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EP-4241833-B1 - PACING CONTROL APPARATUS, AND MEDICAL DEVICE

EP4241833B1EP 4241833 B1EP4241833 B1EP 4241833B1EP-4241833-B1

Inventors

  • WANG, LI

Dates

Publication Date
20260506
Application Date
20211104

Claims (15)

  1. A pacing control apparatus, comprising: a heart rate acquisition module for obtaining an actual heart rate of a patient; a first determination module for determining whether the actual heart rate meets a preset low heart rate condition, and if the first determination module determines the actual heart rate is below a preset low heart rate, calling a duration acquisition module to obtain a first low heart rate duration in which heart of the patient beats at the actual heart rate, wherein the first low heart rate duration is the duration in which the actual heart rate is consecutively below the preset low heart rate; the first determination module is also used for calling a pacing module to perform cardiac pacing to the patient by using a preset pacing rate when the first low heart rate duration reaches a preset low heart rate duration; wherein the preset low heart rate condition is used for representing that the patient is in a life-critical state.
  2. The pacing control apparatus according to claim 1, wherein the preset pacing rate, the preset low heart rate and the preset low heart rate duration are parameters that can be reset according to the patient's condition.
  3. The pacing control apparatus according to claim 1, wherein the preset low heart rate is greater than 0 bpm and less than or equal to 40 bpm.
  4. The pacing control apparatus according to claim 3, wherein the preset low heart rate is greater than or equal to 10 bpm and less than or equal to 30 bpm.
  5. The pacing control apparatus according to claim 1, wherein the preset low heart rate duration ranges from 1 s to 5 min.
  6. The pacing control apparatus according to claim 1, wherein the preset low heart rate duration ranges from 1 s to 60 s.
  7. The pacing control apparatus according to claim 6, wherein the preset low heart rate duration ranges from 10 s to 60 s.
  8. The pacing control apparatus according to any one of claims 1 to 7, wherein the preset pacing rate ranges from 40 bpm to 80 bpm.
  9. The pacing control apparatus according to any one of claims 1 to 7, wherein the pacing control apparatus also comprises: a self-heartbeat number acquisition module for obtaining the number of self heartbeats of the patient during a first pacing time period; a total-heartbeat number acquisition module for obtaining the total number of heartbeats of the patient during a given time period; wherein the given time period comprises the first pacing time period, and a duration corresponding to the given time period is greater than or equal to a duration corresponding to the first pacing time period; a ratio calculation module for calculating the ratio of the number of self heartbeats to the total number of heartbeats; a second determination module for determining whether the ratio is greater than or equal to a first given threshold, and if the ratio is greater than or equal to the first given threshold, controlling to terminate pacing.
  10. The pacing control apparatus according to claim 9, wherein if the ratio is less than the first given threshold, the second determination module is also used for determining whether the ratio is less than or equal to a second given threshold, and if the ratio is less than or equal to the second given threshold, the second determination module is also used for calling the pacing module to continue to execute the step of performing cardiac pacing to the patient by using the preset pacing rate.
  11. The pacing control apparatus according to claim 10, wherein if the ratio is greater than the second given threshold and less than the first given threshold, the second determination module is also used for reducing the preset pacing rate to a first pacing rate, and determining whether the first pacing rate is less than a minimum pacing rate, if not, calling the pacing module to perform cardiac pacing to the patient by using the first pacing rate; and if so, calling the pacing module to perform cardiac pacing to the patient by using the minimum pacing rate.
  12. The pacing control apparatus according to claim 11, wherein the first given threshold of the pacing control apparatus ranges from 50 to 100%, and the second given threshold of the pacing control apparatus ranges from 0 to 30%.
  13. The pacing control apparatus according to claim 11, wherein the minimum pacing rate of the pacing control apparatus ranges from 40 bpm to 60 bpm.
  14. A medical device, comprising the pacing control apparatus according to any one of claims 1 to 13.
  15. The medical device according to claim 14, wherein the medical device comprises a wearable cardioverter defibrillator (WCD), an external defibrillator, a subcutaneous implantable cardioverter defibrillator (SICD), or a mechanical circulatory support device (MCS).

Description

TECHNICAL FIELD The present disclosure relates to the technical field of medical apparatus, in particular to a pacing control apparatus and a medical device. BACKGROUND Real-time monitoring of a patient's heart rate, and performing timely cardiac pacing when the heart rate meets a given pacing condition to avoid too slow heart rate or even asystole (cardiac arrest) is the most basic purpose of a cardiac medical device. Existing pacing control methods are based on a preset low-limit heart rate, that is, pacing is performed on the patient at the same pacing rate as the preset low-limit heart rate once the monitored patient's heart rate decreases to the preset low-limit heart rate, so as to prevent the patient's heart rate from falling below a given value and keep the patient's heart rate not below the preset low-limit heart rate. For example, when the preset low-limit heart rate is set to 45 bpm, once the monitored patient's heart rate (one heartbeat or R-R interval) is below 45 bpm, pacing is performed on the patient by using a pacing rate of 45 bpm so that the R-R interval of the patient's heart rate will be no longer than the R-R interval of 45 bpm. US patent US 2013/325078 A1 discloses a non-invasive bodily-attached ambulatory medical monitoring and treatment device, which can be configured to pace the heart of a patient at a fixed rate and fixed energy in response to various types of cardiac arrhythmias. Such pacing control method is applied to common endocardial/epicardial pacing. However, for example, transcutaneous pacing (electrical stimulation) tends to cause pain, or even unbearable pain to the patient; however, in the existing pacing control method, pacing is initiated once the patient's heart rate decreases to the preset low-limit heart rate as described above, as a result, there is a problem of frequent pacing operations, which causes patients to be in pain from time to time due to pacing operations, resulting in a poor user experience and reducing the patient's use or compliance with medical apparatus/device. CONTENT OF THE PRESENT INVENTION The technical problem to be solved by the present disclosure is to overcome the defect of frequent pacing in the pacing control method of the prior art, which tends to cause the patient to be in pain from time to time, resulting in a poor use experience. The purpose is to provide a pacing control apparatus and a medical device. The present disclosure provides a pacing control apparatus, comprising: a heart rate acquisition module for obtaining an actual heart rate of a patient;a first determination module for determining whether the actual heart rate meets a preset low heart rate condition, and if so, calling a pacing module to perform cardiac pacing to the patient by using a preset pacing rate; wherein the preset low heart rate condition is used for representing that the patient is in a life-critical state. It is no longer for the patient with bradycardia in the sense of traditional cardiac pacing therapy, but for the patient with severely too slow heart rate or even cardiac arrest due to basic or acute heart disease. The patient in the aforementioned life-critical state is taken as an object needing pacing support, where death is very likely to occur without pacing (the patient is in urgent need of help), that is, the pacing operation in the present disclosure is implemented only as a "necessary"/"life-saving" measure. Specifically, by presetting trigger conditions for the pacing operation, pacing is performed on the patient by using a higher pacing rate only when the pacing is necessary, and the effect of timely and effective pacing is achieved to support the life of the patient; at the same time, the effect of avoiding, to a great extent, unnecessary pacing for the patient during daily use and the pain of the patient caused by pacing stimulation is also achieved, thereby improving the acceptability of the user and/or the use experience. Preferably, the first determination module is used for determining whether the actual heart rate is below a preset low heart rate, and if so, calling the pacing module to perform cardiac pacing to the patient by using the preset pacing rate. By monitoring the real-time heart rate of the patient, it is determined that the patient is in urgent need of help when the real-time heart rate is below the given preset low heart rate (much less than the preset low-limit heart rate in the existing pacing control method), that is, only when the heart rate of the patient is very low can cardiac pacing be triggered for the patient, and the effect of timely and effective pacing is achieved to support the life of the patient Preferably, the first determination module is used for determining whether the actual heart rate is below the preset low heart rate, and if so, calling a duration acquisition module to obtain a duration (that is, a first low heart rate duration) in which the actual heart rate of the patient is consecutively below th