sense) triggers an interatrial conduction timer to create a predetermined AR-AL time interval, at the end of which a stimulation pulse to the second atrium is triggered if the stimulation pulse to the second atrium is not inhibited, and
• wherein the stimulation unit is actuated such that the delivery of a stimulation pulse to the second atrium is suppressed when previously an occurrence of the ventricular sense event occurs in a crosstalk window which adjoins a postatrial ventricular blanking time and at the same time a time interval, between a last ventricular sensed event occurring outside the crosstalk window and a next possible (scheduled) ventricular stimulation event, is greater than a predetermined maximum value.