Patent US3356918A successfully refreshed from Google Patents.
US4429697A
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Dual chamber heart pacer with improved ventricular rate control
Assignee: Pacesetter Inc
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Filing: 1982-04-12
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Granted: 1984-02-07
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Expires: 2002-04-12
Abstract
Abstract A dual-chamber heart pacer whose ventricular pacing rate is closely matched to the physiological requirements of the patient. A "true" atrial rate is determined by counting over a 3-second interval the number of sensed atrial beats, including those which occur during atrial refractory periods. When the atrial rate rises to a threshold level, the ventricular pacing rate decreases gradually from the Wenckebach rate to a fall-back rate independent of atrial sensing. During this decline, atrial pacing pulses may be generated simultaneously with ventricular pacing pulses in an effort to terminate tachycardia. The controlled decline in ventricular pacing rate begins after a 3:2 block has resulted, but before a 2:1 block would otherwise result. The fall-back rate is higher than the standby rate to compensate for the lack of atrial pacing when the system operates at the fall-back rate.
Inventors
- 👤 Tibor A. Nappholz
- 👤 Ronald C. Bradbury
- 👤 Bruce R. Satchwell
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 11:17
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/3621; A61N1/3622
Claims Analysis
Total Claims: 129
Claim 1
Independent Claim
147 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a mesurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate, and for controlling the operating rate of said ventricular pulse generating means to decrease gradually toward said constant rate following said atrial rate first rising above said predetermined atrial upper rate.
Claim 2
Dependent Claim
147 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a mesurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate, and for controlling the operating rate of said ventricular pulse generating means to decrease gradually toward said constant rate following said atrial rate first rising above said predetermined atrial upper rate.
Claim 3
Dependent Claim
88 words
A heart pacer in accordance with claim 1 wherein said controlling means causes the ratio of the number of sensed atrial beats to the number of generated ventricular pacing pulses to equal N:(N-1), with N decreasing as the rate at which atrial beats are sensed increases, while said atrial rate is still below but is in the vicinity of said predetermined atrial upper rate; and said controlling means causes the operating rate of said ventricular pulse generating means to start reducing gradually before said ratio has reached 2:1.
Claim 4
Dependent Claim
32 words
A heart pacer in accordance with claim 2 wherein said controlling means causes the operating rate of said ventricular pulse generating means to start reducing gradually after said ratio has reached 3:2.
Claim 5
Dependent Claim
37 words
A heart pacer in accordance with claim 2 wherein said controlling means limits the minimum operating rate of said ventricular pulse generating means to a standby value, and said constant rate is higher than said standby value.
Claim 6
Dependent Claim
60 words
A heart pacer in accordance with claim 4 further including means under external control for setting the initial rate at which said ventricular pulse generating means first operates when said atrial rate first rises above said predetermined atrial upper rate, the operating rate of said ventricular pulse generating means then decreasing gradually from said initial rate to said constant rate.
Claim 7
Dependent Claim
21 words
A heart pacer in accordance with claim 5 further including means under external control for setting said predetermined atrial upper rate.
Claim 8
Dependent Claim
39 words
A heart pacer in accordance with claim 2 wherein said controlling means causes the time intervals between successive pacing pulses generated by said ventricular pulse generating means to increase in equal increments as its rate of operation decreases gradually.
Claim 9
Dependent Claim
50 words
A heart pacer in accordance with claim 7 further including means for generating atrial pacing pulses, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each generated ventricular pacing pulse during the time that the operating rate of said ventricular pulse generating means decreases gradually.
Claim 10
Dependent Claim
31 words
A heart pacer in accordance with claim 8 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 11
Dependent Claim
41 words
A heart pacer in accordance with claim 2 further inluding means for preventing the operation of said ventricular pulse generating means to be synchronized to the sensing of atrial beats when said atrial rate falls below a value indicative of bradycardia.
Claim 12
Dependent Claim
63 words
A heart pacer in accordance with claim 10 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 13
Dependent Claim
38 words
A heart pacer in accordance with claim 11 wherein said atrial pulse generating means operates approximately simultaneously with said ventricular pulse generating means during the time that the operating rate of the latter is caused to decrease gradually.
Claim 14
Dependent Claim
62 words
A heart pacer in accordance with claim 2 wherein, following operation of said ventricular pulse generating means at said constant rate, said controlling means causes operation at said constant rate to persist until said atrial rate falls below said predetermined atrial upper rate at which time said ventricular pulse generating means once again operates in synchronism with said atrial beat sensing means.
Claim 15
Dependent Claim
52 words
A heart pacer in accordance with claim 2 wherein said controlling means, in controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means, ignores the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means.
Claim 16
Dependent Claim
31 words
A heart pacer in accordance with claim 14 wherein said atrial rate determining means includes in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 17
Dependent Claim
48 words
A heart pacer in accordance with claim 15 further including means for sensing ventricular beats, and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 18
Dependent Claim
37 words
A heart pacer in accordance with claim 1 wherein said controlling means limits the minimum operating rate of said ventricular pulse generating means to a standby value, and said constant rate is higher than said standby value.
Claim 19
Dependent Claim
91 words
A heart pacer in accordance with claim 1 further including means under external control for setting the initial rate at which said ventricular pulse generating means first operates when said atrial rate first rises above said predetermined atrial upper rate, the operating rate of said ventricular pulse generating means then decreasing gradually from said initial rate to said constant rate, said initial rate being settable to a value higher than that at which said vantricular pulse generating means operates when said atrial rate first rises above said predetermined atrial upper rate.
Claim 20
Dependent Claim
21 words
A heart pacer in accordance with claim 1 further including means under external control for setting said predetermined atrial upper rate.
Claim 21
Dependent Claim
39 words
A heart pacer in accordance with claim 1 wherein said controlling means causes the time intervals between successive pacing pulses generated by said ventricular pulse generating means to increase in equal increments as its rate of operation decreases gradually.
Claim 22
Dependent Claim
50 words
A heart pacer in accordance with claim 1 further including means for generating atrial pacing pulses, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each generated ventricular pacing pulse during the time that the operating rate of said ventricular pulse generating means decreases gradually.
Claim 23
Dependent Claim
31 words
A heart pacer in accordance with claim 21 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 24
Dependent Claim
40 words
A heart pacer in accordance with claim 1 further including means for preventing the operation of said ventricular pulse generating means to be synchronized to the sensing of atrial beats when said atrial rate falls below a predetermined minimum value.
Claim 25
Dependent Claim
63 words
A heart pacer in accordance with claim 1 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 26
Dependent Claim
38 words
A heart pacer in accordance with claim 24 wherein said atrial pulse generating means operates approximately simultaneously with said ventricular pulse generating means during the time that the operating rate of the latter is caused to decrease gradually.
Claim 27
Dependent Claim
62 words
A heart pacer in accordance with claim 1 wherein, following operation of said ventricular pulse generating means at said constant rate, said controlling means causes operation at said constant rate to persist until said atrial rate falls below said predetermined atrial upper rate at which time said ventricular pulse generating means once again operates in synchronism with said atrial beat sensing means.
Claim 28
Dependent Claim
52 words
A heart pacer in accordance with claim 1 wherein said controlling means, in controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means, ignores the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means.
Claim 29
Dependent Claim
31 words
A heart pacer in accordance with claim 27 wherein said atrial rate determining means includes in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 30
Dependent Claim
48 words
A heart pacer in accordance with claim 28 further including means for sensing ventricular beats, and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 31
Dependent Claim
142 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate, and for limiting the minimum operating rate of said ventricular pulse generating means to a standby value, said constant rate being higher than said standby value.
Claim 32
Dependent Claim
142 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate, and for limiting the minimum operating rate of said ventricular pulse generating means to a standby value, said constant rate being higher than said standby value.
Claim 33
Dependent Claim
128 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; and means under external control for setting said predetermined atrial upper rate.
Claim 34
Dependent Claim
128 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; and means under external control for setting said predetermined atrial upper rate.
Claim 35
Dependent Claim
169 words
A heart pacer comrising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; means for sensing ventricular beats; means for generating atrial pacing pulses; means for syncrhonizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means; and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 36
Dependent Claim
169 words
A heart pacer comrising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; means for sensing ventricular beats; means for generating atrial pacing pulses; means for syncrhonizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means; and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 37
Dependent Claim
161 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; wherein said controlling means, in controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means, ignores the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means.
Claim 38
Dependent Claim
161 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; wherein said controlling means, in controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means, ignores the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means.
Claim 39
Dependent Claim
140 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; wherein said atrial rate determining means includes in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 40
Dependent Claim
140 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling said ventricular pulse generating means to operate at a constant rate independent of said atrial beat sensing means when said atrial rate is above said predetermined atrial upper rate; wherein said atrial rate determining means includes in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 41
Dependent Claim
48 words
A heart pacer in accordance with claim 34 further including means for sensing ventricular beats, and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 42
Dependent Claim
99 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling the operating rate of said ventricular pulse generating means to decrease over at least several seconds to a constant rate independent of said atrial beat sensing means when said atrial rate rises above said predetermined atrial upper rate.
Claim 43
Dependent Claim
99 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling the operating rate of said ventricular pulse generating means to decrease over at least several seconds to a constant rate independent of said atrial beat sensing means when said atrial rate rises above said predetermined atrial upper rate.
Claim 44
Dependent Claim
87 words
A heart pacer in accordance with claim 36 wherein said controlling means causes the ratio of the number of sensed atrial beats to the number of generated ventricular pacing pulses to equal N:(N-1), with N decreasing as the rate at which atrial beats are sensed increases, while said atrial rate is still below but is in the vicinity of said predetermined atrial upper rate; and said controlling means causes the operating rate of said ventricular pulse generating means to start decreasing before said ratio has reached 2:1.
Claim 45
Dependent Claim
31 words
A heart pacer in accordance with claim 37 wherein said controlling means causes the operating rate of said ventricular pulse generating means to start decreasing after said ratio has reach 3:2.
Claim 46
Dependent Claim
37 words
A heart pacer in accordance with claim 37 wherein said controlling means limits the minimum operating rate of said ventricular pulse generating means to a standby value, and said constant rate is higher than said standby value.
Claim 47
Dependent Claim
59 words
A heart pacer in accordance with claim 37 further including means under external control for setting the initial rate at which said ventricular pulse generating means first operates when said atrial rate first rises above said predetermined atrial upper rate, the operating rate of said ventricular pulse generating means then decreasing from said initial rate to said constant rate.
Claim 48
Dependent Claim
21 words
A heart pacer in accordance with claim 37 further including means under external control for setting said predetermined atrial upper rate.
Claim 49
Dependent Claim
38 words
A heart pacer in accordance with claim 37 wherein said controlling means causes the time intervals between successive pacing pulses generated by said ventricular pulse generating means to increase in equal increments as its rate of operation decreases.
Claim 50
Dependent Claim
49 words
A heart pacer in accordance with claim 42 further including means for generating atrial pacing pulses, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each generated ventricular pacing pulse during the time that the operating rate of said ventricular pulse generating means decreases.
Claim 51
Dependent Claim
31 words
A heart pacer in accordance with claim 43 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 52
Dependent Claim
41 words
A heart pacer in accordance with claim 37 further including means for preventing the operation of said ventricular pulse generating means to be synchronized to the sensing of atrial beats when said atrial rate falls below a value indicative of bradycardia.
Claim 53
Dependent Claim
63 words
A heart pacer in accordance with claim 37 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 54
Dependent Claim
40 words
A heart pacer in accordance with claim 46 wherein said atrial pulse generating means operates approximately simultaneously with said ventricular beat sensing means during the time that the operating rate of said ventricular pulse generating means is caused to decrease.
Claim 55
Dependent Claim
62 words
A heart pacer in accordance with claim 37 wherein, following operation of said ventricular pulse generating means at said constant rate, said controlling means causes operation at said constant rate to persist until said atrial rate falls below said predetermined atrial upper rate at which time said ventricular pulse generating means once again operates in synchronism with said atrial beat sensing means.
Claim 56
Dependent Claim
52 words
A heart pacer in accordance with claim 37 wherein said controlling means, in controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means, ignores the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means.
Claim 57
Dependent Claim
31 words
A heart pacer in accordance with claim 49 wherein said atrial rate determining means includes in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 58
Dependent Claim
48 words
A heart pacer in accordance with claim 50 further including means for sensing ventricular beats, and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 59
Dependent Claim
37 words
A heart pacer in accordance with claim 36 wherein said controlling means limits the minimum operating rate of said ventricular pulse generating means to a standby value, and said constant rate is higher than said standby value.
Claim 60
Dependent Claim
90 words
A heart pacer in accordance with claim 36 further including means under external control for setting the initial rate at which said ventricular pulse generating means first operates when said atrial rate first rises above said predetermined atrial upper rate, the operating rate of said ventricular pulse generating means then decreasing from said initial rate to said constant rate, said initial rate being settable to a value higher than that at which said ventricular pulse generating means operates when said atrial rate first rises above said predetermined atrial upper rate.
Claim 61
Dependent Claim
21 words
A heart pacer in accordance with claim 36 further including means under external control for setting said predetermined atrial upper rate.
Claim 62
Dependent Claim
38 words
A heart pacer in accordance with claim 36 wherein said controlling means causes the time intervals between successive pacing pulses generated by said ventricular pulse generating means in increase in equal increments as its rate of operation decreases.
Claim 63
Dependent Claim
49 words
A heart pacer in accordance with claim 55 further including means for generating atrial pacing pulses, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each generated ventricular pacing pulse during the time that the operating rate of said ventricular pulse generating means decreases.
Claim 64
Dependent Claim
31 words
A heart pacer in accordance with claim 56 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 65
Dependent Claim
40 words
A heart pacer in accordance with claim 36 further including means for preventing the operation of said ventricular pulse generating means to be synchronized to the sensing of atrial beats when said atrial rate falls below a predetermined minimum value.
Claim 66
Dependent Claim
63 words
A heart pacer in accordance with claim 36 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 67
Dependent Claim
37 words
A heart pacer in accordance with claim 59 wherein said atrial pulse generating means operates approximately simultaneously with said ventricular pulse generating means during the time that the operating rate of the latter is caused to decrease.
Claim 68
Dependent Claim
62 words
A heart pacer in accordance with claim 36 wherein, following operation of said ventricular pulse generating means at said constant rate, said controlling means causes operation at said constant rate to persist until said atrial rate falls below said predetermined atrial upper rate at which time said ventricular pulse generating means once again operates in synchronism with said atrial beat sensing means.
Claim 69
Dependent Claim
52 words
A heart pacer in accordance with claim 36 wherein said controlling means, in controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means, ignores the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means.
Claim 70
Dependent Claim
31 words
A heart pacer in accordance with claim 62 wherein said atrial rate determining means includes in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 71
Dependent Claim
48 words
A heart pacer in accordance with claim 63 further including means for sensing ventricular beats, and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 72
Dependent Claim
53 words
A heart pacer in accordance with claim 36 further including means for generating atrial pacing pulses, means for sensing ventricular beats, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each sensed ventricular beat during the time that the operating rate of said ventricular pulse generating means decreases.
Claim 73
Dependent Claim
31 words
A heart pacer in accordance with claim 65 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 74
Dependent Claim
101 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling the operating rate of said ventricular pulse generating means to decrease over at least several cycles of operation to a constant rate independent of said atrial beat sensing means when said atrial rate rises above said predetermined atrial upper rate.
Claim 75
Dependent Claim
101 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate; and means for controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means when said atrial rate is below a predetermined atrial upper rate, and for controlling the operating rate of said ventricular pulse generating means to decrease over at least several cycles of operation to a constant rate independent of said atrial beat sensing means when said atrial rate rises above said predetermined atrial upper rate.
Claim 76
Dependent Claim
94 words
A heart pacer in accordance with claim 67 wherein said controlling means causes the ratio of the number of sensed atrial beats to the number of generated ventricular pacing pulses to equal N:(N-1), with N decreasing as the rate at which atrial beats are sensed increases, while said atrial rate is still below but is in the vicinity of said predetermined atrial upper rate; and said controlling means causes the operating rate of said ventricular pulse generating means to start decreasing independent of said atrial beat sensing means before said ratio has reach 2:1.
Claim 77
Dependent Claim
31 words
A heart pacer in accordance with claim 68 wherein said controlling means causes the operating rate of said ventricular pulse generating means to start decreasing after said ratio has reached 3:2.
Claim 78
Dependent Claim
37 words
A heart pacer in accordance with claim 67 wherein said controlling means limits the minimum operating rate of said ventricular pulse generating means to a standby value, and said constant rate is higher than said standby value.
Claim 79
Dependent Claim
66 words
A heart pacer in accordance with claim 67 further including means under external control for setting the initial rate at which said ventricular pulse generating means first operates when said atrial rate first rises above said predetermined atrial upper rate, the operating rate of said ventricular pulse generating means then decreasing independent of said atrial beat sensing means from said initial rate to said constant rate.
Claim 80
Dependent Claim
21 words
A heart pacer in accordance with claim 67 further including means under external control for setting said predetermined atrial upper rate.
Claim 81
Dependent Claim
45 words
A heart pacer in accordance with claim 67 wherein said controlling means causes the time intervals between successive pacing pulses generated by said ventricular pulse generating means to increase in equal increments as its rate of operation decreases independent of said atrial beat sensing means.
Claim 82
Dependent Claim
56 words
A heart pacer in accordance with claim 67 further including means for generating atrial pacing pulses, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each generated ventricular pacing pulse during the time that the operating rate of said ventricular pulse generating means decreases independent of said atrial beat sensing means.
Claim 83
Dependent Claim
31 words
A heart pacer in accordance with claim 74 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 84
Dependent Claim
40 words
A heart pacer in accordance with claim 67 further including means for preventing the operation of said ventricular pulse generating means to be synchronized to the sensing of atrial beats when said atrial rate falls below a predetermined minimum value.
Claim 85
Dependent Claim
63 words
A heart pacer in accordance with claim 67 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 86
Dependent Claim
47 words
A heart pacer in accordance with claim 77 wherein said atrial pulse generating means operates approximately simultaneously with said ventricular beat sensing means during the time that the operating rate of said ventricular pulse generating means is caused to decrease independent of said atrial beat sensing means.
Claim 87
Dependent Claim
62 words
A heart pacer in accordance with claim 67 wherein, following operation of said ventricular pulse generating means at said constant rate, said controlling means causes operation at said constant rate to persist until said atrial rate falls below said predetermined atrial upper rate at which time said ventricular pulse generating means once again operates in synchronism with said atrial beat sensing means.
Claim 88
Dependent Claim
52 words
A heart pacer in accordance with claim 67 wherein said controlling means, in controlling said ventricular pulse generating means to operate in synchronism with said atrial beat sensing means, ignores the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means.
Claim 89
Dependent Claim
31 words
A heart pacer in accordance with claim 80 wherein said atrial rate determining means includes in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 90
Dependent Claim
48 words
A heart pacer in accordance with claim 81 further including means for sensing ventricular beats, and means for preventing said trial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 91
Dependent Claim
200 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; means for controlling the mode in which said ventricular pulse generating means operates relative to the operation of said atrial beat sensing means dependent upon whether said atrial rate is above or below an atrial upper rate; said ventricular pulse generating means having its operation synchronized to that of said atrial beat sensing means in at least one mode in which the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means is ignored; said atrial rate determining means including in its determination of atrial rate an atrial beat which is sensed during said refractory period; means for sensing ventricular beats; and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 92
Dependent Claim
200 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined; means for controlling the mode in which said ventricular pulse generating means operates relative to the operation of said atrial beat sensing means dependent upon whether said atrial rate is above or below an atrial upper rate; said ventricular pulse generating means having its operation synchronized to that of said atrial beat sensing means in at least one mode in which the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means is ignored; said atrial rate determining means including in its determination of atrial rate an atrial beat which is sensed during said refractory period; means for sensing ventricular beats; and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 93
Dependent Claim
56 words
A heart pacer in accordance with claim 83 wherein said ventricular pulse generating means operates in synchronism with said atrial beat sensing means when said atrial rate is below said atrial upper rate, and operates at a constant rate independent of said atrial beat sensing means when said atrial rate is above said atrial upper rate.
Claim 94
Dependent Claim
35 words
A heart pacer in accordance with claim 84 wherein the operating rate of said ventricular pulse generating means decreases gradually toward said constant rate following said atrial rate first rising above said atrial upper rate.
Claim 95
Dependent Claim
79 words
A heart pacer in accordance with claim 85 wherein the ratio of the number of sensed atrial beats to the number of generated ventricular pacing pulses is equal to N:(N-1), with N decreasing as the rate at which atrial beats are sensed increases, while said atrial rate is still below but is in the vicinity of said atrial upper rate; and the operating rate of said ventricular pulse generating means starts reducing gradually before said ratio has reached 2:1.
Claim 96
Dependent Claim
27 words
A heart pacer in accordance with claim 86 wherein the operating rate of said ventricular pulse generating means starts reducing gradually after said ratio has reached 3:2.
Claim 97
Dependent Claim
59 words
A heart pacer in accordance with claim 85 further including means under external control for setting the initial rate at which said ventricular pulse generating means first operates when said atrial rate first rises above said atrial upper rate, the operating rate of said ventricular pulse generating means then decreasing gradually from said initial rate to said constant rate.
Claim 98
Dependent Claim
40 words
A heart pacer in accordance with claim 88 wherein said initial rate is settable to a value higher than that at which said ventricular pulse generating means operates when said atrial rate first rises above said predetermined atrial upper rate.
Claim 99
Dependent Claim
20 words
A heart pacer in accordance with claim 85 further including means under external control for setting said atrial upper rate.
Claim 100
Dependent Claim
34 words
A heart pacer in accordance with claim 85 wherein the time intervals between successive pacing pulses generated by said ventricular pulse generating means increase in equal increments as its rate of operation decreases gradually.
Claim 101
Dependent Claim
50 words
A heart pacer in accordance with claim 85 further including means for generating atrial pacing pulses, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each generated ventricular pacing pulse during the time that the operating rate of said ventricular pulse generating means decreases gradually.
Claim 102
Dependent Claim
31 words
A heart pacer in accordance with claim 92 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 103
Dependent Claim
40 words
A heart pacer in accordance with claim 85 further including means for preventing the operation of said ventricular pulse generating means to be synchronized to the sensing of atrial beats when said atrial rate falls below a predetermined minimum value.
Claim 104
Dependent Claim
63 words
A heart pacer in accordance with claim 85 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 105
Dependent Claim
35 words
A heart pacer in accordance with claim 95 wherein said atrial pulse generating means operates approximately simultaneously with said ventricular pulse generating means during the time that the operating rate of the latter decreases gradually.
Claim 106
Dependent Claim
56 words
A heart pacer in accordance with claim 85 wherein, following operation of said ventricular pulse generating means at said constant rate, operation at said constant rate persists until said atrial rate falls below said atrial upper rate at which time said ventricular pulse generating means once again operates in synchronism with said atrial beat sensing means.
Claim 107
Dependent Claim
65 words
A heart pacer in accordance with claim 85 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for selectively disabling operation of said atrial pulse generating means as the operating rate of said ventricular pulse generating means decreases gradually.
Claim 108
Dependent Claim
32 words
A heart pacer in accordance with claim 98 further including means for selectively inhibiting the generation of ventricular pacing pulses as the operating rate of said ventricular pulse generating means decreases gradually.
Claim 109
Dependent Claim
32 words
A heart pacer in accordance with claim 85 further including means for selectively inhibiting the generation of ventricular pacing pulses as the operating rate of said ventricular pulse generating means decreases gradually.
Claim 110
Dependent Claim
183 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined as opposed to an atrial rate which is a function of only the single interval between two successive atrial beats; and means for controlling the mode in which said ventricular pulse generating means operates relative to the operation of said atrial beat sensing means dependent upon whether said atrial rate is above or below an atrial upper rate; said ventricular pulse generating means having its operation synchronized to that of said atrial beat sensing means in at least one mode in which the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means is ignored; said atrial rate determining means including in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 111
Dependent Claim
183 words
A heart pacer comprising means for sensing atrial beats; means for generating ventricular pacing pulses; means responsive to said atrial beat sensing means for determining the atrial rate as a function of the number of atrial beats which occur during a measurement interval which is sufficiently long to allow an average value to be determined as opposed to an atrial rate which is a function of only the single interval between two successive atrial beats; and means for controlling the mode in which said ventricular pulse generating means operates relative to the operation of said atrial beat sensing means dependent upon whether said atrial rate is above or below an atrial upper rate; said ventricular pulse generating means having its operation synchronized to that of said atrial beat sensing means in at least one mode in which the sensing of any atrial beat which occurs during a refractory period which follows an operation of said ventricular pulse generating means is ignored; said atrial rate determining means including in its determination of atrial rate an atrial beat which is sensed during said refractory period.
Claim 112
Dependent Claim
48 words
A heart pacer in accordance with claim 101 further including means for sensing ventricular beats; and means for preventing said atrial rate determining means from including in its determination of atrial rate any sensed atrial beat which precedes a sensed ventricular beat by less than a predetermined interval.
Claim 113
Dependent Claim
56 words
A heart pacer in accordance with claim 101 wherein said ventricular pulse generating means operates in synchronism with said atrial beat sensing means when said atrial rate is below said atrial upper rate, and operates at a constant rate independent of said atrial beat sensing means when said atrial rate is above said atrial upper rate.
Claim 114
Dependent Claim
40 words
A heart pacer in accordance with claim 103 wherein the operating rate of said ventricular pulse generating means is decreased to said constant rate over at least several seconds following said atrial rate first rising above said atrial upper rate.
Claim 115
Dependent Claim
78 words
A heart pacer in accordance with claim 104 wherein the ratio of the number of sensed atrial beats to the number of generated ventricular pacing pulses is equal to N:(N-1), with N decreasing as the rate at which atrial beats are sensed increases, while said atrial rate is still below but is in the vicinity of said atrial upper rate; and the operating rate of said ventricular pulse generating means starts decreasing before said ratio has reached 2:1.
Claim 116
Dependent Claim
26 words
A heart pacer in accordance with claim 105 wherein the operating rate of said ventricular pulse generating means starts decreasing after said ratio has reached 3:2.
Claim 117
Dependent Claim
70 words
A heart pacer in accordance with claim 104 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for selectively disabling operation of said atrial pulse generating means as the operating rate of said ventricular pulse generating means decreases over said at least several seconds.
Claim 118
Dependent Claim
37 words
A heart pacer in accordance with claim 107 further including means for selectively inhibiting the generation of ventricular pacing pulses as the operating rate of said ventricular pulse generating means decreases over said at least several seconds.
Claim 119
Dependent Claim
32 words
A heart pacer in accordance with claim 104 further including means for selectively inhibiting the generation of ventricular pacing pulses as the operating rate of said ventricular pulse generating means decreases gradually.
Claim 120
Dependent Claim
64 words
A heart pacer in accordance with claim 104 further including means under external control for setting the initial rate at which said ventricular pulse generating means first operates when said atrial rate first rises above said atrial upper rate, the operating rate of said ventricular pulse generating means then decreasing over said at least several seconds from said initial rate to said constant rate.
Claim 121
Dependent Claim
40 words
A heart pacer in accordance with claim 110 wherein said initial rate is settable to a value higher than that at which said ventricular pulse generating means operates when said atrial rate first rises above said predetermined atrial upper rate.
Claim 122
Dependent Claim
20 words
A heart pacer in accordance with claim 104 further including means under external control for setting said atrial upper rate.
Claim 123
Dependent Claim
30 words
A heart pacer in accordance with claim 104 wherein the rate of operation of said ventricular pulse generating means decreases at a constant rate over said at least several seconds.
Claim 124
Dependent Claim
55 words
A heart pacer in accordance with claim 104 further including means for generating atrial pacing pulses, and means for controlling an atrial pacing pulse to be generated approximately simultaneously with each generated ventricular pacing pulse during the time that the operating rate of said ventricular pulse generating means decreases over said at least several seconds.
Claim 125
Dependent Claim
31 words
A heart pacer in accordance with claim 114 further including means for inhibiting operation of said atrial pulse generating means while said ventricular pulse generating means operates at said constant rate.
Claim 126
Dependent Claim
40 words
A heart pacer in accordance with claim 104 further including means for preventing the operation of said ventricular pulse generating means to be synchronized to the sensing of atrial beats when said atrial rate falls below a predetermined minimum value.
Claim 127
Dependent Claim
63 words
A heart pacer in accordance with claim 104 further including means for sensing ventricular beats, means for generating atrial pacing pulses, means for synchronizing the operation of said atrial pulse generating means to the operation of said ventricular beat sensing means, and means for inhibiting operation of said atrial pulse generating means when said ventricular pulse generating means operates at said constant rate.
Claim 128
Dependent Claim
40 words
A heart pacer in accordance with claim 117 wherein said atrial pulse generating means operates approximately simultaneously with said ventricular pulse generating means during the time that the operating rate of the latter decreases over said at least several seconds.
Claim 129
Dependent Claim
56 words
A heart pacer in accordance with claim 104 wherein, following operation of said ventricular pulse generating means at said constant rate, operation at said constant rate persists until said atrial rate falls below said atrial upper rate at which time said ventricular pulse generating means once again operates in synchronism with said atrial beat sensing means.
References Cited (Backward Citations)
USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1987-02-06 | 1987-08-08 | 1988-02-07 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 1991-02-06 | 1991-08-08 | 1992-02-07 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 1995-02-06 | 1995-08-08 | 1996-02-07 | $7700.00 | Window Closed / Lapsed |