Titrated intermittent pacing therapy
AssigneeCardiac Pacemakers, Inc.
InventorsYanting Dong, Shantha Arcot-Krishnamurthy, Allan C. Shuros, David L. Whitehouse
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Abstract
Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's heart rate or exertion level to control the duty cycles of intermittent pre-excitation pacing.
Claims20
A cardiac device, comprising:
- one or more sensing amplifiers for forming sensing channels for sensing electrical cardiac activity;
- one or more pulse generators for forming pacing channels for delivering pacing pulses to one or more myocardial sites;
- a controller programmed to operate the device in either a normal operating mode or an intermittent pacing therapy (IPT) mode;
- wherein, in the IPT mode, the controller is programmed to deliver paces to the one or more myocardial sites using a pacing mode that results in some degree of ventricular dyssynchrony as compared with the normal operating mode;
- wherein the controller is programmed to:
- switch to the IPT mode according to a timed duty cycle schedule in which the device operates in the IPT mode for A seconds and operates in the normal mode for B seconds;
- set the IPT duty cycle duration values A and B as functions of a sensed or paced heart rate in which different heart rate values correspond to different duty cycle duration values and such that the IPT duty cycle duration value A is decreased in response to an increase in heart rate;
- and,
- deliver paces during the IPT mode at a pacing rate that is a specified percentage above the sensed heart rate wherein the specified percentage varies inversely with sensed heart rate.
A method for operating a cardiac device, comprising:
- sensing electrical cardiac activity;
- delivering pacing pulses to one or more myocardial sites;
- operating the device in either a normal operating mode or an intermittent pacing therapy (IPT) mode;
- in the IPT mode, delivering paces to the one or more myocardial sites using a pacing mode that results in some degree of ventricular dyssynchrony as compared with the normal operating mode;
- switching to the IPT mode according to a timed duty cycle schedule in which the device operates in the IPT mode for A seconds and operates in the normal mode for B seconds;
- setting the IPT duty cycle duration values A and B as functions of a sensed or paced heart rate in which different heart rate values correspond to different duty cycle duration values and such that the IPT duty cycle duration value A is decreased in response to an increase in heart rate;
- and,
- delivering paces during the IPT mode at a pacing rate that is a specified percentage above the sensed heart rate wherein the specified percentage varies inversely with sensed heart rate.
Dependencies are inferred from the claim text.