WO2016131349A1 - 一种治疗心律失常的医疗设备 - Google Patents

一种治疗心律失常的医疗设备 Download PDF

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Publication number
WO2016131349A1
WO2016131349A1 PCT/CN2016/070510 CN2016070510W WO2016131349A1 WO 2016131349 A1 WO2016131349 A1 WO 2016131349A1 CN 2016070510 W CN2016070510 W CN 2016070510W WO 2016131349 A1 WO2016131349 A1 WO 2016131349A1
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Prior art keywords
atrial
pacing
interval
control unit
event
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PCT/CN2016/070510
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English (en)
French (fr)
Inventor
熊建劬
黎贵玲
黄敏
陈欣欣
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上海微创医疗器械（集团）有限公司
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Application filed by 上海微创医疗器械（集团）有限公司 filed Critical 上海微创医疗器械（集团）有限公司
Priority to ES16751880T priority Critical patent/ES2745692T3/es
Priority to US15/550,634 priority patent/US10420946B2/en
Priority to EP16751880.2A priority patent/EP3260165B1/en
Publication of WO2016131349A1 publication Critical patent/WO2016131349A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/025—Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
    • A61N1/3622—Heart stimulators for treating or preventing abnormally high heart rate comprising two or more electrodes co-operating with different heart regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
    • A61N1/3682—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions with a variable atrioventricular delay

Definitions

  • the present invention relates to the field of medical device technology, and in particular to a medical device for treating arrhythmia.
  • Cardiac pacemaker is an electronic therapeutic device implanted in the body.
  • the pulse generator distributes the electric pulse that is powered by the battery.
  • the myocardial contacted by the electrode is stimulated, and the heart is excited and contracted. In order to achieve the purpose of treating cardiac dysfunction caused by certain arrhythmias.
  • DDD pacemakers sense and pace the atria and ventricles. But inappropriate pacing can cause some bad events.
  • Atrial pacing pulse occurs during atrial vulnerability
  • arrhythmia such as atrial tachycardia may be induced. This phenomenon often occurs in two types of situations:
  • NCAP Non-Competitive Atrial Pacing
  • the minimum lower limit frequency is larger, and the ventricular frequency is lower than the lowest lower limit frequency when the atrial refractory period is longer after ventricular pacing.
  • the present invention provides a medical device for treating arrhythmia, comprising: a microprocessor and a digital/analog module connected to the microprocessor; the microprocessor comprising a main control unit and a time control unit
  • the digital/analog module includes a pacing control/generating unit and a sensing control/amplifying unit; the time control unit includes at least a first timing unit and a second timing unit, wherein
  • the main control unit sets the medical device for treating arrhythmia in a DVI (R) mode of operation:
  • the main control unit After receiving the signal that the sensing control/amplifying unit senses an atrial event, the main control unit sets an atrial pacing suppression interval after the atrial sensing event, and sends a signal to the time control unit to control the first timing.
  • the unit enters a timing mode for a period of atrial pacing suppression after the atrial sensing event; if the expected ventricular pacing escape interval occurs, the atrial pacing suppression interval occurs after the atrial sensing event
  • the main control unit sends a signal to the sensing control/amplifying unit and the time control unit, notifying the pacing control/generating unit to issue a pacing pulse, and controlling the second timing unit to set the next interventricular period as the next ventricle a pacing escape interval; if the expected ventricular pacing escape interval occurs during an atrial pacing suppression interval after the atrial sensing event, the primary control unit sends a signal to the time control unit to control the The second timing unit sets the next interventricular interval as the next
  • the main control unit after receiving the signal that the sensing control/amplifying unit senses an atrial event, acquires whether the atrial pacing suppression function is set after the atrial sensing event is acquired. If the information is turned on, the main control unit sets an atrial pacing suppression interval after the atrial sensing event, and sends a signal to the time control unit to control the first timing unit to enter the timing mode, and the duration is the The atrial pacing suppression interval after the atrial perception event.
  • the atrial sensing event During the post-atrial pacing suppression interval, if the signal that the perceptual control/amplification unit perceives the atrial event is received again, the main control unit sends a signal to the time control unit to control the first timing unit to restart timing.
  • the duration is the atrial pacing suppression interval after the atrial perception event.
  • the start time of the atrial pacing suppression interval after the atrial sensing event is the time at which the atrial event is perceived.
  • the main control unit sets an atrial pacing suppression interval after an atrial sensing event, the type flag of the interval is simultaneously set.
  • the main control unit clears the type flag of the interval after the atrial pacing suppression interval expires after the atrial sensing event.
  • the interval type flag indicates that the atrial pacing suppression interval is after the atrial sensing event; otherwise, the atrium after the atrial sensing event is marked. The pacing is suppressed outside the interval.
  • the main control unit marks a virtual atrial pacing event and inhibiting the expected atrial pacing; if the ventricular pacing escape interval expires after the atrial pacing suppression interval, the primary control unit marks a A true atrial pacing event allows for an expected atrial pacing and signals the pacing control/generating unit to dispense an atrial pacing pulse.
  • the main control unit when marked as a virtual atrial pacing event, sets a next ventricular pacing escape interval starting from a virtual atrial pacing event.
  • the main control unit when marked as a real atrial pacing event, sets a next ventricular pacing escape interval starting from a real atrial pacing event.
  • the medical device for treating arrhythmia has the following beneficial effects: the digital/analog module of the present invention notifies the microprocessor to set an atrial sensing event after sensing an atrial event. After the atrial pacing suppression interval, the problem of atrial overspeed can be avoided, and the application on defibrillators and pacemakers has a good effect.
  • FIG. 1 is a schematic structural view of a medical device for treating arrhythmia according to a preferred embodiment of the present invention
  • FIG. 2 is a flow chart showing the operation of a medical device for treating arrhythmia according to a preferred embodiment of the present invention
  • FIG. 3 is a functional timing diagram of a medical device for treating arrhythmia in accordance with a preferred embodiment of the present invention.
  • FIG. 1 is a schematic structural view of a medical device for treating arrhythmia according to a preferred embodiment of the present invention.
  • the present invention can be effectively applied thereto, and the figure should be regarded as an example of the type of device embodying the present invention, without limitation. significance.
  • the present invention provides a medical device for treating arrhythmia comprising a microprocessor 8 and a digital/analog module 9 coupled thereto.
  • the selection and implementation manner of the microprocessor 8 and the like are not limited.
  • the digital/analog module 9 needs to realize the perception of external signals, needs to be able to issue signals to the outside, and needs to be able to interact with external data information.
  • the microprocessor 8 includes a main control unit 1, a time control unit 2, and a data/information interaction interface 3.
  • the time control unit 2 includes at least a first timing unit 11 and a second timing unit 12.
  • the main control unit 1 implements acceptance, processing, and control of events that occur from the digital/analog module 9 in which an event occurs.
  • the main control unit 1 can select, through the time control unit 2, a time-related control function such as timing, timing, etc., for example, the time control unit 2 can capture and record the time when the event occurs, and can also control the event to be generated. Accurate time, etc.
  • the main control unit 1 sets an atrial pacing suppression interval after the atrial sensing event, and sends a signal to the time control unit 2 to set the first timing unit 11 as a timer.
  • the duration of the time is the atrial pacing suppression interval after the atrial perception event.
  • the second timing unit 12, which functions as a timer has an interventricular interval as the next ventricular pacing escape interval for providing accurate time for the occurrence of a ventricular pacing event.
  • the data/information interface 3 implements interaction with data or information and the like between other modules of the device.
  • the data/information interface 3 can be a normal I/O interface or a serial or parallel data transmission module.
  • the data/information interface 3 can receive the perceived event information, issue a pacing event request, serial data interaction, clock data interaction, and the like.
  • the device of the present invention may have other units, for example, the main control unit 10 further includes a control unit 10 (referred to as the PANP control unit 10) that controls the atrial pacing suppression interval function after the atrial sensing event, when receiving an atrial event. After the signal, the main control unit 1 acquires whether the PANP control unit 10 has been turned on.
  • the PANP control unit 10 referred to as the PANP control unit 10
  • the main control unit 1 sets an atrial pacing suppression interval after the atrial sensing event, and sends the atrial pacing suppression interval to the time control unit 2
  • the signal is sent to control the first timing unit 11 to enter a timing mode for a period of atrial pacing suppression after the atrial sensing event.
  • the digital/analog module 9 includes a data/information interaction interface 4, a pacing control/generation unit 5, a perceptual control/amplification unit 6, and a program control unit 7.
  • the data/information interface 4 can interact with the corresponding data/information interface 3, although the implementation may be the same or different.
  • the pacing control/generating unit 5 receives the pacing request of the microprocessor 8 and generates a signal of required intensity to act on the outside, and at the same time bears a small part of the control function, depending on the difference of the affected object, the strength and type of the signal, etc. The difference.
  • the sensing control/amplifying unit 6 is capable of capturing and distinguishing external real signals and notifying the microprocessor 8 while being able to amplify signals, such as cardiac signals.
  • the program control unit 7 is capable of information interaction with the outside world, such as a user.
  • the main control unit 1 of the microprocessor sets a medical device for treating arrhythmia in a DVI (R) working mode to provide a sensing function of an atrial event; the sensing/amplifying unit of the digital/analog module 6 Sending to the main control unit 1 as soon as the atrial event is sensed signal. After receiving the signal, the main control unit 1 acquires the opening and closing information of the PANP function from the PANP control unit 10.
  • DVI DVI
  • the main control unit 1 immediately Setting a PANP atrial pacing suppression interval, otherwise the main control unit 1 may not do any processing; if the expected ventricular pacing escape will occur during the PANP interval, the main control unit 1 notifies the pacing
  • the control/generation unit 5 suppresses the expected atrial pacing, ie the main control unit 1 does not signal the pacing control/generating unit 5 to dispense the atrial pacing pulse, but sends a signal to the time control unit 2, controlling the second
  • the timing unit 12 sets a next ventricular pacing escape interval (PAVI); if the expected ventricular pacing escape will occur outside of the PANP interval, the atrial pacing is normally dispensed, ie the primary control unit 1
  • the beat control/generating unit 5 and the time control unit 2 send a signal informing the pacing control/generating unit 5 to issue an atrial pacing pulse, and controlling the second
  • the main control unit 1 sends a signal to the time control unit 2 to control the first timing unit 11 to restart the timing.
  • the duration is the atrial pacing suppression interval after the atrial perception event.
  • FIG. 3 is a timing diagram of a medical device for treating arrhythmia according to the present invention. As shown in Figure 3,
  • the main control unit 1 After receiving the signal that the atrial event is sensed, the main control unit 1 initiates a ventricular pacing suppression interval (PANP) after the atrial sensing event, and marks the PANP interval type flag; in particular, Whether it is induction outside the ventricular refractory period (PVARP) or induction within PVARP, a PANP is initiated;
  • PANP ventricular pacing suppression interval
  • the DVI (R) mode is a dual-chamber mode, which can pacing both A and V channels, and can also sense both A and V signals.
  • the digital/analog module in the medical device design can sense the atrial signal and notify the main control unit, but the main control unit does not follow the V-way pacing of the AS, so it is a suppression medical device.
  • an A-way pacing is issued before the V-way pacing, wherein the AVI pacing interval satisfies PAVI.
  • ventricular pacing is issued at the end of the post-pacing interventricular interval (PAVI), PVARP, VRP (ventricular refractory period) and AEI restart;
  • the main control unit 1 initiates an atrial uninterrupted period (PANP), the first timing unit 11 turns on the timing mode, and the PANP is the duration, here is the ventricle.
  • PANP atrial uninterrupted period
  • PVARP posterior atrial refractory period
  • PANP atrial uninterrupted period
  • PVARP Induction after ventricular ventricular refractory period
  • the pacing control/generating unit 5 does not transmit the atrial pacing pulse if the ventricular after-trial atrial escape interval (AEI) expires within the PANP.
  • AEI ventricular after-trial atrial escape interval
  • the main control unit 1 can signal the pacing control/generating unit 5 to atrial pacing, and the pacing will be After the interventricular interval (PAVI) as the escape interval, the main control unit 1 sends a signal to the time control unit 2, and the post-pacing interventricular interval (PAVI) is used as the time duration of the second timing unit 12 to reach the room.
  • Room synchronized pacing enhances the purpose of hemodynamic benefit.

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Abstract

一种治疗心律失常的医疗设备，包括：微处理器（8）和数字/模拟模块（9）；主控制单元（1）设置医疗设备在DVI(R)工作模式：接收到感知控制/放大单元（6）感知到心房事件的信号后，主控制单元（1）设置PANP间期并向时间控制单元（2）发送信号，控制第一定时单元（11）进入定时模式时长为PANP间期；若预期的心室起搏逸搏间期溢出将发生在PANP间期外，主控制单元（1）向起搏控制/产生单元（5）和时间控制单元（2）发送信号通知起搏控制/产生单元（5）发放起搏脉冲，控制第二定时单元（12）设置下一房室间期作为下一心室起搏逸搏间期；若预期的心室起搏后逸搏间期溢出将发生在PANP间期内，主控制单元（1）向时间控制单元（2）发送信号，控制第二定时单元（12）设置下一房室间期作为下一心室起搏逸搏间期。

Description

一种治疗心律失常的医疗设备 技术领域
本发明涉及医疗器械技术领域，特别涉及一种治疗心律失常的医疗设备。
背景技术
心脏起搏器(cardiac pacemaker)是一种植入于体内的电子治疗仪器，通过脉冲发生器发放由电池提供能量的电脉冲，通过导线电极的传导，刺激电极所接触的心肌，使心脏激动和收缩，从而达到治疗由于某些心律失常所致的心脏功能障碍的目的。
DDD型起搏器能对心房和心室进行感知和起搏。但不恰当的起搏可能会引起一些不良的事件的发生。
如果心房起搏脉冲发生在心房易损期内可能会诱发心房心动过速等心律不整。此种现象常在下述两类情况发生：
1、在DDD等双腔跟踪模式中，此种现象常是在心房不应期内的心房感知事件附近发生。为了防止此种状况发生，传统做法中，引入了非竞争性心房起搏(Non-Competitive Atrial Pacing,NCAP)。在DDD或DDDR工作模式下，如果该功能开启，一个不应期内的心房感知事件将开启一个NCAP间期。如果预期将要发生的心房起搏事件落在NCAP间期内，则预期发生的心房起搏事件延迟到NCAP间期结束时发生；同时，如果心房起搏被延迟，将对心室事件的时序产生影响：为了保持心室心率的稳定性，将缩短房室间期(PAV)。
但是，按照传统方式实施，有可能导致房室间期过短，最低下限频率较大，心室起搏后心房不应期较长时，心室频率低于最低下限频率。
2、传统的双腔起搏器所提供的DVI或DVIR工作模式，因为没有有效的心房感知，此种现象可以在心房不应期内或是在心房不应期之外的心房事件附近发生，从而导致严重的心动过速问题。本领域需要新的治疗心律失常的医疗设备以更好地解决诱发心房过速的问题。
发明内容
本发明的目的在于提供一种治疗心律失常的医疗设备，以解决现有DVI型医疗设备有严重的心房过速的问题。
为解决上述技术问题，本发明提供一种治疗心律失常的医疗设备，包括：微处理器和与所述微处理器连接的数字/模拟模块；所述微处理器包括主控制单元和时间控制单元；所述数字/模拟模块包括起搏控制/产生单元和感知控制/放大单元；所述的时间控制单元至少包括第一定时单元、第二定时单元，其中，
所述主控制单元设置所述治疗心律失常的医疗设备在DVI(R)工作模式：
接收到所述感知控制/放大单元感知到一心房事件的信号后，所述主控制单元设置一心房感知事件后心房起搏抑制间期，并向时间控制单元发送信号，控制所述第一定时单元进入定时模式，时长为所述的心房感知事件后心房起搏抑制间期；若预期的心室起搏逸搏间期溢出将发生在所述心房感知事件后心房起搏抑制间期外，所述主控制单元向所述感知控制/放大单元和时间控制单元发送信号，通知起搏控制/产生单元发放起搏脉冲，控制所述第二定时单元设置下一房室间期，作为下一心室起搏逸搏间期；若预期的心室起搏逸搏间期溢出将发生在所述心房感知事件后心房起搏抑制间期内，所述主控制单元向时间控制单元发送信号，控制所述第二定时单元设置下一房室间期，作为下一心室起搏逸搏间期。
进一步的，在所述的治疗心律失常的医疗设备中，接收到所述感知控制/放大单元感知到一心房事件的信号后，所述主控制单元获取心房感知事件后心房起搏抑制功能是否设置为开启的信息，若开启，则所述主控制单元设置一心房感知事件后心房起搏抑制间期，并向时间控制单元发送信号，控制所述第一定时单元进入定时模式，时长为所述的心房感知事件后心房起搏抑制间期。
进一步的，在所述的治疗心律失常的医疗设备中，在所述心房感知事件 后心房起搏抑制间期内，若再次接收到所述感知控制/放大单元感知到心房事件的信号，则所述主控制单元向时间控制单元发送信号，控制所述第一定时单元重新开始定时，时长为心房感知事件后心房起搏抑制间期。
进一步的，在所述的治疗心律失常的医疗设备中，所述心房感知事件后心房起搏抑制间期的起始时间为感知到心房事件的时刻。
进一步的，在所述的治疗心律失常的医疗设备中，在所述主控制单元设置一心房感知事件后心房起搏抑制间期时，同时设置该间期的类型标志。
进一步的，在所述的治疗心律失常的医疗设备中，在所述心房感知事件后心房起搏抑制间期期满时，所述主控制单元清除该间期的类型标志。
进一步的，在所述的治疗心律失常的医疗设备中，若所述间期类型标志置起，则标志着处于心房感知事件后心房起搏抑制间期内；否则标志着处于心房感知事件后心房起搏抑制间期外。
进一步的，在所述的治疗心律失常的医疗设备中，若在所述心房感知事件后心房起搏抑制间期内，所述心室起搏逸搏间期期满，则所述主控制单元标记一虚拟心房起搏事件并且抑制预期的心房起搏；若在所述心房感知事件后心房起搏抑制间期外，所述心室起搏逸搏间期期满，则所述主控制单元标记一真实心房起搏事件允许预期的心房起搏，并发送信号通知起搏控制/产生单元发放心房起搏脉冲。
进一步的，在所述的治疗心律失常的医疗设备中，当标记为虚拟心房起搏事件时，所述主控制单元以虚拟心房起搏事件为起点设置下一心室起搏逸搏间期。
进一步的，在所述的治疗心律失常的医疗设备中，当标记为真实心房起搏事件时，所述主控制单元以真实心房起搏事件为起点设置下一心室起搏逸搏间期。
本发明提供的治疗心律失常的医疗设备，具有以下有益效果：本发明的数字/模拟模块在感知到一心房事件后，通知微处理器设置一个心房感知事件 后心房起搏抑制间期，可以避免心房过速的问题，在除颤器、起搏器上应用均起到良好的效果。
附图说明
图1是本发明优选实施例的治疗心律失常的医疗设备结构示意图；
图2是本发明优选实施例的治疗心律失常的医疗设备的工作流程图；
图3是本发明优选实施例的治疗心律失常的医疗设备功能时序图。
具体实施方式
以下结合附图和具体实施例对本发明提出的治疗心律失常的医疗设备作进一步详细说明。根据下面说明和权利要求书，本发明的优点和特征将更清楚。需说明的是，附图均采用非常简化的形式且均使用非精准的比例，仅用以方便、明晰地辅助说明本发明实施例的目的。
请参考图1，其是本发明优选实施例的治疗心律失常的医疗设备的结构示意图，本发明可以有效地应用于其中，应将该图看作实施本发明的装置类型的范例，并无限制意义。
如图1所示，本发明提供一种治疗心律失常的医疗设备，其包括微处理器8及与其连接的数字/模拟模块9。所述微处理器8的选择及实现方式等不限制。所述数字/模拟模块9需要实现对外部信号的感知，需要能够发放信号作用于外部，需要能够与外部进行数据信息交互。
进一步的，所述微处理器8包括主控制单元1、时间控制单元2及数据/信息交互接口3，时间控制单元2至少包括第一定时单元11、第二定时单元12。所述主控制单元1实现从数字/模拟模块9发送的发生事件的消息的接受、处理，对需发生事件等的控制。所述主控制单元1可以选择通过所述时间控制单元2来实现定时、计时等时间相关的控制功能，比如所述时间控制单元2可以捕获及记录事件发生的时间，也可以控制需发生事件的准确发生时间等。 例如，主控制单元1接收到一心房事件的信号后，设置一心房感知事件后心房起搏抑制间期，并向时间控制单元2发送信号，将第一计时单元11设定为定时器的工作模式，定时的时长为心房感知事件后心房起搏抑制间期。又例如，起定时器作用的第二定时单元12，时长为房室间期，作为下一心室起搏逸搏间期，用于为心室起搏事件发生提供准确的时间。所述数据/信息交互接口3实现与装置其他模块间的数据或信息等的交互。所述数据/信息交互接口3可以是普通的I/O接口，也可以是串行或并行的数据传输模块。在本实施例中，所述数据/信息交互接口3能够接收感知事件信息，发放起搏事件请求，串行数据交互，时钟数据交互等。此外，本发明的设备还可以有其他单元，例如主控制单元10还包括控制心房感知事件后心房起搏抑制间期功能的控制单元10(简称PANP控制单元10)，当接收到一心房事件的信号后，所述主控制单元1获取所述PANP控制单元10是否已经开启的信号，如果开启，所述主控制单元1设置一心房感知事件后心房起搏抑制间期，并向时间控制单元2发送信号，控制所述第一定时单元11进入定时模式，时长为所述的心房感知事件后心房起搏抑制间期。
进一步的，所述数字/模拟模块9包括数据/信息交互接口4、起搏控制/产生单元5、感知控制/放大单元6及程控单元7。所述数据/信息交互接口4能够与相应的数据/信息交互接口3进行交互，当然其实现方式可以与其相同也可不同。所述起搏控制/产生单元5接受微处理器8的起搏请求并产生要求强度的信号作用于外部，同时承担少部分的控制功能，根据受作用对象的差异，信号的强度，类型等有所差别。所述感知控制/放大单元6能够捕获及区分外部真实的信号并将其通知微处理器8，同时能够对信号，如心脏信号进行放大。所述程控单元7能够与外界，如用户，进行信息交互。
如图2所示，所述微处理器的主控制单元1设置治疗心律失常的医疗设备在DVI(R)工作模式，提供心房事件的感知功能；所述数字/模拟模块的感知控制/放大单元6一旦感知到所述心房事件后，立即向主控制单元1发送 信号。接受到信号后，主控制单元1从PANP控制单元10获取PANP功能的开闭信息，若当前PANP控制单元10开启PANP(心房感知事件后心房起搏抑制间期)功能，则主控制单元1立即设置一个PANP的心房起搏抑制间期，否则主控制单元1可以不做任何处理；如果预期的心室起搏逸搏将发生在PANP间期内，则所述主控制单元1通知所述起搏控制/产生单元5抑制预期的心房起搏，即所述主控制单元1不发送信号通知起搏控制/产生单元5发放心房起搏脉冲，但是向时间控制单元2发送信号，控制所述第二定时单元12设置下一心室起搏逸搏间期(PAVI)；如果预期的心室起搏逸搏将发生在PANP间期之外，则正常发放心房起搏，即所述主控制单元1向起搏控制/产生单元5和时间控制单元2发送信号，通知所述起搏控制/产生单元5发放心房起搏脉冲，控制所述第二定时单元12设置下一心室起搏逸搏间期。在PANP间期内，若再次接收到感知控制/放大单元5感知到心房事件的信号，则所述主控制单元1向时间控制单元2发送信号，控制所述第一定时单元11重新开始定时，时长为心房感知事件后心房起搏抑制间期。
进一步请参考图3，其是本发明治疗心律失常的医疗设备时序图。如图3所示，
在①序列时刻，在收到感知到心房事件的信号之后，主控制单元1启动一个心房感知事件后心室起搏抑制间期(PANP)，同时标记PANP间期类型标志；特别要说明的是，无论是心室后心房不应期(PVARP)之外感应还是PVARP之内感应，均启动一个PANP；
在本发明中，DVI(R)模式为双腔模式，可以起搏A、V两路，也可以感知A、V两路信号。但是对于A路感知，医疗设备设计中仅是数字/模拟模块可以感知到心房信号并通知主控制单元，但是主控制单元并不根据AS做跟踪的V路起搏，因此是抑制型医疗设备。
进一步的，在V路起搏前发放一个A路起搏，其中AVI起搏间期满足PAVI。
在②序列时刻，当在DVI(R)模式下，在收到感知到VS或VP的信号后主控制单元1计算心室后心房逸搏间期(AEI)，所述AEI＝有效下限频率(eff_lrl)－有效房室逸搏间期(eff_AEI)；其中，如果发生的是VS，则所述eff_AEI需将房室间期残余(effective pavi–AV_interval)计算在内；
在③序列时刻，心室起搏在起搏后房室间期(PAVI)期满时发出，PVARP、VRP(心室不应期)和AEI重启；
在④序列时刻，在收到感知到心房感知事件的信号之后，主控制单元1启动一个心房不起博间期(PANP)，第一定时单元11开启定时模式，PANP作为时长，此处是心室后心房不应期(PVARP)之内感应；
在⑤序列时刻，在收到感知到心房感知事件的信号之后，主控制单元1启动一个心房不起博间期(PANP)，同样第一定时单元11开启定时模式，PANP作为时长，此处是心室后心房不应期(PVARP)之外感应；
在⑥序列时刻，当心室后心房逸搏间期(AEI)到期时如果正好在PANP之内，则起搏控制/产生单元5不发此心房起搏脉冲。但是可以用此并没有实际发出心房脉冲的虚拟时间来计算下一次应该对心室起搏的时间，作为第二定时单元12的定时时长。也就是说，将心房起搏后心室逸搏间期作为逸搏间期，且主控制单元1除清PANP间期类型标志；
在⑦序列时刻，如果心室后心房逸搏间期(AEI)到期时如果在PANP之外，则可由主控制单元1发送信号通知起搏控制/产生单元5对心房起搏，并且将起搏后房室间期(PAVI)作为逸搏间期，主控制单元1向时间控制单元2发送信号，将起搏后房室间期(PAVI)作为第二定时单元12的定时时长，以达房室同步起搏增进血动力学效益的目的。
上述描述仅是对本发明较佳实施例的描述，并非对本发明范围的任何限定，本发明领域的普通技术人员根据上述揭示内容做的任何变更、修饰，均属于权利要求书的保护范围。

Claims (10)

  1. 一种治疗心律失常的医疗设备，其特征在于，包括：微处理器和与所述微处理器连接的数字/模拟模块；所述微处理器包括主控制单元和时间控制单元；所述数字/模拟模块包括起搏控制/产生单元和感知控制/放大单元；所述的时间控制单元至少包括第一定时单元、第二定时单元，其中，
    所述主控制单元设置所述治疗心律失常的医疗设备在DVI(R)工作模式：
    接收到所述感知控制/放大单元感知到一心房事件的信号后，所述主控制单元设置一心房感知事件后心房起搏抑制间期，并向时间控制单元发送信号，控制所述第一定时单元进入定时模式，时长为所述的心房感知事件后心房起搏抑制间期；若预期的心室起搏逸搏间期溢出将发生在所述心房感知事件后心房起搏抑制间期外，所述主控制单元向所述感知控制/放大单元和时间控制单元发送信号，通知起搏控制/产生单元发放起搏脉冲，控制所述第二定时单元设置下一房室间期，作为下一心室起搏逸搏间期；若预期的心室起搏后逸搏间期溢出将发生在所述心房感知事件后心房起搏抑制间期内，所述主控制单元向时间控制单元发送信号，控制所述第二定时单元设置下一房室间期，作为下一心室起搏逸搏间期。
  2. 如权利要求1所述的治疗心律失常的医疗设备，其特征在于，接收到所述感知控制/放大单元感知到一心房事件的信号后，所述主控制单元获取心房感知事件后心房起搏抑制功能是否设置为开启的信息，若开启，则所述主控制单元设置一心房感知事件后心房起搏抑制间期，并向时间控制单元发送信号，控制所述第一定时单元进入定时模式，时长为所述的心房感知事件后心房起搏抑制间期。
  3. 如权利要求1所述的治疗心律失常的医疗设备，其特征在于，在所述心房感知事件后心房起搏抑制间期内，若再次接收到所述感知控制/放大单元感知到心房事件的信号，则所述主控制单元向时间控制单元发送信号，控制 所述第一定时单元重新开始定时，时长为所述的心房感知事件后心房起搏抑制间期。
  4. 如权利要求1所述的治疗心律失常的医疗设备，其特征在于，所述心房感知事件后心房起搏抑制间期的起始时间为感知到心房事件的时刻。
  5. 如权利要求1所述的治疗心律失常的医疗设备，其特征在于，在所述主控制单元设置所述的心房感知事件后心房起搏抑制间期时，同时设置该间期的类型标志。
  6. 如权利要求5所述的治疗心律失常的医疗设备，其特征在于，在所述心房感知事件后心房起搏抑制间期期满时，所述主控制单元清除该间期的类型标志。
  7. 如权利要求5所述的治疗心律失常的医疗设备，其特征在于，若所述间期类型标志置起，则标志着处于心房感知事件后心房起搏抑制间期内；否则标志着处于心房感知事件后心房起搏抑制间期外。
  8. 如权利要求1所述的治疗心律失常的医疗设备，其特征在于，若在所述心房感知事件后心房起搏抑制间期内，所述心室起搏逸搏间期期满，则所述主控制单元标记一虚拟心房起搏事件并且抑制预期的心房起搏；若在所述心房感知事件后心房起搏抑制间期外，所述心室起搏逸搏间期期满，则所述主控制单元标记一真实心房起搏事件并发送信号通知起搏控制/产生单元发放心房起搏脉冲。
  9. 如权利要求8所述的治疗心律失常的医疗设备，其特征在于，当标记为虚拟心房起搏事件时，所述主控制单元以虚拟心房起搏事件为起点设置所述下一心室起搏逸搏间期。
  10. 如权利要求8所述的治疗心律失常的医疗设备，其特征在于，当标记为真实心房起搏事件时，所述主控制单元以真实心房起搏事件为起点设置所述的下一心室起搏逸搏间期。
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