Method for discriminating between ventricular and supraventricular arrhythmias
First Claim
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1. An implantable medical device (IMD) configured for monitoring a patient'"'"'s cardiac rhythm to determine whether an arrhythmia is occurring, the IMD comprising:
- a housing containing a battery and operational circuitry for the IMD;
at least first and second electrodes on the housing and coupled to the operational circuitry, the operational circuitry configured to use the first and second electrodes for sensing a cardiac signal of the patient;
wherein the operational circuitry is configured to detect a plurality of R-waves for the patient in a sensed cardiac signal from the electrodes and observe a measure of interval rate stability for the R-waves to determine whether the intervals are stable or unstable, relative to an interval rate stability threshold;
wherein the operational circuitry is configured to compare a selected R-wave from the plurality of R-waves to a dynamic template representing an immediately preceding R-wave to determine whether the dynamic template is matched by the selected R-wave; and
wherein the operational circuitry is configured to identify atrial fibrillation in response to finding that the intervals are unstable and the selected R-wave matches the dynamic template.
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Abstract
The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.
212 Citations
19 Claims
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1. An implantable medical device (IMD) configured for monitoring a patient'"'"'s cardiac rhythm to determine whether an arrhythmia is occurring, the IMD comprising:
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a housing containing a battery and operational circuitry for the IMD; at least first and second electrodes on the housing and coupled to the operational circuitry, the operational circuitry configured to use the first and second electrodes for sensing a cardiac signal of the patient; wherein the operational circuitry is configured to detect a plurality of R-waves for the patient in a sensed cardiac signal from the electrodes and observe a measure of interval rate stability for the R-waves to determine whether the intervals are stable or unstable, relative to an interval rate stability threshold; wherein the operational circuitry is configured to compare a selected R-wave from the plurality of R-waves to a dynamic template representing an immediately preceding R-wave to determine whether the dynamic template is matched by the selected R-wave; and wherein the operational circuitry is configured to identify atrial fibrillation in response to finding that the intervals are unstable and the selected R-wave matches the dynamic template. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. An implantable medical device (IMD) configured for monitoring a patient'"'"'s cardiac rhythm to determine whether an arrhythmia is occurring, the IMD comprising:
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a housing containing a battery and operational circuitry for the IMD; at least first and second electrodes on the housing and coupled to the operational circuitry, the operational circuitry configured to use the first and second electrodes for sensing a cardiac signal of the patient; wherein the operational circuitry is configured to detect a plurality of R-waves for the patient in a sensed cardiac signal from the electrodes and observe a measure of interval rate stability for the R-waves to determine whether the intervals are stable or unstable, relative to an interval rate stability threshold; wherein the operational circuitry is configured to compare a selected R-wave from the plurality of R-waves to a static template representing a stored template of a sinus cardiac complex template to determine whether the static template is matched by the selected R-wave; and wherein the operational circuitry is configured to identify atrial fibrillation in response to finding that the intervals are unstable and the selected R-wave matches the static template. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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Specification