US5476486A
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Automatic atrial pacing pulse threshold determination utilizing an external programmer and a V-sense electrode
Assignee: Pacesetter Inc
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Filing: 1994-03-04
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Granted: 1995-12-19
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Expires: 2014-03-04
Abstract
Abstract A clinical programming system is disclosed for use with an implanted cardiac pacemaker to automatically determine the minimum pacing energy which is necessary to evoke an atrial depolarization. The system utilizes a series of pacing pulses of progressively decreasing energies to stimulate the atrium and detects following R-waves. The absence of an R-wave indicates the loss of atrial capture.
Inventors
- 👤 Richard M. T. Lu
- 👤 Bruce M. Steinhaus
- 👤 Peter A. Crosby
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-30 10:06
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/37; A61N1/371; A61N1/3712; A61N1/3714
Claims Analysis
Total Claims: 17
Claim 1
Independent Claim
91 words
A method of determining a minimum energy of a pacing pulse necessary to evoke an atrial depolarization response in a heart of a patient, comprising the steps of: generating a series of test atrial pacing pulses, each pulse having sequentially decreasing energy; verifying an occurrence of a ventricular beat within a predetermined interval following each generated test atrial pacing pulse; and determining said minimum energy as a function of the energy of the last test atrial pacing pulse which resulted in the occurrence of a ventricular beat within said predetermined interval.
Claim 2
Independent Claim
91 words
A method of determining a minimum energy of a pacing pulse necessary to evoke an atrial depolarization response in a heart of a patient, comprising the steps of: generating a series of test atrial pacing pulses, each pulse having sequentially decreasing energy; verifying an occurrence of a ventricular beat within a predetermined interval following each generated test atrial pacing pulse; and determining said minimum energy as a function of the energy of the last test atrial pacing pulse which resulted in the occurrence of a ventricular beat within said predetermined interval.
Claim 3
Dependent Claim
41 words
A method according to claim 1 further comprising implanting in said patient a sensor for sensing ventricular beats, said pulse sensor including a telemetry circuit, wherein said verifying step is carried out by detecting a telemetric signal from said telemetry circuit.
Claim 4
Dependent Claim
27 words
A method according to claim 1 further comprising the step of obtaining a surface electrocardiogram, wherein said verifying step is carried out by analyzing said surface electrocardiogram.
Claim 5
Dependent Claim
72 words
A method according to claim 3 further including the steps of: measuring time intervals between a number of a first test atrial pacing pulses and respective following ventricular beats and, if they are similar, then forming an average of such time intervals; and verifying an occurrence of a subsequent ventricular beat only if said subsequent ventricular beat follows a preceding test atrial pacing pulse within a predetermined time window around said average.
Claim 6
Dependent Claim
72 words
A method according to claim 2 further including the steps of: measuring time intervals between a number of a first test atrial pacing pulses and respective following ventricular beats and, if they are similar, then forming an average of such time intervals; and verifying an occurrence of a subsequent ventricular beat only if said subsequent ventricular beat follows a preceding test atrial pacing pulse within a predetermined time window around said average.
Claim 7
Dependent Claim
71 words
A method according to claim 1 further including the steps of: measuring time intervals between a number of first test atrial pacing pulses and respective following ventricular beats and, if they are similar, then forming an average of such time intervals; and verifying an occurrence of a subsequent ventricular beat only if said subsequent ventricular beat follows a preceding test atrial pacing pulse within a predetermined time window around said average.
Claim 8
Dependent Claim
93 words
Apparatus for determining a minimum energy of a pacing pulse necessary to evoke an atrial depolarization response in a heart of a patient, comprising: means for generating a series of test atrial pacing pulses, each pulse having sequentially decreasing energy; means for verifying an occurrence of a ventricular beat within a predetermined interval following each generated test atrial pacing pulse; and means for determining said minimum energy as a function of the energy of the last test atrial pacing pulse which resulted in the occurrence of a ventricular beat within said predetermined interval.
Claim 9
Dependent Claim
93 words
Apparatus for determining a minimum energy of a pacing pulse necessary to evoke an atrial depolarization response in a heart of a patient, comprising: means for generating a series of test atrial pacing pulses, each pulse having sequentially decreasing energy; means for verifying an occurrence of a ventricular beat within a predetermined interval following each generated test atrial pacing pulse; and means for determining said minimum energy as a function of the energy of the last test atrial pacing pulse which resulted in the occurrence of a ventricular beat within said predetermined interval.
Claim 10
Dependent Claim
42 words
Apparatus according to claim 7 wherein said means for verifying includes means implanted in said patient for sensing ventricular beats, said implanted means including a telemetry circuit and means external of said patient for detecting a telemetric signal from said telemetry circuit.
Claim 11
Dependent Claim
29 words
Apparatus according to claim 7 further comprising means for obtaining a surface electrocardiogram indicative of ventricular beats, wherein said means for verifying includes means for analyzing said surface electrocardiogram.
Claim 12
Dependent Claim
74 words
Apparatus according to claim 9 further including means for measuring time intervals between a number of a first test atrial pacing pulses and respective following ventricular beats and, if they are similar, then forming an average of such time intervals; and wherein said verifying means verifies an occurrence of a subsequent ventricular beat only if said subsequent ventricular beat follows a preceding test atrial pacing pulse within a predetermined time window around said average.
Claim 13
Dependent Claim
18 words
Apparatus according to claim 10 wherein said window is within a range of plus and minus 50 milliseconds.
Claim 14
Dependent Claim
74 words
Apparatus according to claim 8 further including: means for measuring time intervals between a number of a first test atrial pacing pulses and respective following ventricular beats and, if they are similar, then forming an average of such time intervals; and wherein said verifying means verifies an occurrence of a subsequent ventricular beat only if said subsequent ventricular beat follows a preceding test atrial pacing pulse within a predetermined time window around said average.
Claim 15
Dependent Claim
18 words
Apparatus according to claim 12 wherein said window is within a range of plus and minus 50 milliseconds.
Claim 16
Dependent Claim
75 words
Apparatus according to claim 7 further including: means for measuring the time intervals between a number of a first test atrial pacing pulses and respective following ventricular beats and, if they are similar, then forming an average of such time intervals; and wherein said verifying means verifies an occurrence of a subsequent ventricular beat only if said subsequent ventricular beat follows a preceding test atrial pacing pulse within a predetermined time window around said average.
Claim 17
Dependent Claim
18 words
Apparatus according to claim 14 wherein said window is within a range of plus and minus 50 milliseconds.
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