Leadless pacemaker system

Patent metadata

Field	Value
Publication number	US-9808633-B2
Application number	US-201213665601-A
Country	US
Kind code	B2
Filing date	Oct 31, 2012
Priority date	Oct 31, 2012
Publication date	Nov 7, 2017
Grant date	Nov 7, 2017

Abstract

A device includes a signal generator module, a processing module, and a housing. The signal generator module is configured to deliver pacing pulses to an atrium. The processing module is configured to detect a ventricular activation event and determine a length of an interval between the ventricular activation event and a previous atrial event that preceded the ventricular activation event. The processing module is further configured to schedule a time at which to deliver a pacing pulse to the atrium based on the length of the interval and control the signal generator module to deliver the pacing pulse at the scheduled time. The housing is configured for implantation within the atrium. The housing encloses the stimulation generator and the processing module.

First claim

What is claimed is:

1. A system comprising:
a ventricular pacing device configured for implantation entirely within a ventricle of a heart, the ventricular pacing device configured to sense intrinsic ventricular depolarizations and one of:
inhibit delivery of pacing pulses responsive to sensed intrinsic ventricular depolarizations; or
deliver pacing pulses to the ventricle responsive to an absence of sensed intrinsic ventricular depolarizations; and

an atrial pacing device configured for implantation entirely within an atrium of the heart, the atrial pacing device being operable without receiving communication from the ventricular pacing device and being configured to:
detect ventricular activation events; and
deliver pacing pulses to the atrium, each pacing pulse of the pacing pulses being timed based on when respective ventricular activation events are detected by the atrial pacing device.

2. The system of claim 1 , wherein the ventricular activation event arises due to one of an intrinsic ventricular depolarization or a paced ventricular event.

3. The system of claim 1 , wherein the atrial pacing device is operable without a communication link between the atrial pacing device and the ventricular pacing device.

4. A system comprising:
a ventricular pacing device configured for implantation within a ventricle of a heart, the ventricular pacing device configured to sense intrinsic ventricular depolarizations and one of:
inhibit delivery of pacing pulses responsive to sensed intrinsic ventricular depolarizations; or
deliver pacing pulses to the ventricle responsive to an absence of sensed intrinsic ventricular depolarizations; and

an atrial pacing device configured for implantation within an atrium of the heart, the atrial pacing device being operable without receiving communication from the ventricular pacing device and being configured to:
detect ventricular activation events; and
deliver pacing pulses to the atrium, each pacing pulse of the pacing pulses being timed based on when respective ventricular activation events are detected by the atrial pacing device;

wherein the atrial pacing device is configured to deliver pacing pulses at an atrial pacing rate, and wherein the ventricular pacing device is configured to deliver pacing pulses at a ventricular pacing rate that is less than the atrial pacing rate.

5. The system of claim 4 , wherein the ventricular pacing device is configured to detect intrinsic ventricular depolarizations and inhibit the delivery of a pacing pulse to the ventricle upon detection of an intrinsic ventricular depolarization, wherein the ventricular pacing rate is set such that the ventricular pacing device delivers pacing pulses to the ventricle when atrioventricular (AV) block in the heart prevents intrinsic ventricular depolarizations being precipitated by atrial depolarizations.

6. A system comprising:
a ventricular pacing device configured for implantation within a ventricle of a heart, the ventricular pacing device configured to sense intrinsic ventricular depolarizations and one of:
inhibit delivery of pacing pulses responsive to sensed intrinsic ventricular depolarizations; or
deliver pacing pulses to the ventricle responsive to an absence of sensed intrinsic ventricular depolarizations; and

an atrial pacing device configured for implantation within an atrium of the heart, the atrial pacing device being operable without receiving communication from the ventricular pacing device and being configured to:
detect ventricular activation events; and
deliver pacing pulses to the atrium, each pacing pulse of the pacing pulses being timed based on when respective ventricular activation events are detected by the atrial pacing device;

wherein the atrial pacing device is configured to:
determine a length of an interval between a ventricular activation event of the ventricular activation events and a respective previous atrial event;
schedule a time at which to deliver a pacing pulse of the pacing pulses to the atrium based on the length of the interval; and
control the delivery of the pacing pulse of the pacing pulses at the scheduled time.

7. The system of claim 6 , wherein the atrial pacing device is configured to:
sense ventricular electrical activity; and
detect the ventricular activation events by detecting the ventricular electrical activity.

8. The system of claim 7 , wherein the ventricular electrical activity comprises a far-field R-wave.

9. The system of claim 6 , wherein the atrial pacing device includes a sensor that generates signals that indicate mechanical cardiac characteristics, and wherein the atrial pacing device is configured to detect contraction of the ventricle based on the generated signals.

10. A method comprising:
sensing intrinsic ventricular depolarizations of a ventricle of a heart using a ventricular pacing device configured for implantation within the ventricle;
delivering pacing pulses to the ventricle of the heart using the ventricular pacing device responsive to an absence of the sensed intrinsic ventricular depolarizations;
detecting ventricular activation events using an atrial pacing device that is operable without receiving communication from the ventricular pacing device and configured for implantation entirely within an atrium of the heart; and
delivering, by the atrial pacing device, pacing pulses to the atrium, each pacing pulse of the pacing pulses being timed based on when respective ventricular activation events are detected by the atrial pacing device.

11. The method of claim 10 , wherein the ventricular activation events arise due to one of respective intrinsic ventricular depolarizations or respective paced ventricular events.

12. The method of claim 10 , wherein the atrial pacing device is operable without a communication link between the atrial pacing device and the ventricular pacing device.

13. A method comprising:
sensing intrinsic ventricular depolarizations of a ventricle of a heart using a ventricular pacing device configured for implantation within the ventricle;
delivering pacing pulses to the ventricle of the heart using the ventricular pacing device;
detecting ventricular activation events using an atrial pacing device that is operable without receiving communication from the ventricular pacing device and configured for implantation within an atrium of the heart;
delivering, by the atrial pacing device, pacing pulses to the atrium, each pacing pulse of the pacing pulses being timed based on when respective ventricular activation events are detected by the atrial pacing device;
delivering pacing pulses at an atrial pacing rate using the atrial pacing device; and
delivering pacing pulses at a ventricular pacing rate that is less than the atrial pacing rate using the ventricular pacing device.

14. The method of claim 13 , further comprising inhibiting the delivery of a pacing pulse to the ventricle upon detection of an intrinsic ventricular depolarization, wherein the ventricular pacing rate is set such that pacing pulses are delivered to the ventricle when atrioventricular (AV) block in the heart prevents intrinsic ventricular depolarizations being precipitated by atrial depolarizations.

15. A method comprising:
sensing intrinsic ventricular depolarizations of a ventricle of a heart using a ventricular pacing device configured for implantation within the ventricle;
delivering pacing pulses to the ventricle of the heart using the ventricular pacing device;
detecting ventricular activation events using an atrial pacing device that is operable without receiving communication from the ventric

Assignees

• Medtronic Inc

Inventors

• Bonner Matthew D
• Greenhut Saul E
• Sheldon Todd J
• Demmer Wade M

Classifications

• A61N1/37512 Primary

  Pacemakers · CPC title

• A61N1/36578

  controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone · CPC title

• A61N1/37518

  Anchoring of the implants, e.g. fixation · CPC title

• A61N1/3756 Primary

  Casings with electrodes thereon, e.g. leadless stimulators · CPC title

• A61N1/0587

  Epicardial electrode systems; Endocardial electrodes piercing the pericardium · CPC title