Vitatron Medical B. V.

Medtronic, Inc.

Bernardus F Vonk

Geeske Van Oort

Johannes S Van Der Veen

Harry B Kerver

There is provided a pacemaker system with capture verification and threshold testing, in which the pacemaker adjusts the post-stim pulse portion of a triphasic pulse to minimize polarization, and waits after each change in delivered pace pulses for a stabilization interval, in order to enhance capture verification. The threshold test utilizes a pace pulse pair, comprising a prior search pulse which is varied during the test, and the regular pacing pulse which is above threshold. When delivery of the pulse pairs is initiated, the search pulse is adjusted to optimize polarization, and the pacemaker waits for a predetermined stabilization period of time in order to allow for minimum polarization and to optimize capture detection. The search pulse is increased incrementally in output value toward threshold, and following each such increase the pacemaker waits for a stabilization interval. The pacemaker detects when capture is achieved by the search pulse, thereby providing an indication of threshold. The polarization minimization feature involves scanning the post-stim duration to find the optimal duration. The polarization minimization also enables detection of repolarization signals, and consequent pacemaker functions such as AAIR pacing and suppression of atrial tachycardia.

Pacemaker system and method with improved evoked response and

There is provided an output stage for a battery powered implantable device, such as a cardiac pacemaker, for generating biphasic or triphasic pulses, each pulse having at least a prestimulus or poststimulus pulse of a first polarity, and a stimulus pulse of opposite polarity. The output stage provides for charging of a small sized pacing capacitor from the battery through a high rate charge pump only during delivery of a prestim or poststim pulse, and for discharging the pacing capacitor during the stimulus portion of the overall pulse. A fast or high rate capacitive charge pump is used with a controllable high rate clock signal, adjustment of the clock signal being used for controlling the charging rate during the prestim or poststim pulses, thereby allowing for tuning of the parameters of the prestim or poststim pulse portions. The charge pump is enabled only during such charging pulse durations, thereby eliminating the need for a large holding capacitor, and enabling an output stage with a significantly reduced capacitor requirement.

Stimulus system with controllable switched capacitor output stage

There is provided a pacemaker having automatic adjustment of the sensitivity for sensing cardiac signals such as QRS, T and P waves. The pacemaker has software for examining each inputted signal, obtaining a measure of the peak amplitude, e.g. one-half, comparing such measure with a stored software sensitivity level, and adjusting the software sensitivity level each beat so that it effectively tracks beat-to-beat changes in the signal amplitude. The adjusted software sensitivity level is used for determining when an input signal is to be accepted as a true signal, or rejected.

Pacemaker with automatic sensitivity adjustment

There is provided a pacemaker system with capture verification and threshold testing, in which the pacemaker waits after each change in delivered pace pulses for a stabilization interval, in order to minimize polarization and enhance capture verification. The threshold test utilizes a pace pulse pair, comprising a prior search pulse which is varied during the test, and the regular pacing pulse which is above threshold. When delivery of the pulse pairs is initiated, the search pulse is adjusted to optimize polarization, and the pacemaker waits for predetermined stabilization period of time in order to allow for minimum polarization and to optimize capture detection. The search pulse is increased incrementally in output value toward threshold, and following each such increase the pacemaker waits for a stabilization interval. The pacemaker detects when capture is achieved by the search pulse, thereby providing an indication of threshold.

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Wehl, Netherlands

Bernardus F Vonk