US5074301A
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US
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Apparatus and method for atrial pace before ventricular shock in dual chamber arrhythmia control system
Assignee: Pacesetter Inc
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Filing: 1990-07-16
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Granted: 1991-12-24
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Expires: 2010-07-16
Abstract
Abstract An apparatus and method for tachyarrhythmia reversion provides a pacing pulse to the atrium at a predetermined time prior to the delivery of a cardioversion shock to the ventricle. The pacing pulse depolarizes the atrium producing an atrial refractory period., The cardioversion shock therapy is delivered during this refractory period in order to avoid the vulnerable zone of the atrium. This minimizes post-shock arrhythmias attributable to shock delivery during the atrial vulnerable zone. When used with bradycardia support pacing, a post-shock therapy pacing delay or pause is introduced, following reversion of the tachyarrhythmia, before delivering the bradycardia support pacing. The magnitude of the delay period is substantially greater than the normal bradycardia support pacing standby interval.
Inventors
- 👤 Norma L. Gill
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 16:34
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/3621; A61N1/3622; A61N1/38; A61N1/39; A61N1/3956; A61N1/3962; A61N1/39622
Claims Analysis
Total Claims: 31
Claim 1
Independent Claim
120 words
An implantable cardioverting device adapted to be electrically connected to a patient's heart for the reversion of tachyarrhythmias, comprising: means for detecting the presence of a tachyarrhythmia; means responsive to the detection of a tachyarrhythmia by said detection means for delivering an atrial pacing pulse to the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and means responsive to the detection of said tachyarrhythmia by said detection means for delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 2
Dependent Claim
120 words
An implantable cardioverting device adapted to be electrically connected to a patient's heart for the reversion of tachyarrhythmias, comprising: means for detecting the presence of a tachyarrhythmia; means responsive to the detection of a tachyarrhythmia by said detection means for delivering an atrial pacing pulse to the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and means responsive to the detection of said tachyarrhythmia by said detection means for delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 3
Dependent Claim
140 words
An implantable combined dual chamber pacing and cardioverting device adapted to be electrically connected to the atrium and the ventricle of a patient's heart for the reversion of tachyarrhythmias, comprising: means for providing bradycardia support pacing for both the atrium and the ventricle; means for detecting the presence of a tachyarrhythmia; means responsive to the detection of a tachyarrhythmia by said detection means for delivering a pacing pulse to the atrium to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and means responsive to the detection of said tachyarrhythmia by said detection means for delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 4
Dependent Claim
140 words
An implantable combined dual chamber pacing and cardioverting device adapted to be electrically connected to the atrium and the ventricle of a patient's heart for the reversion of tachyarrhythmias, comprising: means for providing bradycardia support pacing for both the atrium and the ventricle; means for detecting the presence of a tachyarrhythmia; means responsive to the detection of a tachyarrhythmia by said detection means for delivering a pacing pulse to the atrium to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and means responsive to the detection of said tachyarrhythmia by said detection means for delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 5
Dependent Claim
51 words
A device according to claim 2, including means for delaying, for a post therapy delay period, the providing of bradycardia support pacing after said therapy means delivers said cardioversion shock therapy, said post therapy delay period being a period of time substantially longer than a normal bradycardia support pacing standby interval.
Claim 6
Dependent Claim
20 words
A device according to claim 3, wherein said post therapy delay period is between substantially two and substantially five seconds.
Claim 7
Independent Claim
26 words
A device according to any one of claims 1-4, including means for synchronizing the delivery of said atrial pacing pulse with the R-wave of the heart.
Claim 8
Independent Claim
19 words
A device according to any one of claims 1-4, including means for delivering antitachycardia pacing therapy to the atrium.
Claim 9
Independent Claim
19 words
A device according to any one of claims 1-4, including means for delivering antitachycardia pacing therapy to the ventricle.
Claim 10
Independent Claim
23 words
A device according to any one of claims 1-4, including means for delivering antitachycardia pacing therapy to both the atrium and the ventricle.
Claim 11
Independent Claim
18 words
A device according to any one of claims 1-4, wherein said cardioversion shock therapy includes a monophasic waveform.
Claim 12
Independent Claim
18 words
A device according to any one of claims 1-4, wherein said cardioversion shock therapy includes a biphasic waveform.
Claim 13
Independent Claim
23 words
A device according to any one of claims 3 and 4, wherein said post therapy delay period is a fixed period of time.
Claim 14
Independent Claim
21 words
A device according to any one of claims 3 and 4, wherein said post therapy delay period is a programmable parameter.
Claim 15
Independent Claim
25 words
A device according to any one of claims 3 and 4, wherein said post therapy delay period is between substantially three and substantially four seconds.
Claim 16
Independent Claim
24 words
A device according to any one of claims 1-4, wherein said atrial pacing pulse is delivered about 100 milliseconds before said cardioversion shock therapy.
Claim 17
Independent Claim
86 words
A method of reverting tachyarrhythmia in a patient's heart, comprising the steps of: detecting the presence of a tachyarrhythmia; delivering an atrial pacing pulse to the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 18
Independent Claim
86 words
A method of reverting tachyarrhythmia in a patient's heart, comprising the steps of: detecting the presence of a tachyarrhythmia; delivering an atrial pacing pulse to the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; and delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart will be simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy.
Claim 19
Independent Claim
109 words
A method of reverting tachyarrhythmia and providing bradycardia support pacing in a patient's heart, comprising the steps of: detecting the presence of a tachyarrhythmia; delivering a pacing pulse to the atrium of the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart are simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy; determining that the tachyarrhythmia has been reverted; and, thereafter, delivering bradycardia support pacing to the heart when required.
Claim 20
Independent Claim
109 words
A method of reverting tachyarrhythmia and providing bradycardia support pacing in a patient's heart, comprising the steps of: detecting the presence of a tachyarrhythmia; delivering a pacing pulse to the atrium of the heart to depolarize the atrium and produce for a limited period of time an atrial refractory condition therein; delivering cardioversion shock therapy to the heart during the period of said atrial refractory condition, whereby both the atrium and the ventricle of the heart are simultaneously in a refractory condition immediately following the delivery of the cardioversion shock therapy; determining that the tachyarrhythmia has been reverted; and, thereafter, delivering bradycardia support pacing to the heart when required.
Claim 21
Dependent Claim
56 words
A method according to claim 16 which includes, after the step of determining that the tachyarrhythmia has been reverted and before the step of delivering bradycardia support pacing, the further step of delaying the delivery of bradycardia support pacing for a period of time that is substantially longer than a normal bradycardia support pacing standby interval.
Claim 22
Dependent Claim
25 words
A method according to claim 17, wherein said period of delaying the delivery of bradycardia support pacing is between substantially two and substantially five seconds.
Claim 23
Independent Claim
24 words
A method according to any one of claims 15-18, wherein said atrial pacing pulse is delivered in synchronism with the R-wave of the heart.
Claim 24
Independent Claim
19 words
A method according to any one of claims 15-18, including the step of delivering antitachycardia pacing to the atrium.
Claim 25
Independent Claim
19 words
A method according to any one of claims 15-18, including the step of delivering antitachycardia pacing to the ventricle.
Claim 26
Independent Claim
23 words
A method according to any one of claims 15-18, including the step of delivering antitachycardia pacing to both the atrium and the ventricle.
Claim 27
Independent Claim
17 words
A method according to any one of claims 15-18, wherein said cardioversion therapy includes a monophasic waveform.
Claim 28
Independent Claim
17 words
A method according to any one of claims 15-18, wherein said cardioversion therapy includes a biphasic waveform.
Claim 29
Independent Claim
26 words
A method according to any one of claims 15-18, wherein said pacing pulse to the atrium is delivered about 100 milliseconds before said cardioversion shock therapy.
Claim 30
Dependent Claim
21 words
A method according to claim 18, wherein said period of delaying the delivery of bradycardia support pacing is a fixed period.
Claim 31
Dependent Claim
21 words
A method according to claim 18, wherein said period of delaying the delivery of bradycardia support pacing is a programmable parameter.
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| 7.5 Years (Year 8) | 1998-12-23 | 1999-06-24 | 1999-12-24 | $3760.00 | Window Closed / Lapsed |
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