Abstract

A rate-responsive cardiac pacemaker comprising a minute ventilation circuit and an activity circuit. The minute ventilation circuit computes a first target pacing rate as a function of measurements of the patient's pleural blood impedance, and the activity circuit computes a second target pacing rate as a function of measured levels of patient activity. A rate control function establishes a rate-responsive pacing rate based on the first and second target pacing rates. The minute ventilation circuit delta-modulates an analog impedance waveform and maintains short-term and long-term weighted averages of delta-modulator output counts. Variations in the difference between the short-term and long-term weighted average values are determinative of the first target pacing rate. Variations in an activity sensor output signal are determinative of the second target pacing rate. Physician-programmable parameters for the pacemaker include selection of a rate-response setting, upper and lower pacing rate limits, and rate-smoothing attack and decay settings.