摘要:
An apparatus and method for displaying and controlling parameters for a programmable living tissue stimulator system. Visual indicators corresponding to control parameters or signals for the tissue stimulator system are divided into a predetermined number of groups. One of these groups containing a parameter to be selected for the tissue stimulator system is selected, the selected group being identified by a visually identifiable indication. A parameter within that group is then selected for transmission to an implanted memory means which controls an implanted tissue stimulator. In a specific embodiment, a matrix of visual indicators consisting of R rows and S columns is provided, each visual indicator corresponding to a specific control signal. A means is provided whereby at least one visual indicator contained in a selected R row will blink on and off, the blinking indicators identifying control signals to be selected for the implanted memory means. Selection of a control signal within the selected R row causes the blinking to cease and the visual indicator corresponding to the selected signal to turn on when the selected signal is stored within the implanted memory means. Visual indicators corresponding to the unselected control signals in the selected R row turn off after a signal selection is made.
摘要:
A non-programmable automatic implantable cardioverter/defibrillator (AICD) capable of providing programmable thresholds for triggering high energy stimulation pulse(s) from the AICD is coupled to an implantable programmable pacemaker which preferably includes bradycardia support and/or tachycardia support using low enery output pulses. When the low energy antitachycardia pulse(s) from the pacemaker fail to terminate a tachycardia, or whenever other various thresholds, as sensed by programmable sensing circuits of the pacemaker, are exceeded, the high enery pulses from the AICD may be selectively invoked by an AICD trigger circuit included within the pacemaker. Coupling between the AICD and pacemaker is by either a direct electrical connection, or by an indirect connection, such as through the use of narrow pulse sequences generated by the pacemaker which are of insufficient energy to invoke a cardiac response but are of sufficient energy to be sensed by the AICD sensing circuits.
摘要:
An implantable cardiac stimulation device applies pacing stimulation pulses to a heart and senses evoked responses to the pacing stimulation pulses. A pulse generator applies the stimulation pacing pulses to the heart in accordance with a pacing configuration. A sensor control selects an evoked response sensing electrode configuration from among a plurality of evoked response sensing electrode configurations in response to the pacing configuration. A sensor is then programmed to sense the evoked responses with the selected evoked response sensing electrode configuration. In accordance with a preferred embodiment, signal-to-noise ratios obtained with the various electrode configurations are used to select a best electrode configuration for sensing evoked responses.
摘要:
An implantable cardiac stimulation device applies pacing stimulation pulses to a heart and senses evoked responses to the pacing stimulation pulses. A pulse generator applies the stimulation pacing pulses to the heart in accordance with a pacing configuration. A sensor control selects an evoked response sensing electrode configuration from among a plurality of evoked response sensing electrode configurations in response to the pacing configuration. A sensor is then programmed to sense the evoked responses with the selected evoked response sensing electrode configuration. In accordance with a preferred embodiment, signal-to-noise ratios obtained with the various electrode configurations are used to select a best electrode configuration for sensing evoked responses.
摘要:
A pacemaker mediated tachycardia (PMT) is detected by circuitry within an implantable pacemaker. The PMT is detected by first detecting a tachycardia condition that includes a prescribed number of consecutive cardiac cycles having a rate faster than a prescribed rate. Each cardiac cycle of the tachycardia condition includes a natural atrial event, i.e., a P-wave, and a paced ventricular event, i.e., a V-pulse generated by a pacemaker. After the prescribed number of such cardiac cycles, e.g., two to ten, a P-V delay in a single cardiac cycle is modified by a first prescribed amount, e.g., 50 milliseconds. The time interval of a V-P interval associated with at least one cardiac cycle preceding the modified P-V delay is then compared to a V-P interval immediately following the modified P-V delay. Only if the difference between the V-P intervals thus measured is less than a second prescribed amount, e.g., 25 milliseconds, is a PMT indicated. If a PMT is indicated, a PMT termination regimen, e.g., extending PVARP, is automatically invoked by the pacemaker for a prescribed number of cardiac cycles, such as one or two cardiac cycles.
摘要:
The present invention is an apparatus (1) for interpreting and displaying cardiac events of a heart connected to a cardiac pacing means (2) comprising a telemetry head (4), a first interpreting mean 6 with means connected to said telemetry head (4), a second interpreting means (12) with means connected to a plurality of ECG electrodes having paddles 8a at their digital end via electrical conduit (10), a control means (14) with means connected to said first and second interpreting means, (6) and (12) respectively, a multi-section memory means (16) with means connected to said control means (14), a D/A convertor (20) with means connected to said memory (16) a printing means (22) with means connected to said D/A convertor (20), logic means (24) with means connected to said memory means (16) and a display means (26) with means connected to said logic means (24).
摘要:
A cardiac stimulation apparatus capable of stimulation in the DDI modality having a first sensing system (46) for sensing electrical activity in the atrium, a second sensing system (48) for sensing electrical activity in the ventricle, a pulse generator logic (24) connected to the first (46) and second (48) sensing systems responsive to electrical activity sensed by the first (46) and second (48) sensing systems for determining the timing for supplying electrical pulses to the atrium and ventricle for their depolarization, a first circuit within the pulse generator logic (24) for preventing synchronization of timing within the pulse generator (24) for producing apparatus generated pulses to the ventricle when electrical activity is sensed in the atrium, a second circuit within the pulse generator logic (24) for inhibiting an apparatus generated pulse to the atrium when electrical activity is sensed resulting from natural depolarization of the atrium, and pulse generator logic timing means (32, 34, 44) for interacting with the pulse generator logic (24) for carrying out timing functions for pulse generation.
摘要:
An implantable device programmer includes a variety of features for allowing a clinician to perform an automated and customized follow-up examination of a patient having an implanted cardiac implantable device, the implantable device being of the type which captures and stores various types of diagnostic data for subsequent retrieval and evaluation. A custom protocol feature of the programmer allows the clinician pre-specify and then semi-automatically follow an ordered sequence of protocol steps, each protocol step involving the interrogation of the implantable device and the display by the programmer of associated implantable device data (such as a heart rate histogram, or the results of a ventricular capture test). When the clinician initiates a custom protocol, the programmer automatically retrieves all of the diagnostic data records of the protocol in the protocol order. This automatic retrieval is performed in the background, allowing the clinician to begin viewing the initial diagnostic data records of the protocol while the other items are being retrieved. Via a user interface of the programmer, the clinician can rapidly and efficiently sequence through the data display screens associated with the protocol, to thereby view the various diagnostic data records and/or perform the various diagnostic tests of the protocol.
摘要:
In a first embodiment, hysteresis is provided in a rate-responsive pacemaker to allow for natural AV synchrony when possible. In the absence of natural SA node signals, the heart is stimulated at a rate determined by the sensing of physiological need. When a natural heart signal is detected, the hysteresis is activated to extend the escape interval by a predetermined amount which is related to the sensed physiological need. The stimulating pulses are inhibited as long as normal heart activity is sensed. The extension of the escape interval under such conditions eliminates possible competition between normal activity and the paced stimulation. In a second embodiment automatic mode switching is provided in a dual chamber pacemaker to allow for more efficient operation at higher heart rates. When the heart rate (natural or paced) exceeds a prescribed level, such as 90 beats per minute, the pacemaker operates in a single chamber mode, such as VVI.
摘要:
An apparatus for interpreting and displaying cardiac events of a heart connected to an implanted cardiac pacing means (2) is disclosed. The apparatus includes a telemetry head (4), at least one interpreting means (6), and a controller (14). Information telemetered from the implanted pacing means is separated into identifiable sets of data pertaining to prescribed functions, such as atrial events, ventricular events, pacemaker timed events, sensor events, and the like. Skin ECG information may also be received through another interpreting means (12) in addition to pacemaker telemetered data. Parallel processing channels are employed to process all the received data while maintaining synchronization therebetween. Memory means (16) allow the synchronized processed data to be stored for subsequent print out through a D/A converter (20) and printer (22), or to be displayed on a display monitor (26). The display monitor is controlled by display logic (24) that includes the capability to simultaneously display a plurality of selected data sets while maintaining the synchronization therebetween, and that further allows displayed events to be identified with unique markers (44, 46, 64, 66 ) or synchronized with displayed time intervals (82, 84, 92, 94) associated with the operation of the pacemaker.