US5871508A — Apparatus for cardiac pacing in transplant

Claim 1

Independent Claim 212 words

An implantable medical pacemaker comprising an implantable pulse generator with sensing, pacing, and control circuitry housed therein and for providing electrical stimulus pacing pulses so as to drive a heart rate in a transplanted or donor heart having atrial and ventricular tissue, and wherein atrial tissue from a native heart is present in a patient, said pacemaker being adapted and disposed for electrical connection by three leads to three points of said hearts' tissue through three lead bores located in a connector block providing electrical connection to said sensing and pacing circuitry, a first lead for sensing a sinus rhythm in the native atrial tissue by connection thereto, a second lead for delivering atrial pacing pulses from said pacemaker to atrial tissue of said transplanted heart, and also by a third lead connectable to said native atrial tissue so as to provide a connection from said native atrial tissue to said sensing circuitry for sensing depolarizations of said native atrial tissue so as to enable timing circuitry in said control circuitry to determine when to provide pacing pulses to said donor atrial tissue and said donor ventricular tissue so as to provide both improved hemodynamics and chronotropic competence for the transplant patient in accord with a program for configuring said control circuitry.

Claim 2

Dependent Claim 212 words

An implantable medical pacemaker comprising an implantable pulse generator with sensing, pacing, and control circuitry housed therein and for providing electrical stimulus pacing pulses so as to drive a heart rate in a transplanted or donor heart having atrial and ventricular tissue, and wherein atrial tissue from a native heart is present in a patient, said pacemaker being adapted and disposed for electrical connection by three leads to three points of said hearts' tissue through three lead bores located in a connector block providing electrical connection to said sensing and pacing circuitry, a first lead for sensing a sinus rhythm in the native atrial tissue by connection thereto, a second lead for delivering atrial pacing pulses from said pacemaker to atrial tissue of said transplanted heart, and also by a third lead connectable to said native atrial tissue so as to provide a connection from said native atrial tissue to said sensing circuitry for sensing depolarizations of said native atrial tissue so as to enable timing circuitry in said control circuitry to determine when to provide pacing pulses to said donor atrial tissue and said donor ventricular tissue so as to provide both improved hemodynamics and chronotropic competence for the transplant patient in accord with a program for configuring said control circuitry.

Claim 3

Dependent Claim 55 words

A pacemaker as set forth in claim 1 wherein said sensing circuitry comprises a sensor for providing a signal to said pacemaker representative of cardiac demand of a patient, and program means for basing said stimulating pulses timing on said cardiac demand during times when said pacemaker cannot track said native atrial tissue sinus rate.

Claim 4

Dependent Claim 64 words

A pacemaker as set forth in claim 1 wherein said pacemaker has sensor for providing a signal to said pacemaker representative of cardiac demand of a patient, and program means for basing said stimulating pulses timing on said cardiac demand during times when said pacemaker cannot track said native atrial tissue sinus rate and when said sinus rate is inadequate for sensed cardiac demand.

Claim 5

Dependent Claim 43 words

A pacemaker as set forth in claim 1 and comprising: means for determining donor cardiac tissue rejection having signal generating means for communicating the status of said rejection, and means for transmitting information on said status to a receiver outside said the patient.

Claim 6

Dependent Claim 44 words

A pacemaker as set forth in claim 4 and wherein said means for determining rejection further comprises means for interpreting variations in timing and morphology of signals derived from said donor heart tissue and memory means for storing a value representative of said interpretation.

Claim 7

Dependent Claim 32 words

A pacemaker as set forth in claim 1 wherein said control circuitry further comprises capture detection program means for determining whether stimulation pulses delivered to donor atrial tissue has caused depolarizations thereof.

Claim 8

Dependent Claim 131 words

A pacemaker comprising an implantable pulse generator with sensing, pacing, and control circuitry housed therein and having two atrial sense amplifier circuits and one ventricular amplifier sense circuit, the output of each of which can be read independently by circuitry in said pacemaker and a connector block with three lead bores: a first lead connector bore adapted and disposed to provide electrical connection between a native atrial sense amplifier circuit in said pacemaker and a lead connected to a native atrium, a second lead connector bore adapted and disposed to provide electrical connection between a donor atrium and a donor atrium sense amplifier circuit in said pacemaker, and a third lead connector bore adapted and disposed to provide electrical connection between a donor ventricle and a donor ventricular pacing amplifier circuit.

Claim 9

Dependent Claim 131 words

A pacemaker comprising an implantable pulse generator with sensing, pacing, and control circuitry housed therein and having two atrial sense amplifier circuits and one ventricular amplifier sense circuit, the output of each of which can be read independently by circuitry in said pacemaker and a connector block with three lead bores: a first lead connector bore adapted and disposed to provide electrical connection between a native atrial sense amplifier circuit in said pacemaker and a lead connected to a native atrium, a second lead connector bore adapted and disposed to provide electrical connection between a donor atrium and a donor atrium sense amplifier circuit in said pacemaker, and a third lead connector bore adapted and disposed to provide electrical connection between a donor ventricle and a donor ventricular pacing amplifier circuit.

Claim 10

Dependent Claim 33 words

A pacemaker as set forth in claim 7 and further comprising a ventricular sense circuit for sensing electrical activity of the donor ventricle through an electrical connection in said third lead connector bore.

Claim 11

Dependent Claim 37 words

A pacemaker as set forth in claims 7 or 8 and further comprising an atrial pace amplifier circuit connected to supply pacing pulses to said donor atrium through an electrical connection in said second lead connector bore.

Claim 12

Dependent Claim 136 words

A pacemaker comprising an implantable pulse generator with sensing, pacing, and control circuitry housed therein and having two atrial sense amplifier circuits, one for a donor atrium and one for a native atrium, and one ventricular amplifier sense circuit, and a connector block with two lead bores: a first lead connector bore adapted and disposed to provide electrical connection between a native atrial sense amplifier circuit in said pacemaker and one side of a split lead connected to a native atrium and also adapted and disposed to provide electrical connection between a donor atrium and a donor atrium sense amplifier circuit in said pacemaker through the other side of said split lead, and a second lead connector bore adapted and disposed to provide electrical connection between a donor ventricle and a donor ventricular pacing amplifier circuit.

Claim 13

Dependent Claim 136 words

A pacemaker comprising an implantable pulse generator with sensing, pacing, and control circuitry housed therein and having two atrial sense amplifier circuits, one for a donor atrium and one for a native atrium, and one ventricular amplifier sense circuit, and a connector block with two lead bores: a first lead connector bore adapted and disposed to provide electrical connection between a native atrial sense amplifier circuit in said pacemaker and one side of a split lead connected to a native atrium and also adapted and disposed to provide electrical connection between a donor atrium and a donor atrium sense amplifier circuit in said pacemaker through the other side of said split lead, and a second lead connector bore adapted and disposed to provide electrical connection between a donor ventricle and a donor ventricular pacing amplifier circuit.

Claim 14

Dependent Claim 21 words

A pacemaker as set forth in claims 10 or 7 further comprising a pacing amplifier connected to pace the donor atrium.

Claim 15

Dependent Claim 25 words

An implantable device as set forth in claim 11 wherein said atrial pacing amplifier is switchably connectable between said donor and a patient's native atrium.

Annuity Stage	Window Opens	Payment Deadline	Surcharge Period Until	Estimated Fee	Status
3.5 Years (Year 4)	2002-02-15	2002-08-17	2003-02-16	$2000.00	Window Closed / Lapsed
7.5 Years (Year 8)	2006-02-15	2006-08-17	2007-02-16	$3760.00	Window Closed / Lapsed
11.5 Years (Year 12)	2010-02-15	2010-08-17	2011-02-16	$7700.00	Window Closed / Lapsed

Apparatus for cardiac pacing in transplant

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