Variable rate pacemaker having upper rate limit governor based on hemodynamic performance

摘要

A rate adaptive pacemaker of the type having a variable rate cardiac stimulating pulse generator (32) and a sensor for monitoring some physiologic parameter (18) whereby the pulse generator stimulating rate can be adjusted to meet physiologic demand is further provided with a hemodynamic sensor (34) which is operative to provide an output signal representing the pumping performance of the heart in response to the pacing stimulation. The signal from the hemodynamic sensor (34) is processed and then used in an algorithm to determine whether further rate increase should be permitted based upon whether the rate increase would be accompanied by a further increase in cardiac output, a plateau or a decrease in cardiac output. Hence, the adaptive rate pacemaker is provided with a real-time, hemodynamic maximum pacing rate instead of a pre-programmed, fixed, maximum rate.