St. Jude Medical Ab

Carl Johan Höijer

Martin Obel

Hans Schüller

An implantable cardiac stimulating device has a pacing circuit connected via an electrode lead system to a first electrode which stimulates and detects activity in the left ventricle, a second electrode to stimulate and detect activity in the right atrium, and to a third electrode to detect activity in the left atrium. Upon the occurrence of a paced or sensed depolarization of the right atrium, a first AV-delay is started. When the subsequent left atrial depolarization is detected, a new AV-interval is started that is optimized for the left side of the heart. Either the left ventricle only, or both ventricles, is paced at the optimized left side AV-interval.

Cardiac stimulating device

A heart stimulator has an atrial and ventricular pulse generator for producing atrial and ventricular stimulation pulses, an atrial sensor for sensing atrial signals and an evoked response detector for detecting the occurrence of incipient fusion beats from measured ventricular signals. A determination unit determines an incipient fusion AV-interval from the sensed atrial signals and the detected fusion beats, and a controller controls the pulse generator to deliver stimulation pulses at a controlled AV-interval which is shorter than the incipient fusion AV-interval. The evoked response detector includes an averaging unit which forms an average amplitude value of the measured ventricular signals during a predetermined time window of each cardiac cycle, and a comparator which compares the average value for each cardiac cycle with a predetermined limit criterion, and supplies the result of the comparison to the determination unit for determining a measured ventricular signal resulted from an incipient fusion beat or a completely stimulated capture.

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Malmö, Sweden

Carl Johan Höijer