Claims
- 1. A cardiac rhythm management device for stimulating a ventricle of a patient's heart, said rhythm management device including:
(a) circuitry for sensing and tracking independently atrial and ventricular depolarization events; (b) stimulation device for delivering an electrical stimulus to at least one of an atrium and ventricle of a heart; (c) a timing circuit for associating with a lapsed time the sensed and tracked depolarization events and delivery of electrical stimulus; and (d) a controller having a plurality of timing and pacing intervals including the intervals selected from the group consisting of Atrial Maximum Tracking Rate (AMTR) interval, Post Ventricular Atrial Refractory Period (PVARP) interval, Sensed Atrial to Ventricular delay (SAV) interval, and Sensed Post Ventricular Atrial Refractory Period (S-PVARP) interval, said controller electrically coupled to said means for sensing and tracking, said stimulation means, and said timing circuit, wherein said controller sets said PVARP interval equal to said S-PVARP interval for a next subsequent cardiac cycle, after sensing an intrinsic ventricular depolarization, and further wherein a time associated with said S-PVARP is less than a time associated with an initial PVARP included in said controller.
- 2. The cardiac device as recited in claim 1, said controller further including an initial AMTR interval and a time delay between sensing ventricular depolarization and ventricular pacing (RV) interval, wherein said controller sets said AMTR interval equal to said RV interval for the next subsequent cardiac cycle, wherein a time associated with said RV interval is less than a time associated with said initial AMTR interval.
- 3. The cardiac device as recited in claim 1, said controller further including an initial AMTR interval, wherein said controller sets said AMTR and PVARP intervals to an initial AMTR interval and the initial PVARP interval after delivery of the electrical stimulus to the ventricle by said stimulation means.
- 4. The cardiac device as recited in claim 1, said controller further includes a Refractory Atrial to Ventricular (RAV) delay interval, wherein said controller substitutes said RAV interval for the SAV interval for said next subsequent cardiac cycle.
- 5. The cardiac device as recited in claim 1, wherein sensing an intrinsic ventricular depolarization occurs after an intrinsic atrial depolarization is sensed prior to an end of the PVARP interval.
- 6. The cardiac device as recited in claim 2, further including a device for determining an amount of time lapsed between a sensed intrinsic atrial depolarization and an immediately following subsequent sensed ventricular depolarization (PR interval).
- 7. The cardiac device as recited in claim 6, further including a device for determining an amount of time lapsed between a tracked atrial event and an immediately following subsequent sensed intrinsic atrial depolarization (PP interval).
- 8. The cardiac device as recited in claim 7, wherein said controller instead sets said AMTR interval equal to said RV interval and said PVARP interval equal to said S-PVARP interval for a next subsequent cardiac cycle, only if said PP interval exceeds said AMTR interval.
- 9. The cardiac device as recited in claim 6, wherein said S-PVARP interval is set between zero milliseconds and an amount equal to the RV interval minus a PR interval.
- 10. The cardiac device as recited in claim 6, wherein said controller modifies at least one of said AMTR, RV, and PVARP intervals wherein said AMTR interval is greater than a sum divided by two of the RV interval, PVARP interval, and PR interval.
- 11. The cardiac device as recited in claim 6, wherein said controller instead sets said AMTR interval equal to said RV interval and said PVARP interval equal to said S-PVARP interval for a next subsequent cardiac cycle, only if the AMTR interval exceeds a sum divided by two of the RV interval, PVARP interval, and PR interval.
- 12. The cardiac device as recited in claim 7, wherein said controller instead sets said AMTR interval equal to said RV interval and said PVARP interval equal to said S-PVARP interval for a next subsequent cardiac cycle, only if the PP interval exceeds a sum divided by two of the RV interval, PVARP interval, and PR interval.
- 13. The cardiac device as recited in claim 1, wherein said timing circuit further including a counter for counting the number of consecutive sensed ventricular depolarization events.
- 14. The cardiac device as recited in claim 1, wherein said timing circuit further including a counter for counting the number of consecutive sensed ventricular depolarizations occurring after an intrinsic atrial depolarization is sensed prior to an end of the PVARP interval.
- 15. The cardiac device as recited in claim 1, wherein said timing circuit further including a counter for counting the number of times said controller sets consecutively said AMTR interval equal to said RV interval and said PVARP interval equal to said S-PVARP interval for a next subsequent cardiac cycle.
- 16. The cardiac device as recited in claim 1, wherein said controller instead sets said PVARP interval equal to said S-PVARP interval for all subsequent cardiac cycles until said controller verifies said AMTR interval expires before said SAV interval expires during a subsequent cardiac cycle.
- 17. The cardiac device as recited in claim 7, said controller further includes a pacing interval constant, wherein said controller instead sets said PVARP interval equal to said S-PVARP interval for all subsequent cardiac cycles until said controller verifies said PP interval is less than a sum of said AMTR interval and said pacing interval constant.
- 18. The cardiac device as recited in claim 1, wherein said S-PVARP is set dynamically by said controller.
- 19. A cardiac rhythm management device for stimulating a ventricle of a patient's heart, said rhythm management device including:
(a) means for sensing and tracking independently atrial and ventricular depolarization events; (b) stimulation means for delivering an electrical stimulus to at least one of an atrium and ventricle of a heart; (c) a timing circuit for associating with a lapsed time the sensed and tracked depolarization events and delivery of electrical stimulus; and (d) a controller having a plurality of timing and pacing intervals including the intervals selected from the group consisting of Atrial Maximum Tracking Rate (AMTR) interval, Post Ventricular Atrial Refractory Period (PVARP) interval, Sensed Atrial to Ventricular delay (SAV) interval, time delay between sensing a tracked ventricular event and an atrial stimulation (VA) interval, Sensed VA (time delay between sensing an intrinsic ventricular depolarization and an atrial stimulation; S-VA) interval, and Paced Atrial Ventricular delay interval (PAV), said controller electrically coupled to said means for sensing and tracking, said stimulation means, and said timing circuit, wherein said controller sets said VA interval equal to said S-VA interval for a next subsequent cardiac cycle, after sensing an intrinsic ventricular depolarization, and further wherein a time associated with said S-VA interval is less than a time associated with said VA interval.
- 20. The cardiac device as recited in claim 19, wherein said controller sets said VA interval to an initial VA interval after delivery of the electrical stimulus to the ventricle by said stimulation means.
- 21. The cardiac device as recited in claim 19, further including a Minimum Ventricular Pacing (MVP) interval, wherein said controller sets sets the sum of said S-VA interval and said PAV interval less than said MVP interval.
- 22. The cardiac device as recited in claim 19, further including a means for determining an amount of time lapsed between a sensed intrinsic atrial depolarization and an immediately following subsequent sensed intrinsic ventricular depolarization (PR interval).
- 23. The cardiac device as recited in claim 19, further including a means for determining an amount of time lapsed between a tracked atrial event and an immediately following subsequent sensed atrial depolarization (PP interval).
- 24. The cardiac device as recited in claim 19, wherein said S-VA is set dynamically by said controller.
- 25. The cardiac device as recited in claim 19, wherein said controller further includes means for detecting a physiological AV nodal refractory period, wherein said controller sets said S-VA interval to result in stimulating the atrium during said physiological AV nodal refractory period.
Parent Case Info
[0001] This application is a Divisional Application of co-pending application Ser. No. 09/420,679, filed Oct. 19, 1999, which is a continuation-in-part of application Ser. No. 08/833,281, filed on Apr. 4, 1997, now U.S. Pat. No. 5,983,138, and entitled “DEVICE AND METHOD FOR VENTRICULAR TRACKING AND PACING”.
Divisions (1)
|
Number |
Date |
Country |
Parent |
09420679 |
Oct 1999 |
US |
Child |
10062048 |
Jan 2002 |
US |
Continuation in Parts (1)
|
Number |
Date |
Country |
Parent |
08833281 |
Apr 1997 |
US |
Child |
09420679 |
Oct 1999 |
US |