EP0401962A2
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Device for combined cardiac pacing and defibrillation
Assignee: Ventritex Inc
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Filing: 1990-04-09
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Granted: —
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Expires: 2010-04-09
Abstract
Abstract A method is disclosed for combined cardiac pacing and defibrillating with an implanted pacer/defibrillator having sensing and pacing leads connected to the atrium and the ventricle. P-waves and R-waves are sensed, and a V-V timer and a V-A timer are reset if an R-wave is sensed. If an R-wave is sensed during the V-V timer interval, a pacing stimulus to the ventricle is inhibited. If a P-wave is sensed during the V-A timer interval, a pacing stimulus to the atrium is inhibited. If an R-wave is sensed during the V-V timer interval, arrhythmia therapy is provided if an arrhythmia is determined to be present. If the sensed ventricular rate is greater than a selected tachycardia rate but is less than a selected fibrillation rate, then a determination is made whether the sensed atrial rate is greater than a selected fibrillation rate, and if so, the V-V and V-A timers are reset, but if the sensed atrial rate is not greater than a selected fibrillation rate, then arrhythmia therapy is provided. If an arrhythmia is present, the charging of a capacitor commences but if the arrhythmia ceases, the charging discontinues. If the capacitor is charged and the arrhythmia is still present, then a shock is delivered to the heart during a time period that is outside the vulnerable zones of the atrium and the ventricle.
Inventors
- 👤 Benjamin D. Pless
- 👤 Michael Sweeney
- 👤 Roger Winkle
- 👤 Anthony Nathan
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-23 21:13
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/3621; A61N1/3622; A61N1/38; A61N1/39; A61N1/3956; A61N1/3962; A61N1/39622; A61N1/3987
Claims Analysis
Total Claims: 15
Claim 1
Independent Claim
168 words
A device for combined cardiac pacing and defibrillating which comprises: an implantable DDI pacer/defibrillator having a V-V timer for timing a V-V time interval and a V-A timer for timing a V-A time interval, and having sensing and pacing leads for connection to the atrium and the ventricle; means for sensing P-waves and R-waves; means for resetting the V-V timer and the V-A timer if an R-wave is sensed; means for providing a pacing stimulus to the ventricle if no R-wave is sensed during the V-V time interval; means for inhibiting the pacing stimulus to the ventricle if an R-wave is sensed during the V-V time interval; means for inhibiting a pacing stimulus to the atrium if a P-wave is sensed during the V-A time interval; means for determining the presence of an arrhythmia if an R-wave is sensed during the V-V time period; and means for providing arrhythmia therapy if an R-wave is sensed during the V-V time period and an arrhythmia is determined to be present.
Claim 2
Independent Claim
168 words
A device for combined cardiac pacing and defibrillating which comprises: an implantable DDI pacer/defibrillator having a V-V timer for timing a V-V time interval and a V-A timer for timing a V-A time interval, and having sensing and pacing leads for connection to the atrium and the ventricle; means for sensing P-waves and R-waves; means for resetting the V-V timer and the V-A timer if an R-wave is sensed; means for providing a pacing stimulus to the ventricle if no R-wave is sensed during the V-V time interval; means for inhibiting the pacing stimulus to the ventricle if an R-wave is sensed during the V-V time interval; means for inhibiting a pacing stimulus to the atrium if a P-wave is sensed during the V-A time interval; means for determining the presence of an arrhythmia if an R-wave is sensed during the V-V time period; and means for providing arrhythmia therapy if an R-wave is sensed during the V-V time period and an arrhythmia is determined to be present.
Claim 3
Independent Claim
168 words
A device for combined cardiac pacing and defibrillating which comprises: an implantable DDI pacer/defibrillator having a V-V timer and a V-A timer; means for sensing P-waves and R-waves; means for resetting the V-V timer and the V-A timer if an R-wave is sensed; means for providing a pacing stimulus to the ventricle if no R-wave is sensed during the V-V time interval; means for inhibiting the pacing stimulus to the ventricle if an R-wave is sensed during the V-V time interval; means for inhibiting a pacing stimulus to the atrium if a P-wave is sensed by the V-A time interval; means for determining the presence of an arrhythmia if an R-wave is sensed during the V-V time interval; means for resetting said V-V and V-A timers if no arrhythmia is determined to be present; means for providing a pacing stimulus to the atrium only if an R-wave was sensed during the previous V-V time interval and if no R-wave or P-wave is sensed during the V-A time interval.
Claim 4
Independent Claim
168 words
A device for combined cardiac pacing and defibrillating which comprises: an implantable DDI pacer/defibrillator having a V-V timer and a V-A timer; means for sensing P-waves and R-waves; means for resetting the V-V timer and the V-A timer if an R-wave is sensed; means for providing a pacing stimulus to the ventricle if no R-wave is sensed during the V-V time interval; means for inhibiting the pacing stimulus to the ventricle if an R-wave is sensed during the V-V time interval; means for inhibiting a pacing stimulus to the atrium if a P-wave is sensed by the V-A time interval; means for determining the presence of an arrhythmia if an R-wave is sensed during the V-V time interval; means for resetting said V-V and V-A timers if no arrhythmia is determined to be present; means for providing a pacing stimulus to the atrium only if an R-wave was sensed during the previous V-V time interval and if no R-wave or P-wave is sensed during the V-A time interval.
Claim 5
Independent Claim
84 words
A device for treating cardiac arrhythmia which comprises: an implantable pulse generator; means for sensing the ventricle to determine if a ventricular arrhythmia is present; means for sensing the atrium to determine if an atrial arrhythmia is present; means for inhibiting treatment for a ventricular arrhythmia if the sensed atrial arrhythmia is determined to be more severe than the sensed ventricular arrhythmia; means for treating for a ventricular arrhythmia if the sensed atrial arrhythmia is determined to be less severe than the ventricular arrhythmia.
Claim 6
Independent Claim
84 words
A device for treating cardiac arrhythmia which comprises: an implantable pulse generator; means for sensing the ventricle to determine if a ventricular arrhythmia is present; means for sensing the atrium to determine if an atrial arrhythmia is present; means for inhibiting treatment for a ventricular arrhythmia if the sensed atrial arrhythmia is determined to be more severe than the sensed ventricular arrhythmia; means for treating for a ventricular arrhythmia if the sensed atrial arrhythmia is determined to be less severe than the ventricular arrhythmia.
Claim 7
Dependent Claim
132 words
An implantable pulse generator for treating cardiac arrhythmia, which comprises: a sensing lead for connection to a chamber of the heart, said sensing lead having a distal end for connection to the heart and a proximal end; sensing circuit means for connection to said proximal end; energy storage means; means for providing a first voltage supply to said sensing circuit means; means for providing a second, different voltage supply to said energy storage means; means for sensing the heart chamber to determine if an arrhythmia is present; means for commencing the charging of said energy storage means via said second voltage supply if an arrhythmia is present, and for discontinuing said charging if the arrhythmia ceases, with said sensing circuit means being operable to continue sensing the heart chamber during said charging.
Claim 8
Dependent Claim
132 words
An implantable pulse generator for treating cardiac arrhythmia, which comprises: a sensing lead for connection to a chamber of the heart, said sensing lead having a distal end for connection to the heart and a proximal end; sensing circuit means for connection to said proximal end; energy storage means; means for providing a first voltage supply to said sensing circuit means; means for providing a second, different voltage supply to said energy storage means; means for sensing the heart chamber to determine if an arrhythmia is present; means for commencing the charging of said energy storage means via said second voltage supply if an arrhythmia is present, and for discontinuing said charging if the arrhythmia ceases, with said sensing circuit means being operable to continue sensing the heart chamber during said charging.
Claim 9
Dependent Claim
64 words
A device as described in Claim 4, including means for determining whether the energy storage means is charged to a predetermined level; means for delivering a shock to the heart during a time period that is outside the vulnerable zones of the atrium and the ventricle; and if the energy storage means is charged to said predetermined level and the arrhythmia is still present.
Claim 10
Dependent Claim
38 words
A device as described in Claim 4, including means for delivering a shock to the heart, if the arrhythmia is still present, during a time period that is outside the vulnerable zones of the atrium and the ventricle.
Claim 11
Dependent Claim
19 words
A device as described in Claim 6, in which the shock is delivered in synchrony with an atrial event.
Claim 12
Dependent Claim
23 words
A device as described in Claim 5, in which the shock is not delivered during a predetermined time zone after sensing a P-wave.
Claim 13
Independent Claim
133 words
A device for treating cardiac arrhythmia comprising: an implantable pulse generator; means for sensing the ventricule to determine if an arrhythmia is present; means for commencing the charging of energy storage means if an arrhythmia is present and for discontinuing said charging if the arrhythmia ceases; means for determining whether the energy storage means is charged if the arrhythmia does not cease; means for determining whether the ventricular rate is greater than a selected treatment required rate if the energy storage means is charged and the arrhythmia is still present; means for delivering a shock to the heart a predetermined time after sensing a P-wave and during a time period that is outside the vulnerable zones of the atrium and the ventricle if the ventricular rate is greater than said selected treatment-required rate.
Claim 14
Independent Claim
133 words
A device for treating cardiac arrhythmia comprising: an implantable pulse generator; means for sensing the ventricule to determine if an arrhythmia is present; means for commencing the charging of energy storage means if an arrhythmia is present and for discontinuing said charging if the arrhythmia ceases; means for determining whether the energy storage means is charged if the arrhythmia does not cease; means for determining whether the ventricular rate is greater than a selected treatment required rate if the energy storage means is charged and the arrhythmia is still present; means for delivering a shock to the heart a predetermined time after sensing a P-wave and during a time period that is outside the vulnerable zones of the atrium and the ventricle if the ventricular rate is greater than said selected treatment-required rate.
Claim 15
Dependent Claim
87 words
A device as described in Claim 9 including: means for delivering a shock to the heart in synchrony with an R-wave outside of the vulnerable zones of the atrium and the ventricle if the ventricular rate is not greater than a selected treatment-required rate but is greater than a selected tachycardia rate; and means for providing a safety timing period before delivering any shock to the heart if the ventricular rate is not greater than a selected treatment-required rate but is greater than a selected tachycardia rate.
References Cited (Backward Citations)
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