Patent ID: 6718206
Filing Date: 2004-04-06
Classification: A61N

Abstract:
A method of providing atrial-ventricular (AV) synchronous pacing to a heart through a dual chamber pacemaker pulse generator coupled with pacing leads extending to ventricular pace/sense electrodes disposed in operative relation to a ventricle, atrial pace/sense electrodes disposed in operative relation to an atrium, and His bundle pace electrodes disposed along the AV septum in operative relation to the bundle of His comprising the steps of:determining the intrinsic AR interval of the patient's heart by: sensing at least one P-wave associated with depolarization of an atrium through the atrial pace/sense electrodes as an atrial sensed event; sensing at least one R-waves associated with depolarizations of a ventricle through the ventricular pace/sense electrodes as a ventricular sensed event; and timing an intrinsic AR interval from at least one pair of successive atrial and ventricular sensed events; establishing an A-H delay as a function of the determined intrinsic AR interval; establishing an AV delay that is shorter than the determined intrinsic AR interval; and synchronously pacing the patient's heart by: establishing an atrial pacing escape interval; timing out the atrial pacing escape interval; sensing P-waves associated with depolarizations of the atrium through the atrial pace/sense electrodes as atrial sensed events; restarting the atrial pacing escape interval on the sensing of an atrial sensed event within said atrial pacing escape interval; delivering an atrial pace pulse through the atrial pace/sense electrodes to the atrium at the time out of the atrial pacing escape interval; timing out the A-H delay from an atrial sensed event or delivery of an atrial pace pulse; delivering a His bundle pacing pulse through the His bundle pace electrodes to the bundle of His upon time-out of the A-H delay; timing out the AV delay from an atrial sensed event or delivery of an atrial pace pulse; sensing R-waves associated with depolarizations of the ventricle through the ventricular pace/sense electrodes as ventricular sensed events; halting the time-out of the AV delay upon a ventricular sensed event occurring during time-out of the AV delay; and delivering a ventricular pacing pulse through the ventricular pace/sense electrodes upon time-out of the AV delay; wherein the step of establishing an A-H delay as a function of the determined intrinsic AR interval comprises setting the A-H delay to be shorter than the AV delay.