Pacesetter, Inc.

Melinda A Endaya

Paul A Levine

Brian M Mann

Siew Bee Er

A pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The stored information can be retrieved by means of a telemetry communication link. The pacemaker automatically lengthens an AV delay. The pacemaker determines atrial capture by generating atrial stimulation pulses while maintaining the ventricular stimulation pulse amplitude at a level known to ensure ventricular capture, and by detecting loss of atrial capture. In response to the loss of atrial capture, a processor automatically records the atrial capture threshold, and restores the AV delay to its pre-test value. The pulse generator also delivers a backup atrial stimulation pulse concurrent with a ventricular stimulation pulse to reduce the possibility of a retrograde P-wave initiating a pacemaker-mediated tachycardia (PMT).

Method and apparatus of determining atrial capture threshold while avoiding pacemaker mediated tachycardia

A pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The stored information can be retrieved by means of a telemetry communication link. The pacemaker automatically lengthens a post-ventricular atrial refractory period (PVARP). The pacemaker determines atrial capture threshold by generating atrial stimulation pulses while maintaining the ventricular stimulation pulse amplitude at a level known to ensure ventricular capture, and by detecting loss of atrial capture. In response to loss of atrial capture, a processor automatically triggers a premature ventricular contraction (PVC) response to prevent a retrograde P-wave from initiating a pacemaker-mediated tachycardia. Also in response to loss of atrial capture, the processor sets the atrial stimulation pulse amplitude to a value above the atrial capture threshold in a subsequent cardiac cycle, and restores the PVARP to its pre-test value.

Implantable stimulation device and method for determining atrial autocapture using PVC response

A pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The stored information can be retrieved by a telemetry communication link. The programmer includes features for allowing the physician to interactively adjust program parameters while viewing the results of parameter changes in real-time. The programmer performs a ventricular sensitivity threshold test by setting the stimulation device to an atrial tracking mode, and by assessing the ventricular sensing of the pacemaker. If ventricular sensing is confirmed, the processor performs a ventricular sensitivity threshold test to determine the pacemaker ventricular sensitivity threshold, and then automatically adjusts the ventricular sensitivity to within a safety margin from the ventricular sensitivity threshold. The programmer also performs an atrial sensitivity threshold test by setting the stimulation device to the atrial tracking mode, and by assessing the atrial sensing of the pacemaker. If atrial sensing is confirmed, the programmer determines whether the base rate is less than the sensed atrial rate by 20 BPM or more; if so, the processor performs an atrial sensitivity threshold test to determine the pacemaker atrial sensitivity threshold, and automatically adjusts the atrial sensitivity to within a safety margin from the atrial sensitivity threshold.

Implantable stimulation device and method for determining ventricular and atrial sensitivity thresholds

A pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The stored information can be retrieved by means of a telemetry communication link. The pacemaker automatically lengthens a post-ventricular atrial refractory period (PVARP). The pacemaker determines atrial capture threshold by generating atrial stimulation pulses while maintaining the ventricular stimulation pulse amplitude at a level known to ensure ventricular capture, and by detecting loss of atrial capture. In response to the loss of atrial capture, a processor automatically shortens the AV delay in a subsequent cardiac cycle, to reduce the possibility of a retrograde P-wave initiating a pacemaker-mediated tachycardia (PMT). Also in response to the loss of atrial capture, the pacemaker records the atrial capture threshold, restores the PVARP to its pre-test value, and sets the atrial stimulation pulse amplitude to a value above the atrial capture threshold.

Implantable stimulation device and method for determining atrial autocapture using programmable AV delay

Implantable stimulation device and method for determining a trial autocapture using backup atrial stimulation

A pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The stored information can be retrieved by means of a telemetry communication link. The pacemaker automatically lengthens a post-ventricular atrial refractory period (PVARP). The pacemaker determines atrial capture by generating atrial stimulation pulses while maintaining the ventricular stimulation pulse amplitude at a level known to ensure ventricular capture, and by detecting loss of atrial capture. In response to loss of atrial capture, a processor automatically records the atrial capture threshold, and restores the PVARP and the atrial pulse amplitude to their pre-test values. A pulse generator delivers a backup atrial stimulation pulse concurrently with a ventricular stimulation pulse, and the processor automatically initiates a premature ventricular contraction (PVC) response to reduce the possibility of a retrograde P-wave initiating a pacemaker-mediated tachycardia (PMT).

Implantable stimulation device and method for determining atrial autocapture using programmable PVARP

A pacemaker generates and transmits real-time intracardiac electrogram signals to an external display device for display thereon. Simultaneously, the pacemaker senses a variety of events occurring either within the heart tissue or within the pacemaker itself and transmits signals representative of those events for display, using appropriate marker icons, along with the intracardiac electrograms. In this manner, a physician viewing the intracardiac electrograms is simultaneously apprised of the various events. In one example, events displayed along with the intracardiac electrograms include the detection of atrial and ventricular events occurring within the heart during a non-absolute refractory period following generation of a stimulation signal. Other examples of events displayed along with the intracardiac electrograms include operations triggered within the pacemaker as a result of the condition of the patient, such as an auto-mode switching event, or operations triggered within the pacemaker as a result of the condition of the pacemaker itself, such as a battery test operation. Still other examples of events include pacemaker programming operations triggered using a remote programming device by a physician. Such events include an electrophysiological artificially-induced arrhythmia operation. In the described example, the external display device also presents surface electrocardiograms along with the intracardiac electrograms and the event marker icons.

Method and apparatus for detecting and displaying diagnostic information

An improved pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The information stored within the pacemaker can be retrieved by means of a telemetry communication link. The system automatically identifies significant patient events (such as regions of increased heart rate, or loss of atrial or ventricular capture) and displays the significant events to the monitoring physician so that the physician is not required to scroll through the retrieved data to identify significant events. Furthermore, the system automatically suggests modifications to pacemaker parameters based upon certain retrieved data. The physician need only confirm the changes in order to modify the parameters within the pacemaker, so that the modification of pacemaker parameters is reduced to a 'one step' process. The system also includes features for allowing the physician to interactively adjust program parameters while viewing the results of parameter changes in real-time.

Growing community of inventors

Granada Hills, CA, United States of America

Melinda A Endaya