WO1997011746A1 - Adaptive search av and auto pvarp adaptation to same with additional benefit - Google Patents
Adaptive search av and auto pvarp adaptation to same with additional benefit Download PDFInfo
- Publication number
- WO1997011746A1 WO1997011746A1 PCT/US1996/013667 US9613667W WO9711746A1 WO 1997011746 A1 WO1997011746 A1 WO 1997011746A1 US 9613667 W US9613667 W US 9613667W WO 9711746 A1 WO9711746 A1 WO 9711746A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- interval
- value
- pacemaker
- pvarp
- determining
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
- A61N1/3682—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions with a variable atrioventricular delay
Definitions
- This invention relates to adjustments made to the timing of specific pacemaker monitored intervals, particularly the AV interval and the PVARP or PVAB.
- AV AtrioVentricular, or the time between the beginning of an atrial event and the beginning ofthe next and probably dependent ventricular event
- PVARP Post Ventricular Atrial Refractory Period, that is, the time the pacemaker considers sensing events in the atrium after a ventricular pace as non-events
- PVAB Post Ventricular Atrial Blanking period, i.e. the period of time after a pace that the re is no sensing at all in the atrium.
- TARP Total Atrial Refractory Period
- TAB Total Atrial Blanking period
- the indication for changing the length of the AV interval is primarily rate _ adaptive pacing.
- Rate adaptive pacers which follow a patient's physiologic demand have been available for some time.
- Recent examples include U.S. Patent No. 5,271,395 (Wahlstrand et al.), U.S. Patent No. 4,856,524 (Baker, Jr.) which use an AV interval timer instead of an activity sensor (as in U.S. Patent No. 5,052,388 to Sivula et al.), and one which uses minute ventilation (as in 5,271 ,395 Wahlstrand) to determine the appropriate pacing rate. Adjusting AV intervals to be different for atrial synchronous verses atrial ventricular sequential pacing has been taught in US Patent No. 4,421,116 issued to Markowitz. Also, shortening AV intervals to be delivered after an atrial pacing pulse for DDl mode pacing was shown in Levine et al., US Patent No. 5,417,714.
- Pacemaker technology has been around for some 30 years.
- the technology for implanting such hermetically sealed electrical pulse generators (usually with batteries for power) responsive to a patient's pacing needs are well known in many aspects and those will not be described with particularity here. Instead, the reader should refer to descriptions available in the art cited in this application and other readily available literature.
- An AV interval is important to maintain for AV block patients.
- AV block means that an event in such a patient's atrium will not propagate into the ventricle, and thus the ventricles must be artificially paced.
- the AV interval is used to time such an artificial ventricular pacing pulse.
- a particularly problematic situation exists in intermittent AV block patients, since the opportunity for natural conduction will be prevented by having an AV interval that is shorter than the natural one.
- CardioMyopathy (HOCM).
- Bailey, et al (article 188, X World Con.) that an automated AV interval adjustment could be used to maintain ventricular capture or to prevent ventricular pseudofusion.
- some complications develop where the pacing device depends on an adjusting AV _ interval for also adjusting the PVARP.
- a V block is not something currently available in a pacemaker system.
- the atrial tracking behavior of a pacemaker at high rates is defined by the upper tracking rate interval time value and the sum of the AV interval and the time of the PVARP.
- changes to the AV interval on an ambulatory basis for preservation of AV conduction or optimization for HOCM patients would alter this behavior at high rates as the changes have not been coordianted with the value of PVARP or the pacemaker's upper rate.
- Other adjustments can also be made which are described in reference to alternate preferred embodiments herein. Summary of the Invention
- An implantable dual chamber pulse generator(IPG) capable of determining if AV conduction is occurring so as to eliminate a substantial number of unnecessary ventricular paces wherein said IPG maintains in memory an updatable value for an AV interval upon which value said IPG makes a determination of when to deliver a next ventricular pacing pulse, said IPG further characterized in that it has: means for determining whether a Ventricular Sense(VS) event would possibly occur after a scheduled Ventricular Pace(VP) by causing a temporary extension to the
- An implantable dual chamber pulse generator(IPG) capable of determining if
- AV conduction is occurring so as to eliminate a substantial number of unnecessary ventricular paces
- said IPG maintains in memory an updatable value for an AV interval upon which value said IPG makes a determination of when to deliver a next ventricular pacing pulse
- said IPG further comprising: means for determining whether a Ventricular Sense(VS) event would occur after a scheduled Ventricular Pace(VP) having a set of rules to apply to a set of stored data on AV event sequences, whereby said set of rules will determine whether to lengthen or to shorten or to not change the duration of said stored AV interval value, and means for adjusting the AV interval value responsive to said means for determining.
- the pacemaker of claims 1-3 further comprising means for storing a predetermined number of AV event cycles' timing values prior to each use of said determining means.
- the pacemaker of claim 4 wherein said determining means determines whether more than a predetermined amount of said stored event cycles either ended in a VP event or a VS event within FT.
- said means for determining further determines whether more than said predetermined number ended in VS that were shorter than TST, and if so shortening the AV interval value kept by the pacemaker, but if not and if, less than or the same number of stored event cycles ended in a VP or a VS within FT, then leaving the current value of said pacemaker maintained AV interval as is.
- the pacemaker of claims 1-6 further comprising a min/max determining means to determine whether the value for AV interval kept by the pacemaker is within range of predetermined max and min values.
- a pacemaker having means for automatically adjusting the PVARP on a beat to beat basis in a pacemaker in a patient, that keeps values for a 2: 1 block point and a corresponding interval value therefor and which also keeps at least one value for an AV interval, said means for adjusting comprising: means to determine a 2: 1 block point for a given beat to beat sequence, and means to set the PVARP equal to the interval value ofthe 2: 1 block point minus one ofthe at least one interval values for the AV interval.
- a pacemaker as set forth in claims 1-10 having means to reset the AV interval value up to a predetermined minimum.
- An IPG as set forth in claims 1-11 further comprising means for storing values for Sense AV intervals and Pace AV intervals, such that said means for lengthening said AV interval value allows for the adding to or subtracting from said stores values for a Sense AV interval and for a Paced AV interval such that the stored and updatable value for the AV interval is added to or subtracted from said Pace AV interval value after an atrial pace but added to or subtracted from said Sense AV interval value after an atrial sense.
- Figs la and lb are paired marker charmel and surface ECG diagrams.
- Fig. 2 is a block diagram schematic of an implantable pulse generator (IPG or pacemaker) that may be used with preferred embodiments of this invention.
- IPG implantable pulse generator
- Fig. 3 is a flow chart ofthe adaptive AV search algorithm in accord with a preferred embodiment.
- Fig 4 is a continuation ofthe flowchart in Fig 3 for a preferred embodiment.
- Fig. 5 is a flow chart of another form ofthe algorithm of figs 3 and 4.
- Fig. 6 is a flow diagram ofthe Automatic PVARP adaptation algorithm in accord with a preferred embodiment.
- Fig. 7 is a graph of heart rate vs time showing the 2:1 block point vis-a-vis atrial rate.
- FIG. 2 is a block circuit diagram illustrating one possible form of a pacemaker 10 capable of carrying out the present invention.
- the present invention is described in conjunction with a microprocessor-based architecture, it is understood that it could be implemented in other technology such as digital logic- based, custom integrated circuit (IC) architecture, analog circuits, etc., if desired. It is also understood that the present invention may be implemented in cardioverters, defibrillators and the like.
- Lead 14 includes an electrode 24 located near its distal end positioned within the right ventricle 16.
- Electrode 24 is coupled by a lead conductor 14 through an input capacitor 26 to the node 28, and to the input/output terminals of an input/output circuit 30.
- Lead 15 has a distal electrode positioned within the right atrium 17.
- Electrode 22 is coupled by a lead conductor 15 through an input capacitor 75 to a node 76, and to the input/output terminals ofthe input/output circuit 30.
- Input/Output Circuit 30 contains the operating input and output analog circuits for digital controlling and timing circuits to detect electrical signals derived from the heart, such as the cardiac electrogram (EGM or ECG). It also receives output from sensors (not shown but which may be connected to the leads 14 and 15), and it is the part which applies stimulating pulses to the heart under the control of software- implemented algorithms in a Microcomputer Circuit 32.
- ECG cardiac electrogram
- Microcomputer Circuit 32 has an On-Board Circuit 34 and an Off-Board Circuit 36.
- On-Board Circuit 34 includes a microprocessor 38, a system clock 40, and on-board RAM 42 and ROM 44.
- Off-Board Circuit 36 includes an off-board RAM/ROM Unit 46.
- Microcomputer Circuit 32 is coupled by Data Communication
- Microcomputer Circuit 32 may be fabricated of custom IC devices augmented by standard RAM/ROM components. The computation and running ofthe algorithmic processes described below occur within this circuit area generally, based on signals from the rest of the IPG. all the variables defined in terms of value are preferably stored and updated within this circuit 32.
- An antenna 52 is connected to Input/Output Circuit 30 for purposes of uplink/downlink telemetry through a radio frequency (RF) Transmitter/Receiver
- RF TX RX Telemetering both analog and digital data between antenna 52 and an external device, such as an external programmer (not shown), is accomplished in the preferred embodiment by means as substantially described in U.S. Pat. No. 5,127,404, issued on July 7, 1992, entitled “Telemetry Format for Implantable Medical Device", incorporated herein by reference.
- a reed switch 51 is connected to Input/Output Circuit 30 to enable patient follow-up via disabling the sense amplifier 146 and enabling telemetry and programming functions, as is known in the art.
- a Crystal Oscillator Circuit 56 typically a 32,768 Hz crystal-controlled oscillator, provides main timing clock signals to Digital Controller/Timer Circuit 50. Most timing periods depend on a clock to turn on or off under program control, and the length of timing is generally established with reference to a number of clock cycles.
- a Vref Bias Circuit 58 generates a stable voltage reference and bias currents for the analog circuits of Input/Output Circuit 30.
- An ADC/Multiplexer Circuit (ADC/MUX) 60 digitizes analog signals and voltages to provide telemetry and a _ replacement time-indicating or end-of-life function (EOL).
- POR functions to initialize the pacemaker 10 with programmed values during power-up, and reset the program values to default states upon the detection of a low battery condition or transiently in the presence of certain undesirable conditions such as unacceptably high electromagnetic interference (EMI), for example.
- the operating commands for controlling the timing ofthe pacemaker depicted in Figure 2 are coupled by bus 48 to Digital Controller/Timer Circuit 50 wherein digital timers set the overall escape interval ofthe pacemaker, as well as various refractory, blanking and other timing windows for controlling the operation ofthe peripheral components within Input/Output Circuit 50.
- This circuit works hand-in- glove with the microcomputer circuit 32 as will be appreciated by those of ordinary skill in this art.
- Digital Controller/Timer Circuit 50 is coupled to sense amplifiers (SENSE) 64 and 67, and to electrogram (EGM) amplifiers 66 and 73 for receiving amplified and processed signals picked up from electrode 24 through lead 14 and capacitor 26, and for receiving amplified and processed signals picked up from electrode 22 through lead 15 and capacitor 75, representative ofthe electrical activity ofthe patient's ventricle 16 and atrium 17, respectively.
- SENSE amplifiers 64 and 67 produce sense event signals for re-setting the escape interval timer within Circuit 50.
- the electrogram signal developed by EGM amplifier 66 is used in those occasions when the implanted device is being interrogated by the external prograrnmer/transceiver (not shown) in order to transmit by uplink telemetry a representation ofthe analog electrogram ofthe patient's electrical heart activity as described in U.S. Pat. No. 4,556,063, issued to Thompson et al., entitled “Telemetry System for a Medical Device", incorporated herein by reference.
- Output pulse generators 68 and 71 provide the pacing stimuli to the patient's heart 1 1 through output capacitors 74 and 77 and leads 14 and 15 in response to paced trigger signals developed by Digital Controller/Timer Circuit 50 each time the escape interval times out, or an externally transmitted pacing command has been received, or in response to other stored commands as is well known in the pacing art.
- pacemaker 10 is capable _ of operating in various non-rate-responsive modes which include DDD, DDl, VVI,
- pacemaker 10 can be programmably configured to operate such that it varies its rate only in response to one selected sensor output, or in response to both sensor outputs, if desired. Many other features and functions of pacemakers may be inco ⁇ orated without going beyond the scope of this invention.
- Figs la and lb in which a marker channel diagram 90 and time associated surface ECG 91 are shown, the terms PVARP, PVAB, TAB, TARP and (S and P)AV are visually illustrated. They are defined in text in the background section above. It is useful to also observe that the second "QRS complex" QRS2(91 ) is wider than the first, due, we believe, to the fact that it is paced as opposed to "natural”.
- This algorithm generally adapts the AV interval to lengthen where the patient is capable of AV conduction and to shorten otherwise.
- the adaptive AV search should not be used since its purpose is to promote natural conduction to the ventricle rather than to maintain an artificially early ventricular pacing therapy as is used for the HOCM patient.
- the first step is to enable the algorithm in step 11 , assuming or determining initial values for the AV intervals.
- Running the pacemaker on these values in step 12 the pacemaker collects data or runs for a number of AV event sequences until the decision at step 13 is satisfied. (To satisfy step 13, no event cycles that end in a safety pace are counted.
- a "Safety Pace” is a pacing pulse that is triggered by a ventricular sense which occurs within a set period, in preferred embodiments, 110 ms of an atrial pace. The pacemaker thus delivers a ventricular safety pace at 110 ms AV interval.
- the ventricular sense was crosstalk, that is, sensing ofthe atrial pace energy in the ventricle, this provides pacing support in the ventricle. If it was a true ventricular event (R-wave), the ventricular pace will be close enough to the R-wave to land in cardiac refractory tissue and not capture the heart. The algorithm will not count safety paces so as to ignore the ventricular senses that trigger safety paces since we don't know if they were really R-waves. The algorithm will also ignore all data from heartbeats during which the AV interval was shortened to preserve a high 2:1 block point. In other words, those beats that cause the automatic PVARP algorithm to set the SAV shorter because the PVARP is longer than the patient's retrograde conduction time are ignored. This is described with reference to Fig. 6 below, step 211.)
- step 14 the program moves to step 14, where it makes a determination of whether more than one half the event cycles end in either a VP or a VS within
- Step 15 the AV interval value is lengthened (step 15), if not, a second determination is made in step 20.
- Step 21 shortens the AV interval if it was determined in step 20 that more than one half of the VS-ended event cycles in the collected data are shorter than (i.e., occur before)the Too Short Tolerance point.
- AV delay is shortened (this prevents a 1 -way algorithm, _ shortening the AV when conduction times are shorter than the AV interval value.
- step 22 If neither criteria is met, zero out the counters (step 22) and leave the AV as programrned(step 19).
- Typical values for fusion tolerance (FT) would be 30ms before the VS, and too short tolerance (TST) would be 60-70 ms.
- TST too short tolerance
- the next thing this algorithm does is to check if the AV interval is too long or too short(step 16). These values are set by the manufacturer in the preferred embodiment devices.
- a block 17 is included in the figure to suggest that the value could be reset to the minimum or maximum value either after the lengthening or shortening is done or that the algorithm could hold the value till resolution of step 16. Only if we satisfy the first rule to extend the AV, and want to extend the AV, but we would exceed the maximum AV allowed, will the algorithm go into a new search mode to determine whether to continue this search AV algorithm and if so at what extended intervals.
- this is accomplished by using progressively longer search delay times - starting at for example, 1 hour, and doubling each time until a maximum of 16 hours, and then turning the search for an appropriate AV interval off altogether because there is sufficient proof of natural conduction.
- the feature could turn itself off entirely if a number of times we searched to the maximum AV and did not discover conduction.
- TST Too Short Tolerance
- Fig 4 the algorithm 100 is modified below the dotted line to accommodate two AV intervals. Taken together with Fig 3 where indicated this provides a complete flow chart for this form ofthe preferred embodiment algorithm.
- the activity is to EXTEND PAV, rather than to EXTEND the AV interval value, and so on, throughout the diagram.
- step 14 the branch into fig. 3, step 14 is taken, but if the majority of these 16 cycles are initiated with AS events, the branch to 14a in fig 4 is taken. In this way the SAV values and PAV values are maintained independently.
- sixteen is not a necessary number for the number of data cycles to satisfy step 13, nor is it necessary that a simple majority be used for making the later determination, however, given the constraints of power, time and memory in the modern pacemaker, these seem preferred values.
- Values for FT in the preferred embodiment is roughly 16 microseconds(msecs) and for TST, roughly 40msecs, although the reader may prefer other similar values without abandoning the ambit of this invention.
- Steps 21 and 21a shorten their AV/SAV/PAV intervals by 7.8125 msecs, and 15 and 15a lengthen their AV/PAV/SAV intervals by 15.625msecs, although obviously different values could be used if desired.
- the pacemaker can establish them as separate values by keeping a start value of different magnitudes for each and adding or subtracting the value ofthe single offset from that start value.
- the start values could be, for example, 120msecs for the SAV and 150msecs for the PAV. IN this scheme, they would move in tandem, but always be separated by 30 msecs.
- a more general preferred algorithm for search A V is described with reference to Fig. 5 in which the algorithm 103 Starts with some initial values in step 51. On the first round step 52 may be skipped, but generally it will wait a programmed number of beats before moving to the search for VS events in step 53. If a VS is found by extending the AV interval and sensing one during the search beat taken in step 53, this algorithm moves on to step 57, in which the pacemaker kept value ofthe AV interval is updated.
- step 53 the preferred embodiment goes through an attenuation routine in step 56, just like the attenuation routine in step 17/17a of Figs 3 and 4.
- Preferred values for Minimum times for AV would be around 50 milliseconds(msecs) and for a Maximum value generally around 250msecs.
- Automatic PVARP The PVARP has two main purposes in the pacemaker. First it protects from retrograde atrial events being sensed by the pacemaker and starting AV rhythms inappropriately. Otherwise the resulting rhythm will be a "Circus movement or "Endless loop" tachycardia. If the PVARP length is longer than the patient's VA conduction time this rhythm cannot occur. Secondly the PVARP controls the range of rates the patient can synchronize to.
- TARP Total Atrial Refractory Period
- an upper rate is often set to help the patient avoid an ischemic condition which would occur if the intrinsic rate were to be followed. This can occur because of a diseased condition in the patient's heart, or in other words, because the heart is incapable of operating at the rates the body wants it to.
- the physician will set the upper rate to something he feels the patient's heart can handle. Since the atrial rate may go beyond that, the Wenkebaching that occasionally drops a ventricular pace is a hemodynamicly reasonable compromise to the heart's assumed diminished capability and the body's intrinsic demand.
- Atrial tachycardia or flutter is not something that should be allowed to develop either, and the pacemaker will assume that a tachy condition has developed when the atrial rate to the ventricular rate is approaching 2:1.
- This automatic PVARP is designed to determine what the appropriate 2: 1 block point is for a current atrial rate, and allows the pacemaker to be responsive to intrinsic need. It is designed to accommodate changing AV interval size which may be occurring for other reasons (HOCM therapy, for example).
- the 2: 1 block can be any value above the atrial (A-A) interval value. In the presently most preferred embodiment we have chosen 30 beats per minute (bpm). the atrial interval is one of those values kept by the pacemaker and updated on a regular basis.
- the MAI or mean atrial interval although it is not actually a "mean” value, rather it represents the value determined by our pacemakers to be the true atrial interval value.
- This MAI value is used to determine if a tachyarrhythmia or flutter is occurring in the atrium, and to follow the intrinsic rate, among other things Thus if the 30bpm we have chosen is added to the MAI of, say, 100 bpm, and the current A-A interval indicates that the intrinsic rate is greater than or equal to 130bpm, our pacemaker determines that a tachy condition is occurring. In other words, the 2: 1 block point has been reached or exceeded.
- Step 1 add 30 bpm to the MAI.
- Step 2 if greater than 100 bpm use (30+MAI)bpm else use 100 bpm.
- Step 3 use the lesser of the value from Step 2 or (35bpm +Upper Rate) This gives us a 2:1 point bounded by 100 bpm and Upper rate + 35 bpm, and allows it to move up with increasing intrinsic rate.
- the automatic PVARP algorithm 200 starts with the occurrence of an AV sequential ventricular event(step 201).
- the Current 2:1 block point is set(Step 202) equal to the sum of the temp SAV value and the temp PVARP values. In other words the program is initialized with the current values.
- the next step 203 sets the
- Target 2:1 equal to the true atrial interval (current MAI or MA"R" for Rate).
- the sorting to find the correct 2:1 value to use is done.
- the step 204 value picks the maximum between the value from step 203 and 100 bpm.
- step 205 picks the minimum from between that and the upper tracking rate plus the offset of 35 bpm.
- the algorithm decides whether the temporary 2: 1 is less than the target 2:1 established in step 205.
- the temporary 2:1 was either the initial value or the one set the last time through this algorithm.
- the new value for PVARP is set at the Target 2:1 minus the current operating SAV interval rate value. In this case the program can then exit and wait for the next ventricular event.
- the answer to the question of 206 is yes, a nother determination must be made, that is, is the current PVARP value less than the patient's retrograde conduction time? (this is a number either set by the pacemaker manufacturer or the physician). If yes, the PVARP value is increased to be at least as long as that retrograde conduction time (step 209) and the SAV value is set to the value ofthe Target 2: 1 minus this PVARP value.
- the next step 211 is a way for this algorithm to function with the algorithm of Figs 3 and 4 above. In other words, if we have gone down this step 209 branch, this ventricular beat should be ignored by the adaptive AV search. The simplest way to accomplish this is to add a flag bit to the data kept for this beat by the AV search algorithms, this flag being set by this
- step 212 the algorithm decides if the SAV value determined in step 210 is less than the minimum SAV and if so resets it to the minimum SAV value(step 213), and in either case exits.
- step 208 if a no decision was taken, the PVARP value is set to the Target 2: 1 minus the SAV value in step 214, then if this is less than the patient's retrograde conduction time, again the step 209 branch is taken. Otherwise the program can exit here.
- Target 2 120 bpm, or 500ms.
- Subtracting the SAV would give a PVARP of 300ms, which is shorter than the minimum allowed. So PVARP can only go down to 350.
- Current TARP 550, different from the Target TARP of 500ms. this will require the SAV to shorten by 50ms or down to the minimum allowed) so
Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU72350/96A AU716594B2 (en) | 1995-09-29 | 1996-08-23 | Adaptive search AV and auto PVARP adaptation to same with additional benefit |
EP96933737A EP0794813B1 (en) | 1995-09-29 | 1996-08-23 | Adaptive search av algorithm |
JP51341897A JP4041912B2 (en) | 1995-09-29 | 1996-08-23 | Implantable two-chamber pulse generator |
DE69628906T DE69628906T2 (en) | 1995-09-29 | 1996-08-23 | ADAPTABLE SEARCH OF AV DELAY |
CA002204615A CA2204615C (en) | 1995-09-29 | 1996-08-23 | Adaptive search av and auto pvarp adaptation to same with additional benefit |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US53660295A | 1995-09-29 | 1995-09-29 | |
US08/536,602 | 1995-09-29 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1997011746A1 true WO1997011746A1 (en) | 1997-04-03 |
Family
ID=24139191
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1996/013667 WO1997011746A1 (en) | 1995-09-29 | 1996-08-23 | Adaptive search av and auto pvarp adaptation to same with additional benefit |
Country Status (7)
Country | Link |
---|---|
US (2) | US5861007A (en) |
EP (1) | EP0794813B1 (en) |
JP (2) | JP4041912B2 (en) |
AU (1) | AU716594B2 (en) |
CA (1) | CA2204615C (en) |
DE (1) | DE69628906T2 (en) |
WO (1) | WO1997011746A1 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2001037927A1 (en) * | 1999-11-22 | 2001-05-31 | St. Jude Medical Ab | A cardiac pacer |
US7463925B2 (en) | 1997-04-04 | 2008-12-09 | Cardiac Pacemakers, Inc. | Methods and systems for promoting ventricular pacing |
EP2098265A3 (en) * | 2000-12-21 | 2009-11-25 | Medtronic, Inc. | Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support |
US9375579B2 (en) | 2002-09-17 | 2016-06-28 | Medtronic, Inc. | Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support |
CN112202626A (en) * | 2020-08-04 | 2021-01-08 | 长春创世麒麟科技有限公司 | Real-time data communication heartbeat packet pushing method |
Families Citing this family (98)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6285908B1 (en) * | 1996-05-14 | 2001-09-04 | Pacesetter, Inc. | Implantable stimulation device and method for determining atrial autocapture using programmable AV delay |
US6115632A (en) * | 1998-06-17 | 2000-09-05 | Cardiac Pacemakers, Inc. | Dual chamber pulse generator with periodic PMT control |
US6179865B1 (en) * | 1999-04-01 | 2001-01-30 | Cardiac Pacemakers, Inc. | Cross chamber interval correlation |
US6430438B1 (en) | 1999-05-21 | 2002-08-06 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system with atrial shock timing optimization |
US7142918B2 (en) * | 2000-12-26 | 2006-11-28 | Cardiac Pacemakers, Inc. | Apparatus and method for pacing mode switching during atrial tachyarrhythmias |
US6285907B1 (en) | 1999-05-21 | 2001-09-04 | Cardiac Pacemakers, Inc. | System providing ventricular pacing and biventricular coordination |
US7062325B1 (en) * | 1999-05-21 | 2006-06-13 | Cardiac Pacemakers Inc | Method and apparatus for treating irregular ventricular contractions such as during atrial arrhythmia |
US7212860B2 (en) * | 1999-05-21 | 2007-05-01 | Cardiac Pacemakers, Inc. | Apparatus and method for pacing mode switching during atrial tachyarrhythmias |
US6501988B2 (en) | 2000-12-26 | 2002-12-31 | Cardiac Pacemakers Inc. | Apparatus and method for ventricular rate regularization with biventricular sensing |
US8064997B2 (en) * | 1999-05-21 | 2011-11-22 | Cardiac Pacemakers, Inc. | Method and apparatus for treating irregular ventricular contractions such as during atrial arrhythmia |
US6351669B1 (en) | 1999-05-21 | 2002-02-26 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system promoting atrial pacing |
US7181278B2 (en) * | 1999-05-21 | 2007-02-20 | Cardiac Pacemakers, Inc. | Apparatus and method for ventricular rate regularization |
US6216035B1 (en) | 1999-10-05 | 2001-04-10 | Cardiac Pacemakers, Inc. | Determination of pacemaker wenckebach and adjustment of upper rate limit |
US7039461B1 (en) | 2000-05-13 | 2006-05-02 | Cardiac Pacemakers, Inc. | Cardiac pacing system for prevention of ventricular fibrillation and ventricular tachycardia episode |
US6501987B1 (en) * | 2000-05-26 | 2002-12-31 | Cardiac Pacemakers, Inc. | Rate smoothing control |
US7349734B2 (en) * | 2000-05-15 | 2008-03-25 | Cardiac Pacemakers, Inc. | Method and apparatus for delivering defibrillation shock therapy while reducing electrical dispersion due to ventricular conduction disorder |
US8512220B2 (en) * | 2000-05-26 | 2013-08-20 | Cardiac Pacemakers, Inc. | Rate smoothing control |
US6424865B1 (en) * | 2000-07-13 | 2002-07-23 | Cardiac Pacemakers, Inc. | Ventricular conduction delay trending system and method |
US6512951B1 (en) | 2000-09-14 | 2003-01-28 | Cardiac Pacemakers, Inc. | Delivery of atrial defibrillation shock based on estimated QT interval |
FR2816218B1 (en) * | 2000-11-08 | 2003-05-09 | Ela Medical Sa | IMPLANTABLE ACTIVE MEDICAL DEVICE, IN PARTICULAR CARDIAC PACEMAKER, DEFIBRILLATOR, CARDIOVERTER OR MULTI-SITE DEVICE, COMPRISING MEANS FOR DETECTION OF A RISK OF FUSION SITUATION |
US7881793B2 (en) * | 2000-12-21 | 2011-02-01 | Medtronic, Inc. | System and method for ventricular pacing with progressive conduction check interval |
US9931509B2 (en) | 2000-12-21 | 2018-04-03 | Medtronic, Inc. | Fully inhibited dual chamber pacing mode |
US7738955B2 (en) * | 2000-12-21 | 2010-06-15 | Medtronic, Inc. | System and method for ventricular pacing with AV interval modulation |
US7254441B2 (en) | 2000-12-21 | 2007-08-07 | Medtronic, Inc. | Fully inhibited dual chamber pacing mode |
US7245966B2 (en) | 2000-12-21 | 2007-07-17 | Medtronic, Inc. | Ventricular event filtering for an implantable medical device |
US6957100B2 (en) * | 2000-12-26 | 2005-10-18 | Cardiac Pacemakers, Inc. | Method and system for display of cardiac event intervals in a resynchronization pacemaker |
WO2003002243A2 (en) * | 2001-06-27 | 2003-01-09 | Remon Medical Technologies Ltd. | Method and device for electrochemical formation of therapeutic species in vivo |
US7844332B2 (en) | 2002-10-18 | 2010-11-30 | Cardiac Pacemakers, Inc. | Atrioventricular delay adjustment enhancing ventricular tachyarrhythmia detection |
US8433396B2 (en) * | 2003-04-18 | 2013-04-30 | Medtronic, Inc. | Methods and apparatus for atrioventricular search |
US6889083B2 (en) * | 2003-04-21 | 2005-05-03 | Medtronic, Inc. | Atrial tracking recovery to restore cardiac resynchronization therapy in dual chamber tracking modes |
US7957801B2 (en) * | 2003-04-25 | 2011-06-07 | Medtronic, Inc. | Dynamic pacing interval extension for detection of intrinsic ventricular activity |
US7203540B2 (en) * | 2003-12-22 | 2007-04-10 | Cardiac Pacemakers, Inc. | Method and system for setting cardiac resynchronization therapy parameters |
US7123960B2 (en) | 2003-12-22 | 2006-10-17 | Cardiac Pacemakers, Inc. | Method and system for delivering cardiac resynchronization therapy with variable atrio-ventricular delay |
US7248924B2 (en) * | 2004-10-25 | 2007-07-24 | Medtronic, Inc. | Self limited rate response |
US7930029B2 (en) | 2004-12-15 | 2011-04-19 | Cardiac Pacemakers, Inc. | Template initialization for evoked response detection |
US8229561B2 (en) * | 2004-12-15 | 2012-07-24 | Cardiac Pacemakers, Inc. | Atrial retrograde management |
US7587240B2 (en) * | 2004-12-15 | 2009-09-08 | Cardiac Pacemakers, Inc. | Atrial capture verification |
US7908006B2 (en) * | 2004-12-15 | 2011-03-15 | Cardiac Pacemakers, Inc. | Cardiac pacing response classification using an adaptable classification interval |
US7593773B2 (en) * | 2005-01-21 | 2009-09-22 | Medtronic, Inc. | Implantable medical device with ventricular pacing protocol including progressive conduction search |
US7542799B2 (en) * | 2005-01-21 | 2009-06-02 | Medtronic, Inc. | Implantable medical device with ventricular pacing protocol |
US7286873B2 (en) * | 2005-03-31 | 2007-10-23 | Medtronic, Inc. | Method of optimizing mechanical heart rate during delivery of coupled or paired pacing |
US7613514B2 (en) * | 2005-04-19 | 2009-11-03 | Cardiac Pacemakers, Inc. | Selective resynchronization therapy optimization based on user preference |
US7457666B2 (en) | 2005-05-25 | 2008-11-25 | Cardiac Pacemakers, Inc. | Retrograde atrial sensing for identifying sub-threshold atrial pacing |
US7424323B1 (en) * | 2005-09-01 | 2008-09-09 | Pacesetter, Inc. | Implantable cardiac stimulation device providing autocapture with PMT avoidance and method |
US8840660B2 (en) | 2006-01-05 | 2014-09-23 | Boston Scientific Scimed, Inc. | Bioerodible endoprostheses and methods of making the same |
US7925344B2 (en) | 2006-01-20 | 2011-04-12 | Medtronic, Inc. | System and method of using AV conduction timing |
US8089029B2 (en) | 2006-02-01 | 2012-01-03 | Boston Scientific Scimed, Inc. | Bioabsorbable metal medical device and method of manufacture |
US8046063B2 (en) | 2006-02-28 | 2011-10-25 | Medtronic, Inc. | Implantable medical device with adaptive operation |
US9644039B2 (en) | 2006-03-24 | 2017-05-09 | The Regents Of The University Of California | Acid-degradable and bioerodible modified polyhydroxylated materials |
US8048150B2 (en) | 2006-04-12 | 2011-11-01 | Boston Scientific Scimed, Inc. | Endoprosthesis having a fiber meshwork disposed thereon |
US7894898B2 (en) * | 2006-06-15 | 2011-02-22 | Medtronic, Inc. | System and method for ventricular interval smoothing following a premature ventricular contraction |
US7869872B2 (en) * | 2006-06-15 | 2011-01-11 | Medtronic, Inc. | System and method for determining intrinsic AV interval timing |
US7783350B2 (en) * | 2006-06-15 | 2010-08-24 | Medtronic, Inc. | System and method for promoting intrinsic conduction through atrial timing modification and calculation of timing parameters |
US7565196B2 (en) * | 2006-06-15 | 2009-07-21 | Medtronic, Inc. | System and method for promoting intrinsic conduction through atrial timing |
US7502646B2 (en) * | 2006-07-31 | 2009-03-10 | Medtronic, Inc. | Pacing mode event classification with rate smoothing and increased ventricular sensing |
US7715914B2 (en) * | 2006-07-31 | 2010-05-11 | Medtronic, Inc. | System and method for improving ventricular sensing |
US7515958B2 (en) | 2006-07-31 | 2009-04-07 | Medtronic, Inc. | System and method for altering pacing modality |
US7502647B2 (en) * | 2006-07-31 | 2009-03-10 | Medtronic, Inc. | Rate smoothing pacing modality with increased ventricular sensing |
US7720537B2 (en) | 2006-07-31 | 2010-05-18 | Medtronic, Inc. | System and method for providing improved atrial pacing based on physiological need |
US7689281B2 (en) | 2006-07-31 | 2010-03-30 | Medtronic, Inc. | Pacing mode event classification with increased ventricular sensing |
US7856269B2 (en) | 2006-07-31 | 2010-12-21 | Medtronic, Inc. | System and method for determining phsyiologic events during pacing mode operation |
WO2008017028A2 (en) | 2006-08-02 | 2008-02-07 | Boston Scientific Scimed, Inc. | Endoprosthesis with three-dimensional disintegration control |
JP2010503489A (en) | 2006-09-15 | 2010-02-04 | ボストン サイエンティフィック リミテッド | Biodegradable endoprosthesis and method for producing the same |
US8057534B2 (en) | 2006-09-15 | 2011-11-15 | Boston Scientific Scimed, Inc. | Bioerodible endoprostheses and methods of making the same |
JP2010503485A (en) | 2006-09-15 | 2010-02-04 | ボストン サイエンティフィック リミテッド | Medical device and method for manufacturing the same |
ES2368125T3 (en) | 2006-09-15 | 2011-11-14 | Boston Scientific Scimed, Inc. | BIOEROSIONABLE ENDOPROOTHESIS WITH BIOESTABLE INORGANIC LAYERS. |
CA2663762A1 (en) | 2006-09-18 | 2008-03-27 | Boston Scientific Limited | Endoprostheses |
US8290590B2 (en) | 2006-11-17 | 2012-10-16 | Cardiac Pacemakers, Inc. | Dynamic morphology based atrial automatic threshold |
US7801610B2 (en) * | 2006-11-17 | 2010-09-21 | Cardiac Pacemakers, Inc. | Methods and systems for management of atrial retrograde conduction and pacemaker mediated tachyarrhythmia |
US7636598B2 (en) | 2006-12-07 | 2009-12-22 | Cardiac Pacemakers, Inc. | Cardiac device interface to reduce ventricular pacing |
US20080188900A1 (en) * | 2006-12-21 | 2008-08-07 | G&L Consulting, Llc | Heart rate reduction method and system |
EP2277563B1 (en) | 2006-12-28 | 2014-06-25 | Boston Scientific Limited | Bioerodible endoprostheses and method of making the same |
US7986993B1 (en) | 2007-06-27 | 2011-07-26 | Pacesetter, Inc. | Implantable cardiac device providing AV interval hysteresis to promote intrinsic conduction while providing PMT avoidance and method |
US8052745B2 (en) | 2007-09-13 | 2011-11-08 | Boston Scientific Scimed, Inc. | Endoprosthesis |
WO2009075749A1 (en) * | 2007-12-11 | 2009-06-18 | Cardiac Pacemakers, Inc. | Lv unipolar sensing or pacing vector |
JP5438687B2 (en) | 2007-12-13 | 2014-03-12 | カーディアック ペースメイカーズ, インコーポレイテッド | A system that provides unipolar detection vectors |
US20090234413A1 (en) * | 2008-03-13 | 2009-09-17 | Sambelashvili Aleksandre T | Apparatus and methods of adjusting atrioventricular pacing delay intervals in a rate adaptive pacemaker |
US7941218B2 (en) | 2008-03-13 | 2011-05-10 | Medtronic, Inc. | Apparatus and methods of optimizing atrioventricular pacing delay intervals |
US7998192B2 (en) | 2008-05-09 | 2011-08-16 | Boston Scientific Scimed, Inc. | Endoprostheses |
US8236046B2 (en) | 2008-06-10 | 2012-08-07 | Boston Scientific Scimed, Inc. | Bioerodible endoprosthesis |
US9375578B2 (en) * | 2008-07-23 | 2016-06-28 | Medtronic, Inc. | Cardiac pacing methods and apparatus |
US7985252B2 (en) | 2008-07-30 | 2011-07-26 | Boston Scientific Scimed, Inc. | Bioerodible endoprosthesis |
US8382824B2 (en) | 2008-10-03 | 2013-02-26 | Boston Scientific Scimed, Inc. | Medical implant having NANO-crystal grains with barrier layers of metal nitrides or fluorides |
WO2010099430A1 (en) * | 2009-02-27 | 2010-09-02 | Medtronic, Inc. | A system and method for conditional biventricular pacing |
WO2010099382A1 (en) * | 2009-02-27 | 2010-09-02 | Medtronic, Inc. | System and method for conditional biventricular pacing |
US8244354B2 (en) * | 2009-02-27 | 2012-08-14 | Medtronic, Inc. | System and method for conditional biventricular pacing |
US8267992B2 (en) | 2009-03-02 | 2012-09-18 | Boston Scientific Scimed, Inc. | Self-buffering medical implants |
US8452405B2 (en) * | 2009-05-05 | 2013-05-28 | Cardiac Pacemakers, Inc. | Methods and systems for mitigating the occurrence of arrhythmia during atrial pacing |
US9037237B2 (en) * | 2009-07-29 | 2015-05-19 | Medtronic, Inc. | Algorithm to modulate atrial-ventricular delay and rate response based on autonomic function |
US8024042B2 (en) | 2009-10-23 | 2011-09-20 | Medtronic, Inc. | Minimum ventricular pacing to break the repetitive AR-VS pattern |
WO2011119573A1 (en) | 2010-03-23 | 2011-09-29 | Boston Scientific Scimed, Inc. | Surface treated bioerodible metal endoprostheses |
US8478407B2 (en) | 2011-07-28 | 2013-07-02 | Medtronic, Inc. | Methods for promoting intrinsic activation in single chamber implantable cardiac pacing systems |
US8744576B2 (en) | 2011-07-29 | 2014-06-03 | Medtronic, Inc. | Sampling intrinsic AV conduction time |
US8583233B2 (en) | 2011-07-29 | 2013-11-12 | Medtronic, Inc. | Modification of AV conduction time sampling rate |
US9789317B2 (en) * | 2015-02-26 | 2017-10-17 | Medtronic, Inc. | Pacing crosstalk detection |
US10004906B2 (en) | 2015-07-16 | 2018-06-26 | Medtronic, Inc. | Confirming sensed atrial events for pacing during resynchronization therapy in a cardiac medical device and medical device system |
US10694967B2 (en) | 2017-10-18 | 2020-06-30 | Medtronic, Inc. | State-based atrial event detection |
US11911622B2 (en) | 2020-09-22 | 2024-02-27 | Medtronic, Inc. | Conduction system pacing with adaptive timing to maintain AV and interventricular synchrony |
Citations (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4108148A (en) * | 1976-11-03 | 1978-08-22 | Sheldon Thaler | Pacer with automatically variable A-V interval |
US4421116A (en) * | 1980-10-14 | 1983-12-20 | Medtronic, Inc. | Heart pacemaker with separate A-V intervals for atrial synchronous and atrial-ventricular sequential pacing modes |
US4856524A (en) * | 1988-08-29 | 1989-08-15 | Intermedics, Inc. | A-V responsive rate adaptive pacemaker |
US5024222A (en) * | 1990-02-21 | 1991-06-18 | Siemens-Pacesetter, Inc. | Hemodynamically rate responsive pacemaker and method of automatically adjusting the escape and A-V intervals |
EP0589860A2 (en) * | 1992-09-14 | 1994-03-30 | Hans Schüller | Pacemaker |
EP0597728A2 (en) * | 1992-11-13 | 1994-05-18 | Pacesetter, Inc. | Implantable pacemaker having AV interval for providing ventricular pacing |
EP0600631A2 (en) * | 1992-11-13 | 1994-06-08 | Pacesetter, Inc. | Dual-chamber implantable pacemaker, having adaptive AV interval that prevents ventricular fusion beats |
EP0607951A2 (en) * | 1993-01-19 | 1994-07-27 | Vitatron Medical B.V. | Dual chamber pacemaker with automatically optimized AV delay |
US5417714A (en) * | 1992-03-05 | 1995-05-23 | Pacesetter, Inc. | DDI pacing with PVC-protected hysteresis and automatic AV interval adjustment |
US5423868A (en) * | 1994-04-12 | 1995-06-13 | Telectronics Pacing Systems, Inc. | Dual chamber pacemaker which detects, confirms and terminates pacemaker mediated tachycardia |
WO1995024944A1 (en) * | 1994-03-17 | 1995-09-21 | Medtronic, Inc. | Method and apparatus for dual chamber cardiac pacing |
US5514163A (en) * | 1995-02-21 | 1996-05-07 | Medtronic, Inc. | Dual chamber pacing system and method with optimized adjustment of the AV escape interval for treating cardiomyopathy |
US5534016A (en) * | 1995-02-21 | 1996-07-09 | Vitatron Medical, B.V. | Dual chamber pacing system and method utilizing detection of ventricular fusion for adjustment of the atrial-ventricular delay as therapy for hypertrophic obstructive cardiomyopathy |
WO1996025977A1 (en) * | 1995-02-21 | 1996-08-29 | Medtronic, Inc. | Dual chamber pacing system and method with continual adjustment of the av escape interval so as to maintain optimized ventricular pacing for treating cardiomyopathy |
Family Cites Families (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4091817A (en) * | 1976-09-27 | 1978-05-30 | American Optical Corporation | P-Wave control, R-wave inhibited ventricular stimulation device |
US4284082A (en) * | 1979-12-12 | 1981-08-18 | Medtronic B.V.Kerkrade | Ventricular synchronized atrial pacemaker and method of operation |
US4337776A (en) * | 1980-08-29 | 1982-07-06 | Telectronics Pty. Ltd. | Impedance measuring pacer |
US4554920A (en) * | 1982-11-22 | 1985-11-26 | Intermedics, Inc. | Microprocessor controlled cardiac pacemaker and method for avoiding pacer sustained tachycardia |
US5003975A (en) * | 1988-04-19 | 1991-04-02 | Siemens-Pacesetter, Inc. | Automatic electrode configuration of an implantable pacemaker |
US4899750A (en) * | 1988-04-19 | 1990-02-13 | Siemens-Pacesetter, Inc. | Lead impedance scanning system for pacemakers |
US5052388A (en) * | 1989-12-22 | 1991-10-01 | Medtronic, Inc. | Method and apparatus for implementing activity sensing in a pulse generator |
US5127404A (en) * | 1990-01-22 | 1992-07-07 | Medtronic, Inc. | Telemetry format for implanted medical device |
US5085215A (en) * | 1990-03-20 | 1992-02-04 | Telectronics Pacing Systems, Inc. | Metabolic demand driven rate-responsive pacemaker |
US5144950A (en) * | 1990-08-30 | 1992-09-08 | Vitatron Medical B.V. | Rate controlled pacemaker system using ar interval for rate control |
US5318594A (en) * | 1990-11-30 | 1994-06-07 | Ela Medical | DDD type cardiac pacemaker having automatic operating mode switching |
US5282838A (en) * | 1992-06-08 | 1994-02-01 | Cardiac Pacemakers, Inc. | Dual chamber cardiac pacemaker employing hysteresis to maximize the number of normally conducted ventricular beats with an optimum A-V delay for paced ventricular beats |
US5713933A (en) * | 1994-11-30 | 1998-02-03 | Medtronic, Inc. | Method and apparatus for automatic pacing threshold determination |
US5540725A (en) * | 1995-07-11 | 1996-07-30 | Pacesetter, Inc. | Upper rate response for implantable pacemaker based on atrial lock interval pacing |
US5674255A (en) * | 1995-12-14 | 1997-10-07 | Cardiac Pacemakers, Inc. | Dual chamber pacer having automatic PVARP |
-
1996
- 1996-08-23 WO PCT/US1996/013667 patent/WO1997011746A1/en active IP Right Grant
- 1996-08-23 AU AU72350/96A patent/AU716594B2/en not_active Ceased
- 1996-08-23 JP JP51341897A patent/JP4041912B2/en not_active Expired - Fee Related
- 1996-08-23 DE DE69628906T patent/DE69628906T2/en not_active Expired - Lifetime
- 1996-08-23 CA CA002204615A patent/CA2204615C/en not_active Expired - Fee Related
- 1996-08-23 EP EP96933737A patent/EP0794813B1/en not_active Expired - Lifetime
-
1997
- 1997-02-26 US US08/806,302 patent/US5861007A/en not_active Expired - Lifetime
-
1998
- 1998-10-21 US US09/176,570 patent/US6167307A/en not_active Expired - Lifetime
-
2006
- 2006-07-21 JP JP2006199245A patent/JP4036882B2/en not_active Expired - Fee Related
Patent Citations (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4108148A (en) * | 1976-11-03 | 1978-08-22 | Sheldon Thaler | Pacer with automatically variable A-V interval |
US4421116A (en) * | 1980-10-14 | 1983-12-20 | Medtronic, Inc. | Heart pacemaker with separate A-V intervals for atrial synchronous and atrial-ventricular sequential pacing modes |
US4856524A (en) * | 1988-08-29 | 1989-08-15 | Intermedics, Inc. | A-V responsive rate adaptive pacemaker |
US5024222A (en) * | 1990-02-21 | 1991-06-18 | Siemens-Pacesetter, Inc. | Hemodynamically rate responsive pacemaker and method of automatically adjusting the escape and A-V intervals |
US5417714A (en) * | 1992-03-05 | 1995-05-23 | Pacesetter, Inc. | DDI pacing with PVC-protected hysteresis and automatic AV interval adjustment |
EP0589860A2 (en) * | 1992-09-14 | 1994-03-30 | Hans Schüller | Pacemaker |
EP0600631A2 (en) * | 1992-11-13 | 1994-06-08 | Pacesetter, Inc. | Dual-chamber implantable pacemaker, having adaptive AV interval that prevents ventricular fusion beats |
EP0597728A2 (en) * | 1992-11-13 | 1994-05-18 | Pacesetter, Inc. | Implantable pacemaker having AV interval for providing ventricular pacing |
EP0607951A2 (en) * | 1993-01-19 | 1994-07-27 | Vitatron Medical B.V. | Dual chamber pacemaker with automatically optimized AV delay |
WO1995024944A1 (en) * | 1994-03-17 | 1995-09-21 | Medtronic, Inc. | Method and apparatus for dual chamber cardiac pacing |
US5423868A (en) * | 1994-04-12 | 1995-06-13 | Telectronics Pacing Systems, Inc. | Dual chamber pacemaker which detects, confirms and terminates pacemaker mediated tachycardia |
US5514163A (en) * | 1995-02-21 | 1996-05-07 | Medtronic, Inc. | Dual chamber pacing system and method with optimized adjustment of the AV escape interval for treating cardiomyopathy |
US5534016A (en) * | 1995-02-21 | 1996-07-09 | Vitatron Medical, B.V. | Dual chamber pacing system and method utilizing detection of ventricular fusion for adjustment of the atrial-ventricular delay as therapy for hypertrophic obstructive cardiomyopathy |
WO1996025977A1 (en) * | 1995-02-21 | 1996-08-29 | Medtronic, Inc. | Dual chamber pacing system and method with continual adjustment of the av escape interval so as to maintain optimized ventricular pacing for treating cardiomyopathy |
Non-Patent Citations (1)
Title |
---|
ALT: "Different beneficial AV Intervals with DDD Pacing after Sensed or Paced Atrial Events", 1987, FUTURA PUBLISHING COMPANY,INC, MOUNT KISCO,NEW YORK, XP000609782 * |
Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7463925B2 (en) | 1997-04-04 | 2008-12-09 | Cardiac Pacemakers, Inc. | Methods and systems for promoting ventricular pacing |
US7471981B2 (en) | 1997-04-04 | 2008-12-30 | Cardiac Pacemakers, Inc. | Methods and systems for promoting ventricular pacing |
US7483739B2 (en) | 1997-04-04 | 2009-01-27 | Cardiac Pacemakers, Inc. | Methods and systems for promoting ventricular pacing |
WO2001037927A1 (en) * | 1999-11-22 | 2001-05-31 | St. Jude Medical Ab | A cardiac pacer |
US7065406B1 (en) | 1999-11-22 | 2006-06-20 | St. Jude Medical Ab | Cardiac pacemaker utilizing prolonged A-V interval and ventricular autocapture |
EP2098265A3 (en) * | 2000-12-21 | 2009-11-25 | Medtronic, Inc. | Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support |
US9375579B2 (en) | 2002-09-17 | 2016-06-28 | Medtronic, Inc. | Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support |
CN112202626A (en) * | 2020-08-04 | 2021-01-08 | 长春创世麒麟科技有限公司 | Real-time data communication heartbeat packet pushing method |
Also Published As
Publication number | Publication date |
---|---|
AU716594B2 (en) | 2000-03-02 |
CA2204615A1 (en) | 1997-04-03 |
JP2006272028A (en) | 2006-10-12 |
US6167307A (en) | 2000-12-26 |
JPH10509907A (en) | 1998-09-29 |
DE69628906D1 (en) | 2003-08-07 |
CA2204615C (en) | 2003-10-07 |
DE69628906T2 (en) | 2004-05-19 |
AU7235096A (en) | 1997-04-17 |
JP4036882B2 (en) | 2008-01-23 |
EP0794813B1 (en) | 2003-07-02 |
EP0794813A1 (en) | 1997-09-17 |
US5861007A (en) | 1999-01-19 |
JP4041912B2 (en) | 2008-02-06 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US5861007A (en) | Adaptive search AV and auto PVARP adaptation to same with additional benefit | |
EP0800414B1 (en) | Pacemaker with a modified tachycardia detection based on ffrw sensing | |
US5643326A (en) | Dual chamber pacing with atrial and ventricular independence | |
US5713929A (en) | Arrhythmia and fibrillation prevention pacemaker using ratchet up and decay modes of operation | |
EP0796130B1 (en) | Pacemaker for tachy determination based on blocked 2:1 sensing | |
US5501701A (en) | Pacemaker with vasovagal syncope detection and therapy | |
US5441525A (en) | Pacemaker with vasovagal syncope detection | |
EP0496865B1 (en) | Dual chamber rate responsive pacemaker | |
US5658320A (en) | Atrial tachyarrhythmia detection in implantable pulse generators | |
US5237992A (en) | Implantable pacemaker providing hysteresis in dual-chamber modes | |
EP0757577B1 (en) | Pacemaker with vasovagal syncope detection |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A1 Designated state(s): AU CA JP |
|
AL | Designated countries for regional patents |
Kind code of ref document: A1 Designated state(s): AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL PT SE |
|
ENP | Entry into the national phase |
Ref document number: 2204615 Country of ref document: CA Ref country code: CA Ref document number: 2204615 Kind code of ref document: A Format of ref document f/p: F |
|
WWE | Wipo information: entry into national phase |
Ref document number: 1996933737 Country of ref document: EP |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application | ||
WWP | Wipo information: published in national office |
Ref document number: 1996933737 Country of ref document: EP |
|
WWG | Wipo information: grant in national office |
Ref document number: 1996933737 Country of ref document: EP |