Method for discriminating between ventricular and supraventricular arrhythmias
First Claim
Patent Images
1. A method for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the method comprising:
- receiving a cardiac complex using implanted electrodes;
obtaining a cardiac rate from the cardiac signal;
determining whether the cardiac rate;
exceeds a first threshold but does not exceed a second threshold;
or;
exceeds the second threshold;
and;
if the cardiac rate exceeds the second threshold, directing therapy to the heart;
or if the cardiac rate exceeds the first threshold but does not exceed the second threshold, directing further analysis of the cardiac complex to determine whether therapy is indicated.
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Accused Products
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.
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Citations
93 Claims
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1. A method for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the method comprising:
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receiving a cardiac complex using implanted electrodes;
obtaining a cardiac rate from the cardiac signal;
determining whether the cardiac rate;
exceeds a first threshold but does not exceed a second threshold;
or;
exceeds the second threshold;
and;
if the cardiac rate exceeds the second threshold, directing therapy to the heart;
orif the cardiac rate exceeds the first threshold but does not exceed the second threshold, directing further analysis of the cardiac complex to determine whether therapy is indicated. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method of cardiac signal analysis comprising:
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receiving a cardiac complex from an implanted electrode pair;
analyzing the cardiac complex to determine whether a patient is likely experiencing an arrhythmia; and
comparing a portion of the cardiac complex to a template by performing a mathematical calculation between the cardiac complex and the template;
wherein the comparing step is performed only if it is determined that the patient is likely experiencing an arrhythmia. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18)
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19. A method of discriminating between cardiac rhythms comprising:
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receiving a first electric signal between a first electrode pair;
analyzing the first electric signal to calculate a cardiac rate for a patient;
comparing the cardiac rate to first and second thresholds; and
;
selecting one of the following options;
a) if the cardiac rate is below the first threshold, advancing to a next iteration of the method by receiving a second electric signal between the first electrode pair, the second electric signal coming temporally after the first electric signal;
orb) if the cardiac rate is above the second threshold, determining that therapy should be delivered to the patient;
orc) advancing into a subroutine for enhanced analysis;
wherein the subroutine for enhanced analysis includes comparing a portion of the first electric signal to a template.
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20. A method of discriminating between cardiac rhythms comprising:
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receiving a cardiac complex;
determining that an arrhythmia is likely;
analyzing the cardiac complex using a first metric to determine whether a malignant arrhythmia is occurring and, if so, determining that therapy is indicated;
if not, then analyzing the cardiac complex using a second metric to determine whether a malignant arrhythmia is occurring and, if so, determining that therapy is indicated. - View Dependent Claims (21)
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22. A method of signal analysis comprising:
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receiving a first cardiac complex from a first implanted electrode pair disposed to capture electrical information related to ventricular activity along a first sensing vector;
receiving a second cardiac complex from a second implanted electrode pair disposed to capture electrical information related to ventricular activity along a second sensing vector;
generating a first metric related to the first cardiac complex;
generating a second metric related to the second cardiac complex; and
comparing the first metric to the second metric to determine whether a ventricular originating arrhythmia is occurring. - View Dependent Claims (23, 24, 25, 26)
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27. A method of monitoring cardiac function as part of operation of an implantable cardiac treatment device comprising:
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receiving a cardiac complex from first and second implanted electrodes;
comparing the cardiac complex to a template to determine whether therapy is indicated;
wherein the template is a dynamically changing template formed using a number of recently sensed cardiac complexes. - View Dependent Claims (28)
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29. A method of discriminating between cardiac rhythms comprising:
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receiving a cardiac complex from implanted electrodes;
obtaining a beat rate and determining whether an arrhythmia is likely; and
, if so;
(a) analyzing the cardiac complex using a first mathematical determination to yield a first result, and comparing the first result to a first threshold to yield a first Boolean value;
(b) analyzing the cardiac complex using a second mathematical determination to yield a second result, and comparing the second result to a second threshold to yield a second Boolean value;
(c) performing a first Boolean logic function using at least one of the first Boolean value and the second Boolean value to determine whether therapy is needed. - View Dependent Claims (30, 31, 32, 33, 34, 35)
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36. A method of discriminating between cardiac rhythms comprising:
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receiving a cardiac complex from implanted electrodes;
obtaining a cardiac rate and determining whether an arrhythmia is likely; and
, if so;
(a) analyzing the cardiac complex using a first metric to determine whether a malignant arrhythmia is occurring and, if so, determining that therapy is indicated;
(b) if not, then analyzing the cardiac complex using a second metric to determine whether a malignant arrhythmia is occurring and, if so, determining that treatment is indicated. - View Dependent Claims (37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48)
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49. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a cardiac complex using the lead electrode assembly;
obtaining a cardiac rate from the cardiac signal;
determining whether the cardiac rate;
exceeds a first threshold but does not exceed a second threshold;
or;
exceeds the second threshold; and
;
if the cardiac rate exceeds the second threshold, directing therapy to the heart;
orif the cardiac rate exceeds the first threshold but does not exceed the second threshold, directing further analysis of the cardiac complex to determine whether therapy is indicated. - View Dependent Claims (50, 51, 52, 53, 54, 55, 56, 57)
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58. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a cardiac complex using at least one electrode on the lead electrode assembly;
analyzing the cardiac complex to determine whether a patient is likely experiencing an arrhythmia; and
comparing a portion of the cardiac complex to a template by performing a mathematical calculation between the cardiac complex and the template;
wherein the comparing step is performed only if it is determined that the patient is likely experiencing an arrhythmia. - View Dependent Claims (59, 60, 61, 62, 63, 64)
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65. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a first electric signal between a first electrode pair including an electrode on the lead electrode assembly;
analyzing the first electric signal to calculate a cardiac rate for a patient;
comparing the cardiac rate to first and second thresholds; and
;
selecting one of the following options;
a) if the cardiac rate is below the first threshold, advancing to a next iteration of the method by receiving a second electric signal between the first electrode pair, the second electric signal coming temporally after the first electric signal;
orb) if the cardiac rate is above the second threshold, determining that therapy should be delivered to the patient;
orc) advancing into a subroutine for enhanced analysis;
wherein the subroutine for enhanced analysis includes comparing a portion of the first electric signal to a template.
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66. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a cardiac complex;
determining that an arrhythmia is likely;
analyzing the cardiac complex using a first metric to determine whether a malignant arrhythmia is occurring and, if so, determining that therapy is indicated;
if not, then analyzing the cardiac complex using a second metric to determine whether a malignant arrhythmia is occurring and, if so, determining that therapy is indicated. - View Dependent Claims (67)
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68. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a first cardiac complex from a first implanted electrode pair disposed to capture electrical information related to ventricular activity along a first sensing vector;
receiving a second cardiac complex from a second implanted electrode pair disposed to capture electrical information related to ventricular activity along a second sensing vector;
generating a first metric related to the first cardiac complex;
generating a second metric related to the second cardiac complex; and
comparing the first metric to the second metric to determine whether a ventricular originating arrhythmia is occurring. - View Dependent Claims (69, 70, 71)
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72. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a cardiac complex from first and second implanted electrodes;
comparing the cardiac complex to a template to determine whether therapy is indicated;
wherein the template is a dynamically changing template formed using a number of recently sensed cardiac complexes. - View Dependent Claims (73)
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74. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a cardiac complex from implanted electrodes;
obtaining a beat rate and determining whether an arrhythmia is likely; and
, if so;
(a) analyzing the cardiac complex using a first mathematical determination to yield a first result, and comparing the first result to a first threshold to yield a first Boolean value;
(b) analyzing the cardiac complex using a second mathematical determination to yield a second result, and comparing the second result to a second threshold to yield a second Boolean value;
(c) performing a first Boolean logic function using at least one of the first Boolean value and the second Boolean value to determine whether therapy is needed. - View Dependent Claims (75, 76, 77, 78, 79, 80)
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81. An implantable cardioverter/defibrillator comprising:
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a lead electrode assembly including a number of electrodes; and
a canister housing operational circuitry;
wherein;
the lead electrode assembly is coupled to the canister; and
the operational circuitry is configured to perform steps for discriminating between cardiac rhythms of a patient'"'"'s heart which are appropriate for therapy, the steps including;
receiving a cardiac complex from implanted electrodes;
obtaining a beat rate and determining whether an arrhythmia is likely; and
, if so, analyzing the cardiac complex using a first metric to determine whether a malignant arrhythmia is occurring and;
if so, determining that therapy is indicated;
if not, analyzing the cardiac complex using a second metric to determine whether a malignant arrhythmia is occurring and, if so, determining that treatment is indicated. - View Dependent Claims (82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93)
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Specification