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EP0331309A2 Expired / Lapsed EP ⏱️ 0.0 years remaining

Rate-responsive pacemaker

Assignee: Individual
•
Filing: 1989-02-16
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Granted: —
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Expires: 2009-02-16
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Abstract

Abstract A pacemaker has means for producing first and second signals one of which changes rapidly in response to changes in exercise level but may inaccurately represent the appropriate pacing rate. Such signal may be derived from a vibration sensor. The second signal accurately represents the required pacing rate but changes slowly in response to exercise level and may represent any of a number of different physiological variables, such as respiratory rate. The signals may be derived from the same or separate sensors. A control circuit provides a pacing rate appropriate to resting conditions if the first signal has a value less than a threshold regardless of the value of the second signal. The pacing rate is elevated to a predetermined level, such as 95 beats/min, if the first signal exceeds the threshold but the second signal has a value indicative of a pacing rate less than the predetermined level. The pacing rate is further elevated to substantially equal that indicated by the value of the second signal when the first signal exceeds the threshold and the second signal indicates a rate higher than the predetermined rate.

Inventors

  • 👤 Stuart Charles Webb
  • 👤 Leland Milton Lewis
  • 👤 Jayne Alison Morris-Thurgood

Bibliographic Details

Application Number —
Jurisdiction EP
Data Source google_patents
Last Synchronized 2026-10-31 13:20
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/365; A61N1/36585

Claims Analysis

Total Claims: 36
Claim 1
Independent Claim 186 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in response to changes in exercise level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to provide a relatively low pacing rate when said first signal has a value less than a threshold; (B) to provide a predetermined pacing rate higher than said relatively low rate when the first signal exceeds said threshold and the second signal has a value indicative of a pacing rate less than said predetermined rate; and (C) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate, regardless of the amount by which said first signal may exceed said threshold.
Claim 2
Dependent Claim 186 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in response to changes in exercise level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to provide a relatively low pacing rate when said first signal has a value less than a threshold; (B) to provide a predetermined pacing rate higher than said relatively low rate when the first signal exceeds said threshold and the second signal has a value indicative of a pacing rate less than said predetermined rate; and (C) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate, regardless of the amount by which said first signal may exceed said threshold.
Claim 3
Dependent Claim 18 words
A pacemaker according to claim 1, wherein said control means is operable to change the pacing rate linearly.
Claim 4
Dependent Claim 18 words
A pacemaker according to claim 1, wherein the control means is operable to change the pacing rate nonlinearly.
Claim 5
Dependent Claim 18 words
A pacemaker according to claim 1, wherein the control means is operable to change the pacing rate stepwise.
Claim 6
Dependent Claim 25 words
A pacemaker according to any preceding claim, comprising a first sensor for providing said first signal and a second sensor for providing said second signal.
Claim 7
Dependent Claim 27 words
A pacemaker according to claim 5, wherein said first sensor is operable to sense bodily vibrations and said second sensor is operable to sense a physiological variable.
Claim 8
Dependent Claim 32 words
A pacemaker according to claim 5, wherein said physiological variable is evoked QT interval, respiratory rate, minute ventilation, mixed venous temperature, venous oxygen saturation, or rate of change of right ventricular pressure.
Claim 9
Dependent Claim 32 words
A pacemaker according to any of claims 1 to 5, having a single sensor and processing means for processing signals from said single sensor to produce said first and second signals respectively.
Claim 10
Dependent Claim 21 words
A pacemaker according to claim 8, wherein said single sensor is a vibration sensor and said processing means comprises filtering means.
Claim 11
Dependent Claim 41 words
A pacemaker according to claim 9 wherein said filtering means is operable to provide said first signal by passing a frequency band in the region of 10Hz and to provide said second signal by passing frequencies less than about 0.5 Hz.
Claim 12
Dependent Claim 13 words
A pacemaker according to ciaim 10 wherein said second signal represents respiratory rate.
Claim 13
Dependent Claim 13 words
A pacemaker according to ciaim 10 wherein said second signal represents respiratory rate.
Claim 14
Dependent Claim 29 words
A pacemaker according to any of claims 6, 7 and 9 to 11, wherein said threshold is defined as both a magnitude and a frequency of said first signal.
Claim 15
Dependent Claim 15 words
A pacemaker according to any preceding claim, wherein said predetermined rate is approximately 95 beats/min.
Claim 16
Dependent Claim 37 words
A pacemaker according to any preceding ciaim, wherein said control means is operable to define predetermined minimum and maximum values for said pacing rate and to maintain the pacing rate within said values regardless of said signals.
Claim 17
Dependent Claim 37 words
A pacemaker according to any preceding ciaim, wherein said control means is operable to define predetermined minimum and maximum values for said pacing rate and to maintain the pacing rate within said values regardless of said signals.
Claim 18
Dependent Claim 204 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in response to changes in exercise level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to provide a relatively low pacing rate unless said first signal includes frequency components having an amplitude above a predetermined amplitude and a frequency above a threshold frequency of at least 7 cycles per second; (B) to provide a predetermined pacing rate higher than said relatively low rate when said first signal includes frequency components having an amplitude above said predetermined amplitude and a frequency above said threshold frequency and the second signal has a value indicative of a pacing rate less than said predetermined rate; and (C) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate.
Claim 19
Dependent Claim 204 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in response to changes in exercise level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to provide a relatively low pacing rate unless said first signal includes frequency components having an amplitude above a predetermined amplitude and a frequency above a threshold frequency of at least 7 cycles per second; (B) to provide a predetermined pacing rate higher than said relatively low rate when said first signal includes frequency components having an amplitude above said predetermined amplitude and a frequency above said threshold frequency and the second signal has a value indicative of a pacing rate less than said predetermined rate; and (C) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate.
Claim 20
Dependent Claim 15 words
A pacemaker according to claim 15, wherein said threshold frequency is 10 cycles per second.
Claim 21
Dependent Claim 188 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in response to changes in exercise level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to define for said first signal a single substantially constant threshold value: (B) to provide a relatively low pacing rate when said first signal has a value less than said threshold value; (C) to provide a predetermined pacing rate higher than said relatively low rate when the first signal exceeds said threshold value and the second signal has a value indicative of a pacing rate less than said predetermined rate; and (D) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate.
Claim 22
Dependent Claim 188 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in response to changes in exercise level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to define for said first signal a single substantially constant threshold value: (B) to provide a relatively low pacing rate when said first signal has a value less than said threshold value; (C) to provide a predetermined pacing rate higher than said relatively low rate when the first signal exceeds said threshold value and the second signal has a value indicative of a pacing rate less than said predetermined rate; and (D) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate.
Claim 23
Dependent Claim 193 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in respone to changes in exerices level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to provide a relatively low pacing rate when said first signal has a value less than a threshold; B) to provide a predetermined pacing rate higher than said relatively low rate when the first signal exceeds said threshold and the second signal has a value indicative of a pacing rate less than said predetermined rate; (C) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate; and (D) to increase said pacing rate above said predetermined pacing rate solely in response to increase in said second signal.
Claim 24
Dependent Claim 193 words
A pacemaker comprising: sensing means for providing a first signal which changes relatively rapidly in response to changes in a patient's exercise level but may inaccurately represent the pacing rate appropriate to said exercise level and a second signal which changes relatively slowly in respone to changes in exerices level but, after having changed, relatively accurately represents the required pacing rate; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to provide a relatively low pacing rate when said first signal has a value less than a threshold; B) to provide a predetermined pacing rate higher than said relatively low rate when the first signal exceeds said threshold and the second signal has a value indicative of a pacing rate less than said predetermined rate; (C) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal exceeds said threshold and the second signal indicates a rate higher than said predetermined rate; and (D) to increase said pacing rate above said predetermined pacing rate solely in response to increase in said second signal.
Claim 25
Dependent Claim 23 words
A pacemaker according to claim 18, wherein said predetermined rate is at least 20 beats per minute above said relatively low pacing rate.
Claim 26
Dependent Claim 24 words
A pacemaker according to claim 19, wherein said predetermined rate is between 20 and 30 beats per minute above said relatively low pacing rate.
Claim 27
Dependent Claim 22 words
A pacemaker according to claim 20, wherein said predetermined rate is approximately 25 beats per minute above said relatively low pacing rate.
Claim 28
Dependent Claim 215 words
A pacemaker comprising: first sensing means for providing a first signal in response to bodily vibrations arising from a patient's activity; second sensing means for providing a second signal which changes in response to a physiological parameter which varies in response to a patient's activity; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to define for said first signal a threshold for components of said first signal having a frequency of at leasst 7Hz; (B) to provide a relatively low pacing rate when said first signal is such that said threshold is not exceeded; (C) to provide a predetermined pacing rate which is from 20 to 30 beats/min higher than said relatively low rate when the first signal is such that said threshold is exceeded and the second signal has a value indicative of a pacing rate less than said predetermined rate; (D) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal is such that said threshold is exceeded and the second signal indicates a rate higher than said predetermined rate: and (E) to increase said pacing rate above said predetermined pacing rate solely in respone to increase in said second signal.
Claim 29
Dependent Claim 215 words
A pacemaker comprising: first sensing means for providing a first signal in response to bodily vibrations arising from a patient's activity; second sensing means for providing a second signal which changes in response to a physiological parameter which varies in response to a patient's activity; and control means for controlling pacing rate in response to said sensing means, said control means being operative: (A) to define for said first signal a threshold for components of said first signal having a frequency of at leasst 7Hz; (B) to provide a relatively low pacing rate when said first signal is such that said threshold is not exceeded; (C) to provide a predetermined pacing rate which is from 20 to 30 beats/min higher than said relatively low rate when the first signal is such that said threshold is exceeded and the second signal has a value indicative of a pacing rate less than said predetermined rate; (D) to provide a pacing rate substantially equal to that indicated by the value of said second signal when the first signal is such that said threshold is exceeded and the second signal indicates a rate higher than said predetermined rate: and (E) to increase said pacing rate above said predetermined pacing rate solely in respone to increase in said second signal.
Claim 30
Dependent Claim 43 words
A sensing arrangement for a pacemaker, comprising a single sensor, and signal processing means for processing signals from said sensor to produce a first output signal representative of a first biological variable and a second output signal representative of a second biological variable.
Claim 31
Dependent Claim 43 words
A sensing arrangement for a pacemaker, comprising a single sensor, and signal processing means for processing signals from said sensor to produce a first output signal representative of a first biological variable and a second output signal representative of a second biological variable.
Claim 32
Dependent Claim 23 words
An arrangement according to claim 23, wherein said first biological variable is bodily vibration and said second biological variable is a physiological variable.
Claim 33
Dependent Claim 13 words
An arrangement according to claim 24, wherein said sensor is a vibration sensor.
Claim 34
Dependent Claim 13 words
An arrangement according to claim 25, wherein said processing means comprises filtering means.
Claim 35
Dependent Claim 41 words
An arrangement according to claim 26, wherein said filtering means is operable to provide said first signal by passing a frequency band in the region of 10 Hz and to provide said second signal by passing frequencies less than about 0.5Hz.
Claim 36
Dependent Claim 17 words
An arrangement according to any of claims 25 to 27, wherein said physiological variable is respiratory rate.

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