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Abstract

A dual-chamber AV sequential pacemaker with the capability of automatically adjusting right heart AV interval to optimize left heart AV interval by compensating for pacing-induced inter-atrial and inter-ventricular conduction delays. Depending on the pacing and sensing action, as determined by the patient's native rate, the predetermined threshold rate and intrinsic AV interval, the pacemaker selects the AV interval. Right heart AV interval is adjusted to compensate for the heart's inter-atrial and inter-ventricular delays. Threshold values are previously estimated, using mean values measured using non-invasive techniques. The pacemaker has a dual phase operating mechanism consisting of an analysis phase followed by a pacing phase. The P wave rate is sensed and compared to a predetermined base rate. If the sensed P wave rate is above the baseline, atrial depolarizations will be sensed by the pacemaker and small number (default=4) of consecutive native AV intervals will be averaged. If this average is less than a predetermined threshold value, the system will continue in the demand mode, sensing P and R waves. If the average is greater than said value, then the ventricle is paced for n number of times the analysis phase (default=100 cycles), each followed by a short AV delay (Default=50 ms) that is intended to compensate for the delay introduced in the onset of left ventricular depolarization after pacing the right ventricular apex. When P wave rate is below the predetermined rate, atrial pacing will occur.

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First Claim