A pulse stimulation device capable of effectively avoiding pacing during atrial vulnerable period

Abstract

The present invention discloses a pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing, comprising an atrial sensing module, a pacing control module, an atrial pacing module, a clock / timing module and a storage module; the atrial sensing module senses and sends an atrial self-activity signal to the pacing control module; when the pacing control module identifies the atrial self-activity signal as an atrial sensing event in the refractory period, the clock / timing module is controlled to perform timing of the sequentially adjacent T1 period and T2 period according to the sequentially adjacent T1 period and T2 period stored in the storage module; when the pacing control module determines that the expected atrial pacing event occurs in the T2 period, the atrial pacing module is inhibited from issuing the atrial pacing event, so as to solve the problem of the risk of atrial fibrillation caused by atrial vulnerable period pacing.

Description

Technical Field

[0001] The present invention belongs to the technical field of medical devices, and in particular relates to a pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing. Background Art

[0002] An implantable medical device is an electronic therapeutic instrument implanted in the body. It emits electrical pulses powered by a battery through a pulse generator, which are conducted through wire electrodes to stimulate the myocardium that the electrodes contact, causing the heart to become excited and contracted, thereby achieving the purpose of treating heart dysfunction caused by certain arrhythmias.

[0003] After myocardial cells generate action potentials, they will completely or partially lose their excitability within a very short period of time. If the myocardial cells are stimulated again at this time, no new action potentials will be generated. This characteristic is called the cardiac refractory period. The cardiac refractory period is divided into an absolute refractory period and a relative refractory period. During the absolute refractory period, myocardial cells completely lose their excitability, and during the relative refractory period, myocardial cells partially lose their excitability. The atrial muscle has a very short period of ECG instability near its relative refractory period, which is called the atrial vulnerable period. At this time, the myocardium is in the early stages of repolarization, and the speed and order of excitability recovery between cell groups vary greatly, so the reactivity, conductivity and refractory period are extremely inconsistent or incompletely synchronized. At this time, if a strong stimulus is given or premature beats occur, atrial fibrillation is likely to occur.

[0004] During operation, implantable cardiac rhythm management devices (such as pacemakers) may fail to sense atrial signals or inappropriately identify atrial action potentials as interference signals within the refractory period, and inappropriately deliver atrial pacing stimuli during the atrial vulnerable period, which can easily induce atrial fibrillation.

[0005] The following treatment plans exist at present: 1. Do not deal with atrial vulnerable period pacing at all. This method has the risk of inducing atrial fibrillation. 2. Immediately start a period of atrial pacing inhibition interval when an atrial sensing signal is detected during the refractory period. When the expected atrial pacing occurs during this period, a scheme of delaying this atrial pacing until the expiration of the atrial pacing inhibition interval is adopted. This method requires delaying atrial pacing, which may cause adverse reactions such as shortening of the AV interval or even a decrease in the ventricular pacing frequency, which is not conducive to atrioventricular hemodynamic conduction and ventricular stability. 3. Immediately start a period of atrial pacing inhibition interval when an atrial sensing signal is detected during the refractory period. When the expected atrial pacing occurs during this period, a scheme of directly inhibiting this atrial pacing is adopted, such as a medical device for treating arrhythmias disclosed in the patent application with application publication number CN104623805A, and a medical device for treating arrhythmias disclosed in the patent application with application publication number CN104623804A. In this method, a long interval after the atrial sensing signal during the refractory period is marked as the atrial pacing inhibition interval. If the atrial sensing signal during the refractory period is an interference signal, an atrial pacing treatment and possible atrioventricular conduction will be lost. This adverse reaction is particularly obvious when there is a lot of interference, resulting in an increase in the percentage of ventricular pacing.

[0006] Therefore, there are major defects in the prior art, and it is not possible to effectively avoid atrial vulnerable period pacing. Summary of the invention

[0007] In view of the above, an object of the present invention is to provide a pulse stimulation device that can effectively avoid atrial vulnerable period pacing, so as to solve the problem of the risk of atrial fibrillation caused by atrial vulnerable period pacing.

[0008] To achieve the above-mentioned purpose of the invention, an embodiment of the present invention provides a pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing, comprising an atrial sensing module, a pacing control module, an atrial pacing module, a clock / timing module and a storage module;

[0009] The atrial sensing module senses and sends the atrial self-activity signal to the pacing control module; when the pacing control module identifies the atrial self-activity signal as an atrial sensing event in the refractory period, the clock / timing module is controlled to perform timing of the sequentially adjacent T1 period and T2 period according to the sequentially adjacent T1 period and T2 period stored in the storage module, wherein the T1 period is used as a stable period, and its start time is the time when the atrial sensing module detects the atrial sensing event, and the T2 period is used as an atrial pacing adjustment window interval in the atrial vulnerable period, and its start time is the end time of T1;

[0010] When the pacing control module determines that the expected atrial pacing event occurs during the T2 period, the atrial pacing module is inhibited from issuing an atrial pacing event.

[0011] Preferably, the T1 period and the T2 period are dynamically adjustable according to the physiological state of the user.

[0012] Preferably, the pulse stimulation device further comprises a treatment control module, which automatically adjusts the T2 period and the T1 period according to the atrial cardiac event state of the user obtained from the pacing control module, and updates the same to the storage module.

[0013] Preferably, the pulse stimulation device further comprises a threadless control module, through which the pulse stimulation device receives the T2 period and T1 period adjusted by an external device according to the physiological state of the user, and updates them to the storage module.

[0014] Preferably, when the pacing control module determines that the expected atrial pacing event occurs in the T1 period, the pacing control module controls the atrial pacing module to normally deliver the atrial pacing event.

[0015] Preferably, when the pacing control module determines that an atrial event occurs within the atrial refractory period, the clock / timing module controls the clock / timing module to start timing for the T1 period, and the clock / timing module notifies the pacing control module when the T1 period timing expires; the pacing control module controls the clock / timing module to start timing for the T2 period based on the notification when the T1 period timing expires, and sets a T2 start flag; the clock / timing module notifies the pacing control module when the T2 period timing expires; the pacing control module sets a T2 end flag based on the notification when the T2 period timing expires.

[0016] Preferably, the pacing control module determines that the expected atrial pacing event occurs in the T2 period according to the start mark of the T2 period, and inhibits the atrial pacing module from issuing an atrial pacing event.

[0017] Preferably, when the pacing control module determines that the expected atrial pacing event occurs in the T1 period according to the T1 period timing expiration information, the atrial pacing module is controlled to normally deliver the atrial pacing event.

[0018] Preferably, when the pacing control module identifies the atrial self-activity signal, if the atrial self-activity occurs within the atrial refractory period, it is identified as an atrial sensing event within the refractory period; if the atrial self-activity does not affect the pacing timing, all atrial self-activity is also identified as an atrial sensing event within the refractory period.

[0019] Preferably, the pulse stimulation device is suitable for single or dual chamber modes with atrial pacing.

[0020] Compared with the prior art, the pulse stimulation device provided by the embodiment of the present invention, which can effectively avoid atrial vulnerable period pacing, has the following beneficial effects at least:

[0021] Splitting a period of time after an atrial sensing event during the refractory period into a temporally adjacent stable period TI and an atrial pacing adjustment window interval T2 used as an atrial vulnerable period, while flexibly and accurately defining the atrial vulnerable period T2 (T2 interval) can more physiologically adapt to different patients and different physiological conditions, thereby reducing the risk of atrial fibrillation caused by atrial pacing during the atrial vulnerable period in single-chamber and dual-chamber atrial pacing modes, while reducing the probability of normal atrial pacing therapy and its possible atrioventricular conduction being inhibited, and reducing the risk of an increased ventricular pacing percentage. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without creative work.

[0023] Figure 1 It is a schematic diagram of the structure of a pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing provided by an embodiment of the present invention;

[0024] Figure 2 is a schematic diagram of the T1 period and the T2 period provided by an embodiment of the present invention;

[0025] Figure 3 is a schematic structural diagram of a pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing provided by another embodiment of the present invention;

[0026] Figure 4 is a schematic structural diagram of a pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing provided by another embodiment of the present invention;

[0027] Figure 5 It is the timing process of the T1 period and the T2 period implemented by the pacing control module and the clock / timing module provided in the embodiment of the present invention;

[0028] Figure 6 This is a control process of atrial pacing events implemented by the pacing control module and atrial pacing module provided in the embodiment of the present invention. DETAILED DESCRIPTION

[0029] To make the purpose, technical solution and advantages of the present invention more clearly understood, the present invention is further described in detail below in conjunction with the accompanying drawings and embodiments. It should be understood that the specific implementation methods described herein are only used to explain the present invention and do not limit the scope of protection of the present invention.

[0030] In order to solve the risk of atrial fibrillation caused by atrial pacing during the vulnerable period of atrial heart due to interference or inappropriate parameter settings; at the same time, to solve the risk that the delay of atrial pacing during the vulnerable period of atrial heart in the prior art may lead to the adverse reaction of shortening the AV interval or even reducing the ventricular pacing frequency, which is not conducive to atrioventricular hemodynamic conduction and ventricular stability; at the same time, to solve the risk that the long atrial pacing inhibition period after the atrial sensing event in the prior art may lead to the loss of atrial pacing treatment and its possible atrioventricular conduction, and this adverse reaction is particularly obvious in the case of more interference, leading to the risk of increased pacing percentage; at the same time, to solve the risk that atrial fibrillation caused by atrial pacing during the vulnerable period of atrial heart in the single-chamber pacing mode that is not solved in the prior art; at the same time, to solve the defect that the definition of the vulnerable period of atrial heart in the prior art cannot be flexibly adjusted. The embodiment provides a pulse stimulation device that can effectively avoid atrial vulnerable period pacing as an implantable medical device.

[0031] Figure 1 Schematic diagram of the structure of a pulse stimulation device that can effectively avoid atrial vulnerable period pacing provided by an embodiment of the present invention. Figure 1 As shown, the pulse stimulation device 100 for effectively avoiding atrial vulnerable period pacing provided by the embodiment includes an atrial sensing module 101, a pacing control module 102, an atrial pacing module 103, a clock / timing module 104, and a storage module 105, wherein the atrial sensing module 101 is used to sense the atrial self-activity signal. The pacing control module 102, as the core of the pulse stimulation device, is used to control the timing work of the clock / timing module 104 according to the atrial self-activity signal, and also controls the atrial pacing module 103 to issue atrial pacing events according to the timing result of the clock / timing module 104. The storage module 105 stores the T1 period and T2 period that are adjacent in time sequence.

[0032] In the embodiment of the present invention, the time after the atrial sensing event in the refractory period is divided into the T1 period and T2 period which are adjacent in time sequence, wherein the T1 period is a stable period, and its starting time is the time when the atrial sensing event is detected. The T1 period is regarded as a stable period in the atrial refractory period after the atrial time. Atrial pacing within this time limit will not cause the risk of atrial fibrillation. When interference exists, the long atrial pacing inhibition period after atrial sensing is reduced, which may lead to the loss of normal atrial pacing treatment and its possible atrioventricular conduction; it is beneficial to atrioventricular hemodynamic conduction and reduce the percentage of ventricular pacing. The T2 period is defined as a period of atrial pacing adjustment window interval (Atrial Tachycardia Atrial Pace Adjustments, ATAPA) that can prevent atrial tachycardia after the atrial sensing event in the refractory period. The ATAPA is regarded as an atrial vulnerable period, and no atrial pacing event is performed during this period to prevent the risk of atrial fibrillation. Specifically, the starting time of the T2 period is the ending time of the T1 period, that is, the T1 period and the T2 period are two periods adjacent in time sequence.

[0033] Figure 2 Schematic diagram of the T1 period and the T2 period provided by the embodiment of the present invention. The embodiment will be combined with the accompanying drawings to clearly illustrate the T1 period and the T2 period. Figure 2 As shown, the interval between atrial pacing (AP) and ventricular pacing (VP) is the post-atrial pacing atrioventricular interval (PAVI), the LRI (Lower Rate Interval) lower limit frequency interval is entered immediately after atrial pacing (AP), and the post-ventricular atrial refractory period (PVARP) is entered immediately after ventricular pacing (VP). The atrial sensing event (AR) occurs within the PVARP, and the AR is identified as the AR within the refractory period. The T1 period and the T2 period defined in the embodiment of the present invention are the timing after the AR, as shown in FIG. Figure 2 As shown, the start time of the T1 period is the AR time, the start time of the T2 period is the end time of the T1 period, atrial pacing events can be performed during the T1 period, atrial pacing events are suppressed during the T2 period, and the ventricular pacing sequence is not affected. The embodiment of the present invention can more accurately determine the range of the atrial vulnerable period by defining the T1 period and the T2 period, reduce the risk of atrial pacing treatment and corresponding atrioventricular conduction being suppressed due to the too rough definition of the atrial vulnerable period, and reduce the risk of increased ventricular pacing percentage.

[0034] In the embodiment of the present invention, the defined T1 period and T2 period are both stored in the storage module 105. When the pulse stimulation device 100 is working, the atrial sensing module 101 senses and sends the atrial self-activity signal to the pacing control module 102. When the pacing control module 102 identifies the atrial self-activity signal as an atrial sensing event in the refractory period, the clock / timing module 104 is controlled to time the T1 period and T2 period that are adjacent in time sequence according to the T1 period and T2 period stored in the storage module 105. When the pacing control module 102 determines that the expected atrial pacing event occurs in the T2 period, the atrial pacing module 103 is inhibited from issuing the atrial pacing event. When the pacing control module 102 determines that the expected atrial pacing event occurs in the T1 period, the atrial pacing module 103 is controlled to normally issue the atrial pacing event. When the pacing control module 102 determines that the expected atrial pacing event occurs outside the T1 period and the T2 period, the atrial pacing module 103 is controlled to normally issue the atrial pacing event as needed.

[0035] In the embodiment of the present invention, when the pacing control module 102 identifies the atrial self-activity signal, if the atrial self-activity occurs within the atrial refractory period, it is identified as an atrial sensing event within the refractory period; if the atrial self-activity does not affect the pacing timing, all atrial self-activity is also identified as an atrial sensing event within the refractory period.

[0036] In the embodiment of the present invention, the T1 period and the T2 period are dynamically adjustable according to the physiological state of the patient. That is, by flexibly defining the size and position of the T2 period to accurately control the atrial vulnerable period T2, the flexibility of the definition of the atrial vulnerable period is greatly increased, and it can be more physiologically adapted to different patients and different physiological states, thereby better reducing the risk of atrial fibrillation caused by atrial pacing during the atrial vulnerable period in the atrial pacing mode.

[0037] In the embodiment of the present invention, the purpose of setting the ATAPA, that is, the T2 period, is to define the physiological atrial vulnerability period. The physiological atrial vulnerability period is generally a certain interval within a few thousand milliseconds after the atrial sensing event, such as the interval of 200 to 300ms after the atrial sensing event. This interval may vary according to different users, different diseases, different activity states, and different physiological states. The differences and changes in the physiological atrial vulnerability period are simulated by the flexibly adjustable ATAPA interval, thereby achieving precise control of the ATAPA of each user. When the size and position of the T2 period are dynamically adjusted, the end time of the T1 period can be adjusted, and the end time of the T2 period can also be adjusted.

[0038] In one embodiment, if Figure 3As shown, the pulse stimulation device 100 provided in the embodiment further includes a treatment control module 301, which automatically adjusts the T2 period and the T1 period according to the atrial cardiac event state of the user or the physiological state of the user obtained from the pacing control module 102, and updates the T2 period and the T1 period to the storage module 105. The ATAPA interval is automatically adjusted by the treatment method embedded in the treatment control module 301. For example, when the treatment method detects the occurrence of atrial tachycardia, the ATAPA interval is extended, such as 100 to 350 ms, in order to reduce the atrial pacing in the atrial vulnerable period to aggravate the atrial tachycardia, and at the same time reduce the detection of the atrial tachycardia state by the atrial pacing in the atrial vulnerable period.

[0039] In one embodiment, if Figure 4 As shown, the pulse stimulation device 100 provided in the embodiment further includes a threadless control module 401. The pulse stimulation device 100 receives the T2 period and T1 period adjusted by the external device according to the physiological state of the user through the threadless control module 401, and updates them to the storage module 105. Medical staff can perform data exchange between the external device and the threadless control module 401 according to the evaluation results of different users to set a targeted ATAPA interval range, and update it to the storage module 105. For example, for patients who often suffer from atrial tachycardia, a wide ATAPA interval, such as 100-350ms, can be used to reduce atrial pacing during the atrial vulnerable period to aggravate atrial tachycardia. Internal data can also be sent to the external device through the threadless control module 401.

[0040] In one embodiment, if Figure 5 As shown, the timing process of the T1 period and the T2 period implemented by the pacing control module 102 and the clock / timing module 104 includes:

[0041] When the pacing control module 102 determines that the atrial sensing event does not occur within the atrial refractory period, it processes and controls the pacing sequence according to the atrial sensing event outside the refractory period;

[0042] When the pacing control module 102 determines that the atrial sensing event occurs within the atrial refractory period, it controls the clock / timing module 104 to start timing for the T1 period, and the clock / timing module 104 notifies the pacing control module 102 when the T1 period timing expires; the pacing control module 102 notifies the clock / timing module 104 to start timing for the T2 period based on the expiration of the T1 period timing, and sets the T2 start flag, for example, setting ATAPA_Flag=1, indicating that the T2 period has started; the clock / timing module 104 notifies the pacing control module 102 when the T2 period timing expires; the pacing control module 102 notifies the setting of the T2 end flag based on the expiration of the T2 period timing, for example, setting ATAPA_Flag=0, indicating that the T2 period has ended, that is, the ATAPA interval has been completed.

[0043] In one embodiment, if Figure 6 As shown, the control process of atrial pacing events implemented by the pacing control module and the atrial pacing module includes:

[0044] When the expected atrial pacing interval controlled by the clock / timing module 104 expires, the pacing control module 102 is notified. When the pacing control module 102 determines that the expected atrial pacing event occurs in the T2 period according to the start mark of the T2 period, the atrial pacing module 103 is inhibited from issuing an atrial pacing event. Specifically, it can be determined whether ATAPA_Flag is 1. When ATAPA_Flag=1, it means that the current period is in the T2 period, and the pacing control module 102 inhibits the atrial pacing module 103 from issuing an atrial pacing pulse.

[0045] When the expected atrial pacing interval controlled by the clock / timing module 104 expires, the pacing control module 102 is notified. The pacing control module 102 determines that the expected atrial pacing event occurs in the T1 period according to the end mark of the T2 period, and controls the atrial pacing module 103 to normally issue the atrial pacing event. Specifically, it can be determined whether ATAPA_Flag is 1. When ATAPA_Flag=0, which is not 1, it means that the current period is in the T1 period, and the pacing control module 102 controls the atrial pacing module 103 to normally issue the atrial pacing pulse. However, the ventricular pacing sequence is not affected.

[0046] The pulse stimulation device provided in the above embodiment that can effectively avoid atrial vulnerable period pacing is applicable to single-chamber and dual-chamber modes with atrial pacing, including but not limited to DDD, DVI, DDI, AAI, and AOO. Compared with the prior art, the pulse stimulation device is also applicable to single-chamber modes with atrial pacing, which greatly expands the scope of application and can reduce the risk of atrial fibrillation caused by atrial vulnerable period pacing to a greater extent.

[0047] The pulse stimulation device provided in the above embodiment can effectively avoid atrial vulnerable period pacing. In the mode where atrial sensing can affect the pacing timing, such as DDD, DDI, and AAI, if the atrial self-activity occurs in the atrial refractory period, it is identified as an atrial sensing event in the refractory period. In the mode where atrial sensing does not affect the pacing timing, such as DVI and AOO, all atrial self-activity is identified as an atrial sensing event in the refractory period. In the dual-chamber mode, the atrial refractory period in the embodiment generally refers to the post-ventricular atrial refractory period (PVARP, post Ventricular Atrial refractory period), and in the single-chamber mode, the atrial refractory period described in the present invention generally refers to the post-atrial atrial refractory period (ARP, Atrial refractory period).

[0048] The pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing provided in the embodiment is to explain the process of effectively avoiding atrial vulnerable period pacing by the division of the above-mentioned functional modules, and the above-mentioned functions can be assigned to different functional modules as needed, that is, the computer program stored in the storage medium is divided into different functional modules to complete all or part of the functions described above. In the embodiment, the pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing can be implemented in an application-specific integrated circuit chip (ASIC), a digital signal processing chip (DSP) or a microcontroller chip (MCU).

[0049] In one embodiment, a pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing is provided, comprising a memory, a processor, and a computer program stored in the machine memory and executable on the processor, wherein a portion of the memory in the memory is used as a storage module to store sequentially adjacent T1 periods and T2 periods, and when the processor executes the computer program, the following steps are implemented:

[0050] The atrial sensing module senses and sends atrial self-activity signals to the pacing control module;

[0051] When the pacing control module identifies the atrial self-activity signal as an atrial sensing event in the refractory period, the clock / timing module is controlled to perform timing of the sequentially adjacent T1 period and T2 period according to the sequentially adjacent T1 period and T2 period stored in the storage module;

[0052] When the pacing control module determines that the expected atrial pacing event occurs during the T2 period, the atrial pacing module is inhibited from issuing an atrial pacing event;

[0053] When the pacing control module determines that the expected atrial pacing event occurs in the T1 period, the pacing control module controls the atrial pacing module to normally deliver the atrial pacing event.

[0054] In one embodiment, when the processor executes the computer program, the following steps are also implemented: the treatment control module automatically adjusts the T2 period and the T1 period according to the user's atrial cardiac event state or the user's physiological state obtained from the pacing control module, and updates them to the storage module.

[0055] In one embodiment, when the processor executes the computer program, it also implements the following steps: receiving the T2 period and the T1 period adjusted according to the physiological state of the user by the external device, and updating them to the storage module.

[0056] The specific implementation methods described above provide a detailed description of the technical solutions and beneficial effects of the present invention. It should be understood that the above is only the most preferred embodiment of the present invention and is not intended to limit the present invention. Any modifications, supplements and equivalent substitutions made within the scope of the principles of the present invention should be included in the protection scope of the present invention.

Claims

1. A pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing, characterized in that: It includes an atrial sensing module, a pacing control module, an atrial pacing module, a clock / timing module and a storage module; The atrial sensing module senses and sends the atrial self-activity signal to the pacing control module; when the pacing control module identifies the atrial self-activity signal as an atrial sensing event in the refractory period, the clock / timing module is controlled to time the T1 period and T2 period that are adjacent in time sequence according to the T1 period and T2 period that are adjacent in time sequence stored in the storage module, wherein the atrial sensing event in the refractory period is divided into the T1 period and T2 period that are adjacent in time sequence at a certain time sequence, the T1 period is used as a stable period, and its start time is the time when the atrial sensing event is detected, and the T2 period is used as an atrial pacing adjustment window interval in the atrial vulnerable period, and its start time is the end time of the T1 period, and the T1 period and the T2 period are dynamically adjustable according to the physiological state of the user; When the pacing control module determines that the atrial sensing event occurs within the atrial refractory period, the clock / timing module controls the clock / timing module to start timing the T1 period, and the clock / timing module notifies the pacing control module when the T1 period timing expires. When the pacing control module determines that the expected atrial pacing event occurs in the T1 period based on the T1 period timing expiration information, the atrial pacing module controls the atrial pacing module to normally deliver the atrial pacing event; The pacing control module notifies and controls the clock / timing module to start timing for the T2 period and sets the T2 start flag when the T1 period timing expires; the clock / timing module notifies the pacing control module when the T2 period timing expires; the pacing control module notifies and sets the T2 end flag when the T2 period timing expires; the pacing control module determines that the expected atrial pacing event occurs in the T2 period based on the T2 period start flag, and suppresses the atrial pacing module from issuing an atrial pacing event.

2. The pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing as claimed in claim 1, characterized in that: It also includes a treatment control module, which automatically adjusts the T2 period and the T1 period according to the atrial cardiac event state of the user or the physiological state of the user obtained from the pacing control module, and updates the T2 period and the T1 period to the storage module.

3. The pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing as claimed in claim 1, characterized in that: It also includes a threadless control module, through which the pulse stimulation device receives the T2 period and T1 period adjusted by an external device according to the physiological state of the user, and updates them to the storage module.

4. The pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing as claimed in claim 1, characterized in that: When the pacing control module identifies the atrial self-activity signal, if the atrial self-activity occurs within the atrial refractory period, it is identified as an atrial sensing event within the refractory period. If the atrial self-activity does not affect the pacing timing, all atrial self-activity is also identified as an atrial sensing event within the refractory period.

5. The pulse stimulation device capable of effectively avoiding atrial vulnerable period pacing as claimed in any one of claims 1 to 4, characterized in that: The pulse stimulation device is suitable for single and dual chamber modes with atrial pacing.

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