Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support

摘要

A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).

主权项

1. A method of promoting an atrial-based pacing modality, comprising the steps of:
pacing an atrial chamber of a heart pursuant to an atrial-based pacing modality; detecting a ventricular response from the pacing; and based on a predetermined criteria, determining whether a relatively reliable AV conduction condition exists: if the relatively reliable conduction condition is present, continuing the atrial-based pacing modality, and if the relatively reliable conduction condition is not present, switching to a dual-chamber pacing modality; in the event that the ventricular response is a PVC, switching the pacing modality to a dual-chamber pacing modality for at least one cardiac cycle or for a predetermined period of time; determining a number of pacing modality switches that have occurred during the predetermined period of time; and in the event that the number of pacing modality switches exceeds a predetermined threshold number, then continuing the dual-chamber pacing modality without performing a step of determining whether relatively reliable AV conduction condition is present and discontinuing the pacing modality switching, and
in the event that the number of mode switches do not exceed the predetermined threshold number, then repeatedly performing the step of detecting whether relatively reliable AV conduction condition is present.