EP0310025A2
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EP
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Sef adjusting rate responsive cardiac pacemaker
Assignee: Individual
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Filing: 1988-09-28
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Granted: —
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Expires: 2008-09-28
Abstract
Abstract It has been found from studies of healthy persons and patient's wearing pacemakers that the basic cardiovascular condition and the heart rate response varies considerably between different individuals. Thus, for effective control the individual differences must be taken into account. It would not be desirable to face the complexity of a pacemaker system that did not automatically adjust to these individual differences because there could not be knowledgeable persons in the field who could establish critical control conditions. This invention thus provides pacemaker methods for automatically establishing operating conditions for proper pacing rate control of a wide range of different individual conditions. Thus on line real time physiologically variable signals from the patient indicative of the patient's basic condition and suitable for pacing rate control are averaged over long and short term intervals and used to develop a pacing control signal. Typically the respiratory rate signal taken for a patient will provide information for adjusting the pacing rate to both the basic condition of the patient and the instantaneous conditions encountered such as exercise.
Inventors
- 👤 Eckhard Dr. Alt
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-26 23:22
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/365; A61N1/36514; A61N1/36521; A61N1/36571
Claims Analysis
Total Claims: 24
Claim 1
Independent Claim
135 words
The method of regulating the pacing rate for a patient's heartbeat comprising the steps of: producing in response to the ventilatory activity of the patient an on line real time respiratory signal corresponding to the dynamic respiratory activity of the patient, developing from said respiratory signal a long term average of the respiratory rate of the patient representative of the patient's basic cardiopulmonary condition, establishing a basic pacing rate relationship to the the long long term average respiratory rate signal for control of the patient's heartbeat, establishing a short term average from the respiratory rate signal representative of the patient's instantaneous cardiopulmonary condition, varying the basic pacing rate as a function of the short term average to produce a pacing control signal, and pacing the patient's heartbeat as a function of the pacing control signal.
Claim 2
Independent Claim
135 words
The method of regulating the pacing rate for a patient's heartbeat comprising the steps of: producing in response to the ventilatory activity of the patient an on line real time respiratory signal corresponding to the dynamic respiratory activity of the patient, developing from said respiratory signal a long term average of the respiratory rate of the patient representative of the patient's basic cardiopulmonary condition, establishing a basic pacing rate relationship to the the long long term average respiratory rate signal for control of the patient's heartbeat, establishing a short term average from the respiratory rate signal representative of the patient's instantaneous cardiopulmonary condition, varying the basic pacing rate as a function of the short term average to produce a pacing control signal, and pacing the patient's heartbeat as a function of the pacing control signal.
Claim 3
Dependent Claim
105 words
The method of Claim 1 with the further steps of: deriving from said respiratory signal a signal representing a long term average of the patient's tidal volume representing his individual basic pulmonary condition as a basic tidal volume signal, deriving from said respiratory signal a signal representing a short term average of the patient's tidal volume representing the instantaneous pulmonary condition of the patient, varying the basic tidal volume signal as a function of the short term average of the tidal volume signal to establish a tidal volume control signal, and varying the pacing control signal as a function of the tidal volume control signal.
Claim 4
Dependent Claim
104 words
The method of Claim 1 with the further steps of: producing from the cardiovascular system of the patient an on line real time cardiac signal representative of the patient's cardiac activity, deriving from the cardiac signal a long term average representing the patient's basic cardiac condition as a basic cardiac signal, deriving from said cardiac signal a short term average as an instantaneous cardic signal representing the patient's instantaneous cardiac condition, varying the basic cardiac signal as a function of the instantaneous cardic signal to derive a cardiac control signal, and varying the pacing control signal as a function of the cardiac control signal.
Claim 5
Dependent Claim
115 words
The method of Claim 1 with the further steps of: producing in response to the physical activity of the patient an activity signal representative of the level of physical activity of the patient, developing a long term average of the activity signal to produce a basic activity signal representative of the basic level of physical activity of the patient, developing a short term average of the activity signal to produce an instantaneous activity signal representative of the instantaneous activity of the patient, varying the basic activity signal as a function of the instantaneous activity signal to provide an activity control signal, and varying the pacing control signal as a function of the activity control signal.
Claim 6
Dependent Claim
47 words
The method of Claim 1 with the further steps of: producing in response to the physical activity of the patient an activity signal representative of the level of physical activity of the patient, and varying the pacing control signal as a function of the activity control signal.
Claim 7
Independent Claim
109 words
The method of controlling the pacing rate of a patient wearing a pacemaker comprising the steps of: producing an on line real time activity signal from the cardiovascular-pulmonary system of a patient representative of a physiological activity variably related to the change of heartbeat rate in a normal person, developing a basic activity signal from a long term average of the activity signal, developing an instantaneous activity signal from a short term average of the activity signal, varying the basic activity signal as a function of the instantaneous activity signal to produce an activity control signal, and pacing the heart at a rate controlled by the activity control signal.
Claim 8
Independent Claim
109 words
The method of controlling the pacing rate of a patient wearing a pacemaker comprising the steps of: producing an on line real time activity signal from the cardiovascular-pulmonary system of a patient representative of a physiological activity variably related to the change of heartbeat rate in a normal person, developing a basic activity signal from a long term average of the activity signal, developing an instantaneous activity signal from a short term average of the activity signal, varying the basic activity signal as a function of the instantaneous activity signal to produce an activity control signal, and pacing the heart at a rate controlled by the activity control signal.
Claim 9
Dependent Claim
108 words
A heart pacemaker comprising in combination, pulse generator means for producing pacing pulses, means for measuring physiological activity of a patient representative of dynamically changing physiological activity and individual characteristics of the patient relating to pacing rate, means for averaging a parameter of the measured data that is related to pacing rate over a predetermined long term period to establish a base line characteristic, means for modifying the base line characteristic with a short term average of the same parameter to account for instantaneous dynamic changes for effecting changes in pacing rates, and means for controlling the pacing rate as a function of the modified base line characteristic.
Claim 10
Dependent Claim
108 words
A heart pacemaker comprising in combination, pulse generator means for producing pacing pulses, means for measuring physiological activity of a patient representative of dynamically changing physiological activity and individual characteristics of the patient relating to pacing rate, means for averaging a parameter of the measured data that is related to pacing rate over a predetermined long term period to establish a base line characteristic, means for modifying the base line characteristic with a short term average of the same parameter to account for instantaneous dynamic changes for effecting changes in pacing rates, and means for controlling the pacing rate as a function of the modified base line characteristic.
Claim 11
Dependent Claim
15 words
The pacemaker of Claim 7 wherein said parameter is the respiratory rate of the patient.
Claim 12
Dependent Claim
31 words
The pacemaker of Claim 8 wherein the base line characteristic is further modified by a sub-signal of a different parameter related to the patient's physiological activity before controlling the pacing rate.
Claim 13
Dependent Claim
17 words
The pacemaker of Claim 7 wherein said parameter is related to the pulmonary activity of the patient.
Claim 14
Dependent Claim
17 words
The pacemaker of Claim 7 wherein said parameter is related to the cardiac activity of the patient.
Claim 15
Independent Claim
93 words
The method of regulating the pacing rate for a patient's heartbeat comprising the steps of: producing from a patient an on line real time dynamic physiological acitivity signal representative of a condition relating to the heartbeat rate, producing a long term average of the activity signal, establishing from the long term average a pacing function having a substantially linear relationship with the heartbeat rate with a predetermined slope, changing the slope in response to a parameter of the activity signal, and pacing the patient's heart at a rate corresponding to the pacing function.
Claim 16
Independent Claim
93 words
The method of regulating the pacing rate for a patient's heartbeat comprising the steps of: producing from a patient an on line real time dynamic physiological acitivity signal representative of a condition relating to the heartbeat rate, producing a long term average of the activity signal, establishing from the long term average a pacing function having a substantially linear relationship with the heartbeat rate with a predetermined slope, changing the slope in response to a parameter of the activity signal, and pacing the patient's heart at a rate corresponding to the pacing function.
Claim 17
Dependent Claim
94 words
Pacemaker apparatus for regulating the pacing rate of a patient comprising in combination: sensing means for deriving from the patient an on line real time dynamic physiological activity signal representative of a condition related to the heartbeat rate, processing means for producing a long term average pacing function of said signal having a substantially linear relationship with the heartbeat rate of a predetermined slope, means for changing the slope in response to a parameter of the activity signal, and means for establishing a pacing rate in response to the slope of the pacing function.
Claim 18
Dependent Claim
94 words
Pacemaker apparatus for regulating the pacing rate of a patient comprising in combination: sensing means for deriving from the patient an on line real time dynamic physiological activity signal representative of a condition related to the heartbeat rate, processing means for producing a long term average pacing function of said signal having a substantially linear relationship with the heartbeat rate of a predetermined slope, means for changing the slope in response to a parameter of the activity signal, and means for establishing a pacing rate in response to the slope of the pacing function.
Claim 19
Independent Claim
120 words
The method of heart pacing comprising the steps of: monitoring a physiological parameter indicative of the metabolic condition of a patient, establishing a long term averaged value from said parameter indicative of an individual patient's condition, formulating from said averaged value a primary functional relationship for control of the pacing rate of an individual patient, deriving an instantaneous physiological change in the patient's condition induced by exercise that varies as a function of the patient's individual need for variation from said primary functional relationship, and controlling the pacing rate of the patient in response to a pacing control algorithm superimposing the variations in the instantaneous changes upon the primary function relationship as a function of the long term average value.
Claim 20
Independent Claim
120 words
The method of heart pacing comprising the steps of: monitoring a physiological parameter indicative of the metabolic condition of a patient, establishing a long term averaged value from said parameter indicative of an individual patient's condition, formulating from said averaged value a primary functional relationship for control of the pacing rate of an individual patient, deriving an instantaneous physiological change in the patient's condition induced by exercise that varies as a function of the patient's individual need for variation from said primary functional relationship, and controlling the pacing rate of the patient in response to a pacing control algorithm superimposing the variations in the instantaneous changes upon the primary function relationship as a function of the long term average value.
Claim 21
Independent Claim
59 words
The method of heat pacing comprising the steps of: monitoring a physiological parameter indicative of the metabolic condition of a patient, establishing a long term function of said monitored parameter indicative of an individual pateint's condition, formulating from said long term function a pacing control signal, and controlling the pacing rate of the patient with the pacing control signal.
Claim 22
Independent Claim
59 words
The method of heat pacing comprising the steps of: monitoring a physiological parameter indicative of the metabolic condition of a patient, establishing a long term function of said monitored parameter indicative of an individual pateint's condition, formulating from said long term function a pacing control signal, and controlling the pacing rate of the patient with the pacing control signal.
Claim 23
Dependent Claim
52 words
Apparatus for pacing the heartbeat of a patient, comprising in combination: measuring means for monitoring a physiological parameter indicative of the metabolic condition of a patient, means for establishing a long term function of said monitored parameter, and means for controlling the pacing rate of the patient from said long term function.
Claim 24
Dependent Claim
52 words
Apparatus for pacing the heartbeat of a patient, comprising in combination: measuring means for monitoring a physiological parameter indicative of the metabolic condition of a patient, means for establishing a long term function of said monitored parameter, and means for controlling the pacing rate of the patient from said long term function.
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