Defining start and end of respirophasic pacing therapy

A pacemaker adjusts cardiac pacing based on respiratory signals to mimic RSA, addressing the inefficiencies of monotonous pacing by varying rates during inspiration and expiration, improving cardiac output and patient outcomes.

WO2026133022A1PCT designated stage Publication Date: 2026-06-25MEDTRONIC INC
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Patent Information

Application Number
PCT/IB2025/062759
Authority / Receiving Office
WO · WO
Patent Type
Applications
Current Assignee / Owner
Priority Date
2024-12-18
Filing Date
2025-12-11
Publication Date
2026-06-25

AI Technical Summary

Technical Problem

Current pacemakers often pace monotonically and do not adjust cardiac pacing rates according to respiratory cycles, which may be unnecessary, ineffective, or counterproductive under certain conditions, such as when a patient is already achieving respiratory sinus arrhythmia, exceeds a heart rate threshold, or has unstable respiration signals.

Method used

A pacemaker that continuously senses physiological signals indicative of respiration to adjust cardiac pacing pulses, determining RSA amplitude, periodicity, and stability thresholds to mimic respiratory sinus arrhythmia by varying pacing rates during inspiration and expiration.

Benefits of technology

Improves patient outcomes by delivering RSA pacing when effective and avoiding it when ineffective, enhancing cardiac output and reducing unnecessary therapy delivery.

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Abstract

A medical device system includes an implantable medical device (IMD) including: sensing circuitry configured to sense one or more physiological signals, the one or more physiological signals being indicative of respiration and heart rate of a patient over a first period of time; and therapy delivery circuitry configured to deliver cardiac pacing pulses to a heart of the patient via a plurality of electrodes; and processing circuitry configured to: determine a baseline respiratory sinus arrhythmia (RSA) amplitude based on the one or more physiological signals; determine a periodicity metric based on the one or more physiological signals; and control the therapy delivery circuitry to adjust a rate of the cardiac pacing based on the one or more physiological signals in response to a determination that the baseline RSA meets a baseline RSA threshold and a determination that the periodicity metric meets a periodicity threshold.
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