Respiratory muscle electromyographic rate responsive pacemak er

摘要

A physiologic rate responsive pacer which alters the pacer's escape interval in response to the patient's respiratory minute ventilation derived from the electromyogram of selected respiratory muscle groups. The directly detected electromyogram (EMG) signal is amplified and band passed filtered, processed to remove any electrocardiogram (ECG) or pacing impulse signal, full-wave rectified, processed to develop a moving time average signal from which the peak, the maximal slope, and the average slope of the EMG moving time average may be calculated and processed in conjunction with the inspiratory and expiratory times between successive slope detections of the moving time average EMG to develop a rate control signal representative of minute ventilation. The EMG may be selectively picked up from electrodes implanted in or near the parasternal intercostal muscles, the external intercostal muscles, the internal intercostal muscles, the diaphragm, or any other respiratory muscle such as the scalenes, or the sternocleidomastoid, and coupled to conventionally designed or special configuration pacemaker pulse generators and cardiac pace/sense lead systems.