EP0334675A1
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EP
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Rate-responsive pacemaker with closed-loop control
Assignee: Telectronics NV
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Filing: 1989-03-23
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Granted: —
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Expires: 2009-03-23
Abstract
Abstract This invention concerns a rate-responsive pacemaker which is provided with a closed-loop control system (46-57) whose rate control parameter is the depolarization gradient. Any difference between the measured value of the rate control parameter and a target value is used to change the pacing rate in a direction which tends to minimize the difference. To calibrate the system for long-term changes due to drugs and the like, the target value is changed in each measurement cycle in accordance with prescribed rules.
Inventors
- 👤 Francis J. Callaghan
- 👤 William Vollman
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-24 00:39
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/37; A61N1/371; A61N1/3712; A61N1/365; A61N1/36507; A61N1/3706
Claims Analysis
Total Claims: 31
Claim 1
Independent Claim
98 words
A rate-responsive pacemaker comprising means for periodically ascertaining the value of a measured rate control parameter ["MRCP"], said rate control parameter being such that its measured value is changed in opposite directions by stress/exercise and heart rate, means for generating pacing pulses at a pacing rate, means for deriving a target value ["target"] which is indicative of changes in said MRCP due to non-stress/exercise and non-rate factors, and means responsive to a change in the difference between MRCP and target for adjusting said pacing rate in a direction which tends to return said difference to its pre-change value.
Claim 2
Dependent Claim
98 words
A rate-responsive pacemaker comprising means for periodically ascertaining the value of a measured rate control parameter ["MRCP"], said rate control parameter being such that its measured value is changed in opposite directions by stress/exercise and heart rate, means for generating pacing pulses at a pacing rate, means for deriving a target value ["target"] which is indicative of changes in said MRCP due to non-stress/exercise and non-rate factors, and means responsive to a change in the difference between MRCP and target for adjusting said pacing rate in a direction which tends to return said difference to its pre-change value.
Claim 3
Dependent Claim
47 words
A rate-responsive pacemaker in accordance with claim 1 wherein said generating means generates pulses only at or above a minimum rate, and said target deriving means changes target in the direction which tends to lower said pacing rate whenever pulses are being generated above said minimum rate.
Claim 4
Dependent Claim
35 words
A rate-responsive pacemaker in accordance with claim 2 wherein said target deriving means changes target at a speed which is programmable, but at all times slow enough such that changes in MRCP permit rate-responsive operation.
Claim 5
Dependent Claim
36 words
A rate-responsive pacemaker in accordance with claim 3 wherein, responsive to said pacing rate being lowered to said minimum rate, said target deriving means changes target in the direction which tends to increase said pacing rate.
Claim 6
Dependent Claim
54 words
A rate-responsive pacemaker in accordance with claim 4 wherein the speed at which said target deriving means changes target in the direction which tends to increase said pacing rate is substantially greater than the highest programmable speed at which said deriving means changes target in the direction which tends to lower said pacing rate.
Claim 7
Dependent Claim
54 words
A rate-responsive pacemaker in accordance with claim 5 further including means for sensing an intrinsic rhythm and in response thereto for inhibiting said generating means, and wherein said target deriving means, responsive to a sensed intrinsic rhythm, changes target in the direction which tends to increase said pacing rate but at the programmed speed.
Claim 8
Dependent Claim
28 words
A rate-responsive pacemaker in accordance with claim 6 wherein said target deriving means is further operative to initialize rate-responsive operation by changing target at a highly accelerated rate.
Claim 9
Dependent Claim
34 words
A rate-responsive pacemaker in accordance with claim 7 wherein target has minimum and maximum permissible limits, and said generating means switches to a predetermined "Stat Set" operation when target reaches either of its limits.
Claim 10
Dependent Claim
48 words
A rate-responsive pacemaker in accordance with claim 8 wherein said MRCP is a parameter which characterizes an evoked potential, and said adjusting means and said target deriving means adjust pacing rate and change target respectively during rate-responsive pacing only in response to the presence of an evoked potential.
Claim 11
Dependent Claim
15 words
A rate-responsive pacemaker in accordance with claim 9 wherein said MRCP is the depolarization gradient.
Claim 12
Dependent Claim
39 words
A rate-responsive pacemaker in accordance with claim 10 wherein said generating means, if inhibited by an intrinsic rhythm, increases its rate so that it can generate a pacing pulse and thereby allow the value of MRCP to be ascertained.
Claim 13
Dependent Claim
36 words
A rate-responsive pacemaker in accordance with claim 2 wherein, responsive to said pacing rate being lowered to said minimum rate, said target deriving means changes target in the direction which tends to increase said pacing rate.
Claim 14
Dependent Claim
52 words
A rate-responsive pacemaker in accordance with claim 12 wherein the speed at which said target deriving means changes target in the direction which tends to increase said pacing rate is substantially greater than the speed at which said deriving means changes target in the direction which tends to lower said pacing rate.
Claim 15
Dependent Claim
70 words
A rate-responsive pacemaker in accordance with claim 12 further including means for sensing an intrinsic rhythm and in response thereto for inhibiting said generating means, and wherein said target deriving means, responsive to a sensed intrinsic rhythm, changes target in the direction which tends to increase said pacing rate but at a speed slower than that at which target is changed when said pacing rate is at said minimum rate.
Claim 16
Dependent Claim
48 words
A rate-responsive pacemaker in accordance with claim 14 wherein said MRCP is a parameter which characterizes an evoked potential, and said adjusting means and said target deriving means adjust pacing rate and change target respectively during rate-responsive pacing only in response to the presence of an evoked potential.
Claim 17
Dependent Claim
15 words
A rate-responsive pacemaker in accordance with claim 15 wherein said MRCP is the depolarization gradient.
Claim 18
Dependent Claim
39 words
A rate-responsive pacemaker in accordance with claim 17 wherein said generating means, if inhibited by an intrinsic rhythm, increases its rate so that it can generate a pacing pulse and thereby allow the value of MRCP to be ascertained.
Claim 19
Dependent Claim
28 words
A rate-responsive pacemaker in accordance with claim 1 wherein said target deriving means is further operative to initialize rate-responsive operation by changing target at a highly accelerated rate.
Claim 20
Dependent Claim
34 words
A rate-responsive pacemaker in accordance with claim 1 wherein target has minimum and maximum permissible limits, and said generating means switches to a predetermined "Stat Set" operation when target reaches either of its limits.
Claim 21
Dependent Claim
48 words
A rate-responsive pacemaker in accordance with claim 1 wherein said MRCP is a parameter which characterizes an evoked potential, and said adjusting means and said target deriving means adjust pacing rate and change target respectively during rate-responsive pacing only in response to the presence of an evoked potential.
Claim 22
Dependent Claim
15 words
A rate-responsive pacemaker in accordance with claim 20 wherein said MRCP is the depolarization gradient.
Claim 23
Dependent Claim
39 words
A rate-responsive pacemaker in accordance with claim 20 wherein said generating means, if inhibited by an intrinsic rhythm, increases its rate so that it can generate a pacing pulse and thereby allow the value of MRCP to be ascertained.
Claim 24
Dependent Claim
15 words
A rate-responsive pacemaker in accordance with claim 1 wherein said MRCP is the depolarization gradient.
Claim 25
Dependent Claim
35 words
A rate-responsive pacemaker in accordance with claim 1 wherein said target deriving means changes target at a speed which is programmable, but at all times slow enough such that changes in MRCP permit rate-responsive operation.
Claim 26
Dependent Claim
70 words
A rate-responsive pacemaker comprising means for generating pacing pulses at a pacing rate, means for ascertaining the value of a rate control parameter ["RCP"], closed-loop control means for adjusting said pacing rate in accordance with the value of said RCP, and means for causing said closed-loop control means to self-adapt to changes in the value of said RCP which are due to factors other than stress, exercise and heart rate.
Claim 27
Dependent Claim
70 words
A rate-responsive pacemaker comprising means for generating pacing pulses at a pacing rate, means for ascertaining the value of a rate control parameter ["RCP"], closed-loop control means for adjusting said pacing rate in accordance with the value of said RCP, and means for causing said closed-loop control means to self-adapt to changes in the value of said RCP which are due to factors other than stress, exercise and heart rate.
Claim 28
Independent Claim
96 words
A method of controlling rate-responsive pacing comprising the steps of periodically ascertaining the value of a measured rate control parameter ["MRCP"], said rate control parameter being such that its measured value is changed in opposite directions by stress/exercise and heart rate, generating pacing pulses at a pacing rate, deriving a target value ["target"] which is indicative of changes in said MRCP due to non-stress/exercise and non-rate factors, and responsive to a change in the difference between MRCP and target adjusting said pacing rate in a direction which tends to return said difference to its pre-change value.
Claim 29
Independent Claim
96 words
A method of controlling rate-responsive pacing comprising the steps of periodically ascertaining the value of a measured rate control parameter ["MRCP"], said rate control parameter being such that its measured value is changed in opposite directions by stress/exercise and heart rate, generating pacing pulses at a pacing rate, deriving a target value ["target"] which is indicative of changes in said MRCP due to non-stress/exercise and non-rate factors, and responsive to a change in the difference between MRCP and target adjusting said pacing rate in a direction which tends to return said difference to its pre-change value.
Claim 30
Independent Claim
69 words
A method of controlling rate-responsive pacing comprising the steps of generating pacing pulses at a pacing rate, ascertaining the value of a rate control parameter ["RCP"], utilizing closed-loop control for adjusting said pacing rate in accordance with the value of said RCP, and causing said closed-loop control to self-adapt to changes in the value of said RCP which are due to factors other than stress, exercise and heart rate.
Claim 31
Independent Claim
69 words
A method of controlling rate-responsive pacing comprising the steps of generating pacing pulses at a pacing rate, ascertaining the value of a rate control parameter ["RCP"], utilizing closed-loop control for adjusting said pacing rate in accordance with the value of said RCP, and causing said closed-loop control to self-adapt to changes in the value of said RCP which are due to factors other than stress, exercise and heart rate.
References Cited (Backward Citations)
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