DEVICES AND METHODS FOR ADJUSTING PACING RATES IN AN IMPLANTABLE MEDICAL DEVICE

摘要

Systems, devices, and methods are disclosed for limiting the duration of elevated pacing rates in an implantable medical device. An illustrative device may include a housing, a plurality of electrodes connected to the housing, and a controller within the housing and connected to the electrodes. The controller may deliver pacing pulses to the electrodes at a base pacing rate, detect a measure of elevated metabolic demand which may vary over time, deliver pacing pulses at an elevated pacing rate based on the measure of elevated metabolic demand. The controller may change a heart stress tracking value (HSTV) when the pacing rate is elevated and may be changed faster during times of relatively higher elevated pacing rates than times of relatively lower elevated pacing rates. The elevated pacing rate may be reduced back toward the base pacing rate after the HSTV crossed a predetermined heart stress threshold.

主权项

1. A Leadless Cardiac Pacemaker (LCP) comprising:
an outer housing; a plurality of exposed electrodes connected relative to the outer housing; and a controller disposed within the outer housing and operatively connected to the plurality of exposed electrodes, wherein the controller is configured to:
deliver pacing pulses via the plurality of exposed electrodes at a base pacing rate;detect a measure of metabolic demand, wherein the measure of metabolic demand varies over time;deliver pacing pulses at an elevated pacing rate relative to the base pacing rate after determining an elevated metabolic demand with respect to a base measure of metabolic demand, wherein the elevated pacing rate varies with time and is dependent on the detected measure of metabolic demand;change a heart stress tracking value during times when pacing pulses are delivered at the elevated pacing rate, wherein the heart stress tracking value is changed faster during times when higher elevated pacing rates are delivered relative to times when lower elevated pacing rates are delivered; anddetermine if the heart stress tracking value crosses a predetermined heart stress threshold, and if so, reduce the elevated pacing rate back toward the base pacing rate.