A method and apparatus for alleviating or preventing hemodynamic collapse
by delivering ventricular synchronized atrial pacing under certain
conditions precedent to or during delivery of an anti-tachyarrhythmia
therapy by an implantable cardioverter/defibrillator (ICD) are disclosed.
The atrial pacing mode is preferably the AVT pacing mode, wherein the
atria (A) are paced, the ventricles (V) are sensed, and the atrial pacing
is triggered (T) by the ventricular sense signals. Alternatively, the ADD
pacing mode can be employed if the underlying sinus atrial depolarizations
can be sensed occasionally as non-refractory, atrial sense signals and
employed to inhibit the delivery of an atrial pace pulse. The VS-AP delay
between a ventricular sense (VS) and the delivered atrial pace (AP) pulse
synchronization of the atrial pacing pulses can be selected to be a
function of the prevailing V-V interval of the VT episode. The prevention
or alleviation is accomplished by delivering atrial pacing pulses to the
atria in synchronization with detected ventricular sense signals, whereby
the atrial depolarization rate is increased and synchronized to the
ventricular depolarization rate sufficiently to eject blood from the atria
into the ventricles to be ejected therefrom upon a subsequent ventricular
contraction.