# US 8,543,204 B2 · Timing pacing pulses in single chamber implantable cardiac pacemaker systems

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- Number: US 8,543,204 B2
- Document ID: US8543204B2
- Status: Granted
- Kind: B2
- Application number: 13/335,249
- Filed: 2011-12-22
- Published: 2013-06-27
- Granted: 2013-09-24
- Earliest claimed: 2011-12-22
- Assignees: Medtronic, Inc.
- Applicants: Wade M. Demmer; Paul A. Belk
- Inventors: Wade M. Demmer; Paul A. Belk
- Web page: https://patentgrep.com/patent/US8543204B2

## CPC

- A61N 1/36507: {controlled by gradient or slope of the heart potential}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

Methods for timing pacing pulses in an implantable single chamber pacemaker create a simulated, or virtual chamber in order to apply dual chamber-type algorithms and modes. For example, a virtual atrium may be constructed based on information provided by the ventricle, that is, the timing of actual intrinsic ventricular events, and the timing of paced ventricular events, both of which may be sensed as ventricular depolarization by electrodes of the implanted system.

## Claims

### Claim 1

A method for timing pacing pulses in a single chamber implantable cardiac pacemaker, the method comprising applying one or more dual chamber pacing algorithms by creating a virtual chamber.

### Claim 2 (depends on 1)

The method of claim 1, wherein creating the virtual chamber comprises:
constructing a virtual atrium by creating virtual sensed atrial events and virtual paced atrial events, the virtual sensed atrial events according to a virtual sensed AV interval, and the virtual paced atrial events according to a virtual paced AV interval, the virtual sensed and paced AV intervals being based upon intrinsic ventricular events sensed by implanted electrodes of the pacemaker; and
applying, by means of the implanted electrodes, a ventricular pacing pulse to create a paced ventricular event that is timed according to either the virtual paced AV interval or the virtual sensed AV interval, whenever an intrinsic ventricular event is not detected by the sensing within the virtual sensed AV interval.

### Claim 3 (depends on 2)

The method of claim 2, wherein the virtual sensed AV interval is further based upon a historic pattern of sensed intrinsic ventricular events.

### Claim 4 (depends on 2)

The method of claim 2, wherein the virtual paced AV interval is greater than the virtual sensed AV interval.

### Claim 5 (depends on 2)

The method of claim 2, wherein the virtual paced AV interval is further based upon a pre-programmed rate.

### Claim 6 (depends on 2)

The method of claim 2, wherein the virtual paced AV interval is further based upon input from a rate response sensor that tracks patient activity.

### Claim 7

An implantable single chamber cardiac pacemaker comprising a pulse generator having a microprocessor pre-programmed to time pacing pulses delivered by the pulse generator, according to one or more dual chamber algorithms, by creating a virtual chamber.

### Claim 8 (depends on 7)

The pacemaker of claim 7, further comprising implantable electrodes coupled to the pulse generator, and wherein creating the virtual chamber comprises:
constructing a virtual atrium by creating virtual sensed atrial events and virtual paced atrial events, the virtual sensed atrial events according to a virtual sensed AV interval, and the virtual paced atrial events according to a virtual paced AV interval, the virtual sensed and paced AV intervals being based upon intrinsic ventricular events sensed by the implantable electrodes; and
applying, by means of the electrodes, a ventricular pacing pulse to create a paced ventricular event that is timed according to either the virtual paced AV interval or the virtual sensed AV interval, whenever an intrinsic ventricular event is not detected by the sensing within the virtual sensed AV interval.

### Claim 9 (depends on 8)

The pacemaker of claim 8, wherein the virtual sensed AV interval is further based upon a historic pattern of sensed intrinsic ventricular events.

### Claim 10 (depends on 8)

The pacemaker of claim 8, wherein the virtual paced AV interval is greater than the virtual sensed AV interval.

### Claim 11 (depends on 8)

The pacemaker of claim 8, wherein the virtual paced AV interval is further based upon a pre-programmed rate.

### Claim 12 (depends on 8)

The pacemaker of claim 8, wherein the pulse generator further comprises a rate response sensor that tracks patient activity, and the virtual paced AV interval is further based upon input from the rate response sensor.