Method for elimination of ventricular pro-arrhythmic effect caused by atrial therapy

• US 20040220624A1
• Filed: 04/30/2003
• Published: 11/04/2004
• Est. Priority Date: 04/30/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gillberg, Jeffrey M., Brown, Mark L., Ritscher, David E.
• Granted Patent: US 7,536,224 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions

Abstract

A system and method are provided for controlling atrial anti-tachycardia pacing (ATP) delivery based on detection of ventricular pro-arrhythmia during or immediately after atrial ATP. Ventricular pro-arrhythmia is detected based on one or more criteria relating to pro-arrhythmic changes including, but not limited to, ventricular rate changes, R-wave morphology changes, and/or 1:1 or nearly 1:1 atrial-ventricular conduction patterns persisting at high ventricular rates. Upon detecting ventricular pro-arrhythmia, a current atrial ATP sequence is aborted. Atrial ATP therapies may subsequently be temporarily or permanently disabled.

Claims

1. An implantable medical device, comprising:

a plurality of electrodes sensing cardiac signals and delivering therapy within a chamber of a heart; and

control circuitry controlling the therapy delivery in response to signals of the sensed cardiac signals sensed during the therapy delivery.

2. The device of claim 1, wherein the control circuitry initiates the therapy in response to receipt of an external input.

3. The device of claim 1, wherein the therapy corresponds to atrial pacing and the control circuitry determines whether ventricular pro-arrhythmia is detected and terminates the therapy delivery in response to ventricular pro-arrhythmia being detected.

4. The device of claim 3, wherein ventricular pro-arrhythmia is detected in response to one of changes in ventricular rate, R-wave morphology, and atrial-ventricular conduction patterns.

5. The device of claim 1, wherein the control circuitry controls the therapy delivery in response to signals of the sensed cardiac signals sensed subsequent to the therapy delivery.

6. The device of claim 5, wherein the therapy corresponds to atrial pacing and the control circuitry determines whether ventricular pro-arrhythmia is detected and terminates the therapy delivery in response to ventricular pro-arrhythmia being detected.

7. The device of claim 6, wherein ventricular pro-arrhythmia is detected in response to one of changes in ventricular rate, R-wave morphology, and atrial-ventricular conduction patterns.

8. The device of claim 1, wherein the plurality of electrodes include leadless electrodes.

9. The device of claim 3, wherein the control circuit determines whether there is an approximately 1:

1 conduction pattern between the atrium and ventricles of the heart, wherein ventricular pro-arrhythmia is determined to be detected in response to determining the approximately 1;

1 conduction pattern.

10. The device of claim 3, further comprising a storage device storing ventricular pro-arrhythmia detections associated with the delivered therapy.

11. The device of claim 3, wherein the control circuitry determines whether ventricular pro-arrhythmia is detected in response to changes in R-wave morphology.

12. The device of claim 11, wherein ventricular pro-arrhythmia is detected in response to R-wave morphology during or subsequent to the delivered therapy is substantially different from a predetermined reference morphology corresponding to R-wave morphology prior to the delivered therapy.