Implantable cardioverter-defibrillator (ICD) tachyarrhythmia detection modifications responsive to detected pacing
First Claim
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1. A method comprising:
- obtaining, with a sensing module of a medical device, cardiac electrical signals;
processing, with a control module of the medical device, the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia;
detecting, with the control module of the medical device, initiation of a pacing train delivered by a second implantable medical device;
determining, with the control module of the medical device, a type of the detected pacing train, wherein determining the type of detected pacing train comprises;
computing at least two cycle lengths using at least three most recently detected pacing spikes,estimating a cycle length of the pacing train based on the at least two computed cycle lengths,comparing the estimated cycle length of the pacing train to at least one cycle length threshold, anddetermining the type of the detected pacing train based on the comparison;
modifying, with the control module of the medical device, a tachyarrhythmia detection algorithm based on the type of the detected pacing train; and
delivering, with a therapy module of the medical device, a shock therapy based on the tachyarrhythmia detection algorithm.
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Abstract
An implantable medical device comprises a sensing module configured to obtain electrical signals from one or more electrodes and a control module configured to process the electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia. The control module detects initiation of a pacing train delivered by a second implantable medical device, determines a type of the detected pacing train, and modifies the tachyarrhythmia detection algorithm based on the type of the detected pacing train.
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Citations
38 Claims
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1. A method comprising:
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obtaining, with a sensing module of a medical device, cardiac electrical signals; processing, with a control module of the medical device, the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia; detecting, with the control module of the medical device, initiation of a pacing train delivered by a second implantable medical device; determining, with the control module of the medical device, a type of the detected pacing train, wherein determining the type of detected pacing train comprises; computing at least two cycle lengths using at least three most recently detected pacing spikes, estimating a cycle length of the pacing train based on the at least two computed cycle lengths, comparing the estimated cycle length of the pacing train to at least one cycle length threshold, and determining the type of the detected pacing train based on the comparison; modifying, with the control module of the medical device, a tachyarrhythmia detection algorithm based on the type of the detected pacing train; and delivering, with a therapy module of the medical device, a shock therapy based on the tachyarrhythmia detection algorithm. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A medical device comprising:
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a sensing module configured to obtain cardiac electrical signals; a control module configured to process the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia, detect initiation of a pacing train delivered by a second implantable medical device, computes at least two cycle lengths using at least three most recently detected pacing spikes, estimates a cycle length of the pacing train based on the at least two computed cycle lengths, compares the estimated cycle length of the pacing train to at least one cycle length threshold, determine a type of the detected pacing train based on the comparison, and modify the tachyarrhythmia detection algorithm based on the type of the detected pacing train; and a therapy module configured to deliver a shock therapy based on the tachyarrhythmia detection algorithm. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A system comprising:
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an implantable cardiac pacemaker device; and an extravascular implantable cardioverter-defibrillator (ICD) system that includes; at least one lead comprising one or more electrodes; and an ICD device electrically connected to the at least one lead, the ICD device comprising; a sensing module configured to obtain cardiac electrical signals; and a control module configured to process the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia, wherein the control module is further configured to detect initiation of a pacing train delivered by the implantable cardiac pacemaker device, determine a type of the detected pacing train, and modify the tachyarrhythmia detection algorithm based on the type of the detected pacing train; and wherein the control module detects the type of pacing train to be an anti-tachycardia pacing (ATP) train and the modification of the tachyarrhythmia detection algorithm results in a delay of a shock; and a therapy module configured to deliver the shock after the delay. - View Dependent Claims (28)
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29. A medical device comprising:
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a sensing module configured to obtain cardiac electrical signals; and a control module configured to process the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia, detect initiation of a pacing train delivered by a second implantable medical device, determine a type of the detected pacing train, and modify the tachyarrhythmia detection algorithm based on the type of the detected pacing train, wherein the tachyarrhythmia detection algorithm includes at least one stage in which the control module analyzes a morphology of a plurality of predetermined segments of the sensed cardiac electrical signal and the control module modifies the tachyarrhythmia detection algorithm by holding the morphology analysis in a current state in response to detecting the type of the pacing train to be anti-tachycardia pacing (ATP); and a therapy module configured to deliver a shock therapy based on the tachyarrhythmia detection algorithm. - View Dependent Claims (30, 31, 32, 33)
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34. A medical device comprising:
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a sensing module configured to obtain cardiac electrical signals; and a control module configured to process the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia, detect initiation of a pacing train delivered by a second implantable medical device, determine a type of the detected pacing train, and modify the tachyarrhythmia detection algorithm based on the type of the detected pacing train, wherein the tachyarrhythmia detection algorithm analyzes segments of the cardiac electrical signals of a predetermined length and classifies each segment as shockable or non-shockable and wherein the control module determines a type of the detected pacing train to be a fast bradycardia pacing train and modifies to the tachyarrhythmia detection algorithm by comparing a morphology of a first sensed event within one of the segments with a morphology of a predetermined number of subsequent sensed events within the segments and classifying the rhythm as shockable or non-shockable based on at least the number of subsequent sensed events having a morphology that matches the morphology of the first sensed event of the tachyarrhythmia; and a therapy module configured to deliver a shock therapy based on the tachyarrhythmia detection algorithm. - View Dependent Claims (35)
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36. A medical device comprising:
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a sensing module configured to obtain cardiac electrical signals; and a control module configured to process the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia, detect initiation of a pacing train delivered by a second implantable medical device, determine a type of the detected pacing train, and modify the tachyarrhythmia detection algorithm based on the type of the detected pacing train, wherein the tachyarrhythmia detection algorithm includes a plurality of stages comprising at least a first stage and a second stage, wherein the control module is configured to modify the tachyarrhythmia detection algorithm by modifying a tachyarrhythmia detection analysis of the second stage; and a therapy module configured to deliver a shock therapy based on the tachyarrhythmia detection algorithm. - View Dependent Claims (37)
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38. A medical device comprising:
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a sensing module configured to obtain cardiac electrical signals; and a control module configured to process the cardiac electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia, detect initiation of a pacing train delivered by a second implantable medical device, determine a type of the detected pacing train, and modify the tachyarrhythmia detection algorithm based on the type of the detected pacing train, wherein the control module is configured to determine the type of the detected pacing train by at least analyzing an onset of the heart rate immediately prior to the detected pacing train; and a therapy module configured to deliver a shock therapy based on the tachyarrhythmia detection algorithm.
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Specification