Variable shortening of AV delay for treatment of cardiac disease

摘要

An implantable pacing device for delivering ventricular pacing may be configured to intermittently and variably reduce the AV delay interval used in an atrial triggered pacing mode in a manner that simulates exercise. The device may be programmed to intermittently switch to and from a variably shortened AV delay mode according to defined entry and exit conditions.

主权项

1. A cardiac device, comprising:
pulse generation circuitry for delivering pacing pulses to one or more ventricular sites; sensing circuitry for receiving electrogram signals from atrial and ventricular electrodes and detecting atrial and ventricular senses; a controller interfaced to the pulse generation and sensing circuitry for controlling the operation of the device in accordance with programmed instructions and programmed to operate in either a normal operating mode or variably shortened AV delay (VSAVD) mode; a respiratory sensor interfaced to the controller; wherein, in the normal operating and VSAVD modes, the controller is programmed to deliver ventricular paces to the one or more ventricular sites in an atrial-triggered pacing mode in which the ventricular paces are delivered upon expiration of an AV delay interval that is triggered by an atrial sense or pace and stopped by a ventricular sense or pace; wherein, in the VSAVD mode, the controller is programmed to shorten the value of the AV delay interval from a normal AV delay value used in the normal operating mode and further programmed to vary the value of the AV delay interval about the shortened value while the VSAVD mode is operative by shortening the AV delay with inspiration and lengthening the AV delay with expiration; and, wherein the controller is programmed to intermittently switch from the normal operating mode to the VSAVD mode according to a one or more specified entry conditions and switch from the VSAVD mode to the normal operating mode according to one or more specified exit conditions.