Atrial synchronized pacemaker having an adaptive atrial...

A - Human Necessities – 61 – N

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326/1.2

A61N 1/36 (2006.01) A61N 1/362 (2006.01)

Patent

CA 1221421

ABSTRACT Disclosed is a pacer for delivering stimulation pulses to the ventricle of a patient's heart in response to detected depolarizations of the atria of the patient's heart. The pacer includes atrial and ventricular terminals for coupling the pacer to the patient's heart. An atrial sense amplifier is coupled to the atrial terminal for generating an atrial sense signal in response to detection of electrical activity in the atria. An A-V delay timer coupled to the atrial sense amplifier times an A-V delay period and generates a ventricular pace signal at the end of the A-V delay period which is initiated by an atrial sense signal. A ventricular pulse generator is coupled to the ventricular terminal and A-V delay timer for producing a stimulation pulse in response to the ventricular pace signal. An upper rate limit timer coupled to the ventricular pulse generator defines an upper rate limit interval for preventing the generation of a ventricular stimulating pulse during the upper rate limit interval, and for generating a ventricular pace signal at the expiration of the upper rate limit interval if a ventricular pace signal is generated during such upper rate limit period, the upper rate limit timer being initiated by the delivery of a ventricular stimulation pulse. An atrial refractory timer is responsively coupled to the A-V delay timer for preventing initiation of the A-V delay timer until the end of an atrial refractory period, the atrial refractory period extending for a first predetermined time period after the occurrence of a ventricular stimulation pulse. A V-A measurement timer is responsively coupled to the A-V delay timer and the upper rate limit timer for measuring V-A time intervals, the V-A time interval extending from the occurrence of a ventricular stimulation pulse to the subsequent initiation of the A-V delay timer. An atrial refractory control is coupled to the V-A measurement timer and coupled to the atrial refractory timer for extending the first predetermined time period when the V-A time intervals are both short and invariant.

448714

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