WO2019001478A1 - Method for realizing double-chamber demand pacing - Google Patents

Abstract

The invention discloses a dual-cavity on-demand pacing implementation method, comprising the steps of: setting an upper limit tracking frequency of a dual-chamber pacemaker to be equal to a lower limit frequency in advance; controlling a dual-chamber pacemaker to operate in a DDD mode, After sensing the atrial event, the atrial pulse is suppressed, and the interventricular phase is opened, and ventricular pacing is delivered at the end of the interventricular interval until the ventricular rate exceeds the upper limit tracking frequency; when the ventricular rate exceeds the upper limit tracking frequency, the atrial event continues to be perceived. And after detecting the atrial sensing event outside the refractory period, suppress the trigger of the atrial pulse until the end of the lower limit frequency interval to release the ventricular pulse to achieve the DDI mode. The present invention sets the UTRI and LRI values consistently, and implements the DDI mode according to the DDD mode, which not only improves the convenience, reliability and direct verifiability of implementing the DDI mode, greatly reduces the workload of verification, and does not require substantial mode conversion. Mode conversion is fast and smooth, physiologically good, and reduces patient discomfort.

Description

Double-cavity on-demand pacing implementation method Technical field

The invention relates to a method for controlling a pacemaker, in particular to a double-cavity on-demand pacing implementation method.

Background technique

Cardiac pacemaker is an electronic therapeutic device implanted in the body. The pulse generator distributes the electric pulse that is powered by the battery. Through the conduction of the wire electrode, the myocardial contacted by the electrode is stimulated, and the heart is excited and contracted. In order to achieve the purpose of treating cardiac dysfunction caused by certain arrhythmias.

A dual-chamber pacemaker is one of the most clinically installed pacemakers. The English abbreviation is DDD. The first D represents a double heart chamber that can be pacing, including the atria and ventricle. The second D represents two (double) heart chambers that can be perceived, including an atrium and a ventricle. The third D represents After the heartbeat senses its own heart, it can be reflected in two ways (double), one is suppression and the other is trigger, so it is also represented by D. The dual-chamber pacemaker has two electrodes that are placed in the two chambers of the heart to sense and pace the atria and ventricles. Generally, one electrode is placed in the right atrium and one is placed in the apex of the right ventricle. The pacemaker itself sets a time limit for the conduction of the ventricle from the atrium (the systole of the ventricle after the atrium), for example 0.20 seconds. If the atrial contraction, after 0.20 seconds, the ventricle does not shrink, then it starts from The beater sends impulses to the electrodes of the right ventricle, stimulating the myocardium and creating ventricular contractions.

Dual-chamber pacemakers typically operate in dual-chamber pacing modes such as DDD, DDI, DOO, ODO, and DVI, depending on user settings. The various modes can be automatically converted as needed, when the atrial rate is lower than the lower limit frequency set by the pacemaker, and the PR interval (perceived interventricular interval) is greater than the AV interval set by the pacemaker (pacing) During the interventricular period, the ventricular pacing is presented. When a ventricular event occurs, in addition to the VAT mode, the other modes of the dual-chamber pacemaker appear to suppress the release of ventricular impulses and reform the pacing frequency. The DDI mode is a dual-chamber on-demand pacing mode, equivalent to AAI+VVI, suitable for patients with sick sinus with atrioventricular block, especially with paroxysmal atrial tachyarrhythmia.

Dual-cavity pacemakers currently on the market, which operate in DDI pacing mode, are typically switched from DDD pacing mode (or other currently operating mode of operation) to DDI pacing mode. When a pacemaker is operating in DDI mode: When an atrial event outside the refractory period is detected, the expected atrial pacing is cancelled. However, a new interventricular interval is initiated when atrial pacing is expected, and ventricular pacing is delivered at the end of the interventricular interval.

Summary of the invention

The technical problem to be solved by the present invention is to provide a dual-cavity on-demand pacing implementation method, which can not only improve the convenience, reliability and direct verifiability of implementing the on-demand DDI mode, but also greatly reduce the workload of verification, and Since the substantial mode conversion is not required, the mode switching is fast and smooth, physiologically good, and the patient's discomfort is reduced.

The technical solution adopted by the present invention to solve the above technical problem is to provide a dual-cavity on-demand pacing implementation method, comprising the steps of: setting an upper limit tracking frequency of a dual-chamber pacemaker to be equal to a lower limit frequency in advance; The cavity pacemaker works according to the DDD mode. After sensing the atrial event, the atrial pulse is suppressed, the interventricular phase is opened, and the ventricular pacing is delivered at the end of the interventricular interval until the ventricular rate exceeds the upper limit tracking frequency; After the upper limit tracking frequency is exceeded, the atrial event is continued to be perceived; and after detecting the atrial sensing event outside the refractory period, the trigger of the atrial pulse is suppressed, and the ventricular pulse is issued to achieve the DDI mode at the end of the lower limit frequency interval.

The dual-chamber on-demand pacing implementation method described above, wherein the dual-chamber pacemaker comprises a microprocessor and a digital/analog module connected thereto, the microprocessor and the digital/analog module interacting through data/information The interfaces are connected.

The dual-cavity on-demand pacing implementation method, wherein the control unit of the microprocessor acquires user setting information through the data/information interaction interface, and sets an upper limit tracking frequency interval UTRI to a lower frequency interval LRI is consistent.

The dual-cavity on-demand pacing implementation method described above, wherein the microprocessor comprises a main control unit and a time control unit, the digital/analog module comprising a pacing control/generation unit, a perceptual control/amplification unit, and a program control unit The perceptual control/amplification unit of the digital/analog module detects an atrial sensing event, and when the main control unit of the microprocessor determines that the event is a ventricular refractory period, the dual-chamber type is controlled The beater continues to operate in accordance with the mode of operation of the DDD mode, and the main control unit of the microprocessor controls the time control unit to set the atrial-aware post-ventricular pacing interval.

The dual-cavity on-demand pacing implementation method, wherein the sensing/amplifying unit of the digital/analog module detects the atrial sensing event As and the ventricular sensing event Vs in real time, first determining the UTRI and the starting point of the above ventricular event The current atrial perception event As is the starting time of the atrial perception of the interventricular interval AsVI timing overflow sequence. If the AsVI first timed out, the atrial perception post-ventricular escape interval is overflowed at the end of UTRI; if UTRI is one step ahead Timed overflow, then set the atrial perception after the ventricular escape interval is overflowed at the end of AsVI.

The above-described dual-chamber on-demand pacing implementation method, wherein the main control unit of the microprocessor controls the pacing control/generation unit to deliver a ventricular pacing pulse when the atrial sensing post-ventricular ventricular interval timeout occurs Vp, and controlling the time control unit to set atrial ventricular refractory period PVARP, ventricular refractory period VRP, upper limit tracking frequency interval UTRI and ventricular chamber atrial escape interval AEI.

The dual-chamber on-demand pacing implementation method described above, wherein the perceptual control/amplification unit of the digital/analog module does not perceive any atrial or ventricular event if the atrial escape interval AEI is timed out after the ventricular event The atrial pacing event is issued when the AEI is timed out; at the same time, the main control unit of the microprocessor controls the time control unit to set the ventricular escape interval ApVI after atrial pacing.

The above-described dual-chamber on-demand pacing implementation method, wherein the atrial sensing post-interventricular interval AsVI, ventricular retroatrial refractory period PVARP, ventricular refractory period VRP and upper limit tracking frequency interval UTRI and atrial pacing The ventricular escape interval ApVI is programmed by the user through the programmed unit, and AEI=LRI-ApVI.

The dual-cavity on-demand pacing implementation method described above, wherein the sensing/amplifying unit of the digital/analog module senses a ventricular event before the ApVI timing overflow, and inhibits ventricular pacing; meanwhile, the microprocessing The main control unit of the device controls the time control unit to set a post-ventricular atrial refractory period PVARP, a ventricular refractory period VRP and an upper limit tracking frequency interval UTRI.

The dual-cavity on-demand pacing implementation method described above, wherein the main control unit of the microprocessor further controls the time control unit to set AEI=LRI-ApVI-the remaining time period of ApVI or AsVI in the previous interventricular period .

The invention also provides a dual-chamber type pacemaker, comprising: a microprocessor comprising a main control unit and a time control unit, the main control unit being configured to acquire user setting information through a data/information interaction interface, and to track the upper limit The frequency interval UTRI is set to be consistent with the lower limit frequency interval LRI; the digital/analog module is connected to the microprocessor through a data/information interface; the digital/analog module includes: a perceptual control/amplification unit, and pacing control/generation The unit; the sensing control/amplifying unit is configured to detect an atrial event, and the pacing control/generating unit is configured to issue or suppress a pacing pulse; the main control unit is further configured to: when the dual chamber type pacemaker operates in the DDD mode, by sensing The control/amplification unit detects the atrial event, and after detecting the atrial event, controls the pacing control/generating unit to suppress the triggering of the atrial pacing pulse, and controls the time control unit to open the interventricular interval, and controls the pacing control/generating unit to The ventricular pacing pulse is delivered after the interventricular interval; until the ventricular rate is detected to exceed the upper limit tracking frequency, continue to pass the perceptual control / The amplifying unit detects the atrial event, determines that the detected atrial event is an ectopic atrial sensing event, and controls the pacing control/generating unit to suppress the trigger of the atrial pacing pulse until the end of the lower limit frequency interval, so that the pacing control/ The generating unit issues a ventricular pacing pulse to implement the DDI mode.

Further, the sensing control/amplifying unit is further configured to detect the atrial sensing event As and the ventricular sensing event Vs in real time, and the main control unit is further configured to determine the UTRI of the previous ventricular event as the starting point and the atrium starting from the current atrial sensing event As Perceive the timed outflow sequence of the interventricular interventricular period AsVI. If the AsVI first timed out, set the atrial perception after the ventricular escape interval is overflowed at the end of UTRI. If the UTRI first timed out, set the atrial perception after ventricular escape. The blog interval overflows at the end of AsVI.

Further, the main control unit is further configured to: when the ventricular sensation is delayed, the pacing control/generation unit issues a ventricular pacing pulse, and controls the time control unit to set a post-ventricular atrial refractory period PVARP, Ventricular refractory period VRP, upper limit tracking frequency interval UTRI and ventricular escape interval AEI.

Further, the main control unit is further configured to: before the ventricular escape interval AEI timing overflow, if the self-atrial or ventricular event is not sensed by the sensing control/amplification unit, then the control occurs when the AEI timing overflows The beat control/generation unit issues an atrial pacing pulse and controls the time control unit to set the ventricular escape interval ApVI after atrial pacing.

Further, the digital/analog module further includes a program control unit, atrial-aware posterior atrioventricular phase AsVI, post-ventricular atrial refractory period PVARP, ventricular refractory period VRP, upper-rate tracking frequency interval UTRI, and atrial pacing after ventricular escape. The ApVI is set by the program control unit programmed time control unit, and the atrial escape interval after the ventricular event is AEI=LRI-ApVI.

Further, the main control unit is further configured to: after the ApVI timing overflows, the pacing control unit generates the ventricular pacing pulse, and controls the pacing control/generation unit to suppress the ventricular pacing pulse, and controls the time control unit to set the ventricular chamber Atrial refractory period PVARP, ventricular refractory period VRP and upper limit tracking frequency interval UTRI.

Further, the main control unit further controls the time control unit to set AEI=LRI-ApVI-the remaining time period of the ApVI or AsVI in the previous interventricular period.

Compared with the prior art, the present invention has the following beneficial effects: the dual-cavity on-demand pacing implementation method provided by the present invention has the same UTRI and LRI values, and does not need to perform any special operation and state machine setting for the DDI working mode. The DDI mode can be implemented according to the DDD mode, which not only improves the convenience, reliability and direct verifiability of the implementation, but also greatly reduces the workload of verification. In addition, when mode conversion between DDD mode and DDI mode (such as room speed may be performed), no special mode switching operation is required, which makes the mode conversion fast, smooth, physiological, and reduces patient discomfort.

DRAWINGS

1 is a schematic diagram showing a mode control flow of a dual-chamber pacemaker according to an embodiment of the present invention;

2 is a schematic diagram of timing control of a dual-chamber pacemaker in DDD mode according to an embodiment of the present invention;

3 is a schematic diagram of timing control of a dual-cavity pacemaker implementing a DDI mode in a DDD mode according to an embodiment of the present invention;

4 is a schematic structural view of a dual-chamber pacemaker used in an embodiment of the present invention.

Detailed ways

The invention will now be further described with reference to the drawings and embodiments.

FIG. 1 is a schematic diagram of a mode control flow of a dual-chamber pacemaker according to an embodiment of the present invention.

Referring to FIG. 1 , a method for implementing a dual-chamber on-demand pacing according to an embodiment of the present invention includes the following steps:

Step S1: setting an upper limit tracking frequency of the dual chamber type pacemaker to be equal to a lower limit frequency;

Step S2: Control the dual-chamber pacemaker to work in DDD mode, after atrial events, suppress atrial pulse, and simultaneously open the interventricular phase (atrial perception post-interventricular interval, AsVI), and in the interventricular phase (AsVI) At the end of the ventricular pacing, until the ventricular rate exceeds the upper limit tracking frequency;

Step S3: After the ventricular rate exceeds the upper limit tracking frequency, continue to sense the atrial event; and after detecting the atrial sensing event outside the refractory period, suppress the trigger of the atrial pulse until the end of the lower limit frequency interval to release the ventricular pulse to implement the DDI mode. In this DDI mode, the upper limit tracking frequency = the lower limit frequency.

It can be understood that if the ventricular rate does not reach the upper limit tracking frequency, ventricular pacing will be issued at the end of the interventricular interval; if the ventricular rate exceeds the upper limit tracking frequency, it will end at the upper tracking frequency interval (UTRI) (also equivalent to the lower limit frequency) At the end of the interval LRI, a ventricular pulse (also called a ventricular pacing) is issued.

When the dual-chamber pacemaker of the embodiment of the present invention operates in the DDI mode, the atrium and the ventricle can be sensed or paced. The working mode is the same as the DDD mode. The user or system automatically sets the UTRI (upper limit tracking frequency interval) and LRI (lower limit frequency interval) values to be consistent on the DDD mode. It can be understood that the values of UTRI and LRI are the same, which is equivalent to setting the upper limit tracking frequency equal to the lower limit frequency.

Compared with the traditional method, the embodiment of the present invention has the same UTRI and LRI values, and does not need to perform any special operation and state machine setting for the DDI working mode, and can implement the DDI mode according to the DDD mode, thereby improving the convenience of the implementation manner. , reliability and direct verifiability, reducing the amount of verification work. In addition, when mode conversion between DDD mode and DDI mode (such as room speed may be performed), no special mode switching operation is required, which makes the mode conversion fast, smooth, physiological, and reduces patient discomfort. The operation of the two modes of the dual chamber pacemaker of the present invention is given below.

First, DDD pacing mode (synchronous dual-chamber pacing mode)

When the dual-chamber pacemaker of the embodiment of the present invention works in the DDD mode, the atrium and the ventricle can be sensed or pacing, and the ventricular pacing can follow the atrial event after the interventricular interval, thereby achieving the synchronization of the atrioventricular, as shown in FIG. 2 As shown, the specific timing is as follows:

1. An atrial event perceived in PVARP (post-ventricular atrial refractory period) Ar (1 sequence moment, atrial perception event during refractory period).

2.As (not expected outside atrial perception events) located before PVARP (post-Vp post-ventricular atrial refractory period) AEI (AEI after ventricular re-ventricular atrial escape interval AEI) before the expiration of As (2 sequence time) is based on AsVI (Atrial Perceptual Posterior Interventricular Phase) as the escape interval, and the projected ventricular pacing time is longer than the UTRI (upper tracking frequency) projection (previous ventricular time point is Benchmark), that is, AsVI is later than UTRI. Therefore, AsVI is counted in the ventricular pacing escape counter and the pacing chamber is set to the ventricle.

3. No ventricular perception before the ventricular pacing escape interval expires, issuing a ventricular pacing pulse Vp (3 sequence moment).

4. Atrial event As perceived by PVARP (4 sequence moment).

5. Using AsVI (4 sequence time), the ventricular pacing time point set for the escape interval is shorter than the upper limit tracking frequency interval (previous ventricular time point, 3 sequence time), that is, 4 sequences The AsVI at the beginning of the time expires before the UTRI starting at the 3rd sequence (AsVI expires at the 5th sequence, and UTRI expires at the 6th sequence). Therefore, the upper limit tracking interval (3 sequence time) is used to adjust the most recent Vp occurrence time and count into the ventricular pacing escape counter, and the pacing chamber is set as the ventricle.

6. Ventricular pacing Vp (6 sequence time) is issued when the ventricular pacing escape counter expires (also UTRI expires).

Second, DDI pacing mode (dual cavity on-demand pacing mode)

When the dual-chamber pacemaker of the embodiment of the present invention operates in the DDI mode, the atrium and the ventricle can be sensed or paced. The working mode is the same as the DDD mode. Only the DDD mode needs to be set by the user or the system to automatically match the values of UTRI and LRI (lower frequency interval). Therefore, UTRI in Figure 3 can be regarded as Equivalent to LRI. As shown in Figure 3, the specific timing control is as follows:

1. As (1 sequence time) outside PVARP (2 sequence time), track atrial activity when UTRI is equal to LRI.

2. Ventricular pacing Vp (2 sequence moment) when the interventricular interval is equal to LRI.

3. Atrial pacing (3 sequence moments) after AEI expires. AEI=LRI–ApVI (ApVI is the atrioventricular phase after atrial pacing).

4.Vs (4 sequence moments) occurs before the ApVI expires, where AEI = LRI - ApVI. However, depending on the projected Vp (ventricular pacing) point, AEI begins at the end of ApVI, but UTRI begins at the Vs (out of ventricular sensation event) point and has a value equal to LRI.

5.2 After the UTRI expiration from the beginning of the sequence time, As (5 sequence time) occurs before the AEI expires. The projected Vp time (6 sequence time) is when the AsVI expires.

6.5 When the AsVI expires at the beginning of the sequence, Vp appears (6 sequence time).

As can be seen from the above, the DDD mode differs from the DDI mode in that the DDI mode has LRI=UTRI and the lower limit frequency LRL=upper limit tracking frequency URL.

Referring to FIG. 4, a dual-chamber pacemaker according to an embodiment of the present invention includes a microprocessor 8 and a digital/analog module 9 connected thereto, and the perception of the atrial ventricle is always on, in any mode. The selection and implementation manner of the microprocessor 8 and the like are not limited. The digital/analog module 9 needs to realize the perception of external signals, needs to be able to issue signals to the outside, and needs to be able to interact with external data information.

Further, the microprocessor 8 includes a main control unit 1, a time control unit 2, and a data/information interaction interface 3. The main control unit 1 controls the occurrence of an event, an event to be generated, and the like. The main control unit 1 can select, through the time control unit 2, a time-related control function such as timing, timing, etc., for example, the time control unit 2 can capture and record the time when the event occurs, and can also control the event to be generated. Accurate time, etc. The data/information interface 3 implements interaction of data or information between the device and other modules. The data/information interface 3 can be a normal I/O interface or a serial or parallel data transmission module. In this embodiment, the data/information interface 3 can receive the perceived event information, issue a pacing event request, serial data interaction, clock data interaction, and the like.

Further, the digital/analog module 9 includes a data/information interaction interface 4, a pacing control/generation unit 5, a perceptual control/amplification unit 6, and a program control unit 7. The data/information interface 4 can interact with the corresponding data/information interface 3, although its implementation can be different. The pacing control/generating unit 5 receives the pacing request of the microprocessor 8 and generates a signal of required intensity to act on the outside, and at the same time bears a small part of the control function, depending on the difference of the affected object, the strength and type of the signal, etc. The difference. The perceptual control/amplification unit 6 is capable of capturing and distinguishing external real signals and notifying the microprocessor 8, such as a heart signal, and the need to be able to amplify the signal according to user settings. The program control unit 7 is capable of information interaction with the outside world, such as a user.

As shown in FIG. 4, the user transmits DDI working mode information to the pacemaker through the program control unit, and the main control unit of the microprocessor acquires user setting information through the data/information interaction interface, and UTRI (upper limit tracking) The frequency interval is set to be consistent with the LRI.

As shown in FIG. 3, the sensing control/amplification unit 6 of the digital/analog module 9 continues to operate in the DDD mode when the ventricle is not expected to be outside the atrial sensing event, the main body of the microprocessor 8. The control unit 1 controls the time control unit 2 to set the atrial-aware post-ventricular pacing interval:

First, determine the UTRI of the above ventricular event (ventricular pacing Vp in the last cardiac cycle, or perceived ventricular event Vs) as the starting point and the timing of the atrioventricular interphase AVI with the current atrial event As as the starting point. Sequence, if AsVI first timed out, set the atrial perception post-ventricular escape interval to overflow at the end of UTRI, as shown in the sequence of 12 in Figure 3; if UTRI first timed out, set the atrial perception of ventricular escape The blog interval overflows at the end of AsVI, as shown in the 56 sequence moment in Figure 3.

Further, the main control unit of the microprocessor controls the pacing control/generation unit to issue the ventricular pacing Vp, and controls the time control unit to set the PVARP, the ventricle, when the ventricular systolic interval is timed out. The refractory period VRP, the upper limit tracking frequency interval UTRI and the ventricular escape interval AEI, as shown in Figure 3, the above-mentioned PVARP, VRP, UTRI and AEI.

Further, atrial perception of posterior atrioventricular phase AsVI, post-ventricular atrial refractory period PVARP, ventricular refractory period VRP, upper-order tracking frequency interval UTRI and atrial pacing ventricular escape interval ApVI are passed by the user through the program control unit Program control settings, AEI=LRI–ApVI.

Atrial pacing is dispensed when the AEI timing overflow occurs if the perceptual control/amplification unit of the digital/analog module does not perceive any atrial or ventricular events before the ventricular escape interval (AEI) timeout The event Ap is as shown in the sequence of 3 sequences in FIG. At the same time, the main control unit 1 of the microprocessor 8 controls the time control unit 2 to set the ventricular escape interval (ApVI) after atrial pacing.

Further, the ApVI is programmed by the user through the program control unit.

Prior to the ApVI timing overflow, the perceptual control/amplification unit of the digital/analog module senses its own ventricular event and ventricular pacing is suppressed. At the same time, the main control unit of the microprocessor controls the time control unit to set a post-ventricular atrial refractory period PVARP, a ventricular refractory period VRP and an upper limit tracking frequency interval UTRI. As shown in the sequence of 4 in Figure 3.

Further, the main control unit of the microprocessor controls the time control unit to set the remaining time period of the ApVI set by the AEI=LRI-ApVI-3 sequence time, thereby maintaining the stability of the room period.

Therefore, in the embodiment of the present invention, by setting the values of UTRI and LRI, it is not necessary to perform any special operation and state machine setting for the DDI working mode, and the DDI mode can be implemented according to the DDD mode, which not only improves the convenience of the implementation mode, but also is reliable. Sexuality and direct verifiability, and greatly reduce the amount of verification work.

While the present invention has been described in its preferred embodiments, the present invention is not intended to be limited thereto, and the present invention may be modified and improved without departing from the spirit and scope of the invention. The scope of protection is defined by the terms of the claims.

Claims (17)

A dual-cavity on-demand pacing implementation method, comprising the steps of: The upper limit tracking frequency of the dual chamber type pacemaker is set to be equal to the lower limit frequency in advance; The dual-chamber pacemaker is controlled to operate in DDD mode. After sensing the atrial event, the atrial pulse is suppressed, and the interventricular interval is opened, and ventricular pacing is delivered at the end of the interventricular interval until the ventricular rate exceeds the upper limit tracking frequency; After the ventricular rate exceeds the upper limit tracking frequency, the atrial event continues to be perceived; and after detecting the atrial sensing event outside the refractory period, the trigger of the atrial pulse is suppressed until the ventricular pulse is delivered at the end of the lower limit frequency interval to implement the DDI mode. The dual-chamber on-demand pacing method of claim 1 wherein said dual chamber pacemaker comprises a microprocessor and a digital/analog module coupled thereto, said microprocessor and digital/ The analog modules are connected via a data/information interface. The dual-cavity on-demand pacing implementation method according to claim 2, wherein the control unit of the microprocessor acquires user setting information through the data/information interaction interface, and the upper limit tracking frequency interval UTRI Set to match the lower limit frequency interval LRI. The dual-cavity on-demand pacing implementation method according to claim 2, wherein said microprocessor comprises a main control unit and a time control unit, said digital/analog module comprising pacing control/generation unit, sensing a control/amplification unit and a program control unit; the sensing/amplifying unit of the digital/analog module detects an atrial sensing event, and when the main control unit of the microprocessor determines that the event is a ventricular refractory period At this time, the dual-chamber pacemaker is controlled to continue to operate in the DDD mode, and the main control unit of the microprocessor controls the time control unit to set the atrial-aware post-ventricular pacing interval. The dual-cavity on-demand pacing implementation method according to claim 4, wherein the sensing/amplifying unit of the digital/analog module detects the atrial sensing event As and the ventricular sensing event Vs in real time, and first determines the upper ventricle The event is the starting point of the UTRI and the current atrial sensing event As as the starting point for the atrial sensing of the interventricular interventricular period AsVI timing overflow sequence. If the AsVI first timed out of time, then the atrial perception post-ventricular ventricular interval is set at the end of UTRI Time overflow; if UTRI first timed out, set the atrial perception post-ventricular escape interval to overflow at the end of AsVI. The dual-chamber on-demand pacing implementation method according to claim 5, wherein the main control unit of the microprocessor controls the pacing control when the atrial sensing post-ventricular ventricular interval timeout occurs The generating unit issues a ventricular pacing pulse, and controls the time control unit to set a post-ventricular atrial refractory period PVARP, a ventricular refractory period VRP, an upper limit tracking frequency interval UTRI, and a post-ventricular atrial escape interval AEI. The dual-chamber on-demand pacing implementation method according to claim 6, wherein the sensing/amplifying unit of the digital/analog module is not perceived before the atrial escape interval AEI timing overflows after the ventricular event To any of the atrial or ventricular events, the atrial pacing event is issued when the AEI is timed out; at the same time, the main control unit of the microprocessor controls the time control unit to set the ventricular escape interval ApVI after atrial pacing. The method for implementing a mode control of a dual-chamber on-demand pacemaker according to claim 6 or 7, wherein the atrial sensing post-interventricular interval AsVI, ventricular retroatrial refractory period PVARP, ventricular refractory period VRP, upper limit tracking frequency interval UTRI and atrial pacing ventricular escape interval ApVI are programmed by the user through the program control unit, and AEI=LRI-ApVI. The dual-chamber on-demand pacing implementation method according to claim 7, wherein the perceptual control/amplification unit of the digital/analog module senses a ventricular event and suppresses ventricular pacing before the ApVI timeout occurs. At the same time, the main control unit of the microprocessor controls the time control unit to set the post-ventricular atrial refractory period PVARP, the ventricular refractory period VRP and the upper limit tracking frequency interval UTRI. The dual-chamber on-demand pacing implementation method according to claim 9, wherein the main control unit of the microprocessor further controls the time control unit to set AEI=LRI-ApVI-in the first interventricular period The remaining time period of ApVI or AsVI. A dual-chamber pacemaker characterized by comprising: a microprocessor comprising a main control unit and a time control unit, the main control unit configured to acquire user setting information through a data/information interaction interface, and set an upper limit tracking frequency interval UTRI to be consistent with a lower limit frequency interval LRI; a digital/analog module connected to the microprocessor via the data/information interface; the digital/analog module comprising: a perceptual control/amplification unit, and a pacing control/generation unit; the perceptual control/amplification The unit is configured to detect an atrial event, the pacing control/generating unit for dispensing or suppressing a pacing pulse; The main control unit is further configured to: When the dual-chamber pacemaker operates in the DDD mode, the atrial event is detected by the sensing control/amplifying unit, and after detecting the atrial event, the pacing control/generating unit is controlled to suppress the triggering of the atrial pacing pulse And controlling the time control unit to open the interventricular interval, and controlling the pacing control/generating unit to issue a ventricular pacing pulse after the end of the interventricular interval; until the ventricular rate is detected to exceed the upper limit tracking frequency, continue to pass The sensing control/amplification unit detects an atrial event, and determines that the detected atrial event is an refractory atrial sensing event, and controls the pacing control/generating unit to suppress triggering of the atrial pacing pulse until the lower frequency interval ends The pacing control/generating unit is caused to dispense a ventricular pacing pulse to achieve a DDI mode. The dual-chamber pacemaker according to claim 11, wherein the sensing control/amplifying unit is further configured to detect the atrial sensing event As and the ventricular sensing event Vs in real time, and the main control unit is further configured to determine the above The UTRI of the ventricular event as the starting point and the atrial perceptual interventricular interphase AsVI with the current atrial sensing event As as the starting point. If the AsVI first overflows in a step, the ventricular ventricular interval is set after the atrial perception. UTRI overflows at the end. If UTRI first overflows in one step, then the atrial perception is set and the ventricular escape interval is overflowed at the end of AsVI. The dual-chamber pacemaker according to claim 12, wherein said main control unit is further configured to: control said pacing control/generation unit to be dispensed when atrial sensation ventricular ventricular interval timeout occurs Ventricular pacing pulse, and control the time control unit to set the ventricular ventricular refractory period PVARP, ventricular refractory period VRP, upper limit tracking frequency interval UTRI and ventricular event after atrial escape interval AEI. The dual-chamber pacemaker according to claim 13, wherein said main control unit is further configured to: pass through said sensing control/amplification unit before an atrial escape interval AEI timing overflow after a ventricular event If no atrial or ventricular events are sensed, the pacing control/generation unit is controlled to issue an atrial pacing pulse when the AEI is timed out, and the time control unit is set to set the ventricular escape interval ApVI after atrial pacing . The dual-chamber pacemaker according to claim 13, wherein said digital/analog module further comprises a program control unit, said atrial sensing post-interventricular interval AsVI, ventricular retroatrial refractory period PVARP, ventricular refractory The scheduled period VRP, the upper limit tracking frequency interval UTRI and the atrial pacing ventricular escape interval ApVI are programmed by the programmed unit to control the time control unit, and the atrial escape interval after the ventricular event AEI=LRI-ApVI. The dual-chamber pacemaker according to claim 14, wherein said main control unit is further configured to: sense the ventricular event by said perceptual control/amplification unit before said ApVI timing overflow, then control the The pacing control/generating unit suppresses the ventricular pacing pulse, and controls the time control unit to set the post-ventricular atrial refractory period PVARP, the ventricular refractory period VRP and the upper limit tracking frequency interval UTRI. The dual-chamber pacemaker according to claim 16, wherein said main control unit further controls said time control unit to set AEI=LRI-ApVI-the remaining time period of ApVI or AsVI in the previous interventricular interval .

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