公开(公告)号：US5991659A

公开(公告)日：1999-11-23

申请号：US164012

申请日：1998-09-30

申请人： Bernhard de Vries ,  Hendrik Reineman ,  Johannes G. F. Idink ,  Hendrik van Rooijen

发明人： Bernhard de Vries ,  Hendrik Reineman ,  Johannes G. F. Idink ,  Hendrik van Rooijen

IPC分类号： A61N1/368

CPC分类号： A61N1/368

摘要： There is provided a pacemaker system with an SRD detection and intervention feature, which enables a simple way of initiating confirmation of SRD, i.e., looking for an AS/AP transition in a DDD or DDI pacemaker, or a transition from a VS to a VP in a DDI pacemaker. This simple initiation of SRD confirmation is made possible by use of a relatively wide hysteresis band which is normally operative when a spontaneous rate is present, and which tracks physiological changes in the patient's natural rate, across the pacemaker rate range. Transitions which result from a gradual decrease in natural rate and thus represent physiological bradycardia are not interpreted as suggesting SRD. The detection is confirmed only after a predetermined number of pace pulses are delivered at the hysteresis rate, i.e., 1-5 pulses. In a preferred embodiment, after confirmation of SRD, pacing starts at a programmable intervention rate, and rate flywheels downward toward a lower rate limit, with intermittent hysteresis scans at a lower rate to enable recovery of an underlying natural rate. The SRD mode is left whenever recovery of a natural rate is confirmed, as by sensing a predetermined number of consecutive natural atrial beats in DDD mode or atrial and/or ventricular beats in DDI mode.

摘要翻译： 提供了具有SRD检测和干预功能的起搏器系统，其使得能够简单地启动SRD的确认，即寻找DDD或DDI起搏器中的AS / AP转换，或从VS到VP的转换 在DDI起搏器。 SRD确认的这种简单的启动是通过使用相对宽的滞后带来实现的，该磁滞带通常在存在自发速率时起作用，并且跟踪起搏器速率范围内的患者的自然率的生理变化。 由于自然率逐渐降低并因此代表生理性心动过缓而产生的转变不被解释为表明SRD。 只有在以滞后率（即1-5个脉冲）传送预定数量的起搏脉冲之后才能确认检测。 在优选实施例中，在确认SRD之后，起搏以可编程的干预率开始，并且速率向下飞向较低的速率限制，间歇性滞后扫描以较低的速率扫描，以恢复潜在的自然率。 如果通过在DDI模式中感测预定数量的DDD模式中的连续天然心房搏动或心房和/或心室搏动来确认自然率的恢复，则SRD模式是残留的。