An intracardiac impedance-derived parameter, Half Cycle Activity (HCA) is
used in sensing and controlling cardiac activities in implantable cardiac
devices such as bradycardia pacemakers and cardioverter defibrillators.
This impedance-derived parameter correlates closely with physical
workload and at the same time provides hemodynamic feedback information.
Thus, it allows a pacemaker system to implement accurately an increase in
hemodynamically driven pacing rate, as well as to limit an inappropriate
decrease of driven pacing rate advised by another sensor such as an
accelerometer. In addition, it determines the maximum pacing rate for the
pacemaker so as to prevent hemodynamic compromise. Therefore, the HCA
parameter may be used to determine a Hemodynamic Upper Rate Limit and a
Hemodynamic Lower Rate Limit, and thus define a Hemodynamic Pacing Range
that is compatible with the range of physiological rate. This allows a
closed-loop control of the pacing rate. In an implantable cardioverter
defibrillator system, the hemodynamic tolerance of arrhythmias can also
be assessed by using the HCA parameter to adjust therapy provided to a
heart, such as antitachycardia pacing and/or cardioverting shocks.