Patent ID: 6070101
Filing Date: 2000-05-30
Classification: A61N

Abstract:
A pacing system for improving the hemodynamic efficiency of a sick heart suffering from conduction delays in conducting spontaneous or evoked depolarizations originating in one of the right or left atrium to the other of the left or right atrium comprising:right atrial lead means for locating first and second right atrial pace/sense electrodes in relation with the right atrium;left atrial lead means for locating first and second left atrial pace/sense electrodes in relation with the left atrium;right atrial depolarization sensing means coupled with said right atrial lead means for sensing spontaneous cardiac depolarizations originating in the right atrium and conducted cardiac depolarizations originating in the left atrial from a spontaneous cardiac depolarization or delivery of a left atrial pacing pulse to the left atrium and for providing a right atrial sensed event signal in response to either a sensed spontaneous or conducted cardiac depolarization;left atrial depolarization sensing means coupled with said left atrial lead means for sensing spontaneous cardiac depolarizations originating in the left atrium and conducted cardiac depolarizations originating in the right atrial from a spontaneous cardiac depolarization or delivery of a right atrial pacing pulse to the right atrium and for providing a left atrial sensed event signal in response to either a sensed spontaneous or conducted cardiac depolarization;escape interval timing means for timing an escape interval establishing a pacing rate and providing an escape interval pace trigger signal at the time out of the escape interval, the escape interval timing means further comprising reset means for restarting the timing of the escape interval in response to one of the right or left atrial sensed event signals;right atrial pacing pulse output means coupled with said right atrial lead means and selectively responsive to an applied pace trigger signal for generating and delivering a right atrial pacing pulse to said right atrial lead means to evoke a right atrial depolarization;left atrial pacing pulse output means coupled with said left atrial lead means and selectively responsive to an applied pace trigger signal for generating and delivering a left atrial pacing pulse to said left atrial lead means to evoke a left atrial depolarization;means for applying said escape interval pace trigger signal to one of said right atrial pacing pulse output means or said left atrial pacing pulse output means;left atrial conduction delay window timing means coupled with said escape interval timing means and said right atrial depolarization sensing means for timing a left atrial conduction delay window from a right atrial sensed event signal and selectively from an escape interval pace trigger signal and for providing a left atrial pace trigger signal at the expiration of the left atrial conduction delay window time, said left atrial conduction delay window timing means further coupled with said left atrial depolarization sensing means and comprising left atrial window terminating means for terminating the timing out of the left atrial conduction delay window in response to a left atrial sensed event signal;means for applying said left atrial pace trigger signal to said left atrial pacing pulse output means as a pace trigger signal for triggering the generation and delivery of a left atrial pacing pulse to said left atrial lead means;right atrial conduction delay window timing means coupled with said escape interval timing means and said left atrial depolarization sensing means for timing a right atrial conduction delay window from a left atrial sensed event signal and selectively from an escape interval pace trigger signal and for providing a right atrial pace trigger signal at the expiration of the right atrial conduction delay window time, said right atrial conduction delay window timing means further coupled with said right atrial depolarization sensing means and comprising right atrial window terminating means for terminating the timing out of the right atrial conduction delay window in response to a right atrial sensed event signal; andmeans for applying said right atrial pace trigger signal to said right atrial pacing pulse output means as a pace trigger signal for triggering the generation and delivery of a right atrial pacing pulse to said right atrial lead means;whereby an excessive conduction delay between a spontaneous or evoked depolarization in the right atrium and the conducted depolarization wave in the left atrial or an excessive conduction delay between a spontaneous or evoked depolarization in the left atrium and the conducted depolarization wave in the right atrium is corrected by generation and delivery of a pacing pulse to the left or right atrium, respectively at the timing out of the corresponding conduction delay window.