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EP0467652A2 Expired / Lapsed EP ⏱️ 0.0 years remaining

Apparatus and method for atrial pace before ventricular shock in dual chamber arrhythmia control system

Assignee: Telectronics NV
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Filing: 1991-07-16
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Granted: —
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Expires: 2011-07-16
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Abstract

Abstract An apparatus and method for tachyarrhythmia reversion provides a pacing pulse to the atrium at a predetermined time prior to the delivery of a cardioversion shock to the ventricle. The pacing pulse depolarizes the atrium producing an atrial refractory period. The cardioversion shock therapy is delivered during this refractory period in order to avoid the vulnerable zone of the atrium. This minimizes post-shock arrhythmias attributable to shock delivery during the atrial vulnerable zone. When used with bradycardia support pacing, a post-shock therapy pacing delay or pause is introduced, following reversion of the tachyarrhythmia, before delivering the bradycardia support pacing. The magnitude of the delay period is substantially greater than the normal bradycardia support pacing standby interval.

Inventors

  • 👤 Norma Louise Gilli

Bibliographic Details

Application Number —
Jurisdiction EP
Data Source google_patents
Last Synchronized 2026-11-03 22:15
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

Claims Analysis

Total Claims: 27
Claim 1
Independent Claim 120 words
An implantable cardioverting device adapted to be electrically connected to a patient's heart for the reversion of tachyarrhythmias, comprising: means for detecting the presence of a tachyarrhythmia; means responsive to the detection of a tachyarrhythmia by said detection means for delivering an atrial pacing pulse to the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and means responsive to the detection of said tachyarrhythmia by said detection means for delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 2
Dependent Claim 49 words
A device according to claim 1, said device further comprising a dual chamber pacing and cardioverting device adapted to be electrically connected to the atrium and the ventricle of the patient's heart, said device further including means for providing bradycardia support pacing for both the atrium and the ventricle.
Claim 3
Dependent Claim 51 words
A device according to claim 2, including means for delaying, for a post therapy delay period, the providing of bradycardia support pacing after said therapy means delivers said cardioversion shock therapy, said post therapy delay period being a period of time substantially longer than a normal bradycardia support pacing standby interval.
Claim 4
Dependent Claim 20 words
A device according to claim 3, wherein said post therapy delay period is between substantially two and substantially five seconds.
Claim 5
Independent Claim 26 words
A device according to any one of claims 1-4, including means for synchronizing the delivery of said atrial pacing pulse with the R-wave of the heart.
Claim 6
Independent Claim 19 words
A device according to any one of claims 1-4, including means for delivering antitachycardia pacing therapy to the atrium.
Claim 7
Independent Claim 19 words
A device according to any one of claims 1-4, including means for delivering antitachycardia pacing therapy to the ventricle.
Claim 8
Independent Claim 23 words
A device according to any one of claims 1-4, including means for delivering antitachycardia pacing therapy to both the atrium and the ventricle.
Claim 9
Independent Claim 18 words
A device according to any one of claims 1-4, wherein said cardioversion shock therapy includes a monophasic waveform.
Claim 10
Independent Claim 18 words
A device according to any one of claims 1-4, wherein said cardioversion shock therapy includes a biphasic waveform.
Claim 11
Independent Claim 23 words
A device according to any one of claims 3 and 4, wherein said post therapy delay period is a fixed period of time.
Claim 12
Independent Claim 21 words
A device according to any one of claims 3 and 4, wherein said post therapy delay period is a programmable parameter.
Claim 13
Independent Claim 25 words
A device according to any one of claims 3 and 4, wherein said post therapy delay period is between substantially three and substantially four seconds.
Claim 14
Independent Claim 24 words
A device according to any one of claims 1-4, wherein said atrial pacing pulse is delivered about 100 milliseconds before said cardioversion shock therapy.
Claim 15
Independent Claim 86 words
A method of reverting tachyarrhythmia in a patient's heart, comprising the steps of: detecting the presence of a tachyarrhythmia; delivering an atrial pacing pulse to the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 16
Dependent Claim 41 words
A method according to claim 15, said method further providing bradycardia support pacing to the heart, said method including the further steps of: determining that the tachyarrhythmia has been reverted; and, thereafter, delivering bradycardia support pacing to the heart when required.
Claim 17
Dependent Claim 56 words
A method according to claim 16 which includes, after the step of determining that the tachyarrhythmia has been reverted and before the step of delivering bradycardia support pacing, the further step of delaying the delivery of bradycardia support pacing for a period of time that is substantially longer than the normal bradycardia support pacing standby interval.
Claim 18
Dependent Claim 25 words
A method according to claim 17, wherein said period of delaying the delivery of bradycardia support pacing is between substantially two and substantially five seconds.
Claim 19
Independent Claim 24 words
A method according to any one of claims 15-18, wherein said atrial pacing pulse is delivered in synchronism with the R-wave of the heart.
Claim 20
Independent Claim 19 words
A method according to any one of claims 15-18, including the step of delivering antitachycardia pacing to the atrium.
Claim 21
Independent Claim 19 words
A method according to any one of claims 15-18, including the step of delivering antitachycardia pacing to the ventricle.
Claim 22
Independent Claim 23 words
A method according to any one of claims 15-18, including the step of delivering antitachycardia pacing to both the atrium and the ventricle.
Claim 23
Independent Claim 17 words
A method according to any one of claims 15-18, wherein said cardioversion therapy includes a monophasic waveform.
Claim 24
Independent Claim 17 words
A method according to any one of claims 15-18, wherein said cardioversion therapy includes a biphasic waveform.
Claim 25
Independent Claim 26 words
A method according to any one of claims 15-18, wherein said pacing pulse to the atrium is delivered about 100 milliseconds before said cardioversion shock therapy.
Claim 26
Dependent Claim 21 words
A method according to claim 18, wherein said period of delaying the delivery of bradycardia support pacing is a fixed period.
Claim 27
Dependent Claim 21 words
A method according to claim 18, wherein said period of delaying the delivery of bradycardia support pacing is a programmable parameter.

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