Upper rate response for implantable pacemaker based on atrial lo

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

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A61N 1368

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active

055407250

ABSTRACT:
Atrial lock interval pacing increases stroke volume and optimizes cardiac output by providing a modified P-wave tracking mode that tracks P-waves up to a maximum instantaneous tracking rate only for short periods of time, to provide a maximum instantaneous ventricular heart rate, yet limits the maximal mean (or average) ventricular rate over a longer period of time, to provide a safe target maximal average rate. Two main types or embodiments of modified P-wave tracking modes may be used. A first provides a sequence of timed intervals that begins upon sensing each P-wave. Such sequence may include, e.g.: (1) a PV interval; (2) a PVARP; (3) a Wenkebach interval; (4) an atrial lock interval; and (4) a P-track interval. P-waves are not tracked during the PV interval or PVARP. P-waves that occur during the Wenkebach or Atrial lock interval are tracked, but not in a conventional manner. P-waves that occur during the P-track interval are tracked in a conventional manner. A second modified P-wave tracking mode defines a maximum mean rate (MMR) interval. The MMR interval (MMRI) is an asynchronous free-running signal that is not synchronized to any cardiac cycle events. During each MMRI, the number of atrial or ventricular events that occur are noted. Ventricular stimulation pulses (V-pulses) are not generated if the resulting ventricular depolarization would represent the second ventricular depolarization of the current MMRI.

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Haskell, Richard J., et al. "Optimum AV Interval in Dual Chamber Pacemakers", PACE, vol. 9, pp. 670-675. (Sep.-Oct. 1986).

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