Pacemaker having PVC response and PMT terminating features

Details Pacemaker having PVC response and PMT terminating features Pacemaker having PVC response and PMT terminating features

1986-07-18

1988-12-06

Kamm, William E.

Surgery

Truss

Pad

A61N 136

Patent

active

047889802

ABSTRACT:
An atrial tracking dual-chamber pacemaker and method of use for reducing the risk of initiating a pacer mediated tachycardia (PMT), and breaking such a PMT if once started. The pacemaker includes means for sensing a premature ventricular contraction (PVC). The pacemaker operates in a conventional manner unless a PVC is sensed. If a PVC is sensed, in accordance with one embodiment, an extended atrial refractory period is triggered in an attempt to block any retrograde atrial events resulting from the PVC. This is followed by an atrial alert time window. After a prescribed A-V delay subsequent to the timing out or other termination of the atrial alert time window, a ventricular stimulation pulse is generated, unless prior ventricular activity is sensed that inhibits such ventricular stimulation pulse. In accordance with another embodiment, the sensing of a PVC triggers, after a suitable refractory period, a retrograde sense period during which any sensed atrial electrical activity is presumed to be a retrograde event. Appropriate steps are taken in order to deal with the retrograde event to prevent its occurrence from triggering a PMT. If a PMT has started, a prescribed number of cycles of the PMT are counted, after which the same action used in response to a sensed PVC is triggered, which action disrupts the rhythm of the PMT so as to break it. If the PMT is not broken with the first attempt, the PVC response is recurringly generated after a prescribed number of subsequent PMT cycles.

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Webb et al., "Improved Method for Evaluating Ventriculoatrial Conduction Before Implantation of Atrial-Sensing Dual Chamber Pacemakers", JACC, vol. 5, No. 6 (Jun. 1985), pp. 1395-1402.

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