CN105268101B - The mode conversion method of high reliability and the Implanted cardiac pacemaker of low-power consumption - Google Patents
The mode conversion method of high reliability and the Implanted cardiac pacemaker of low-power consumption Download PDFInfo
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- CN105268101B CN105268101B CN201510571112.7A CN201510571112A CN105268101B CN 105268101 B CN105268101 B CN 105268101B CN 201510571112 A CN201510571112 A CN 201510571112A CN 105268101 B CN105268101 B CN 105268101B
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Abstract
The invention discloses a kind of high reliability and the mode conversion method of the Implanted cardiac pacemaker of low-power consumption, comprise the following steps：1) pacemaker works in DDD mode, between AV in the phase, closes the atrial sense function of pacemaker；2) the VP_AR_AS sequences for continuously detecting, when time value is respectively less than the phase between patten transformation frequency between the AR_AS in each VP_AR_AS sequences, then PVARP is extended between next AV in the phase, the PVARP after extension is set to be equal to phase average value between VP_AR_AS, and normal AS events are made to fall into PVARP and be changed into AR events, AS events be present in atrial sense phase after PVARP extends, and have a phase between AR_AS to be less than the phase between patten transformation frequency, then the symptom of atrial fibrillation occurs in patient.The present invention can accurately, quickly judge whether patient the symptom of atrial fibrillation occurs, and reliability is higher, and low in energy consumption.
Description
Technical field
The invention belongs to technical field of medical instruments, is related to a kind of mode conversion method of Implanted cardiac pacemaker, tool
Body is related to a kind of mode conversion method of the Implanted cardiac pacemaker of high reliability and low-power consumption.
Background technology
Atrial fibrillation is one of symptom of most common arrhythmia cordis.When patient shows atrial fibrillation symptom, although there is upper limit frequency
The limitation of rate, but ventricle can still be paced with higher frequency, patient is produced significant discomfort sense.Automate the mould of pacemaker
Formula translation function can realize the DDI followed from the DDD that atrium follows to non-atrial patten transformation, make ventricular rate held stationary shape
State.
What earliest implementation pattern was changed is the method for " phase between detection AA ".It is by gathering time value between AA, with patten transformation
Between frequency the phase relatively after, confirm patient whether there is atrial fibrillation symptom.But due to not detecting atrial wave in PVAB, it may cause to examine
Phase is inaccurate between the AA measured, show that the conclusion of atrial fibrillation is probably inaccurate by the phase between detecting AA.For example work as atrial rate
When higher, might have an intrinsic atrial ripple and fall into PVAB, the atrial rate for making to measure only is the half of actual value, cause by
DDD to DDI patten transformation can not be normally carried out.
United States Patent (USP) PACEMAKER FOR TACHY DETERMINATION BASED ON BLOCKED 2:1SENSING
Disclosed " blank forward delivery housing flutters search " function, it is a supplement for " phase between detection AA " function in patten transformation.By adopting
Collect the phase between continuous AA, when meeting following two conditions：First, AA<2 × (phase+PVAB between AV)；Second, AA/2<Pattern turns
The phase between frequency is changed, " blank forward delivery housing flutters search " function can effectively determine whether there is intrinsic atrial event and fall into PVAB, finally
Confirm whether atrial fibrillation occurs, and the implementation pattern translation function after atrial fibrillation is confirmed.
But to higher atrial fibrillation heart rate, might have an intrinsic atrial event fall into PVAB and then occur AR with
AS events, i.e. atrial event sequence are AS- (AS)-AR-AS, wherein (AS) is to fall can not be perceived by pacemaker in PVAB
Atrial event, remaining atrial event can be perceived by pacemaker.Due to the presence of AR events, " blank forward delivery housing flutters search " function is by nothing
Method works.At this moment can only be changed by detecting the method for phase between AA come implementation pattern：It can be counted in the phase between each and obtain two
Time value between AA, i.e. AS_AR and AR_AS.Wherein, AS_AR is 2 times of time value between true AA.Now, if AS_AR>Patten transformation frequency
Phase (slow atrial rate) between rate, and AR_AS<Phase (fast atrial rate) between patten transformation frequency, then pacemaker is possibly correctly to identify
The high atrial rate event of this group, so as to which mistake thinks atrial fibrillation does not occur；And the power consumption of prior art is higher, so that heart rises
Fight device service life reduce.
The content of the invention
A kind of the shortcomings that it is an object of the invention to overcome above-mentioned prior art, there is provided the plant of high reliability and low-power consumption
Enter the mode conversion method of formula pacemaker, this method can accurately, quickly judge whether patient the symptom of atrial fibrillation occurs, can
It is higher and low in energy consumption by property, service life length.
To reach above-mentioned purpose, the pattern of the Implanted cardiac pacemaker of high reliability of the present invention and low-power consumption turns
The method of changing comprises the following steps：
1) pacemaker works in DDD mode, between AV in the phase, closes the atrial sense function of pacemaker；
2) for the VP_AR_AS sequences continuously detected, when time value is small between the AR_AS in each VP_AR_AS sequences
The phase between patten transformation frequency, then PVARP is extended in the phase between next AV, the PVARP after extension is equal between VP_AR_AS
Phase average value, this causes normal AS events to fall into PVARP and be changed into AR events；Atrial sense after PVARP extends
AS events in phase be present, and have a phase between AR_AS to be less than the phase between patten transformation frequency, then the symptom of atrial fibrillation occurs in patient；When
AS events be present in the atrial sense phase after PVARP extensions, and between AR_AS the phase be more than or equal to the phase between patten transformation frequency, then
Patient does not occur the symptom of atrial fibrillation；AS events are not present in atrial sense phase after PVARP extends, then patient does not go out existing apartment
The symptom quivered.
When the symptom of atrial fibrillation occurs in patient, pacemaker is converted to DDI mode from DDD mode；When patient does not go out existing apartment
During the symptom quivered, pacemaker works in DDD mode.
The invention has the advantages that：
The mode conversion method of high reliability of the present invention and the Implanted cardiac pacemaker of low-power consumption when in use,
Judge to whether there is intrinsic atrial event in PVAB by detecting VP_AR_AS sequences and extending PVARP method, and close AV
Between atrial sense function in the phase, simplify correlation computations, power consumption is relatively low, extends the service life of pacemaker.In addition,
The present invention extended with PVARP after the atrial sense phase in the phase be present between AS events and AR_AS and be less than between patten transformation frequency
Phase is according to judging that the symptom of atrial fibrillation occurs in patient, and reliability is significantly improved.
Brief description of the drawings
Fig. 1 is the schematic diagram of implementation pattern of the present invention conversion；
Fig. 2 (a) is the schematic diagram that phase function implementation pattern is changed between detection AA in existing method；
Fig. 2 (b) is the schematic diagram that existing method blank forward delivery housing flutters the conversion of function of search implementation pattern；
Fig. 2 (c) is the schematic diagram of existing method leak present in patten transformation；
Fig. 3 (a) is that existing method realizes the flow chart that DDI mode is transformed into by DDD mode；
Fig. 3 (b) is the flow chart that present invention realization is converted to DDI mode by DDD mode；
Fig. 4 (a) is the relation of two methods when prior art implementation pattern is changed；
Fig. 4 (b) is the relation that the present invention flutters search with blank forward delivery housing when implementation pattern is changed.
Embodiment
The present invention is described in further detail below in conjunction with the accompanying drawings：
Firstly, it is necessary to illustrate, the AR in the present invention represents that atrial refractory period perceives；AS represents atrial sense；AP tables
Show auricular pacemaking；VS represents ventricular sense；VP represents ventricular pacemaking；PVC represents VPB；Atrium is empty after PVAB represents ventricle
Bai Qi；PVARP represents atrial refractory period after ventricle.
The mode conversion method of the Implanted cardiac pacemaker of Fig. 1, high reliability of the present invention and low-power consumption includes
Following steps：
1) pacemaker works in DDD mode, between AV in the phase, closes the atrial sense function of pacemaker；
2) for the VP_AR_AS sequences continuously detected, when time value is small between the AR_AS in each VP_AR_AS sequences
The phase between patten transformation frequency, then PVARP is extended in the phase between next AV, the PVARP after extension is equal between VP_AR_AS
Phase average value, this causes normal AS events to fall into PVARP and be changed into AR events；Atrial sense after PVARP extends
AS events in phase be present, and have a phase between AR_AS to be less than the phase between patten transformation frequency, then the symptom of atrial fibrillation occurs in patient；When
AS events be present in the atrial sense phase after PVARP extensions, and between AR_AS the phase be more than or equal to the phase between patten transformation frequency, then
Patient does not occur the symptom of atrial fibrillation；AS events are not present in atrial sense phase after PVARP extends, then patient does not go out existing apartment
The symptom quivered.
With reference to figure 2 (a), in existing method, when atrial rate is very fast, an AR event is will appear from the phase between each.When adopting
Between the AA collected phase be less than patten transformation frequency between the phase when, emergence pattern is changed.Such as the phase between the AA that is counted in Fig. 2 (a)：
AS_AR and AR_AS is respectively less than the phase between patten transformation frequency.
With reference to figure 2 (b), in existing method, when atrial rate accelerates, above-mentioned AR events no longer occur, and the substitute is
One intrinsic atrial event for falling into PVAB.Phase (AS_AS) time value between true AA between the AA that phase function counts between detection AA
2 times, if but between the AA that now counts on the phase be more than the phase between patten transformation frequency, as shown in Fig. 2 (b), then phase between detection AA
Function can not implementation pattern conversion.Blank forward delivery housing, which flutters function of search, can effectively confirm intrinsic atrial event in PVAB, from
And complete patten transformation.
With reference to figure 2 (c), in existing method, when atrial rate further accelerates, within the phase between one, can go out in PVAB
An existing intrinsic atrial event not perceived, and then there is AR events and AS events, due to the presence of AR events, blank forward delivery housing
Flutterring function of search will no longer work, and phase function can count on the phase between two AA within the phase between one between detecting AA：That is AS_AR with
AR_AS, the former is 2 times of the phase between true AA, the latter's phase between true AA, if there is the situation such as Fig. 2 (c)：That is the phase between AS_AR
More than the phase between patten transformation frequency, and AR_AS is less than the phase between patten transformation frequency, then pacemaker can not correctly identify this group height
Atrial rate event, so as to which mistake thinks atrial fibrillation does not occur.
With reference to figure 3 (a), existing method depends on two kinds of functions：Phase function flutters function of search with blank forward delivery housing between detection AA.
Phase function is in running order all the time between detecting AA；When without AR, blank forward delivery housing flutters function of search also by work, and finally judges
Whether atrial fibrillation is occurred.Existing method has the following disadvantages：1) decision condition of patten transformation obscures, and as shown in Fig. 2 (c), works as sky
White forward delivery housing is flutterred function of search and not worked, while when detecting time value inaccuracy between the AA that phase function between AA is gathered, judges whether to send out
The conclusion of raw atrial fibrillation is insecure；2) compute repeatedly, when not occurring AR events in the relative refractory period of atrium, detect the phase between AA
Function is flutterred function of search with blank forward delivery housing while worked.And it is final in the event of patten transformation, must be by one of two kinds of functions
Determine, that is, there is One function flogging a dead horse.
With reference to figure 3 (b), sequential is divided into two classes by the present invention：There are AR events and without AR events.When there is AR, pass through this
Invention implementation pattern is changed；During without AR, function of search implementation pattern is flutterred by blank forward delivery housing and changed.The advantage of the invention is that：
1) reliability of patten transformation is improved.The present invention may replace phase function between the detection AA in conventional method.The present invention is using inspection
The methods of surveying VP_AR_AS sequences, extension PVARP, demonstrates an intrinsic atrial thing whether is truly present in PVAB from side
Part, thus the conclusion reliability made is higher；2) avoid and compute repeatedly.The present invention works when there are AR events, and blank
Forward delivery housing is flutterred function of search and worked when occurring without AR, both independently of each other, from operating efficiency for, the knot of both the above function
Close undoubtedly efficient；3) low-power consumption, avoid computing repeatedly, reduce power consumption to a certain extent, the present invention is by extending PVARP
The patten transformation of realization, it is not necessary to open the atrial sense function in the phase between AV；And phase function is then depended between AV between detecting AA
Atrial sense function in phase, thus the present invention can be effectively reduced power consumption.
With reference to figure 4 (a), the implementation pattern conversion of conventional method flutters function of search by phase function between detecting AA with blank forward delivery housing
Complete, when atrial fibrillation occurs, may be changed by phase function implementation pattern between detecting AA；Function of search reality may be flutterred by blank forward delivery housing
Existing patten transformation；It is also possible to two kinds of functions while works, and finally by first meeting that the function implementation pattern of switch condition is changed.
With reference to figure 4 (b), the present invention and blank forward delivery housing flutter function of search and detect the precondition main region of phase function between AA
Do not show AR events whether occur：Occur, then function operation of the present invention；Occur without, then blank forward delivery housing flutters function of search work
Make.Therefore in any situation all without the situation for the work simultaneously of two kinds of functions occur, thus its operating efficiency increases.
Claims (2)
- A kind of 1. mode conversion method of high reliability and the Implanted cardiac pacemaker of low-power consumption, it is characterised in that including with Lower step：1) pacemaker works in DDD mode, between AV in the phase, closes the atrial sense function of pacemaker；2) the VP_AR_AS sequences occurred for continuous detection, when time value is respectively less than between the AR_AS in each VP_AR_AS sequences Phase between patten transformation frequency, then PVARP is extended in the phase between next AV, the PVARP after extension is equal to the phase between VP_AR_AS Average value, and normal AS events is fallen into PVARP and is changed into AR events, in atrial sense phase after PVARP extends AS events be present, and have a phase between AR_AS to be less than the phase between patten transformation frequency, then the symptom of atrial fibrillation occurs in patient；Work as PVARP AS events in the atrial sense phase after extension be present, and between AR_AS the phase be more than or equal to the phase between patten transformation frequency, then patient is not There is the symptom of atrial fibrillation；AS events are not present in atrial sense phase after PVARP extends, then patient does not occur the disease of atrial fibrillation Shape.
- 2. the mode conversion method of high reliability according to claim 1 and the Implanted cardiac pacemaker of low-power consumption, its It is characterised by, when the symptom of atrial fibrillation occurs in patient, pacemaker is converted to DDI mode from DDD mode；When patient does not go out existing apartment During the symptom quivered, pacemaker works in DDD mode.
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN106377841B (en) * | 2016-11-28 | 2019-02-15 | 乐普医学电子仪器股份有限公司 | A method of improving dual chamber pacemaker atrium Interference Detection window interference free performance |
| CN109589499B (en) * | 2018-12-06 | 2020-09-15 | 创领心律管理医疗器械（上海）有限公司 | Cardiac pacing system |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1275413A1 (en) * | 1995-09-29 | 2003-01-15 | Medtronic, Inc. | Pacemaker tachy determination based on blocked 2:1 sensing |
| CN101102811A (en) * | 2005-01-21 | 2008-01-09 | 麦德托尼克公司 | Implantable medical device with ventricular pacing protocol |
| CN101472647A (en) * | 2006-06-15 | 2009-07-01 | 麦德托尼克公司 | System and method for promoting intrinsic conduction through atrial timing |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7130683B2 (en) * | 2000-12-21 | 2006-10-31 | Medtronic, Inc. | Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining back support |
| US7580740B2 (en) * | 2005-05-11 | 2009-08-25 | Cardiac Pacemakers, Inc. | Atrial tachyarrhythmia detection using selected atrial intervals |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1275413A1 (en) * | 1995-09-29 | 2003-01-15 | Medtronic, Inc. | Pacemaker tachy determination based on blocked 2:1 sensing |
| CN101102811A (en) * | 2005-01-21 | 2008-01-09 | 麦德托尼克公司 | Implantable medical device with ventricular pacing protocol |
| CN101472647A (en) * | 2006-06-15 | 2009-07-01 | 麦德托尼克公司 | System and method for promoting intrinsic conduction through atrial timing |
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Address after: 721006 Ying Da Road, Weibin District, Baoji, Shaanxi Province, No. 18 Applicant after: Le Pu medical electronic instrument Limited by Share Ltd Address before: 721006 Ying Da Road, Shaanxi, Baoji, No. 18 Applicant before: Qinming Medical Instruments Co., Ltd., Shaanxi |
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