AV SYNCHRONOUS CARDIAC PACING SYSTEM DELIVERING MULTI-SITE VENTRICULAR PACING TRIGGERED BY A VENTRICULAR SENSE EVENT DURING THE AV DELAY

摘要

A pacing system for selectively sensing spontaneous ventricular cardiacdepolarizations at first and second spaced apart ventricular sites during thetime-out of an AV delay and delivering pace pulses to the spaced apartventricular sites in a triggered pacing mode. The first and second ventricularsites are preferably right ventricular (RV) and left ventricular (LV)pace/sense electrode sites, and RV event and LV event signals are sensed atthe RV and LV pace/sense electrodes A V-A pacing escape interval and aventricular refractory period, a trigger pace window, an upper rate intervaland further post-event time periods are started upon a RV or LV sense event ora first ventricular pace pulse delivered upon time-out of the AV delay. Atriggered ventricular pace pulse or pulses is delivered to one or both of theRV and LV pace/sense electrode sites upon detecting an RV sense event or LVsense event during the AV delay. In one triggered pacing mode, a RV or LV pacepulse is delivered upon a RV or LV sense event during the AV delay to one ofthe RV or LV pace/sense electrode sites. In another triggered pacing mode, atriggered pace pulse is delivered to the other one of the RV or LV pace/senseelectrode sites after a triggered pacing delay timed from a non-refractory RVor LV sense event occurring during the AV delay. In still another triggeredpacing mode, a first pace pulse is delivered upon a RV or LV sense event, thetriggered pacing delay is timed out, and a second pace pulse is delivered tothe other one of the RV or LV pace/sense electrode sites after time-out of thetriggered pacing delay. Triggered ventricular pacing is disabled during the V-A escape interval. Such a system could be employed in pacemakers that are partof a cardio defibrillator system if desired.