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Fully inhibited dual chamber pacing modeRelated Patent Categories: Surgery: Light, Thermal, And Electrical Application, Light, Thermal, And Electrical Application, Electrical Therapeutic Systems, Heart Rate Regulating (e.g., Pacing)Fully inhibited dual chamber pacing mode description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20070203525, Fully inhibited dual chamber pacing mode. Brief Patent Description - Full Patent Description - Patent Application Claims
CROSS REFERENCE TO RELATED APPLICATIONS [0001] This application is a continuation application of Ser. No. 10/814,692, filed Mar. 31, 2004, which is a continuation-in-part of application Ser. No. 10/246,816, filed Sep. 17, 2002, which is a continuation-in-part of application Ser. No. 09/746,571, filed Dec. 21, 2000, both of which are herein incorporated by reference in their entireties. BACKGROUND OF THE INVENTION [0002] The present invention relates to implantable medical devices. More particularly, the present invention relates to implantable pacemakers, cardioverters, and defibrillators. DESCRIPTION OF THE RELATED ART [0003] There are a variety of implantable medical devices (IMD) that are used to monitor cardiac conditions and deliver therapy when appropriate. Pacemakers and defibrillators, alone or in combination, typically sense events relating to the cardiac cycle and deliver electrical stimulation to affect a desired result. [0004] Pacemakers sense cardiac cycles and deliver lower energy pulses at predetermined intervals to depolarize cardiac tissue in the atria, ventricles, or both in order to maintain or control the cardiac rhythm. Defibrillators sense fibrillation of the atria or ventricles and deliver a higher energy stimulation in order to defibrillate the heart and reinstate a sinus rhythm. Commonly, both types of functions are included in a single device referred to as an implantable cardioverter/defibrillator (ICD). [0005] The cardiac cycle begins with a depolarization of the atria starting at the SA node, represented by a P-wave on an EKG or EGM. As the depolarization wave travels through the atria, it encounters the AV node, experiences a delay (AV interval) and eventually depolarizes the ventricles, which appears as a QRS complex on the EKG or EGM. Subsequent repolarization of the ventricles appears as a T-wave. At its most basic level, the cardiac cycle consists of an atrial (A) event or P wave, followed by a ventricular event (V) or R-wave. Such events are either intrinsic or paced. Thus, over time multiple cycles simply produce a repetitive A-V-A-V pattern. [0006] For purposes of timing, this overview of the cardiac cycle results in a few relatively simple options. An A-A interval is effectively a complete cycle and represents the interval or time between subsequent atrial events. Similarly, the V-V interval is the time between subsequent ventricular events and also represents a complete cycle. The AV interval is the time between the atrial event and the ventricular event and the VA interval is the time between the ventricular event and the subsequent atrial event. [0007] While very basic and certainly well known, these various intervals represent the framework used for ICD timing. For example, in a patient having complete AV block, depolarization of the atria may occur normally, however the depolarization wave fails to reach the ventricles. Thus, the ventricles depolarize independently of the atria at their own intrinsic rate, which is usually slower than the atrial rate. An ICD configured to pace the ventricles will sense the atrial depolarization. Thus, when A is sensed, an AV escape interval timer is started. At the completion of the AV escape interval, the pacing pulse is delivered. [0008] The particular rules, timers, triggers and operations that the ICD will follow are defined by modes of operation. The NBG Pacemaker code (NASPE/BPEG Generic Pacemaker Code) is typically used to generically indicate the functionality of a given mode or device. The code includes 5 designations. The first indicates the chamber paced, the second the chamber sensed, the third the response to sensing, the fourth relates to programmability and more typically rate responsiveness, and the fifth is related to anti-tachy functions and is often not included. Thus, a VVI/R pacemaker paces in the ventricle, senses in the ventricle, inhibits a pacing pulse based on a sensed event and is rate responsive. As mentioned, this code generically indicates the mode and various manufacturers may implement such modes in different manners and with different specific parameters. [0009] ICD's often have the ability to automatically switch from one mode to another, based on sensed conditions. Thus, a single chamber pacemaker having a single lead may only function in single chamber modes (e.g., VvI). More complex ICD's having, for example, dual, triple or quadruple chambered pacing/sensing will be able to function in any of the available modes, including the single chamber modes. [0010] As long as that device is in a given mode, it will function according to the rules of that mode regardless of other capabilities. For example, a device truly in a VI mode will not respond to atrial events, atrial arrhythmia's etc. If such atrial events are detected while in VVI and they require a response, the device will mode switch to an appropriate mode. With the generic nature of these codes and the ever-changing capabilities of ICD's, the codes are often used to indicate the closest approximation for a given mode. Thus, in a given context for a particular device, a specific mode may have capabilities that go beyond the code designations. However, every mode will have a set of rules and the device will not violate those rules when operating in that mode. SUMMARY OF THE INVENTION [0011] The present invention, in one embodiment, is a mode for an implantable medical device, for example a pacemaker or ICD. [0012] The present invention includes a method of selectively providing cardiac pacing with an implantable medical device. The method includes setting a flag during a given cardiac cycle in response to ventricular activity and precluding a ventricular pacing pulse during a current cardiac cycle if the flag is present at the onset of the current cardiac cycle. [0013] In one embodiment, the present invention is an implantable medical device comprising means for sensing cardiac depolarizations. The implantable medical device also includes means for pacing and means for controlling the means for pacing according to a selected mode, wherein one selectable mode is a fully inhibited DDI (FIDDI) mode. [0014] In another embodiment, the present invention is an implantable medical device comprising means for sensing cardiac depolarizations and means for pacing according to a selectable mode. The implantable medical device also includes means for mode switching to an atrial based pacing mode upon the sensing of ventricular activity in a given cardiac cycle and means for mode switching from the atrial based pacing mode to a dual chamber mode at the completion of the given cardiac cycle, wherein the dual chamber mode includes a first set of parameters that are implemented for a first cardiac cycle while operating in the dual chamber mode such that the implemented parameters preclude the delivery of a ventricular pacing pulse during the first cardiac cycle and a second set of parameters implemented in a second consecutive cardiac cycle while operating in the dual chamber mode such that ventricular pacing is delivered unless inhibited. [0015] In another embodiment, the present invention is an implantable medical device comprising a controller and a ventricular lead operably coupled to the controller and configured to deliver ventricular pacing pulses and sense ventricular depolarizations. The implantable medical device also includes an atrial lead operable coupled to the controller and configured to deliver atrial pacing pulses and sense atrial depolarizations and a memory including a plurality of algorithms defining pacing modalities selectable by the controller, wherein one of the pacing modalities is fully inhibited DDI. [0016] In another embodiment, the present invention is a computer readable medium including instructions that define a pacing mode that when implemented on an implantable medical device cause the implantable medical device to set a flag in response to ventricular activity occurring in a current cardiac cycle, wherein the flag is valid for a subsequent cardiac cycle. In addition, the IDM determines if a flag is present at the start of a given cardiac cycle, initiates an atrial escape interval if the flag is present at the start of the given cardiac cycle, and initiates an AV interval if no flag is present at the start of the given cardiac cycle. In addition, the IMD delivers a ventricular pacing pulse at the completion of the AV interval and initiates a VA interval at the completion of the AV interval. [0017] The present invention also include a method of operating an implantable medical device in a mode, the method comprising setting a flag during a first cardiac cycle if a pre-established criteria is met during the first cardiac cycle. The method also includes determining whether the flag has been set at the initiation of a second cardiac cycle that is consecutive to the first cardiac cycle, acting in a first manner during the second cardiac cycle and while remaining in the mode if the flag has been set and acting in a second manner during the second cardiac cycle and while remaining in the mode if the flag has not been set. [0018] In another embodiment, the present invention is an implantable medical device (IMD) having mode-switching capability for delivering pacing therapy in a selected mode, comprising an atrial lead, a ventricular lead, and a memory. The IMD also includes a processing module in electronic communication with the ventricular lead and the memory wherein the processing module sets a flag in the memory during a first cardiac cycle if a pre-established criteria is sensed or delivered via the ventricular lead during the first cardiac cycle and determines whether the flag has been set at the initiation of a second cardiac cycle that is consecutive to the first cardiac cycle. Also included is a controller that initiates an atrial escape interval and precludes ventricular pacing during the second cardiac cycle and while remaining in the selected mode if the flag has been set and the controller initiates an AV interval and a ventricular pacing pulse during the second cardiac cycle and while remaining in the selected mode if the flag has not been set. [0019] The present invention also includes a method of selectively providing cardiac pacing with an implantable medical device. The method includes setting a flag during a given cardiac cycle in response to ventricular activity and delivering a ventricular pacing pulse during a current cardiac cycle only if a flag is absent at the onset of the given cardiac cycle. [0020] While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be realized, the invention is capable of modifications in various obvious aspects, all without departing from the spirit and scope of the present invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive. Continue reading about Fully inhibited dual chamber pacing mode... 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