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US6411848B2 Expired / Lapsed US ⏱️ 0.0 years remaining

System providing ventricular pacing and biventricular coordination

Assignee: Cardiac Pacemakers Inc
•
Filing: 2001-04-18
•
Granted: 2002-06-25
•
Expires: 2021-04-18
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Abstract

Abstract A cardiac rhythm management system includes techniques for computing an indicated pacing interval, AV delay, or other timing interval. In one embodiment, a variable indicated pacing interval is computed based at least in part on an underlying intrinsic heart rate. The indicated pacing interval is used to time the delivery of biventricular coordination therapy even when ventricular heart rates are irregular, such as in the presence of atrial fibrillation. In another embodiment, a variable filter indicated AV interval is computed based at least in part on an underlying intrinsic AV interval. The indicated AV interval is used to time the delivery of atrial tracking biventricular coordination therapy when atrial heart rhythms are not arrhythmic. Other indicated timing intervals may be similarly determined. The indicated pacing interval, AV delay, or other timing interval can also be used in combination with a sensor indicated rate indicator.

Inventors

  • 👤 Andrew P. Kramer
  • 👤 Jeffrey E. Stahmann
  • 👤 Rene H. Wentkowski
  • 👤 Kenneth L. Baker
  • 👤 Jesse W. Hartley
  • 👤 David B. Krig

Bibliographic Details

Application Number —
Jurisdiction US
Data Source google_patents
Last Synchronized 2026-11-09 22:25
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/3621; A61N1/3627; A61N1/365; A61N1/368; A61N1/3682; A61N1/38; A61N1/39; A61N1/395; A61N1/3956; A61N1/3962; A61N1/39622; A61N1/3987

Claims Analysis

Total Claims: 22
Claim 1
Independent Claim 51 words
A method, including: obtaining atrio-ventricular (AV) intervals between atrial events and successive ventricular events; computing a first indicated AV interval based at least on a most recent AV interval duration and a previous value of the first indicated AV interval; and providing pacing therapy, based on the first indicated AV interval.
Claim 2
Independent Claim 51 words
A method, including: obtaining atrio-ventricular (AV) intervals between atrial events and successive ventricular events; computing a first indicated AV interval based at least on a most recent AV interval duration and a previous value of the first indicated AV interval; and providing pacing therapy, based on the first indicated AV interval.
Claim 3
Dependent Claim 63 words
The method of claim 1 , in which computing the first indicated AV interval includes differently weighting at least one of (1) the most recent AV interval duration, or (2) the previous value of the first indicated AV interval, if the most-recent AV interval is concluded by a paced beat than if the most recent AV interval is concluded by a sensed beat.
Claim 4
Dependent Claim 79 words
The method of claim 1 , in which computing the first indicated AV interval includes summing a first addend based on the most recent AV interval duration and a second addend based on the previous value of the first indicated AV interval, wherein at least one of the first and second addends is different if the most recent AV interval is concluded by an intrinsic beat than if the most recent AV interval is concluded by a paced beat.
Claim 5
Dependent Claim 55 words
The method of claim 1 , in which computing the first indicated AV interval (T n ) is carried out according to T n =A·AV n +B·T n-1 where A and B are coefficients, AV n is the most recent AV interval, and T n-1 is the previous value of the first indicated AV interval.
Claim 6
Dependent Claim 65 words
The method of claim 4 , in which computing the first indicated AV interval (T n ) is carried out according to: T n =A·AV n +B·T n-1 if AV n is concluded by an intrinsic beat, otherwise is carried out according to T n =C·AV n +D·T n-1 , if AV n is concluded by a paced beat, where C and D are coefficients.
Claim 7
Dependent Claim 23 words
The method of claim 5 , in which at least one of A, B, C, and D is a function of heart rate.
Claim 8
Dependent Claim 88 words
The method of claim 1 , in which computing the first indicated AV interval (T n ) is carried out according to T n =a·w·AV n +(1−w)·T n-1 if AV n is concluded by an intrinsic beat, otherwise is carried out according to T n =b·w·AV n +(1−w)·T n−1 , if AV n is concluded by a paced beat, where a, b, and w are coefficients, AV n is the most recent AV interval duration, and T n-1 is the previous value of the first indicated AV interval.
Claim 9
Dependent Claim 31 words
The method of claim 1 , in which the first indicated AV interval is limited by at least one of a maximum AV interval value and a minimum AV interval value.
Claim 10
Dependent Claim 42 words
The method of claim 1 , in which providing pacing therapy is based on the first indicated AV interval if no atrial tachyarrhythmia is present, and providing pacing therapy is independent of the first indicated AV interval if atrial tachyarrhythmia is present.
Claim 11
Dependent Claim 35 words
The method of claim 1 , in which computing the first indicated AV interval is also based on a remotely user-programmable parameter that corresponds to a desired degree of shortening vs. lengthening of AV interval.
Claim 12
Dependent Claim 29 words
The method of claim 1 , in which computing the first indicated AV interval is also based on a goal proportion of paced ventricular beats to sensed ventricular beats.
Claim 13
Dependent Claim 97 words
A cardiac rhythm management system, including: an atrial sensing circuit; a ventricular sensing circuit; a controller, the controller including: an atrio-ventricular (AV) interval timer, obtaining AV intervals between atrial events and successive ventricular events; a first register, for storing a first indicated AV interval; and a filter, updating the first indicated AV interval based on a most recent AV interval provided by the AV interval timer and previous value of the first indicated AV interval stored the first register; and a ventricular therapy circuit, providing pacing therapy based at least partially on the first indicated AV interval.
Claim 14
Dependent Claim 97 words
A cardiac rhythm management system, including: an atrial sensing circuit; a ventricular sensing circuit; a controller, the controller including: an atrio-ventricular (AV) interval timer, obtaining AV intervals between atrial events and successive ventricular events; a first register, for storing a first indicated AV interval; and a filter, updating the first indicated AV interval based on a most recent AV interval provided by the AV interval timer and previous value of the first indicated AV interval stored the first register; and a ventricular therapy circuit, providing pacing therapy based at least partially on the first indicated AV interval.
Claim 15
Dependent Claim 59 words
The system of claim 12 , in which the filter differently weighting at least one of (1) the most recent AV interval duration, or (2) the previous value of the first indicated AV interval, if the most recent AV interval is concluded by a paced beat than if the most recent AV interval is concluded by a sensed beat.
Claim 16
Dependent Claim 91 words
The system of claim 13 , in which the filter includes coefficients A, B, C, and D, and the filter computes the first indicated AV interval (T n ) according to: T n =A·AV n +B·T n-1 if AV n is concluded by an intrinsic beat, otherwise is carried out according to T n =C·AV n +D·T n-1 , if AV n is concluded by a paced beat, where AV n is the most recent AV interval duration and T n-1 is the previous value of the first indicated AV interval.
Claim 17
Dependent Claim 29 words
The system of claim 12 , in which the filter includes a switch that disables the filter when the atrial sensing circuit indicates that an atrial tachyarrhythmia is present.
Claim 18
Dependent Claim 47 words
The system of claim 12 , including a programmer remote from and communicatively coupled to the controller, and in which the controller includes a first parameter that is programmable by the programmer, and the programmer includes an indicator based on a second parameter received from the controller.
Claim 19
Dependent Claim 39 words
The system of claim 16 , in which the first indicated AV interval is also based on the remotely user-programmable first parameter, wherein the first parameter corresponds to a desired degree of shortening vs. lengthening of the AV interval.
Claim 20
Dependent Claim 34 words
The system of claim 12 , in which the controller includes a goal proportion of paced ventricular beats to sensed ventricular beats, and the first indicated AV interval is also based on the goal.
Claim 21
Dependent Claim 39 words
The method of claim 1 , in which the computing a first indicated AV interval is based on the most recent AV interval duration and a duration of the AV interval that immediately precedes the most recent AV interval.
Claim 22
Dependent Claim 44 words
The system of claim 2 , in which the filter updates the first indicatedpacing interval based on a most recent AV interval provided by the AV interval timer and an immediately preceding value of the first indicated AV interval stored in the first register.

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USPTO Annuity & Maintenance Windows

Annuity Stage Window Opens Payment Deadline Surcharge Period Until Estimated Fee Status
3.5 Years (Year 4) 2005-06-24 2005-12-24 2006-06-25 $2000.00 Window Closed / Lapsed
7.5 Years (Year 8) 2009-06-24 2009-12-24 2010-06-25 $3760.00 Window Closed / Lapsed
11.5 Years (Year 12) 2013-06-24 2013-12-24 2014-06-25 $7700.00 Window Closed / Lapsed

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