[go: up one dir, main page]

US3595242A - Atrial and ventricular demand pacer - Google Patents

Atrial and ventricular demand pacer Download PDF

Info

Publication number
US3595242A
US3595242A US810519A US81051969A US3595242A US 3595242 A US3595242 A US 3595242A US 810519 A US810519 A US 810519A US 81051969 A US81051969 A US 81051969A US 3595242 A US3595242 A US 3595242A
Authority
US
United States
Prior art keywords
pacer
patient
accordance
atrial
ventricular
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
US810519A
Other languages
English (en)
Inventor
Barouh V Berkovits
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
American Optical Corp
Original Assignee
American Optical Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=25204045&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=US3595242(A) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by American Optical Corp filed Critical American Optical Corp
Priority to US810519A priority Critical patent/US3595242A/en
Priority to IL33744A priority patent/IL33744A/en
Priority to NO00480/70A priority patent/NO126899B/no
Priority to AT202670A priority patent/AT302522B/de
Priority to DE2010724A priority patent/DE2010724C3/de
Priority to NL7003205.A priority patent/NL155453B/xx
Priority to CH340970A priority patent/CH534524A/de
Priority to JP45023190A priority patent/JPS4940992B1/ja
Priority to SE03833/70A priority patent/SE356903B/xx
Priority to BR217673/70A priority patent/BR7017673D0/pt
Priority to ES377899A priority patent/ES377899A1/es
Priority to DK154170AA priority patent/DK130771B/da
Priority to BE747983A priority patent/BE747983A/fr
Priority to FR7011787A priority patent/FR2040175A5/fr
Priority to GB1492670A priority patent/GB1307912A/en
Priority to US00113877A priority patent/US3709229A/en
Publication of US3595242A publication Critical patent/US3595242A/en
Application granted granted Critical
Assigned to COOK PACEMAKER CORPORATION reassignment COOK PACEMAKER CORPORATION LICENSE (SEE DOCUMENT FOR DETAILS). EFFECTIVE 03/27/81 Assignors: ATLANTIC RICHFIELD COMPANY
Assigned to TELECTRONICS PTY. LIMITED reassignment TELECTRONICS PTY. LIMITED CONFIRMS THE GRANTING OF LICENSE AGREEMENT DATED JULY 1, 1973 SUBJECT TO CONDITIONS IN AGREEMENT DATED JANUARY 16, 1984 (SEE REORD FOR DETAILS). Assignors: HONEYWELL MEDICAL ELECTRONICS B.V.
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions

Definitions

  • the electrical activity of a normal heart begins with a nerve impulse generated by a bundle of fibers located in the sinoatrial node.
  • the impulse spreads across the two atria while they contract and speed the flow of blood into the ventricles underneath them.
  • the atrial activity of the heart corresponds to the P-wave in an electrocardiogram trace.
  • the electrical impulse continues to spread across the atrioventricular (AV) node, which in turn stimulates the left and right ventricles.
  • AV atrioventricular
  • an interval of approximately l2() 160 milliseconds elapses between atrial and ventricular stimulation.
  • the ventricular activity corresponds to the QRS portion of the electrocardiogram, and typically has a duration of 80 milliseconds.
  • the ventricular muscles repolarize, and this portion of the electrical activity of the heart corresponds to the T-wave in the electrocardiogram.
  • the ventricular is far more important than the atrial.
  • the atrial contractions cause the ventricular contractions to be more efficient; the ventricular contractions are more effective if the ventricles are first filled with blood. While a patient can survive without proper atrial action, he cannot survive without ventricular contractions.
  • an AV block that is, an AV node which is opencircuited, life cannot be sustained (unless the ventricles somehow beat on their own without AV stimulation, and even in such a case the heartbeat rate is generally far too slow).
  • AV block that is, an AV node which is opencircuited
  • the demand pacer was introduced.
  • electrical heart-stimulating impulses are provided only in the absence of natural heartbeats. If only a single natural heartbeat is absent, only a single electrical impulse is generated. If more than one natural heartbeat is missing, an equal number of electrical impulses will be provided. No matter how many electrical stimuli are generated, they occur at essentially the same time spacing from each other and from previous natural heartbeats-as would be the case if they were all natural heartbeats. The result is an overall integrated" operation, Le, a mutually exclusive cooperation of natural heartbeats and stimulating impulses.
  • the demand pacer of this type is disclosed in my U.S. Pat. No. 3,345,990 issued on Oct. 10, 1967.
  • a demand pacer is primed to generate an impulse at a predetermined time after the last natural heartbeat. If another natural heartbeat occurs duringfthe timeout interval of the pacer, an impulse is not generated and the timeout period starts all over again. On the other hand, if a natural heartbeat does not take place by the end of timeout period a stimulating impulse is generated.
  • the pacemaker circuitry must determine if a natural heartbeat has occurred. The largest magnitude electrical signal generated by the heart activity is the QRS complex corresponding to ventricular contraction. To determine whether a natural heartbeat has occurred, an electrode is generally coupled to a ventricle. Since in most cases ventricular stimulation is required, the same electrode can be used for both stimulating the ventricles and detecting a natural heartbeat, as disclosed in my aforesaid patent.
  • a demand pacer of this type In the presence of noise, erroneous operation of a demand pacer of this type can take place.
  • the noise may result in the generation of an electrical signal on the ventricular electrode, and the pacer circuitry may treat this noise as indicative of a natural heartbeat and inhibit the generation of a stimulating impulse even if one is required.
  • the pacemaker timeout period In this improved demand pacer, in the presence of noise the pacemaker timeout period is not interrupted. Continuous stimulating impulses are generated, even if they are not required. It is better to provide an impulse even ifit is not required than it is not to provide an impulse ifit is required.
  • Ventricular pacer stimulation has been used in the past to treat this disorder.
  • atrial stimulation would leave the patient unprotected from unpredictable AV block.
  • Both types of pacing could be accomplished with the use of two individual pacers. But even if they are combined in a single package many problems must be overcome, especially if a demand-type operation is desired. One of the most obvious problems concerns the timing sequence of the two types of pacing.
  • the first function of the pacer is to generate an atrial-stimulating impulse. After a predetermined time interval, the pacer functions to generate a ventricular-stimulating impulse.
  • Three electrodes are provided--a neutral electrode, an electrode for atrial stimulation and an electrode for ventricular stimulation.
  • the ventricular electrode also serves to detect the occurrence of a ventricular contraction.
  • the pacer exhibits two timeout or escape intervals.
  • the ventricular escape interval is l60250 milliseconds longer than the atrial escape interval.
  • the ventricular escape interval is greater than the normal interval between two heartbeats (as in a conventional demand pacer).
  • the atrial escape interval is greater than the normal interval between atrial and ventricular beats (P to R), but less than the normal interbeat interval (R to R).
  • Both timeout periods begin with the generation of the last heartbeat (natural or stimulated). If another ventricular contraction does not occurwithin the atrial timeout period, that is, in the absence of a premature ventricular contraction, the atrial-stimulating impulse is generated. The atria contract and fill the ventricles with blood.
  • the detected EGG signal on the ventricular electrodes resets both timeout circuits and the ventricular impulse is not generated.
  • a ventricular impulse is generated at the end ofthe ventricular timeout interval.
  • FIG. 1 is the same as FIG. 1 in my copending application Ser. No. 727,l29 and depicts a preferred demand pacer for ventricular stimulation, and further shows in heavy lines the additional circuit elements and the five conductors -84 which are required to connect the demand pacer of FIG. I to the atrial-stimulating circuit of FIG. 3;
  • FIG. 2 depicts a typical electrocardiogram
  • FIG. 3 depicts an atrial-stimulating circuit which, when used with the circuit of FIG. 1, provides bifocal stimulation in accordance with the preferred embodiment of the present invention
  • FIG. 4 depicts the arrangement of FIGS. I and 3;
  • FIG. 1 is identical to that disclosed in my copending application Ser. No. 727,129. (In said application, conductor 11 extends directly from electrode E1 to capacitor 17- there is no FET switch 92 in the signal path.) Electrodes El and E2 are implanted in the patients heart, electrode E2 being the neutral electrode and electrode El being positioned to stimulate the ventricles of the patient's heart. When switch S is closed, the pacer functions to continuously supply electrical impulses at a fixed rate. When the pacer is operated in the demand mode, however, switch 5 is open. Current flows between electrodes El and E2 to stimulate the ventricles only when an electrical stimulus is required.
  • Capacitor 65 serves to provide a source of current when an impulse is required. At that time, transistor T9 conducts and the capacitor discharges through the electrodes. Capacitor 57 charges through potentiometers 35 and 37 until the voltage across it causes transistors T7 and T8 to conduct. At that time, capacitor 57 discharges through transistors T7 and T8, transistor T9 conducts, and an impulse is delivered to the patients heart from capacitor 65.
  • the setting of potentiometer 37 controls the time taken for capacitor 57 to discharge, that is, the width of each impulse.
  • the setting of potentiometer 35 controls the time required for capacitor 57 to charge to that level which causes conduction in transistors T7 and T8, that is, the interpulse interval. Ordinarily, in the absence of conduction of transistor T6, capacitor 57 would continuously charge and discharge, and impulses would be supplied to the patients heart at fixed intervals determined by the setting of potentiometer 35.
  • Electrode E1 is coupled over conductor 11 to the base of transistor T1.
  • a typical ECG. is shown in FIG. 2, and transistors T1 and T2 conduct when electrode El detects a ventricular contraction which results in the generation of an R wave. (Excessive signals are shorted through Zener diode 67 to prevent damage to transistor T1.) With the conduction of these transistors, a positive pulse is delivered to the base of transistor T6. Transistor T6 conducts and capacitor 57 discharges through it. Thus, although the capacitor was previously charging to the level which would have resulted in the generation of an impulse, it is discharged and a new timeout interval begins. This arrangement ensures that an impulse is not generated ifa natural heartbeat has occurred. The timeout interval is such that impulses are generated with an interpulse interval slightly in excess of the desired natural interbeat interval. Only if a natural heartbeat is missing is a stimulating impulsegenerated.
  • transistor T6 The remaining transistors in the circuit serve to prevent conduction of transistor T6 in the presence of noise. In the presence of noise it would otherwise be possible for transistor T6 to conduct and prevent the generation of an impulse even though one is required. For this reason, when the pacer detects extraneous noise, transistor T6 is prevented from operating and impulses are delivered at a fixed rate.
  • the illustrative embodiment of the invention is derived by adding the circuit elements and conductors shown in heavy lines in FIG. I, and combining the circuits of FIGS. 1 and 3, as shown in FIG. 4.
  • the circuit of FIG. 3 is in almost all respects identical to the circuitry on the right side of FIG. 1.
  • the various elements in the circuit of FIG. 3 are designated by the same numerals as the equivalent elements in FIG. 1 with the addition of prime symbols.
  • Conductor 80 couples potentiometer 35' and resistor 59' to a terminal of battery 7 just as potentiometer 35 and resistor 59 are coupled to the same terminal in FIG. 1.
  • Conductor 81 couples the base of transistor T7 to the o ther terminal of battery 7 just as the base of transistor T7 in FIG. I is coupled to this terminal.
  • Conductor 82 couples the base of transistor T6 to the right side of capacitor 53, just as the base of transistor T6 in FIG. 1 is coupled to the right side of the capacitor.
  • Conductor 83 serves to provide a common neutral for the circuits of FIGS. 1 and 3.
  • conductor 84 serves to extend a signal to disable FET switch 92, as will be described below.
  • Electrode E3 in FIG. 3 is implanted in the patients heart to stimulate his atria.
  • the circuit of FIG. 3 functions just as does the circuit on the right side of FIG. 1, except that each stimulating impulse results in an atrial contraction rather than a ventricular contraction.
  • Capacitor 57 charges through potentiometers 35 and 37'. After a predetermined interval, when the capacitor voltage has reached the level required to control conduction of transistors T7 and T8, the two transistors conduct and forward bias the base-emitter junction of transistor T9. The charge on capacitor 65' flows through transistor T9 and electrodes E2 and E3.
  • the width of each pulse is determined by the setting of potentiometer 37' which determines the time required for capacitor 57' to discharge through transistors T7 and T8.
  • the interpulse interval is determined by the setting of potentiometer 35' which determines the time required for capacitor 57 to charge to the level which causes transistors T7 and T8 to conduct.
  • any pulse delivered through capacitor 53 as a result of the detection of an R-wave causes transistor T6 to conduct along with transistor T6.
  • capacitor 57 discharges through transistor T6
  • capacitor 56 discharges through transistor T6.
  • the timeout period of the circuit of FIG. 3 is not concluded and an atrial-stimulating pulse is not generated. Instead, the timeout begins once again.
  • FIG. 5 depicts a timing sequence which will be helpful in understanding the present invention.
  • Two R-waves are shown and represent two successive beats (ventricular contractions) of the patients. heart. Typically, the time interval between them is less than 760 milliseconds. The P-wave associated with the second Rwave is shown occurring before it.
  • Potentiometer 35' has a value such that capacitor 57 charges to the level required for the conduction of transistors T7 and T8 after 600 milliseconds have elapsed since the last capacitor discharge.
  • the atrial-stimulating pulse E3 is thus shown occurring 600 milliseconds after the first R-wave.
  • the atria are stimulated following the P- wave during a normal heartbeat. Actually, if a P-wave has been generated it is an indication that the atria have contracted and an atrial-stimulating impulse on electrode E3 is not required. However, if such an impulse is generated following the atrial contraction, that is, during the refractory interval of the atria, it has no effect on the beating action of the patients heart. (The generation of an atrial-stimulating impulse prior to the natural atrial contraction can induce an atrial premature heat which is not desirable.)
  • Potentiometer 35in FIG. 1 has a value such that the timeout interval for the ventricular stimulation is 800 milliseconds.
  • the pulse designated E1 in FIg. 5 is shown occurring 800 milliseconds after the first R-wave, which is slightly after the second R-wave should it be present. If the second R-wave is detected on electrode E1, both timeout circuits are reset and an impulse is not generated on electrode El. This is the desired demand-type operation. If a natural heartbeat does not occur within 800 milliseconds after the last heartbeat, and impulse is generated on electrode E1 to stimulate the ventricular contraction.
  • the ventricular stimulation is provided to correct any AV block.
  • a normal ventricular contraction can occur approximately I20- milliseconds after the atrial stimulation.
  • the ventricular timeout period in the circuit of Fig. 3 is 200 milliseconds longer than the atrial timeout period in the circuit of Hg. 1; sufficient time is allowed for a natural ventricular contraction before a ventricular-stimulating impulse is generated. In general, the ventricular timeout period should exceed the atrial timeout period by 160-250milliseconds.
  • FET switch 92 is inserted in conductor 11 between electrode El and capacitor 17 in the base circuit of transistor T1.
  • the switch is normally conducting due to its connection through resistor 94 to neutral conductor 9.
  • the negative pulse generated at electrode E3 is transmitted over conductor 84 and through diode 95 to capacitor 93.
  • the capacitor charges and turns off the FET switch.
  • capacitor 93 discharges'through resistor 94.
  • the time constant of the capacitor-resistor combination is such that the FET switch remains off for approximately an additional 6 milliseconds to prevent erroneous detection of a ventricular contraction for a few additional milliseconds until after all transients have died down. In this manner, the heartbeat detection circuit is disabled during each atrial stimulation and for a short interval thereafter.
  • Capacitor 91 is provided to short high frequency transients, arising from the FET switching, to conductor 9. r
  • the timeout intervals of 600 milliseconds and 800 milliseconds shown in FIG. 5 are not critical. Considerable flexibility is possible. Generally, the timeout interval for the circuit of FIG. 3 should be such that an impulse is generated at electrode E3 some time between the P and R-waves following a previous R-wave. The timeout interval for the circuit of FIG. 1 should be such that an impulse is generated at electrode El at a time after the last R-wave which exceeds the desired period between natural heartbeats.
  • the pacer of the invention serves to correct for the condition known as atrial bradycardia at the same time that it protects against ventricular asystole.
  • a pacer comprising terminal means for connection to a patients heart for atrial stimulation, terminal means for connection to said patients heart for ventricular stimulation, means for detecting the beating of said patients heart, means for generating an electrical stimulus on said atrial terminal means following a first predetermined time interval after the detection of the last beating of said patients heart, and means for generating an electrical stimulus on said ventricular terminal means following a second predetermined time interval after the detection of the last beating of said patients heart.
  • a pacer in accordance'with claim 2 wherein said second predetermined time interval is longer than the normal interval between successive R-waves in the electrocardiographic waveform of said patient, and further including means for disabling the operation of said detecting means during the generation of an electrical stimulus on said atrial terminal means.
  • a pacer in accordance with claim 7 further including means for controlling said atrial and ventricular generating means to generate said respective electrical stimuli independent of the operation of said detecting means in the presence of noise which would otherwise be confused with the beating of said patients heart.
  • a pacer in accordance with claim 7 wherein said second predetermined time interval is longer than said first predetermined time interval by -250 milliseconds.
  • a pacer in accordance with claim 4 wherein said detecting means is connected to said ventricular terminal means, and further including means for disabling the operation of said detecting means during the generation of an electrical stimulus on said atrial terminal means.
  • a pacer in accordance with claim 2 further including means for controlling said atrial and ventricular generating means to generate said respective electrical stimuli independent of the operation of said detecting means in the presence of noise which would otherwise be confused with the beating of said patients heart.
  • a pacer comprising terminal means for connection to a patients heart for atrial stimulation, terminal means for connection to said patients heart for ventricular stimulation, a first timing circuit including first means for generating an electrical impulse on said atrial terminal means, a second timing circuit including second means for generating an electrical impulse on said ventricular terminal means, means for detecting a beating action of said patients heart, and means responsive to the operation of said detecting means for resetting said first and said second timing circuits.
  • a pacer in accordance with claim 18 further including means for preventing the resetting of said first and second timing circuits responsive to the operation of said detecting means in the presence of noise which would otherwise be confused with a beating action of said patients heart.
  • a pacer in accordance with claim 14 further including means for preventing the resetting of said second timing circuit responsive to the operation of said detecting means in the presence of noise which would otherwise be confused with a beating action of said patients heart.
  • a pacer comprising terminal means for connection to a patients heart for atrial stimulation, terminal means for connection to said patients heart for ventricular stimulation, means for detecting a beating action of said patients heart, means for applying an electrical impulse to said atrial terminal means following a first predetermined time interval after the detection of the last beating action of said patients heart, and
  • a pacer comprising terminal means for connection to a UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION Patent No 3 595 242 Dated July 27 1971 Barouh V. Berkovits Inventor(s) It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Physiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Electrotherapy Devices (AREA)
US810519A 1969-03-26 1969-03-26 Atrial and ventricular demand pacer Expired - Lifetime US3595242A (en)

Priority Applications (16)

Application Number Priority Date Filing Date Title
US810519A US3595242A (en) 1969-03-26 1969-03-26 Atrial and ventricular demand pacer
IL33744A IL33744A (en) 1969-03-26 1970-01-20 Bifocal demand pacemaker a water-soluble composition comprising sufadimidine and pyrimethamine
NO00480/70A NO126899B (fr) 1969-03-26 1970-02-11
AT202670A AT302522B (de) 1969-03-26 1970-03-04 Herzschrittmacher
DE2010724A DE2010724C3 (de) 1969-03-26 1970-03-06 Herzschrittmacher
NL7003205.A NL155453B (nl) 1969-03-26 1970-03-06 Gangmaker, voorzien van een atriumprikkelgenerator.
CH340970A CH534524A (de) 1969-03-26 1970-03-09 Bedarfsgesteuerter Herzschrittmacher
JP45023190A JPS4940992B1 (fr) 1969-03-26 1970-03-20
SE03833/70A SE356903B (fr) 1969-03-26 1970-03-20
BR217673/70A BR7017673D0 (pt) 1969-03-26 1970-03-23 Marca-passo de demanda bifocal
ES377899A ES377899A1 (es) 1969-03-26 1970-03-24 Mejoras introducidas en marca-pasos para el corazon.
DK154170AA DK130771B (da) 1969-03-26 1970-03-25 Dobbeltvirkende hjertestimulator.
BE747983A BE747983A (fr) 1969-03-26 1970-03-26 Entraineur a la demande a double fonction (
FR7011787A FR2040175A5 (fr) 1969-03-26 1970-03-26
GB1492670A GB1307912A (en) 1969-03-26 1970-03-26 Heart pacemakers
US00113877A US3709229A (en) 1969-03-26 1971-02-09 Free-running atrial and demand ventricular pacer

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US810519A US3595242A (en) 1969-03-26 1969-03-26 Atrial and ventricular demand pacer

Publications (1)

Publication Number Publication Date
US3595242A true US3595242A (en) 1971-07-27

Family

ID=25204045

Family Applications (1)

Application Number Title Priority Date Filing Date
US810519A Expired - Lifetime US3595242A (en) 1969-03-26 1969-03-26 Atrial and ventricular demand pacer

Country Status (15)

Country Link
US (1) US3595242A (fr)
JP (1) JPS4940992B1 (fr)
AT (1) AT302522B (fr)
BE (1) BE747983A (fr)
BR (1) BR7017673D0 (fr)
CH (1) CH534524A (fr)
DE (1) DE2010724C3 (fr)
DK (1) DK130771B (fr)
ES (1) ES377899A1 (fr)
FR (1) FR2040175A5 (fr)
GB (1) GB1307912A (fr)
IL (1) IL33744A (fr)
NL (1) NL155453B (fr)
NO (1) NO126899B (fr)
SE (1) SE356903B (fr)

Cited By (46)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3757791A (en) * 1971-12-30 1973-09-11 American Optical Corp Synchronized atrial and ventricular pacer and timing circuitry therefor
US3783878A (en) * 1971-12-06 1974-01-08 American Optical Corp Atrial and ventricular pacer having independent rate and av delay controls
US3814106A (en) * 1972-04-14 1974-06-04 American Optical Corp Atrial and ventricular pacer having independent rate controls and means to maintain a constant av delay
DE2455391A1 (de) * 1973-11-23 1975-07-03 American Optical Corp Batterie
DE2505029A1 (de) * 1974-02-14 1975-08-21 American Optical Corp Fluessigkeitsabdichtung fuer implantierbare herzschrittmacher
DE2701104A1 (de) * 1977-01-12 1978-07-13 Medtronic France S A Herzschrittmacher
WO1979000070A1 (fr) * 1977-07-27 1979-02-22 S Joseph Stimulateur cardiaque
EP0039269A1 (fr) * 1980-04-30 1981-11-04 Medtronic, Inc. Commande de la période réfractaire du détecteur auriculaire d'un entraîneur cardiaque pour éviter sa réponse aux ondes R
FR2494119A1 (fr) * 1980-11-14 1982-05-21 Cordis Corp Stimulateur cardiaque programmable multimode commande par un microprocesseur
US4386610A (en) * 1980-05-27 1983-06-07 Cordis Corporation Ventricular-inhibited cardiac pacer
US4401119A (en) * 1981-02-17 1983-08-30 Medtronic, Inc. Prolongation of timing intervals in response to ectopic heart beats in atrial and ventricular pacemakers
US4407287A (en) * 1981-02-17 1983-10-04 Medtronic, Inc. Atrial and ventricular-only pacemaker responsive to premature ventricular contractions
US4471784A (en) * 1981-04-06 1984-09-18 Tesla Koncernovy Podnik Source of pulses for electronic suppression of pain
US4890617A (en) * 1987-11-25 1990-01-02 Medtronic, Inc. Dual chamber activity responsive pacer
US5265601A (en) * 1992-05-01 1993-11-30 Medtronic, Inc. Dual chamber cardiac pacing from a single electrode
US5364337A (en) * 1990-10-15 1994-11-15 Medtronic, Inc. Muscle powered cardiac assist system
WO2002051499A1 (fr) 2000-12-21 2002-07-04 Medtronic, Inc. Mode adi/r prefere de stimulation cardiaque permanente permettant de supprimer la stimulation ventriculaire tout en conservant un support auxiliaire
US20030078627A1 (en) * 2000-12-21 2003-04-24 Medtronic, Inc. Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support
US20050021096A1 (en) * 2003-07-24 2005-01-27 Mirowski Family Ventures, L.L.C. Methods, apparatus, and systems for multiple stimulation from a single stimulator
US20050055059A1 (en) * 2000-12-21 2005-03-10 Betzold Robert A. Ventricular event filtering for an implantable medical device
US20050055057A1 (en) * 2003-09-05 2005-03-10 Mirowski Famliy Ventures, L.L.C. Method and apparatus for providing ipselateral therapy
US20050055058A1 (en) * 2003-09-08 2005-03-10 Mower Morton M. Method and apparatus for intrachamber resynchronization
US20050177197A1 (en) * 2000-12-21 2005-08-11 Medtronic, Inc. System and method for ventricular pacing with progressive conduction check interval
US20050267539A1 (en) * 2000-12-21 2005-12-01 Medtronic, Inc. System and method for ventricular pacing with AV interval modulation
US20060167508A1 (en) * 2005-01-21 2006-07-27 Willem Boute Implantable medical device with ventricular pacing protocol including progressive conduction search
US20060167506A1 (en) * 2005-01-21 2006-07-27 Stoop Gustaaf A Implantable medical device with ventricular pacing protocol
US7248924B2 (en) 2004-10-25 2007-07-24 Medtronic, Inc. Self limited rate response
US7254441B2 (en) 2000-12-21 2007-08-07 Medtronic, Inc. Fully inhibited dual chamber pacing mode
US20070203523A1 (en) * 2006-02-28 2007-08-30 Betzold Robert A Implantable medical device with adaptive operation
US20070219589A1 (en) * 2006-01-20 2007-09-20 Condie Catherine R System and method of using AV conduction timing
USRE39897E1 (en) 1989-01-23 2007-10-23 Mirowski Family Ventures, L.L.C. Method and apparatus for treating hemodynamic disfunction
US20070293897A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Promoting Instrinsic Conduction Through Atrial Timing Modification and Calculation of Timing Parameters
US20070293898A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Determining Intrinsic AV Interval Timing
US20070293899A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Ventricular Interval Smoothing Following a Premature Ventricular Contraction
US20070293900A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Promoting Intrinsic Conduction Through Atrial Timing
US20080027490A1 (en) * 2006-07-31 2008-01-31 Sheldon Todd J Pacing Mode Event Classification with Rate Smoothing and Increased Ventricular Sensing
US20080027493A1 (en) * 2006-07-31 2008-01-31 Sheldon Todd J System and Method for Improving Ventricular Sensing
US7502647B2 (en) 2006-07-31 2009-03-10 Medtronic, Inc. Rate smoothing pacing modality with increased ventricular sensing
US7515958B2 (en) 2006-07-31 2009-04-07 Medtronic, Inc. System and method for altering pacing modality
US7689281B2 (en) 2006-07-31 2010-03-30 Medtronic, Inc. Pacing mode event classification with increased ventricular sensing
US7720537B2 (en) 2006-07-31 2010-05-18 Medtronic, Inc. System and method for providing improved atrial pacing based on physiological need
US20100222839A1 (en) * 2009-02-27 2010-09-02 Medtronic, Inc. System and method for conditional biventricular pacing
US20100222834A1 (en) * 2009-02-27 2010-09-02 Sweeney Michael O System and method for conditional biventricular pacing
US20100222838A1 (en) * 2009-02-27 2010-09-02 Sweeney Michael O System and method for conditional biventricular pacing
US7856269B2 (en) 2006-07-31 2010-12-21 Medtronic, Inc. System and method for determining phsyiologic events during pacing mode operation
US9931509B2 (en) 2000-12-21 2018-04-03 Medtronic, Inc. Fully inhibited dual chamber pacing mode

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2155903B1 (fr) * 1971-10-14 1974-03-29 Bondivenne Jean
ZA727526B (en) * 1971-12-06 1973-11-28 American Optical Corp Atrial and ventricular demand pacer
DE3127597A1 (de) * 1981-07-13 1983-02-17 Siemens AG, 1000 Berlin und 8000 München Verfahren und herzschrittmacher zur bifokalen stimulierung des herzens
DE20300248U1 (de) * 2002-07-31 2003-09-11 Froli Kunststoffwerk Heinrich Federelement für Betten

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3241556A (en) * 1962-05-17 1966-03-22 Cotelec Soc Fr D Etudes Et De Cardiac stimulators
US3433228A (en) * 1966-05-06 1969-03-18 Cordis Corp Multimode cardiac pacer

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3241556A (en) * 1962-05-17 1966-03-22 Cotelec Soc Fr D Etudes Et De Cardiac stimulators
US3433228A (en) * 1966-05-06 1969-03-18 Cordis Corp Multimode cardiac pacer

Cited By (89)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3783878A (en) * 1971-12-06 1974-01-08 American Optical Corp Atrial and ventricular pacer having independent rate and av delay controls
US3757791A (en) * 1971-12-30 1973-09-11 American Optical Corp Synchronized atrial and ventricular pacer and timing circuitry therefor
US3814106A (en) * 1972-04-14 1974-06-04 American Optical Corp Atrial and ventricular pacer having independent rate controls and means to maintain a constant av delay
DE2455391A1 (de) * 1973-11-23 1975-07-03 American Optical Corp Batterie
DE2505029A1 (de) * 1974-02-14 1975-08-21 American Optical Corp Fluessigkeitsabdichtung fuer implantierbare herzschrittmacher
DE2701104A1 (de) * 1977-01-12 1978-07-13 Medtronic France S A Herzschrittmacher
WO1979000070A1 (fr) * 1977-07-27 1979-02-22 S Joseph Stimulateur cardiaque
EP0039269A1 (fr) * 1980-04-30 1981-11-04 Medtronic, Inc. Commande de la période réfractaire du détecteur auriculaire d'un entraîneur cardiaque pour éviter sa réponse aux ondes R
US4386610A (en) * 1980-05-27 1983-06-07 Cordis Corporation Ventricular-inhibited cardiac pacer
FR2494119A1 (fr) * 1980-11-14 1982-05-21 Cordis Corp Stimulateur cardiaque programmable multimode commande par un microprocesseur
US4401119A (en) * 1981-02-17 1983-08-30 Medtronic, Inc. Prolongation of timing intervals in response to ectopic heart beats in atrial and ventricular pacemakers
US4407287A (en) * 1981-02-17 1983-10-04 Medtronic, Inc. Atrial and ventricular-only pacemaker responsive to premature ventricular contractions
US4471784A (en) * 1981-04-06 1984-09-18 Tesla Koncernovy Podnik Source of pulses for electronic suppression of pain
US4890617A (en) * 1987-11-25 1990-01-02 Medtronic, Inc. Dual chamber activity responsive pacer
USRE39897E1 (en) 1989-01-23 2007-10-23 Mirowski Family Ventures, L.L.C. Method and apparatus for treating hemodynamic disfunction
US5364337A (en) * 1990-10-15 1994-11-15 Medtronic, Inc. Muscle powered cardiac assist system
US5265601A (en) * 1992-05-01 1993-11-30 Medtronic, Inc. Dual chamber cardiac pacing from a single electrode
US7245966B2 (en) 2000-12-21 2007-07-17 Medtronic, Inc. Ventricular event filtering for an implantable medical device
WO2002051499A1 (fr) 2000-12-21 2002-07-04 Medtronic, Inc. Mode adi/r prefere de stimulation cardiaque permanente permettant de supprimer la stimulation ventriculaire tout en conservant un support auxiliaire
US6772005B2 (en) 2000-12-21 2004-08-03 Medtronic, Inc. Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support
US7881793B2 (en) 2000-12-21 2011-02-01 Medtronic, Inc. System and method for ventricular pacing with progressive conduction check interval
US20050055059A1 (en) * 2000-12-21 2005-03-10 Betzold Robert A. Ventricular event filtering for an implantable medical device
US7738955B2 (en) 2000-12-21 2010-06-15 Medtronic, Inc. System and method for ventricular pacing with AV interval modulation
US8060202B2 (en) 2000-12-21 2011-11-15 Medtronic, Inc. Ventricular event filtering for an implantable medical device
US20050177197A1 (en) * 2000-12-21 2005-08-11 Medtronic, Inc. System and method for ventricular pacing with progressive conduction check interval
US20050267539A1 (en) * 2000-12-21 2005-12-01 Medtronic, Inc. System and method for ventricular pacing with AV interval modulation
US7599740B2 (en) 2000-12-21 2009-10-06 Medtronic, Inc. Ventricular event filtering for an implantable medical device
EP2098265A2 (fr) 2000-12-21 2009-09-09 Medtronic, Inc. ADI/R préféré : Mode de stimulation permanente pour supprimer la stimulation ventriculaire tout en conservant un support d'appoint
US7130683B2 (en) 2000-12-21 2006-10-31 Medtronic, Inc. Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining back support
US7218965B2 (en) 2000-12-21 2007-05-15 Medtronic, Inc. Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support
US9931509B2 (en) 2000-12-21 2018-04-03 Medtronic, Inc. Fully inhibited dual chamber pacing mode
US20030078627A1 (en) * 2000-12-21 2003-04-24 Medtronic, Inc. Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support
US20040143299A1 (en) * 2000-12-21 2004-07-22 Medtronic, Inc. Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support
US7254441B2 (en) 2000-12-21 2007-08-07 Medtronic, Inc. Fully inhibited dual chamber pacing mode
US9375579B2 (en) 2002-09-17 2016-06-28 Medtronic, Inc. Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support
US8761905B2 (en) 2003-07-24 2014-06-24 Mirowski Family Ventures, L.L.C. Methods, apparatus, and systems for multiple stimulation from a single stimulator
US20050021096A1 (en) * 2003-07-24 2005-01-27 Mirowski Family Ventures, L.L.C. Methods, apparatus, and systems for multiple stimulation from a single stimulator
US8249725B2 (en) 2003-07-24 2012-08-21 Mirowski Family Ventures, L.L.C. Methods, apparatus, and systems for multiple stimulation from a single stimulator
US7231249B2 (en) 2003-07-24 2007-06-12 Mirowski Family Ventures, L.L.C. Methods, apparatus, and systems for multiple stimulation from a single stimulator
US9566444B2 (en) 2003-07-24 2017-02-14 Mirowski Family Ventures, L.L.C. Methods, apparatus, and systems for multiple stimulation from a single stimulator
US20070208387A1 (en) * 2003-07-24 2007-09-06 Mirowski Family Ventures, L.L.C. Methods, apparatus, and systems for multiple stimulation from a single stimulator
US20070191893A1 (en) * 2003-09-05 2007-08-16 Mirowski Family Ventures, L.L.C. Method and apparatus for providing ipselateral therapy background
US20050055057A1 (en) * 2003-09-05 2005-03-10 Mirowski Famliy Ventures, L.L.C. Method and apparatus for providing ipselateral therapy
US8744558B2 (en) 2003-09-05 2014-06-03 Mirowski Family Ventures, L.L.C. Method and apparatus for providing ipselateral therapy
US20050055058A1 (en) * 2003-09-08 2005-03-10 Mower Morton M. Method and apparatus for intrachamber resynchronization
US11207524B2 (en) 2003-09-08 2021-12-28 Mirowski Family Ventures, LLC Method and apparatus for intrachamber resynchronization
US9901739B2 (en) 2003-09-08 2018-02-27 Mirowski Family Ventures, LLC Method and apparatus for intrachamber resynchronization
US7904157B2 (en) 2004-10-25 2011-03-08 Medtronic, Inc. Self limited rate response
US20070299478A1 (en) * 2004-10-25 2007-12-27 Casavant David A Self Limited Rate Response
US7248924B2 (en) 2004-10-25 2007-07-24 Medtronic, Inc. Self limited rate response
US7542799B2 (en) 2005-01-21 2009-06-02 Medtronic, Inc. Implantable medical device with ventricular pacing protocol
US20060167506A1 (en) * 2005-01-21 2006-07-27 Stoop Gustaaf A Implantable medical device with ventricular pacing protocol
US7593773B2 (en) 2005-01-21 2009-09-22 Medtronic, Inc. Implantable medical device with ventricular pacing protocol including progressive conduction search
US20060167508A1 (en) * 2005-01-21 2006-07-27 Willem Boute Implantable medical device with ventricular pacing protocol including progressive conduction search
US8229560B2 (en) 2006-01-20 2012-07-24 Medtronic, Inc. System and method of using AV conduction timing
US7925344B2 (en) 2006-01-20 2011-04-12 Medtronic, Inc. System and method of using AV conduction timing
US20070219589A1 (en) * 2006-01-20 2007-09-20 Condie Catherine R System and method of using AV conduction timing
US20070203523A1 (en) * 2006-02-28 2007-08-30 Betzold Robert A Implantable medical device with adaptive operation
US8046063B2 (en) 2006-02-28 2011-10-25 Medtronic, Inc. Implantable medical device with adaptive operation
US9415227B2 (en) 2006-02-28 2016-08-16 Medtronic, Inc. Implantable medical device with adaptive operation
US7869872B2 (en) 2006-06-15 2011-01-11 Medtronic, Inc. System and method for determining intrinsic AV interval timing
US20110112596A1 (en) * 2006-06-15 2011-05-12 Medtronic, Inc. System and method for determining intrinsic av interval timing
US20070293897A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Promoting Instrinsic Conduction Through Atrial Timing Modification and Calculation of Timing Parameters
US20070293898A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Determining Intrinsic AV Interval Timing
US20070293899A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Ventricular Interval Smoothing Following a Premature Ventricular Contraction
US20070293900A1 (en) * 2006-06-15 2007-12-20 Sheldon Todd J System and Method for Promoting Intrinsic Conduction Through Atrial Timing
US7783350B2 (en) 2006-06-15 2010-08-24 Medtronic, Inc. System and method for promoting intrinsic conduction through atrial timing modification and calculation of timing parameters
US7894898B2 (en) 2006-06-15 2011-02-22 Medtronic, Inc. System and method for ventricular interval smoothing following a premature ventricular contraction
US7565196B2 (en) 2006-06-15 2009-07-21 Medtronic, Inc. System and method for promoting intrinsic conduction through atrial timing
US8032216B2 (en) 2006-06-15 2011-10-04 Medtronic, Inc. System and method for determining intrinsic AV interval timing
US7502646B2 (en) 2006-07-31 2009-03-10 Medtronic, Inc. Pacing mode event classification with rate smoothing and increased ventricular sensing
US7502647B2 (en) 2006-07-31 2009-03-10 Medtronic, Inc. Rate smoothing pacing modality with increased ventricular sensing
US7715914B2 (en) 2006-07-31 2010-05-11 Medtronic, Inc. System and method for improving ventricular sensing
US7689281B2 (en) 2006-07-31 2010-03-30 Medtronic, Inc. Pacing mode event classification with increased ventricular sensing
US20100174334A1 (en) * 2006-07-31 2010-07-08 Medtronic, Inc. System and method for providing improved atrial pacing based on physiological need
US7720537B2 (en) 2006-07-31 2010-05-18 Medtronic, Inc. System and method for providing improved atrial pacing based on physiological need
US7856269B2 (en) 2006-07-31 2010-12-21 Medtronic, Inc. System and method for determining phsyiologic events during pacing mode operation
US7515958B2 (en) 2006-07-31 2009-04-07 Medtronic, Inc. System and method for altering pacing modality
US20080027490A1 (en) * 2006-07-31 2008-01-31 Sheldon Todd J Pacing Mode Event Classification with Rate Smoothing and Increased Ventricular Sensing
US20080027493A1 (en) * 2006-07-31 2008-01-31 Sheldon Todd J System and Method for Improving Ventricular Sensing
US8565873B2 (en) 2006-07-31 2013-10-22 Medtronic, Inc. System and method for providing improved atrial pacing based on physiological need
US8229558B2 (en) 2009-02-27 2012-07-24 Medtronic, Inc. System and method for conditional biventricular pacing
US20100222837A1 (en) * 2009-02-27 2010-09-02 Sweeney Michael O System and method for conditional biventricular pacing
US8396553B2 (en) 2009-02-27 2013-03-12 Medtronic, Inc. System and method for conditional biventricular pacing
US8265750B2 (en) 2009-02-27 2012-09-11 Medtronic, Inc. System and method for conditional biventricular pacing
US20100222839A1 (en) * 2009-02-27 2010-09-02 Medtronic, Inc. System and method for conditional biventricular pacing
US8244354B2 (en) 2009-02-27 2012-08-14 Medtronic, Inc. System and method for conditional biventricular pacing
US20100222838A1 (en) * 2009-02-27 2010-09-02 Sweeney Michael O System and method for conditional biventricular pacing
US20100222834A1 (en) * 2009-02-27 2010-09-02 Sweeney Michael O System and method for conditional biventricular pacing

Also Published As

Publication number Publication date
BR7017673D0 (pt) 1973-03-07
GB1307912A (en) 1973-02-21
BE747983A (fr) 1970-08-31
NO126899B (fr) 1973-04-09
DE2010724A1 (de) 1970-10-15
DK130771B (da) 1975-04-14
IL33744A0 (en) 1970-03-22
ES377899A1 (es) 1972-10-16
SE356903B (fr) 1973-06-12
AT302522B (de) 1972-10-25
DE2010724B2 (de) 1980-03-20
DK130771C (fr) 1975-09-15
CH534524A (de) 1973-03-15
JPS4940992B1 (fr) 1974-11-06
DE2010724C3 (de) 1981-01-15
IL33744A (en) 1973-03-30
NL155453B (nl) 1978-01-16
NL7003205A (fr) 1970-09-29
FR2040175A5 (fr) 1971-01-15

Similar Documents

Publication Publication Date Title
US3595242A (en) Atrial and ventricular demand pacer
EP1899003B1 (fr) Systeme de stimulation neurale destine a prevenir une decharge simultanee
EP1150743B1 (fr) Stimulation antitachycardique
US9061156B2 (en) Automatic selection of stimulation chamber for ventricular resynchronization therapy
US4989602A (en) Programmable automatic implantable cardioverter/defibrillator and pacemaker system
EP0607197B1 (fr) Procede et appareil de stimulation anti-tachycardie a grande surface
US4595009A (en) Protection circuit for implantable cardioverter
US5222493A (en) Verification of capture using an indifferent electrode mounted on the pacemaker connector top
US20080046017A1 (en) Cardiac rhythm management system with staggered pulses for coordination therapy
US7421294B2 (en) System and method for preventing recurrence of atrial tachyarrhythmia
US3661158A (en) Atrio-ventricular demand pacer with atrial stimuli discrimination
US6047213A (en) Atrial tracking cardiac stimulator
US3709229A (en) Free-running atrial and demand ventricular pacer
Levine Normal and abnormal rhythms associated with dual-chamber pacemakers
US6115632A (en) Dual chamber pulse generator with periodic PMT control
US3766413A (en) Rate discrimination circuit

Legal Events

Date Code Title Description
AS Assignment

Owner name: COOK PACEMAKER CORPORATION, INDIANA

Free format text: LICENSE;ASSIGNOR:ATLANTIC RICHFIELD COMPANY;REEL/FRAME:003852/0285

Effective date: 19810327

Owner name: COOK PACEMAKER CORPORATION, P.O. BOX 99, BLOOMINGT

Free format text: LICENSE;ASSIGNOR:ATLANTIC RICHFIELD COMPANY;REEL/FRAME:003852/0285

Effective date: 19810327

AS Assignment

Owner name: TELECTRONICS PTY. LIMITED

Free format text: CONFIRMS THE GRANTING OF LICENSE AGREEMENT DATED JULY 1, 1973 SUBJECT TO CONDITIONS IN AGREEMENT DATED JANUARY 16, 1984;ASSIGNOR:HONEYWELL MEDICAL ELECTRONICS B.V.;REEL/FRAME:004436/0297

Effective date: 19850306