Implantable and haemodynamically responsive...

A - Human Necessities – 61 – N

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326/1.2

A61N 1/365 (2006.01) A61N 1/362 (2006.01) A61N 1/39 (2006.01)

Patent

CA 2034627

-29- ABSTRACT A cardioverting/defibrillating pacemaker with the ability to sense and respond to haemodynamic com- promise. The ventricular pressure (VP) and electrical activity of the heart are sensed via one or more transvenous or epicardial devices. The filtered peak- to-peak amplitude (VFPPA) or a peak pressure function (VPPF) based upon the right and/or left VP waveform(s) are derived. In one embodiment the VP and the elec- trical activity of the heart are sensed and processed continuously, and the VFPPA or the VPPF continuously derived. The VFPPA or the VPPF, and the ECG are used to initiate bradycardia pacing, antitachycardia pacing and cardioversion/defibrillation therapies. In anoth- er embodiment the VP and electrical activity of the heart are continuously sensed. The electrical activi- ty is processed continuously and used to determine whether or not some irregularity exists. If so, one of the VPPF or VFPPA is derived and used to decide which of the therapies are to be used. One of the VPPF or VFPPA is also periodically determined to en- sure optimal haemodynamic function. In both embodi- ments the degree of haemodynamic compromise is deter- mined by comparing the derived VFPPA or VPPF with programmed values. An algorithm maximizes the effec- tiveness of support pacing. Preferably an ECG trans- venous sensor in the right atrium and a combined ECG/VP sensor in the right ventricle are used.

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