Methods and apparatus for decreasing incidences of early recurrence of atrial fibrillation

• US 20040210256A1
• Filed: 04/17/2003
• Published: 10/21/2004
• Est. Priority Date: 04/17/2003
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Musley, Shaileshkumar V., Warman, Eduardo N., Euler, David E.
• Application Number:
  US10/417,978
• Publication Number:
  US 20040210256A1
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Implantable cardioverter/defibrillators (ICDs) providing atrial cardioversion/defibrillation (C/D) shock therapies in response to detected atrial tachyarrhythmias, particularly atrial fibrillation (AF) or in response to a patient command generated by a patient experiencing AF symptoms are disclosed. The early recurrence of atrial fibrillation (ERAF) following delivery of an atrial C/D shock is detected and delivery of any subsequent atrial C/D shock therapies is delayed for an ERAF sustained duration.

Claims

1. A method of decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to the atria of a patient'"'"'s heart by an implantable cardioverter/defibrillator comprising:

detecting ERAF, if present, following delivery of an atrial C/D shock;

timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

inhibiting delivery of a further atrial C/D shock for the duration of the ERAF sustained duration.

2. The method of claim 1, further comprising:

determining if atrial fibrillation (AF) is present upon time out of the ERAF sustained duration; and

delivering a further atrial C/D shock to the atria upon determining that AF is present upon time out of the ERAF sustained duration.

3. The method of claim 2, further comprising:

detecting AF termination during time out of the ERAF sustained duration; and

terminating the ERAF sustained duration in response to detected AF termination.

4. The method of claim 1, further comprising:

detecting AF termination during time out of the ERAF sustained duration; and

terminating the ERAF sustained duration in response to detected AF termination.

5. A method of decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to a patient'"'"'s heart by an implantable cardioverter/defibrillator responsive to a patient command generated by a patient activator operated by a patient experiencing symptoms of an atrial fibrillation (AF) episode comprising:

delivering the atrial C/D shock to the patient'"'"'s heart in response to the patient command;

detecting ERAF, if present, following delivery of an atrial C/D shock;

timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

inhibiting delivery of a further atrial C/D shock in response to a further patient command for the duration of the ERAF sustained duration.

6. The method of claim 5, further comprising alerting the patient that ERAF is detected and that delivery of the further atrial C/D commanded by the patient is inhibited.

7. A method of decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to a patient'"'"'s heart by an implantable cardioverter/defibrillator responsive to a an atrial fibrillation (AF) episode comprising:

detecting an AF episode;

delivering the atrial C/D shock to the atria of the patient'"'"'s heart in response to the detected AF episode;

detecting ERAF, if present, following delivery of the atrial C/D shock;

timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

delivering a further atrial C/D shock upon time out of the ERAF sustained duration.

8. The method of claim 7, further comprising:

determining if atrial fibrillation (AF) is present upon time out of the ERAF sustained duration; and

delivering the further atrial C/D shock to the atria only upon determining that AF is present upon time out of the ERAF sustained duration.

9. The method of claim 8, further comprising:

detecting AF termination during time out of the ERAF sustained duration; and

terminating the ERAF sustained duration in response to detected AF termination.

10. The method of claim 9, further comprising inhibiting the delivery of the second atrial C/D shock upon termination of the ERAF sustained duration.

11. The method of claim 7, further comprising:

detecting AF termination during time out of the ERAF sustained duration; and

terminating the ERAF sustained duration in response to detected AF termination.

12. The method of claim 11, further comprising inhibiting the delivery of the second atrial C/D shock upon termination of the ERAF sustained duration.

13. A method of decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to a patient'"'"'s heart by an implantable cardioverter/defibrillator responsive to a an atrial fibrillation (AF) episode comprising:

detecting one of an AF episode or a patient command generated by a patient activator operated by a patient experiencing symptoms of an atrial fibrillation (AF) episode;

delivering the atrial C/D shock to the patient'"'"'s heart in response to the detected one of the AF episode or the patient command;

detecting ERAF, if present, following delivery of the atrial C/D shock;

timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

inhibiting delivery of a further atrial C/D shock for the duration of the ERAF sustained duration.

14. A system for decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to the atria of a patient'"'"'s heart by an implantable cardioverter/defibrillator comprising:

means for detecting ERAF, if present, following delivery of an atrial C/D shock;

means for timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

means for inhibiting delivery of a further atrial C/D shock for the duration of the ERAF sustained duration.

15. The system of claim 14, further comprising:

means for determining if atrial fibrillation (AF) is present upon time out of the ERAF sustained duration; and

means for delivering a further atrial C/D shock to the atria upon determining that AF is present upon time out of the ERAF sustained duration.

16. The system of claim 15, further comprising:

means for detecting AF termination during time out of the ERAF sustained duration; and

means for terminating the ERAF sustained duration in response to detected AF termination.

17. The system of claim 14, further comprising:

means for detecting AF termination during time out of the ERAF sustained duration; and

means for terminating the ERAF sustained duration in response to detected AF termination.

18. A system for decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to a patient'"'"'s heart by an implantable cardioverter/defibrillator responsive to a patient command generated by a patient activator operated by a patient experiencing symptoms of an atrial fibrillation (AF) episode comprising:

means for delivering the atrial C/D shock to the patient'"'"'s heart in response to the patient command;

means for detecting ERAF, if present, following delivery of an atrial C/D shock;

means for timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

means for inhibiting delivery of a further atrial C/D shock in response to a further patient command for the duration of the ERAF sustained duration.

19. The system of claim 18, further comprising means for alerting the patient that ERAF is detected and that delivery of the further atrial C/D commanded by the patient is inhibited.

20. A system for decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to a patient'"'"'s heart by an implantable cardioverter/defibrillator responsive to a an atrial fibrillation (AF) episode comprising:

means for detecting an AF episode;

means for delivering the atrial C/D shock to the atria of the patient'"'"'s heart in response to the detected AF episode;

means for detecting ERAF, if present, following delivery of the atrial C/D shock;

means for timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

means for delivering a further atrial C/D shock upon time out of the ERAF sustained duration.

21. The system of claim 20, further comprising:

means for determining if atrial fibrillation (AF) is present upon time out of the ERAF sustained duration; and

means for delivering the further atrial C/D shock to the atria only upon determining that AF is present upon time out of the ERAF sustained duration.

22. The system of claim 21, further comprising:

means for detecting AF termination during time out of the ERAF sustained duration; and

means for terminating the ERAF sustained duration in response to detected AF termination.

23. The system of claim 22, further comprising means for inhibiting the delivery of the second atrial C/D shock upon termination of the ERAF sustained duration.

24. The system of claim 20, further comprising:

means for detecting AF termination during time out of the ERAF sustained duration; and

means for terminating the ERAF sustained duration in response to detected AF termination.

25. The system of claim 24, further comprising means for inhibiting the delivery of the second atrial C/D shock upon termination of the ERAF sustained duration.

26. A system of decreasing incidences of early recurrence of atrial fibrillation (ERAF) following delivery of an atrial cardioversion/defibrillation (C/D) shock to a patient'"'"'s heart by an implantable cardioverter/defibrillator responsive to a an atrial fibrillation (AF) episode comprising:

means for detecting one of an AF episode or a patient command generated by a patient activator operated by a patient experiencing symptoms of an atrial fibrillation (AF) episode;

means for delivering the atrial C/D shock to the patient'"'"'s heart in response to the detected one of the AF episode or the patient command;

means for detecting ERAF, if present, following delivery of the atrial C/D shock;

means for timing out an ERAF sustained duration upon detecting ERAF during the ERAF detect time; and

means for inhibiting delivery of a further atrial C/D shock for the duration of the ERAF sustained duration.