Leadless dual-chamber pacing system and method

Patent metadata

Field	Value
Publication number	US-9522280-B2
Application number	US-201514931698-A
Country	US
Kind code	B2
Filing date	Nov 3, 2015
Priority date	Nov 3, 2014
Publication date	Dec 20, 2016
Grant date	Dec 20, 2016

Abstract

In accordance with an embodiment, a system and method is provided for providing communications between first and second implantable medical devices (IMDs). The system comprises a first implantable medical device (IMD) configured to transmit a first event message during or preceding a first cardiac cycle, and a second IMD configured to receive the first event message, wherein receipt of the first event message configures the second IMD to generate pacing pulses for only a predetermined number (“n”) of consecutive cardiac cycles, wherein n is an integer equal to or greater than 2. The method comprises transmitting a first event message during or preceding a first cardiac cycle from the first IMD, receiving the first event message at the second IMD, in response to receiving the first event message, arming the second IMD to generate a pacing pulse for a second cardiac cycle, and arming the second IMD to generate a pacing pulse for only a predetermined number of consecutive cardiac cycles immediately subsequent to the second cardiac cycle.

First claim

What is claimed is:

1. A cardiac pacing system comprising:
a first implantable medical device (IMD) configured to transmit a first event message during or preceding a first cardiac cycle; and
a second IMD configured to receive the first event message, wherein receipt of the first event message configures the second IMD to generate pacing pulses for only a predetermined number (“n”) of consecutive cardiac cycles, wherein n is an integer equal to or greater than 2, wherein the second IMD comprises a first escape interval timer and a second escape interval timer, and wherein receipt of the first event message:
configures the second IMD to initiate the first escape interval timer to generate a first pacing pulse, and
configures the second IMD to initiate the second escape interval timer for only a predetermined number of one or more subsequent consecutive cardiac cycles to generate one or more subsequent pacing pulses for the one or more subsequent consecutive cardiac cycles, wherein the second IMD is configured to initiate the second escape interval timer so as to configure the second IMD to generate a subsequent pacing pulse during only m immediately subsequent cardiac cycles, where m is an integer between one and ten.

2. The cardiac pacing system of claim 1 , wherein the second IMD is further configured to sense one or more intrinsic cardiac events, and wherein receipt of the first event message configures the second IMD to initiate the second escape interval timer upon either:
generation of one or more subsequent pacing pulses by the second IMD, or sensing one or more intrinsic cardiac events by the second IMD during the one or more subsequent consecutive cardiac cycles.

3. The cardiac pacing system of claim 1 , wherein the first IMD is configured to generate a pacing pulse and sense an intrinsic cardiac event, and wherein the first IMD is configured to transmit the first event message substantially concurrent with either:
generation of a pacing pulse using the first IMD, or
sensing the intrinsic cardiac event using the first IMD.

4. The cardiac pacing system of claim 1 , wherein:
the first IMD is a leadless cardiac pacemaker configured to be implanted within a ventricle of a human heart (ventricular LP) to generate pacing pulses at a target pacing rate of the cardiac pacing system,
the second IMD is a leadless cardiac pacemaker configured to be implanted within an atrium of the human heart (atrial LP) to generate pacing pulses at the target pacing rate of the cardiac pacing system,
the cardiac pacing system is operable to change between a ventricular only operating mode, an atrial only operating mode, and a dual chamber operating mode,
only the atrial LP is configured to change the target pacing rate of the cardiac pacing system when the cardiac pacing system is in an atrial only operating mode, and
only the ventricular LP is configured to change the target pacing rate of the cardiac pacing system when the cardiac pacing system is in a ventricular only operating mode or a dual chamber operating mode.

5. The cardiac pacing system of claim 1 , wherein:
first IMD is a leadless cardiac pacemaker configured to be implanted within a ventricle of a human heart (ventricular LP),
the second IMD is a leadless cardiac pacemaker configured to be implanted within an atrium of the human heart (atrial LP),
the ventricular LP is configured to implement all rate responsive operations of the cardiac pacing system except functions and operations that wholly or in part manage one or more of the PVARP timer, automatic mode switching (AMS), premature ventricular contraction (PVC) response, pacemaker mediated tachycardia (PMT) response, and
the atrial LP is configured to implement the functions and operations of the cardiac pacing system that wholly or in part manage one or more of the PVARP timer, automatic mode switching (AMS), premature ventricular contraction (PVC) response, pacemaker mediated tachycardia (PMT) response.

6. The cardiac pacing system of claim 1 , wherein:
the first IMD is a leadless cardiac pacemaker configured to be implanted within a ventricle of a human heart (ventricular LP),
the second IMD is a leadless cardiac pacemaker configured to be implanted within an atrium of the human heart (atrial LP),
the first escape interval timer is a ventricular-to-atrial escape interval (VAEI) timer, and
the second escape interval timer is an atrial-to-atrial escape interval (AAEI) timer.

7. The cardiac pacing system of claim 1 , wherein:
the first IMD is further configured to deliver pacing pulses,
the second IMD is further configured to transmit event messages, and
at least one of the first or the second IMDs are configured to transmit event messages immediately preceding delivering pacing pulses in order to prepare the IMD receiving event messages for delivery of pacing pulses.

8. The cardiac pacing system of claim 1 , further comprising an
external device, and wherein the first IMD is further configured to:
repeatedly send the first event message to the second IMD at a first interval; and
send a transmission to the external device (“i2p transmission”) at a second interval, wherein the second interval is different from the first interval.

9. A cardiac pacing system comprising:
a first implantable medical device (IMD) configured to transmit a first event message during or preceding a first cardiac cycle; and
a second IMD configured to receive the first event message, wherein receipt of the first event message configures the second IMD to generate pacing pulses for only a predetermined number (“n”) of consecutive cardiac cycles, wherein n is an integer equal to or greater than 2, wherein the second IMD is configured to inhibit generation of a pacing pulse when the second IMD fails to receive the first event message within n cardiac cycles immediately preceding the first cardiac cycle.

10. The cardiac pacing system of claim 9 , wherein the first event message further comprises rate information, and wherein the rate information is at least one of: a target pacing rate, a target pacing interval, or a change in target pacing rate.

11. A cardiac pacing system comprising:
a first implantable medical device (IMD) configured to transmit a first event message during or preceding a first cardiac cycle; and
a second IMD configured to receive the first event message, wherein receipt of the first event message configures the second IMD to generate pacing pulses for only a predetermined number (“n”) of consecutive cardiac cycles, wherein n is an integer equal to or greater than 2, wherein the second IMD comprises a first escape interval timer and a second escape interval timer, and wherein receipt of the first event message:
configures the second IMD to initiate the first escape interval timer to generate a first pacing pulse, and
configures the second IMD to initiate the second escape interval timer for only a predetermined number of one or more subsequent consecutive cardiac cycles to generate one or more subsequent pacing pulses for the one or more subsequent consecutive cardiac cycles, wherein:
the first IMD is further configured to transmit a second event message during a cardiac cycle subsequent to the first cardiac cycle,
the second IMD is further configured to receive the second event message,
receipt of the second event message cancels the second escape interval timer and reinitiates the first escape interval timer of the second IMD, and
the second IMD is further configured to generate a pacing pulse for a second cardiac cycle on expiration of the first escape interval timer.

12. A cardiac pacing system comprising:
a first implantable medical devic

Assignees

• Pacesetter Inc

Inventors

• Fishler Matthew G
• Persson Benjamin T
• Gurunathan Suresh
• Chin Donald
• Swift Stephen J

Classifications

• A61N1/37288 Primary

  Communication to several implantable medical devices within one patient · CPC title

• A61N1/3622

  comprising two or more electrodes co-operating with different heart regions · CPC title

• A61N1/36514

  controlled by a physiological quantity other than heart potential, e.g. blood pressure (controlled by two or more physical parameters A61N1/36585) · CPC title

• A61N1/3702

  Physiological parameters (A61N1/365 takes precedence; evoked response A61N1/371) · CPC title

• H04W56/001

  Synchronization between nodes · CPC title