摘要:
An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers. The device is provided with a pulse synchronizer which defines a first synchronization interval initiated following a sensed atrial event and a second synchronization interval initiated responsive to a sensed ventricular event and a pulse triggerer which triggers delivery of a cardioversion or defibrillation pulse responsive to the first and second synchronization intervals simultaneously being underway. In particular, the pulse triggerer may be responsive to initiation of the first synchronization interval during the second synchronization interval. In addition, the synchronizer may also define minimum time intervals following ventricular events and the triggerer may additionally be responsive to expiration of a defined minimum time interval following a ventricular event preceding the sensed ventricular event which initiated the second synchronization interval currently underway.
摘要:
An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers.
摘要:
In an implantable pacemaker/cardioverter/defibrillator, a system for correlating the delivery of a cardioversion therapy to an optimum point or phase of the respiratory cycle of the patient to effect delivery of the therapy when the impedance between the cardioversion electrodes is minimized. In a first application for use with cardioversion electrodes located substantially in contact with the heart chamber, the optimum point or phase is at the end of inspiration. In a second application for use with at least one cardioversion electrode located remotely from the heart chamber, the optimum point or phase is at end expiration or beginning of inspiration. The cardioversion therapy is delivered in synchrony with a ventricular sense event, if present. If the optimum point or phase of the respiratory cycle cannot be determined during a therapy time, a pre-shock may be delivered to elicit a respiration cycle through a stimulated contraction of the diaphragm.
摘要:
A method and apparatus for treating fibrillation, particularly atrial fibrillation. In response to detection of fibrillation, a series of low energy pulse bursts is delivered, separated by defined inter-burst intervals, and including bursts unsynchronized to heart depolarizations. Detection of termination of fibrillation during inter-burst intervals results in cancellation of further pulse bursts to prevent reinduction of fibrillation.
摘要:
A cardiac pacemaker and a method of its use. The pacemaker paces a patient's heart in a tachyarrhythmia prevention pacing mode for an extended time period, defines a metric of success of the tachyarrhythmia prevention pacing mode, monitors the metric over the extended time period and, responsive to the monitored metric, adjusts the tachyarrhythmia prevention pacing mode. Adjustment of the tachyarrhythmia prevention pacing mode may take the form of pacing the patient's heart with a different set of electrodes, pacing the patient's heart with a different tachyarrhythmia prevention pacing mode and/or terminating operation of the tachyarrhythmia prevention pacing mode.
摘要:
A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the right ventricle and the coronary sinus/great vein, with the right ventricular and coronary sinus/great vein electrodes connected in common. Optionally a subcutaneous electrode, preferably located in the left pectoral area may also be employed, coupled in common to the right atrial/SVC electrode.
摘要:
A method of and apparatus for delivering ventricular pacing pulses to terminate high rate atrial tachyarrhythmias including fibrillation or flutter or to reduce the requirements for termination of atrial fibrillation or flutter. In response to detected atrial fibrillation or flutter, the apparatus delivers ventricular pacing pulses at a lower rate, for example one third or half of the preceding base pacing rate, for a defined, limited period of time. After delivery of the low rate ventricular pacing pulses for the defined time period, if the high rate atrial tachyarrhythmia is not terminated, an additional therapy such a high energy defibrillation pulse or pacing level pulse trains may be applied to the atria. Prior to the delivery of low rate ventricular pacing pulses, the apparatus may deliver a higher rate of ventricular pacing pulses, for example twice the preceding base pacing rate, so that the transition in rates occurring on delivery of the low rate pulses is made more pronounced.
摘要:
A method an apparatus for treating fibrillation, particularly atrial fibrillation. In response to detection of fibrillation, a high frequency, low energy pulse burst is delivered via pacing electrodes, accompanied by a high energy pulse delivered via defibrillation electrodes. The low energy pulse burst is preferably delivered to an area of the heart which exhibits relatively lower current density during delivery of the high energy pulse.
摘要:
An implantable medical device system and method are provided for synchronizing atrial cardioversion shocks to the ventricular rhythm using an adjustable atrial cardioversion/defibrillation ventricular refractory period. Upon determining a need for an atrial shock therapy, the method determines if the ventricular rate meets synchronization criteria based on an upper ventricular refractory period limit. If synchronization criteria are not met, the refractory period is automatically adjusted in stepwise decrements until the synchronization criteria are met, or until a lower refractory period limit is exceeded. If synchronization criteria are met, an atrial shock is synchronized to the next ventricular depolarization occurring outside the current refractory period. If the lower refractory period limit is exceeded, the atrial therapy is aborted.
摘要:
A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the left pectoral region and the coronary sinus/great vein, with the left pectoral and coronary sinus/great vein electrodes connected in common. Optionally a ventricular electrode may also be employed in conjunction with one or more of the other listed electrodes to accomplish ventricular cardioversion or defibrillation.