Patent ID: 7979125
Filing Date: 2011-07-12
Classification: A61N

Abstract:
1. An implantable heart stimulating device comprising: at least one memory; a first atrial sensing and/or pacing circuit configured to communicate with a first atrial sensing and/or pacing electrode configured to be positioned in an atrium of a heart, said first atrial sensing and/or pacing circuit being configured to enable sensing and/or pacing of the atrium; a first ventricular sensing circuit configured, to communicate with a first ventricular sensing electrode configured to be positioned in or at a first ventricle of said heart, said first ventricular sensing circuit being configured to enable sensing of the first ventricle; a first ventricular pacing circuit configured to communicate with a first ventricular pacing electrode configured to be positioned in or at the first ventricle of said heart, said first ventricular pacing circuit being configured to enable pacing of the first ventricle; a second ventricular sensing circuit configured to communicate with a second ventricular sensing electrode configured to be positioned in or at a second ventricle of said heart, said second ventricular sensing circuit being configured to enable sensing of the second ventricle; a second ventricular pacing circuit configured to communicate with a second ventricular pacing electrode configured to be positioned in or at the second ventricle of said heart, said second ventricular pacing circuit being configured to enable pacing of the second ventricle; a control circuit configured to detect an evoked response to a pacing pulse delivered by said first ventricular pacing circuit by sensing, with said first ventricular sensing circuit, within a first time window that follows after a pacing pulse delivered by said first ventricular pacing circuit; a control circuit being configured to detect an evoked response to a pacing pulse delivered by said second ventricular pacing circuit by sensing, with said second ventricular sensing circuit, within a second time window that follows after a pacing pulse delivered by said second ventricular pacing circuit; said control circuit being configured to operate with time cycles corresponding to normal heart cycles; said control circuit being configured to operate, during the normal operation of the device, with a value PV and/or AV, where PV is the time between the sensing with said first atrial sensing and/or pacing circuit and a subsequent pacing pulse, which may also be inhibited, of said first ventricular pacing circuit and AV is the time between the pacing with said first atrial sensing and/or pacing circuit and a subsequent pacing pulse, which may also be inhibited, of said first ventricular pacing circuit; said control circuit being configured to deliver, within a time cycle pacing pulse with both said first ventricular pacing circuit and said second ventricular pacing circuit with a time gap VV, during the normal operation of the device, between a pacing pulse delivered, or inhibited, by said first ventricular pacing circuit and a pacing pulse delivered, or inhibited, by said second ventricular pacing circuit, wherein said time gap VV is ≧0; said control circuit being configured to execute a capture threshold search, by, during a plurality of time cycles, vary the energy of the pacing pulses delivered by said first ventricular pacing circuit and said second ventricular pacing circuit and to detect, with said first ventricular sensing circuit and said second ventricular sensing circuit, respectively, possible evoked responses during said first time window and said second time window, respectively, and to determine a suitable pulse energy for the pacing pulses delivered by said first ventricular pacing circuit and said second ventricular pacing circuit, respectively; said control circuit being configured to determine a time gap VV where V and by setting VV