ATRIAL AND VENTRICULAR CAPTURE DETECTION AND THRESHOLD-SEEKING PACEMAKER

摘要

Capture detection and stimulation threshold-measurement methods and apparatu s for deriving atrial and ventricular pace pulse (A-pace and V-pace) stimulati on energy strength-duration data. In a first atrial and ventricular threshold test regimen for use with patients having intact A-V conduction of first degree AV block, A-pace pulses are delivered at a test escape interval and A -V delay. Atrial loss of capture (ALOC) in response to an A-pace test stimulus is declared by the absence of a detected ventricular depolarization (V-event) i n the latter portion of the paced A-V delay interval following the delivery of the A-pace test stimulus. In the ventricular threshold test regimen, a V-pac e test stimulus is delivered after a shortened A-V delay. Ventricular loss of capture (VLOC) is declared by the detection of a V-event in the ventricular refractory period of the V-pace test stimulus. In a second algorithm for use in the atrium or ventricle in patients having regular measured sinus rhythm, premature A-pace or V-pace test stimuli are delivered, and the presence of a n A-event or V-event at the end of the measured sinus escape interval is declared to be ALOC or VLOC, respectively. A-pace and V-pace test stimuli ar e repeated to confirm capture declarations at an energy exceeding the LOC test energy. The atrial and ventricular stimulation threshold data derived by varying both pulse amplitude (strength) and width (duration) is stored in memory for telemetry out and analysis and for use in setting the V-pace and A- pace normal pulse width and amplitude used between successive auto-capture tests in order to conserve battery energy.