Control of pacing rate in dual-chamber, rate-adaptive pacemakers

Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems

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A61N 100

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active

056096135

ABSTRACT:
A programmable dual-chamber artificial cardiac pacemaker senses atrial activity and normally tracks the sensed atrial activity in pacing the ventricular activity. An accelerometer located in the case of the pulse generator portion senses physical exercise by a patient when the pacemaker is implanted in the patient, and generates a rate control signal indicative of extent of the sensed physical exercise. The pulse generator is programmed for ventricular pacing rate control in multiple rate zones bounded by rate limits including a ventricular tracking limit (VTL) that varies dynamically with sensed physical exercise and a higher mode switch rate. The ventricular pacing rate tracks the sensed atrial activity on a 1:1 basis for atrial rates below the dynamic VTL (DVTL) during a predetermined interval of time for which the DVTL applies, and tracks the sensed atrial activity in Wenckebach behavior for atrial rates above the DVTL up to the mode switch rate with the ventricular pacing rate limited by the DVTL. The mode switch rate is set to effect a switch from dual-chamber to single-chamber mode when the sensed rate of atrial activity exceeds the mode switch rate for a programmed number of cardiac cycles, in which the ventricular pacing rate is controlled solely by sensed spontaneous ventricular activity without regard to the DVTL or sensed physical exercise. The mode switch rate also effects a reversion to the dual-chamber mode when the sensed rate of atrial activity drops below the mode switch rate for a programmed number of cardiac cycles, in which the ventricular pacing rate is controlled according to the respective one of the multiple rate zones in which the atrial activity rate is present.

REFERENCES:
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patent: 4312355 (1982-01-01), Funke
patent: 4363325 (1982-12-01), Roline
patent: 4421116 (1983-12-01), Markowitz
patent: 4432362 (1984-02-01), Leckrone
patent: 4945909 (1990-08-01), Fearnot et al.

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