Pacemaker with improved capability for detecting onset of tachyarrhythmias and heart failure
First Claim
1. An implantable cardiac treatment system for predicting the onset of an atrial arrhythmia, comprising a pacemaker device and a lead, said lead having a tip electrode adapted to be positioned against the myocardial wall of the patient'"'"'s right atrium to sense P-waves and having conducting means for conducting sensed P-waves, said pacemaker device comprising:
- receiving means for receiving said sensed P-waves from said lead conducting means;
processing means for processing sensed P-waves to obtain a measure of the P-wave signal width of each processed P-wave;
monitoring means for monitoring said width measures over a long period to determine the onset of atrial fibrillation (AF); and
response means for responding to a determination of onset of AF by providing a predetermined AF pacing therapy.
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Accused Products
Abstract
The invention provides a system and method for determining cardiac condition by examining the width of cardiac excitation waves sensed by a tip electrode. In one embodiment, an atrial lead with a tip electrode is positioned against the inside of the atrial wall, and senses passing depolarization (P-wave) waves. The sensed signals are processed to determine effective duration, and then analyzed to determine if there has been a change in conduction velocity. A predetermined decrease in conduction velocity is interpreted to mean that the atrium is at the onset of AF and appropriate atrial pacing therapy is initiated. In a second embodiment, a lead with a tip electrode is positioned adjacent to the left free ventricular wall and R wave durations are obtained. For substantially constant ventricular conduction conditions, R wave duration variations are analyzed to determine ventricular wall thickening of a degree that indicates onset of chronic heart failure.
62 Citations
50 Claims
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1. An implantable cardiac treatment system for predicting the onset of an atrial arrhythmia, comprising a pacemaker device and a lead,
said lead having a tip electrode adapted to be positioned against the myocardial wall of the patient'"'"'s right atrium to sense P-waves and having conducting means for conducting sensed P-waves, said pacemaker device comprising: -
receiving means for receiving said sensed P-waves from said lead conducting means;
processing means for processing sensed P-waves to obtain a measure of the P-wave signal width of each processed P-wave;
monitoring means for monitoring said width measures over a long period to determine the onset of atrial fibrillation (AF); and
response means for responding to a determination of onset of AF by providing a predetermined AF pacing therapy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A system for continuously determining a characteristic of a depolarization wave in a wall of a patient'"'"'s heart and for initiating a pacing response to the heart as a function of said determining, comprising:
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signal means for obtaining a signal representative of the passage of a depolarization wave past a point on said wall;
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t means for determining a measure of the signal width of the depolarization wave from each said obtained signal;
analyzing means for analyzing said signal width measures and for determining when said time width measures indicate a dangerous condition in said heart; and
response means for initiating a pacing therapy in response to a said dangerous condition. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method of determining a potentially dangerous condition of a patient'"'"'s heart, comprising:
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positioning a tip electrode against the inside wall of a chamber of said heart;
obtaining from said tip electrode wave duration signals representative of the time width of passing depolarization waves, and storing data from said signals;
processing said signals to determine a significant change in the time width of said passing depolarization waves; and
indicating a said potentially dangerous condition when a said significant change is determined. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36)
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37. An implantable system for obtaining a measure of relative conduction velocity in a patient'"'"'s atria, comprising:
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a lead that carries a tip electrode, adapted to be positioned within the patient'"'"'s right atrium with said tip electrode snug against the inside wall of said atrium;
sensing means for obtaining from said tip electrode wave samples of depolarization waves that pass said tip electrode;
processing means for processing said wave samples to obtain measures of relative conduction velocity; and
analyzing means for analyzing said measures to provide an indication of change in conduction velocity in said patient'"'"'s atria. - View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48)
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49. A multi-chamber pacing system having leads postionable in a patient'"'"'s heart, comprising:
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wall thickness means for obtaining a measure of left ventricular wall thickness;
wall analysis means for determining when the patient'"'"'s left ventricular wall has thickened unacceptably;
atrial velocity means for obtaining a measure of atrial conduction velocity; and
atrial velocity analysis means for determining when the patient'"'"'s atrial conduction velocity has slowed unacceptably. - View Dependent Claims (50)
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Specification