US4587970A
Expired / Lapsed
US
⏱️ 0.0 years remaining
Tachycardia reversion pacer
Assignee: Pacesetter Inc
•
Filing: 1985-01-22
•
Granted: 1986-05-13
•
Expires: 2005-01-22
Abstract
Abstract There is disclosed a tachycardia control pacer in which there is generated a sequence of pacing pulses at intervals which are a function of the effective refractory period intrinsically associated with the rate of the patient heartbeats. If the tachycardia episode is not terminated, another sequence of pulses is generated; however, the rate of the new sequence is decreased if at least one unevoked heartbeat was sensed during the preceding pacing pulse sequence and the rate is increased in the absence of any unevoked heartbeat having been sensed during the preceding pacing pulses sequence. Also, in order to smooth the transition between the fast pulses used to terminate the tachycardia episode and subsequent beating in sinus rhythm, pacing pulses continue to be generated at increasing pacing intervals until they merge into standby pacing.
Inventors
- 👤 Loraine K. Holley
- 👤 Robert Evans
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-24 14:22
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/3621; A61N1/3622
Claims Analysis
Total Claims: 132
Claim 1
Independent Claim
120 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval as a predetermined function of the rate at which the patient heartbeats are occurring, said predetermined function being based upon the physiological relationship of effective refractory period and tachycardia rate, and (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval.
Claim 2
Independent Claim
120 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval as a predetermined function of the rate at which the patient heartbeats are occurring, said predetermined function being based upon the physiological relationship of effective refractory period and tachycardia rate, and (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval.
Claim 3
Dependent Claim
29 words
A method of operating a tachycardia control pacer in accordance with claim 1 wherein said pacing interval increases with a decreasing patient heartbeat rate but with a decreasing slope.
Claim 4
Dependent Claim
48 words
A method of operating a tachycardia control pacer in accordance with claim 2 wherein at relatively fast tachycardia rates the pacing interval is only slightly less than the intervals between heartbeats, and at relatively slow tachycardia rates the pacing interval is approximately half of the intervals between heartbeats.
Claim 5
Dependent Claim
41 words
A method of operating a tachycardia control pacer in accordance with claim 2 wherein the tachycardia control pacer has stored therein a table representing said predetermined function, and said pacing interval is determined in step (b) by a process of interpolation.
Claim 6
Dependent Claim
28 words
A method of operating a tachycardia control pacer in accordance with claim 4 wherein said predetermined function is empirically determined based upon experiments performed on a sample population.
Claim 7
Dependent Claim
28 words
A method of operating a tachycardia control pacer in accordance with claim 1 wherein said predetermined function is empirically determined based upon experiments performed on a sample population.
Claim 8
Dependent Claim
105 words
A method of operating a tachycardia control pacer in accordance with claim 6 wherein said experiments include the steps of (i) pacing a sample patient population at each of many rates, (ii) for each rate and for each patient, scanning the last pacing interval to determine the effective refractory interval for the respective patient-rate pair, (iii) averaging the data determined in step (ii) to compute a function of effective refractory period versus rate, and (iv) calculating said predetermined function by selecting a pacing interval for each rate which is slightly greater than the respective effective refractory period computed in step (iii) for the same rate.
Claim 9
Dependent Claim
43 words
A method of operating a tachycardia control pacer in accordance with claim 1 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is repeated but with an incremented pacing interval.
Claim 10
Dependent Claim
39 words
A method of operating a tachycardia control pacer in accordance with claim 8 wherein step (c) is repeated with an incremented pacing interval only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 11
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 9 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted.
Claim 12
Dependent Claim
66 words
A method of operating a tachycardia control pacer in accordance with claim 8 wherein step (c) is repeated only after step (a) is first repeated to confirm that the tachycardia episode still exists and step (b) is also repeated to determine a new pacing interval, with the pacing interval used in the repeated step (c) being equal to the determined new pacing interval plus an increment.
Claim 13
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 11 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted.
Claim 14
Dependent Claim
53 words
A method of operating a tachycardia control pacer in accordance with claim 1 further including the step of: (d) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 15
Dependent Claim
67 words
A method of operating a tachycardia control pacer in accordance with claim 13 wherein step (a) is executed to determine whether the tachycardia episode still exists following the sensing of an unevoked heartbeat after the generation of at least one of the pacing pulses in the second sequence of step (d), and if the tachycardia episode still exists then repeating step (c) with a decremented pacing interval.
Claim 16
Dependent Claim
54 words
A method of operating a tachycardia control pacer in accordance with claim 14 wherein step (d) is aborted immediately and step (a) is executed responsive to the beating of the patient's heart following the last pacing pulse within an interval which exceeds a prestored blanking interval but is less than a prestored standby interval.
Claim 17
Dependent Claim
53 words
A method of operating a tachycardia control pacer in accordance with claim 14 wherein, prior to the repeating of step (c), step (b) is first repeated to determine a new pacing interval, with the pacing interval used in the repeated step (c) being equal to the determined new pacing interval less a decrement.
Claim 18
Dependent Claim
56 words
A method of operating a tachycardia control pacer in accordance with claim 16 wherein step (d) is aborted immediately and steps (a) and (b) are executed responsive to the beating of the patient's heart following the last pacing pulse within an interval which exceeds a prestored blanking interval but is less than a prestored standby interval.
Claim 19
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 1 wherein the same electrode is used in steps (a) and (c).
Claim 20
Independent Claim
86 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a sequence of pacing pulses whose inter-pulse intervals are a predetermined function of the rate at which the patient heartbeats are occurring, said predetermined function being based upon the physiological relationship of effective refractory period and tachycardia rate, and (c) generating said sequence of pacing pulses at the rate associated with said inter-pulse intervals.
Claim 21
Independent Claim
86 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a sequence of pacing pulses whose inter-pulse intervals are a predetermined function of the rate at which the patient heartbeats are occurring, said predetermined function being based upon the physiological relationship of effective refractory period and tachycardia rate, and (c) generating said sequence of pacing pulses at the rate associated with said inter-pulse intervals.
Claim 22
Dependent Claim
33 words
A method of operating a tachycardia control pacer in accordance with claim 19 wherein the rate of said pacing pulse sequence decreases with a decreasing patient heartbeat rate and with a decreasing slope.
Claim 23
Dependent Claim
47 words
A method of operating a tachycardia control pacer in accordance with claim 20 wherein at relatively fast tachycardia rates the pacing pulse rate is only slightly greater than the heartbeat rate, and at relatively slow tachycardia rates the pacing pulse rate is approximately twice the heartbeat rate.
Claim 24
Dependent Claim
41 words
A method of operating a tachycardia control pacer in accordance with claim 20 wherein the tachycardia control pacer has stored therein a table representing said predetermined function, and said inter-pulse intervals are determined in step (b) by a process of interpolation.
Claim 25
Dependent Claim
28 words
A method of operating a tachycardia control pacer in accordance with claim 19 wherein said predetermined function is empirically determined based upon experiments performed on a sample population.
Claim 26
Dependent Claim
111 words
A method of operating a tachycardia control pacer in accordance with claim 23 wherein, said experiments include the steps of (i) pacing a sample patient population at each of many rates, (ii) for each rate and for each patient, scanning the last pacing interval to determine the effective refractory interval for the respective patient-rate pair, (iii) averaging the data determined in step (ii) to compute a function of effective refractory period versus rate, and (iv) calculating said predetermined function by selecting a pacing pulse rate for each experimental rate which is slightly less than the inverse of the respective effective refractory period computed in step (iii) for the same experimental rate.
Claim 27
Dependent Claim
44 words
A method of operating a tachycardia control pacer in accordance with claim 19 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is repeated but with a decremented pacing pulse rate.
Claim 28
Dependent Claim
40 words
A method of operating a tachycardia control pacer in accordance with claim 25, wherein step (c) is repeated with a slower pacing pulse rate only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 29
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 26 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted.
Claim 30
Dependent Claim
64 words
A method of operating a tachycardia control pacer in accordance with claim 25 wherein step (c) is repeated only after step (a) is first repeated to confirm that the tachycardia episode still exists and step (b) is also repeated to determine a new pacing rate, with the pacing rate used in the repeated step (c) being slightly less than the determined new pacing rate.
Claim 31
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 28 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted.
Claim 32
Dependent Claim
50 words
A method of operating a tachycardia control pacer in accordance with claim 19 further including the step of: (d) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the rate continuously decreases.
Claim 33
Dependent Claim
68 words
A method of operating a tachycardia control pacer in accordance with claim 30 wherein step (a) is executed to determine whether the tachycardia episode still exists following the sensing of an unevoked heartbeat after the generation of at least one of the pacing pulses in the second sequence of step (d), and if the tachycardia episode still exists then repeating step (c) with an incremented pacing pulse rate.
Claim 34
Dependent Claim
54 words
A method of operating a tachycardia control pacer in accordance with claim 31 wherein step (d) is aborted immediately and step (a) is executed responsive to the beating of the patient's heart following the last pacing pulse within an interval which exceeds a prestored blanking interval but is less than a prestored standby interval.
Claim 35
Dependent Claim
54 words
A method of operating a tachycardia control pacer in accordance with claim 31 wherein, prior to the repeating of step (c), step (b) is first repeated to determine a new pacing pulse rate, with the pacing pulse rate used in the repeated step (c) being slightly greater than the determined new pacing pulse rate.
Claim 36
Dependent Claim
56 words
A method of operating a tachycardia control pacer in accordance with claim 33 wherein step (d) is aborted immediately and steps (a) and (b) are executed responsive to the beating of the patient's heart following the last pacing pulse within an interval which exceeds a prestored blanking interval but is less than a prestored standby interval.
Claim 37
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 19 wherein the same electrode is used in steps (a) and (c).
Claim 38
Independent Claim
139 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval, and (d) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 39
Independent Claim
139 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval, and (d) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 40
Dependent Claim
108 words
A method of operating a tachycardia control pacer in accordance with claim 36, wherein step (d) is merged into standby pacing as the intervals between pacing pulses in said second sequence successively lengthen, and further including the steps of: (e) sensing an unevoked heartbeat after the generation of at least one pacing pulse in the second sequence of step (d), (f) in response to the sensing of an unevoked heartbeat in step (e), executing step (a) to determine whether the tachycardia episode still exists, and (g) in response to determining in step (f) that the tachycardia episode still exists, repeating step (c) but with a decremented pacing interval.
Claim 41
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 37 wherein step (d) is aborted and step (f) is executed immediately responsive to the sensing of a heartbeat in step (e).
Claim 42
Dependent Claim
53 words
A method of operating a tachycardia control pacer in accordance with claim 38, wherein, prior to the repeating of step (c), step (b) is first repeated to determine a new pacing interval, with the pacing interval used in the repeated step (c) being equal to the determined new pacing interval less a decrement.
Claim 43
Dependent Claim
32 words
A method of operating a tachycardia control pacer in accordance with claim 36 wherein said pacing interval of step (b) increases with a decreasing patient heartbeat rate but with a decreasing slope.
Claim 44
Dependent Claim
48 words
A method of operating a tachycardia control pacer in accordance with claim 40 wherein at relatively fast tachycardia rates the pacing interval is only slightly less than the intervals between heartbeats, and at relatively slow tachycardia rates the pacing interval is approximately half of the intervals between heartbeats.
Claim 45
Dependent Claim
47 words
A method of operating a tachycardia control pacer in accordance with claim 36 wherein said function of step (b) is predetermined, the tachycardia control pacer has stored therein a table representing said function, and said pacing interval is determined in step (b) by a process of interpolation.
Claim 46
Dependent Claim
30 words
A method of operating a tachycardia control pacer in accordance with claim 36 wherein said function of step (b) is empirically determined based upon experiments performed on a sample population.
Claim 47
Dependent Claim
104 words
A method of operating a tachycardia control pacer in accordance with claim 43 wherein said experiments include the steps of (i) pacing a sample patient population at each of many rates, (ii) for each rate and for each patient, scanning the last pacing interval to determine the effective refractory interval for the respective patient-rate pair, (iii) averaging the data determined in step (ii) to compute a function of effective refractory period versus rate, and (iv) calculating said function by selecting a pacing interval for each rate which is slightly greater than the respective effective refractory period computed in step (iii) for the same rate.
Claim 48
Dependent Claim
43 words
A method of operating a tachycardia control pacer in accordance with claim 36 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is repeated but with an incremented pacing interval.
Claim 49
Dependent Claim
39 words
A method of operating a tachycardia control pacer in accordance with claim 45 wherein step (c) is repeated with an incremented pacing interval only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 50
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 45 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted.
Claim 51
Dependent Claim
66 words
A method of operating a tachycardia control pacer in accordance with claim 45 wherein step (c) is repeated only after step (a) is first repeated to confirm that the tachycardia episode still exists and step (b) is also repeated to determine a new pacing interval, with the pacing interval used in the repeated step (c) being equal to the determined new pacing interval plus an increment.
Claim 52
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 48 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted.
Claim 53
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 36 wherein the same electrode is used in steps (a) and (c).
Claim 54
Independent Claim
96 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) generating a sequence of pacing pulses at intervals which are a function of the effective refractory period intrinsically associated with the rate of the heartbeats sensed in step (a), and (c) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (b), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 55
Independent Claim
96 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) generating a sequence of pacing pulses at intervals which are a function of the effective refractory period intrinsically associated with the rate of the heartbeats sensed in step (a), and (c) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (b), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 56
Dependent Claim
107 words
A method of operating a tachycardia control pacer in accordance with claim 51 wherein step (c) is merged into standby pacing as the intervals between pacing pulses in said second sequence successively lengthen, and further including the steps of: (d) sensing an unevoked heartbeat after the generation of at least one pacing pulse in the second sequence of step (c), (e) in response to the sensing of an unevoked heartbeat in step (d), executing step (a) to determine whether the tachycardia episode still exists, and (f) in response to determining in step (e) that the tachycardia episode still exists, repeating step (b) but with decremented pacing intervals.
Claim 57
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 52 wherein step (c) is aborted and step (e) is executed immediately responsive to the sensing of a heartbeat in step (d).
Claim 58
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 51 wherein said intervals of step (b) increase as a function of a decreasing patient heartbeat rate but with a decreasing slope.
Claim 59
Dependent Claim
52 words
A method of operating a tachycardia control pacer in accordance with claim 54 wherein at relatively fast tachycardia rates the intervals of step (b) are only slightly less than the intervals between heartbeats, and at relatively slow tachycardia rates the intervals of step (b) are approximately half of the intervals between heartbeats.
Claim 60
Dependent Claim
47 words
A method of operating a tachycardia control pacer in accordance with claim 51 wherein said function of step (b) is predetermined, the tachycardia control pacer has stored therein a table representing said function, and said pacing intervals are determined in step (b) by a process of interpolation.
Claim 61
Dependent Claim
30 words
A method of operating a tachycardia control pacer in accordance with claim 51 wherein said function of step (b) is empirically determined based upon experiments performed on a sample population.
Claim 62
Dependent Claim
103 words
A method of operating a tachycardia control pacer in accordance with claim 57 wherein said experiments include the steps of (i) pacing a sample patient population at each of many rates, (ii) for each rate and for each patient, scanning the last pacing interval to determine the effective refractory interval for the respective patient-rate pair, (iii) averaging the data determined in step (ii) to compute a function of effective refractory period versus rate, and (iv) calculating said function by selecting pacing intervals for each rate which are slightly greater than the respective effective refractory period computed in step (iii) for the same rate.
Claim 63
Dependent Claim
42 words
A method of operating a tachycardia control pacer in accordance with claim 51 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (b) is not an evoked response, step (b) is repeated but with incremented pacing intervals.
Claim 64
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 59 wherein step (b) is repeated with incremented pacing intervals only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 65
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 60 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (b) is not an evoked response, step (b) is immediately aborted.
Claim 66
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 51 wherein the same electrode is used in steps (a) and (b).
Claim 67
Independent Claim
56 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing successive patient heartbeats to confirm the existence of a tachycardia episode, and (b) generating a sequence of pacing pulses at intervals which are a function of the effective refractory period intrinsically associated with the rate of the heartbeats sensed in step (a).
Claim 68
Independent Claim
56 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing successive patient heartbeats to confirm the existence of a tachycardia episode, and (b) generating a sequence of pacing pulses at intervals which are a function of the effective refractory period intrinsically associated with the rate of the heartbeats sensed in step (a).
Claim 69
Dependent Claim
128 words
A method of operating a tachycardia control pacer in accordance with claim 63 further including the step of: (c) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (b), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen so that they merge into standby pacing, (d) sensing an unevoked heartbeat after the generation of at least one pacing pulse in the second sequence of step (c), (e) in response to the sensing of an unevoked heartbeat in step (d), executing step (a) to determine whether the tachycardia episode still exists, and (f) in response to determining in step (e) that the tachycardia episode still exists, repeating step (b) but with decremented pacing intervals.
Claim 70
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 64 wherein step (c) is aborted and step (e) is executed immediately responsive to the sensing of a heartbeat in step (d).
Claim 71
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 63 wherein said intervals of step (b) increase as a function of a decreasing patient heartbeat rate but with a decreasing slope.
Claim 72
Dependent Claim
52 words
A method of operating a tachycardia control pacer in accordance with claim 66 wherein at relatively fast tachycardia rates the intervals of step (b) are only slightly less than the intervals between heartbeats, and at relatively slow tachycardia rates the intervals of step (b) are approximately half of the intervals between heartbeats.
Claim 73
Dependent Claim
47 words
A method of operating a tachycardia control pacer in accordance with claim 63 wherein said function of step (b) is predetermined, the tachycardia control pacer has stored therein a table representing said function, and said pacing intervals are determined in step (b) by a process of interpolation.
Claim 74
Dependent Claim
30 words
A method of operating a tachycardia control pacer in accordance with claim 63 wherein said function of step (b) is empirically determined based upon experiments performed on a sample population.
Claim 75
Dependent Claim
103 words
A method of operating a tachycardia control pacer in accordance with claim 68 wherein said experiments include the steps of (i) pacing a sample patient population at each of many rates, (ii) for each rate and for each patient, scanning the last pacing interval to determine the effective refractory interval for the respective patient-rate pair, (iii) averaging the data determined in step (ii) to compute a function of effective refractory period versus rate, and (iv) calculating said function by selecting pacing intervals for each rate which are slightly greater than the respective effective refractory period computed in step (iii) for the same rate.
Claim 76
Dependent Claim
42 words
A method of operating a tachycardia control pacer in accordance with claim 63 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (b) is not an evoked response, step (b) is repeated but with incremented pacing intervals.
Claim 77
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 71 wherein step (b) is repeated with incremented pacing intervals only after step (a) is repeated once again to conrirm that the tachycardia episode still exists.
Claim 78
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 72 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (b) is not an evoked response, step (b) is immediately aborted.
Claim 79
Dependent Claim
128 words
A method of operating a tachycardia control pacer in accordance with claim 73 further including the step of: (c) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (b), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen so that they merge into standby pacing, (d) sensing an unevoked heartbeat after the generation of at least one pacing pulse in the second sequence of step (c), (e) in response to the sensing of an unevoked heartbeat in step (d), executing step (a) to determine whether the tachycardia episode still exists, and (f) in response to determining in step (e) that the tachycardia episode still exists, repeating step (b) but with decremented pacing intervals.
Claim 80
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 74 wherein step (c) is aborted and step (e) is executed immediately responsive to the sensing of a heartbeat in step (d).
Claim 81
Dependent Claim
128 words
A method of operating a tachycardia control pacer in accordance with claim 72 further including the step of: (c) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (b), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen so that they merge into standby pacing, (d) sensing an unevoked heartbeat after the generation of at least one pacing pulse in the second sequence of step (c), (e) in response to the sensing of an unevoked heartbeat in step (d), executing step (a) to determine whether the tachycardia episode still exists, and (f) in response to determining in step (e) that the tachycardia episode still exists, repeating step (b) but with decremented pacing intervals.
Claim 82
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 76 wherein step (c) is aborted and step (e) is executed immediately responsive to the sensing of a heartbeat in step (d).
Claim 83
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 63 wherein the same electrode is used in steps (a) and (b).
Claim 84
Independent Claim
160 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval, and (d) repeating step (c) until the tachycardia episode is terminated but modifying the pacing interval used for each pacing pulse sequence by (i) increasing it if at least one unevoked heartbeat is sensed during the preceding pacing pulse sequence, or (ii) decreasing it in the absence of any unevoked heartbeat during the preceding pacing pulse sequence.
Claim 85
Independent Claim
160 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval, and (d) repeating step (c) until the tachycardia episode is terminated but modifying the pacing interval used for each pacing pulse sequence by (i) increasing it if at least one unevoked heartbeat is sensed during the preceding pacing pulse sequence, or (ii) decreasing it in the absence of any unevoked heartbeat during the preceding pacing pulse sequence.
Claim 86
Dependent Claim
33 words
A method of operating a tachycardia control pacer in accordance with claim 79 wherein said pacing interval determined in step (b) increases with a decreasing patient heartbeat rate but with a decreasing slope.
Claim 87
Dependent Claim
48 words
A method of operating a tachycardia control pacer in accordance with claim 80 wherein at relatively fast tachycardia rates the pacing interval is only slightly less than the intervals betweeh heartbeats, and at relatively slow tachycardia rates the pacing interval is approximately half of the intervals between heartbeats.
Claim 88
Dependent Claim
41 words
A method of operating a tachycardia control pacer in accordance with claim 80 wherein the tachycardia control pacer has stored therein a table representing a predetermined function, and said pacing interval is determined in step (b) by a process of interpolation.
Claim 89
Dependent Claim
39 words
A method of operating a tachycardia control pacer in accordance with claim 79 wherein step (c) is repeated with an increased pacing interval only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 90
Dependent Claim
39 words
A method of operating a tachycardia control pacer in accordance with claim 79 wherein step (c) is repeated with a decreased pacing interval only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 91
Dependent Claim
43 words
A method of operating a tachycardia control pacer in accordance with claim 79 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted and step (d) is executed.
Claim 92
Dependent Claim
70 words
A method of operating a tachycardia control pacer in accordance with claim 79 wherein step (c) is repeated only after step (a) is first repeated to confirm that the tachycardia episode still exists and step (b) is also repeated to determine a new pacing interval, with the pacing interval used in the repeated step (c) being equal to the determined new pacing interval plus an increment or less a decrement.
Claim 93
Dependent Claim
53 words
A method of operating a tachycardia control pacer in accordance with claim 86 further including the step of: (e) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 94
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 87 wherein the same electrode is used in steps (a) and (c).
Claim 95
Dependent Claim
53 words
A method of operating a tachycardia control pacer in accordance with claim 79 further including the step of: (e) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 96
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 79 wherein the same electrode is used in steps (a) and (c).
Claim 97
Independent Claim
124 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing rate which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at said pacing rate in order to terminate said tachycardia episode, and (d) repeating step (c) until the tachycardia episode is terminated but modifying the pacing rate used for each pacing pulse sequence by (i) decreasing it if at least one unevoked heartbeat is sensed during the preceding pacing pulse sequence, or (ii) increasing it in the absence of any unevoked heartbeat during the preceding pacing pulse sequence.
Claim 98
Independent Claim
124 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing and monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing rate which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at said pacing rate in order to terminate said tachycardia episode, and (d) repeating step (c) until the tachycardia episode is terminated but modifying the pacing rate used for each pacing pulse sequence by (i) decreasing it if at least one unevoked heartbeat is sensed during the preceding pacing pulse sequence, or (ii) increasing it in the absence of any unevoked heartbeat during the preceding pacing pulse sequence.
Claim 99
Dependent Claim
33 words
A method of operating a tachycardia control pacer in accordance with claim 91 wherein said pacing rate determined in step (b) decreases with a decreasing patient heartbeat rate and with a decreasing slope.
Claim 100
Dependent Claim
41 words
A method of operating a tachycardia control pacer in accordance with claim 91 wherein the tachycardia control pacer has stored therein a table representing a predetermined function, and said pacing rate is determined in step (b) by a process of interpolation.
Claim 101
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 91 wherein step (c) is repeated with a decreased pacing rate/only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 102
Dependent Claim
39 words
A method of operating a tachycardia control pacer in accordance with claim 94 wherein step (c) is repeated with an increased pacing rate only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 103
Dependent Claim
43 words
A method of operating a tachycardia control pacer in accordance with claim 91 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted and step (d) is executed.
Claim 104
Dependent Claim
70 words
A method of operating a tachycardia control pacer in accordance with claim 91 wherein step (c) is repeated only after step (a) is first repeated to confirm that the tachycardia episode still exists and step (b) is also repeated to determine a new pacing rate, with the pacing rate used in the repeated step (c) being equal to the determined new pacing rate plus an increment or less a decrement.
Claim 105
Dependent Claim
51 words
A method of operating a tachycardia control pacer in accordance with claim 97 further including the step of: (e) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the pacing rate continuously decreases.
Claim 106
Dependent Claim
51 words
A method of operating a tachycardia control pacer in accordance with claim 91 further including the step of: (e) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the pacing rate continuously decreases.
Claim 107
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 91 wherein the same electrode is used in steps (a) and (c).
Claim 108
Independent Claim
151 words
A method of operating a tachycardia control pacer comprising the steps of: (a) monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval, and (d) repeating step (c) until the tachycardia episode is terminated and preceding each repetition of step (c) by a repetition of step (b), but calculating successive pacing intervals for use in successive repetitions of step (c) by changing the pacing interval determined in step (b) by a predetermined amount.
Claim 109
Independent Claim
151 words
A method of operating a tachycardia control pacer comprising the steps of: (a) monitoring the rate of successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining a pacing interval which is a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at intervals equal to said pacing interval in order to terminate said tachycardia episode, with the first pacing pulse of said sequence being generated following the last heartbeat used to confirm the tachycardia episode after the elapse of an interval which is equal to said pacing interval, and (d) repeating step (c) until the tachycardia episode is terminated and preceding each repetition of step (c) by a repetition of step (b), but calculating successive pacing intervals for use in successive repetitions of step (c) by changing the pacing interval determined in step (b) by a predetermined amount.
Claim 110
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 101 wherein each repetition of step (c) is preceded by a repetition of step (a) prior to the repetition of step (b).
Claim 111
Dependent Claim
43 words
A method of operating a tachycardia control pacer in accordance with claim 101 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted and step (d) is executed.
Claim 112
Dependent Claim
68 words
A method of operating a tachycardia control pacer in accordance with claim 101 wherein step (c) is repeated only after step (a) is first, repeated to confirm that the tachycardia episode still exists before step (b) is also repeated to determine a new pacing interval, with the pacing interval used in the repeated step (c) being equal to the determined new pacing interval changed by a predetermined amount.
Claim 113
Dependent Claim
53 words
A method of operating a tachycardia control pacer in accordance with claim 101 further including the step of: (e) in the event no unevoked heartbeat is sensed during said sequence of pacing pulse generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 114
Independent Claim
111 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining pacing intervals which are a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at the determined pacing intervals in order to terminate said tachycardia episode, and (d) repeating step (c) until the tachycardia episode is terminated and preceding each repetition of step (c) by a repetition of step (b), but calculating successive pacing intervals for use in successive repetitions of step (c) by changing the pacing interval determined in step (b) by predetermined amounts.
Claim 115
Independent Claim
111 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining pacing intervals which are a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at the determined pacing intervals in order to terminate said tachycardia episode, and (d) repeating step (c) until the tachycardia episode is terminated and preceding each repetition of step (c) by a repetition of step (b), but calculating successive pacing intervals for use in successive repetitions of step (c) by changing the pacing interval determined in step (b) by predetermined amounts.
Claim 116
Dependent Claim
34 words
A method of operating a tachycardia control pacer in accordance with claim 106 wherein each repetition of step (c) is preceded by a repetition of step (a) prior to the repetition of step (b).
Claim 117
Dependent Claim
43 words
A method of operating a tachycardia control pacer in accordance with claim 106 wherein if any heartbeat sensed during said sequence of pacing pulses generated in step (c) is not an evoked response, step (c) is immediately aborted and step (d) is executed.
Claim 118
Dependent Claim
67 words
A method of operating a tachycardia control pacer in accordance with claim 106 wherein step (c) is repeated only after step (a) is first repeated to confirm that the tachycardia episode still exists before step (b) is also repeated to determine new pacing intervals, with the pacing intervals used in the repeated step (c) being equal to the determined new pacing intervals changed by a predetermined amount.
Claim 119
Dependent Claim
53 words
A method of operating a tachycardia control pacer in accordance with claim 106 further including the step of: (e) in the event no unevoked heartbeat is sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 120
Independent Claim
107 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining pacing intervals which are a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at the determined pacing intervals in order to terminate said tachycardia episode, (d) blanking the sensing of patient heartbeats for a predetermined interval following the generation of each pacing pulse in step (c), and (e) responsive to the sensing of a patient heartbeat during the execution of step (c), repeating step (c) but with longer pacing intervals.
Claim 121
Independent Claim
107 words
A method of operating a tachycardia control pacer comprising the steps of: (a) sensing successive patient heartbeats to confirm the existence of a tachycardia episode, (b) determining pacing intervals which are a function of the rate at which the patient heartbeats are occurring, (c) generating a sequence of pacing pulses at the determined pacing intervals in order to terminate said tachycardia episode, (d) blanking the sensing of patient heartbeats for a predetermined interval following the generation of each pacing pulse in step (c), and (e) responsive to the sensing of a patient heartbeat during the execution of step (c), repeating step (c) but with longer pacing intervals.
Claim 122
Dependent Claim
29 words
A method of operating a tachycardia control pacer in accordance with claim 111 wherein said function is predetermined and empirically determined based upon experiments performed on a sample population.
Claim 123
Dependent Claim
104 words
A method of operating a tachycardia control pacer in accordance with claim 112 wherein said experiments include the steps of (i) pacing a sample patient population at each of many rates, (ii) for each rate and for each patient, scanning the last pacing interval to determine the effective refractory interval for the respective patient-rate pair, (iii) averaging the data determined in step (ii) to compute a function of effective refractory period versus rate, and (iv) calculating said predetermined function by selecting pacing intervals for each rate which are slightly greater than the respective effective refractory period computed in step (iii) for the same rate.
Claim 124
Dependent Claim
38 words
A method of operating a tachycardia control pacer in accordance with claim 111 wherein step (c) is repeated with longer pacing intervals only after step (a) is repeated once again to confirm that the tachycardia episode still exists.
Claim 125
Dependent Claim
65 words
A method of operating a tachycardia control pacer in accordance with claim 111 wherein step (c) is repeated only after step (a) is first repeated to confirm that the tachycardia episode still exists and step (b) is also repeated to determine new pacing intervals, with the pacing intervals used in the repeated step (c) being equal to the determined new pacing intervals plus an increment.
Claim 126
Dependent Claim
54 words
A method of operating a tachycardia control pacer in accordance with claim 115 further including the step of: (f) in the event a patient heartbeat is not sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 127
Dependent Claim
66 words
A method of operating a tachycardia control pacer in accordance with claim 116 wherein step (a) is executed to determine whether the tachycardia episode still exists following the sensing of a patient heartbeat after the generation of at least one of the pacing pulses in the second sequence of step (f), and if the tachycardia episode still exists then repeating step (c) with shorter pacing intervals.
Claim 128
Dependent Claim
55 words
A method of operating a tachycardia control pacer in accordance with claim 117 wherein, prior to the repeating of step (c), following step (f), step (b) is first repeated to determine new pacing intervals, with the pacing intervals used in the repeated step (c) being equal to the determined new pacing intervals less a decrement.
Claim 129
Dependent Claim
54 words
A method of operating a tachycardia control pacer in accordance with claim 111 further including the step of: (f) in the event a patient heartbeat is not sensed during said sequence of pacing pulses generated in step (c), generating a second sequence of pacing pulses in which the intervals between successive pulses successively lengthen.
Claim 130
Dependent Claim
66 words
A method of operating a tachycardia control pacer in accordance with claim 119 wherein step (a) is executed to determine whether the tachycardia episode still exists following the sensing of a patient heartbeat after the generation of at least one of the pacing pulses in the second sequence of step (f), and if the tachycardia episode still exists then repeating step (c) with shorter pacing intervals.
Claim 131
Dependent Claim
55 words
A method of operating a tachycardia control pacer in accordance with claim 120 wherein, prior to the repeating of step (c), following step (f), step (b) is first repeated to determine new pacing intervals, with the pacing intervals used in the repeated step (c) being equal to the determined new pacing intervals less a decrement.
Claim 132
Dependent Claim
24 words
A method of operating a tachycardia control pacer in accordance with claim 111 wherein the same electrode is used in steps (a) and (c).
References Cited (Backward Citations)
US3939844A
Cited
US3942534A
Cited
US4163451A
Cited
EP0003782A1
Cited
US4181133A
Cited
GB2026870A
Cited
US4307725A
Cited
US4421114A
Cited
US4388927A
Cited
GB2076655A
Cited
US4485818A
Cited
US4384585A
Cited
US4488554A
Cited
US4488553A
Cited
US4407289A
Cited
US4452248A
Cited
EP0081209A1
Cited
EP0087756A2
Cited
US4427011A
Cited
US4429697A
Cited
US4493325A
Cited
US4473078A
Cited
US4467810A
Cited
US4541430A
Cited
EP0113176A1
Cited
US4539991A
Cited
US4543963A
Cited
US4515161A
Cited
USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1989-05-12 | 1989-11-11 | 1990-05-13 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 1993-05-12 | 1993-11-11 | 1994-05-13 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 1997-05-12 | 1997-11-11 | 1998-05-13 | $7700.00 | Window Closed / Lapsed |