公开(公告)号：US06496730B1

公开(公告)日：2002-12-17

申请号：US09439244

申请日：1999-11-12

申请人： Karen J. Kleckner ,  Carleen J. Juran ,  Robert A. Betzold ,  Thomas C. Wendell ,  Charles G. Yerich

发明人： Karen J. Kleckner ,  Carleen J. Juran ,  Robert A. Betzold ,  Thomas C. Wendell ,  Charles G. Yerich

IPC分类号： A61N136

CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3684

摘要： Multi-site cardiac pacing systems for providing pacing to multiple sites in a patient's heart, e.g., in a single heart chamber or in right and left heart chambers, while avoiding inappropriate responses to double sensing of an evoked depolarization conducted between the sites. A conditional refractory period and further post-event time periods, e.g. a conventional refractory period, are started upon a sense event or pacing pulse sensed at or delivered to a first pace/sense site. A sense event detected at another sense site that occurs during the conditional refractory period is characterized as a conditional refractory event, and it restarts shortened post-event time periods and terminates the conditional refractory period. The restarted post-event time periods are reduced in length by the elapsed time between the starting and termination of the conditional refractory period. The undue prolongation of the post-event period due to a sense event resulting from sensing of delayed propagation of a depolarization between the spaced apart pace/sense sites is avoided. However, the full length post-event time periods are restarted if a sense event is then detected during the previously restarted post-event time periods. Multi-site single heart chamber pacemaker and right and left heart chamber pacemaker embodiments of the invention are disclosed. In an atrial synchronous, bi-ventricular pacemaker embodiment, the undue prolongation of the post-event period due to a ventricular event sense event resulting from sensing of delayed propagation of a single ventricular depolarization between the left and right ventricles is avoided, and legitimate atrial sense event signals occurring thereafter are not characterized as refractory and are able to restart the AV delay.

摘要翻译： 多站点心脏起搏系统用于为患者心脏中的多个部位提供起搏，例如在单个心脏室或右心房和左心室中，同时避免对位点之间进行的诱发去极化的双重感测的不适当响应。 条件不应期和事后时间段，例如 传统的不应期，是在感测事件或起搏脉冲上感测到或传递到第一步调/感测部位时启动的。 在有条件的难治期发生的另一感觉部位检测到的感觉事件被表征为条件难治事件，并且重新开始事件发生后时间缩短并终止条件不应期。 重新启动的事件后时间段的长度减小了条件不应期间的起始和终止之间的经过时间。 避免了由于在间隔开的步调/感测部位之间的去极化的延迟传播所导致的感觉事件引起的事后周期的过度延长。 然而，如果在先前重新启动的事件后时间段内检测到感测事件，则重新启动全长事件后时间段。 公开了多部位单心室起搏器和本发明的左心室心脏起搏器实施例。 在心房同步双心室起搏器实施例中，避免了由于在左心室和右心室之间感测到单次心室去极化的延迟传播而导致的心室事件感觉事件引起的事后周期的不适当延长，并且合法心房 此后发生的感测事件信号不被表征为难治性并且能够重新启动AV延迟。