Method and apparatus for adjusting a blanking period during transitioning between operating states in a medical device

• US 10,252,067 B2
• Filed: 09/16/2014
• Issued: 04/09/2019
• Est. Priority Date: 04/24/2014
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Greenhut, Saul E, Stadler, Robert W, Zhang, Xusheng
• Primary Examiner(s): Wu, Eugene T
• Application Number:
  US14/487,248
• Publication Number:
  US 20150306408A1
• Time in Patent Office: 1,666 Days
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/39 Heart defibrillators
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

A method and medical device for adjusting a blanking period that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, determining whether to adjust a blanking period during a first operating state, advancing from the first operating state to a second operating state in response to the sensed cardiac signals, determining, while in the second operating state, whether the blanking period was adjusted while in the first operating state, and adjusting the blanking period while in the second operating state in response to the blanking period being adjusted while in the first operating state.

Claims

1. A method of adjusting a blanking period in a medical device, comprising:

sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors;

determining a blanking period adjustment metric based on the cardiac signals sensed within a blanking period adjustment window extending from an end of a blanking period;

determining whether to increase the blanking period for analysis of the sensed cardiac signals in a first operating state based on the blanking period adjustment metric;

advancing from the first operating state to a second operating state in response to the analysis of the sensed cardiac signals in the first operating state indicating that a cardiac rhythm is a shockable ventricular fibrillation or a fast ventricular tachycardia or is not shockable;

determining whether the blanking period was increased for the analysis of the sensed cardiac signals in the first operating state; and

decreasing the blanking period for analysis of the cardiac signals in the second operating state in response to the blanking period being increased for the analysis of the cardiac signals in the first operating state.

2. The method of claim 1, further comprising:

increasing the blanking period from a first setting to a second setting while in the first operating state; and

decreasing the blanking period from the second setting to the first setting while in the second operating state.

3. The method of claim 1, further comprising:

increasing the blanking period a first predetermined amount while in the first operating state; and

decreasing the blanking period a second predetermined amount not equal to the first predetermined amount while in the second operating state.

4. The method of claim 1, wherein the second operating state comprises charging of a therapy delivery device for delivering therapy.

5. The method of claim 1, wherein determining a blanking period adjustment metric comprises:

setting a blanking period and a blanking period adjustment window for the plurality of sensing vectors in response to the sensed cardiac signals; and

determining first signal differences during the blanking period adjustment window.

6. The method of claim 5, wherein determining first signal differences comprises:

determining signal differences between the cardiac signal sensed during the blanking period adjustment window and the sensing threshold; and

determining a minimum signal difference of the determined signal differences.

7. The method of claim 1, further comprising:

increasing the blanking period from a first setting to a second setting while in the first operating state; and

wherein decreasing the blanking period comprising decreasing the blanking period from the second setting to the first setting while in the second operating state.

8. The method of claim 1, further comprising:

increasing the blanking period a first predetermined amount from a first setting while in the first operating state; and

decreasing the blanking period a second predetermined amount not equal to the first predetermined amount while in the second operating state.

9. A medical device, comprising:

a plurality of electrodes capable of forming a plurality of sensing vectors for sensing cardiac signals; and

a processor configured to determine a blanking period adjustment metric based on the cardiac signals sensed within a blanking period adjustment window extending from an end of a blanking period, determine whether to increase the blanking period for analysis of the sensed cardiac signals in a first operating state based on the blanking period adjustment metric, advance from the first operating state to a second operating state in response to the analysis of the sensed cardiac signals in the first operating state indicating that a cardiac rhythm is a shockable ventricular fibrillation or a fast ventricular tachycardia or is not shockable, determine whether the blanking period was increased for the analysis of the sensed cardiac signals in the first operating state, and decrease the blanking period for analysis of the cardiac signals in the second operating state in response to the blanking period being increased for the analysis of the cardiac signals in the first operating state.

10. The device of claim 9, wherein the processor is further configured to increase the blanking period from a first setting to a second setting while in the first operating state, and decrease the blanking period from the second setting to the first setting while in the second operating state.

11. The device of claim 9, wherein the processor is further configured to increase the blanking period a first predetermined amount while in the first operating state, and decrease the blanking period a second predetermined amount not equal to the first predetermined amount while in the second operating state.

12. The device of claim 9, wherein the second operating state comprises charging of a therapy delivery device for delivering therapy.

13. The device of claim 9, wherein determining a blanking period adjustment metric comprises:

setting a blanking period and a blanking period adjustment window for the plurality of sensing vectors in response to the sensed cardiac signals; and

determining first signal differences during the blanking period adjustment window.

14. The device of claim 13, wherein determining first signal differences comprises:

determining signal differences between the cardiac signal sensed during the blanking period adjustment window and a sensing threshold; and

determining a minimum signal difference of the determined signal differences.

15. The device of claim 14, wherein the processor is further configured to increase the blanking period from a first setting to a second setting while in the first operating state, and wherein a decrease in the blanking period comprises a decrease in the blanking period from the second setting to the first setting while in the second operating state.

16. The device of claim 9, wherein the processor is further configured to increase the blanking period a first predetermined amount from a first setting while in the first operating state, and wherein a decrease in the blanking period comprises a decrease in the blanking period a second predetermined amount not equal to the first predetermined amount while in the second operating state.

17. A non-transitory, computer-readable storage medium storing instructions for causing a processor included in a medical device to perform a method for adjusting a blanking period, the method comprising:

sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors;

determining a blanking period adjustment metric based on the cardiac signals sensed within a blanking period adjustment window extending from an end of a blanking period;

determining whether to increase the blanking period for analysis of the sensed cardiac signals in a first operating state based on the blanking period adjustment metric;

advancing from the first operating state to a second operating state in response to the analysis of the sensed cardiac signals in the first operating state indicating that a cardiac rhythm is a shockable ventricular fibrillation or a fast ventricular tachycardia or is not shockable;

determining whether the blanking period was increased for the analysis of the sensed cardiac signals in the first operating state; and

decreasing the blanking period for analysis of the cardiac signals in the second operating state in response to the blanking period being increased for the analysis of the cardiac signals in the first operating state.