Activation recovery interval for classification of cardiac beats in an implanted device

• US 20050038478A1
• Filed: 08/11/2003
• Published: 02/17/2005
• Est. Priority Date: 08/11/2003
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Burnes, John E., Klepfer, Ruth N.
• Application Number:
  US10/638,653
• Publication Number:
  US 20050038478A1
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions

Abstract

The present invention provides a system and method for classifying cardiac beats based on activation-recovery intervals (ARIs) or an ARI-related parameter such as the spatial dispersion of activation, recovery or ARIs. The beat classification method may be used in monitoring and detecting cardiac rhythms and/or for controlling a cardiac stimulation therapy. The beat classification method includes acquiring a reference ARI for one or more known types of cardiac beats; measuring the activation-recovery interval of an unknown cardiac beat during cardiac activity monitoring; comparing the measured activation-recovery interval to the stored reference ARI(s); and classifying the cardiac beat based on the comparison between the measured ARI and the reference ARI(s).

Claims

1. A method for classifying cardiac beats, comprising:

storing a reference activation recovery interval-related parameter associated with a known non-pathological cardiac beat of a patient;

measuring an actual activation recovery interval-related parameter of an unknown cardiac beat;

comparing the measured parameter to the stored parameter; and

classifying the unknown cardiac beat according to the comparison made between the measured activation recovery interval-related parameter and the reference activation recovery interval-related parameter.

2. A method according to claim 1, wherein the measured parameter and the stored parameter comprise at least a one of:

a spatial dispersion of activation time, a recovery time, an activation-recovery interval.

3. A method according to claim 1, wherein the classification relates to at least a one of:

a loss of pacing capture event, a pacing capture event, a tachycardia event, a bradycardia event, a normal sinus event, a non-normal sinus event, a premature ventricular contraction event, a premature atrial contraction event, an ectopic focus depolarization event, a reentry circuit event.

4. A method according to claim 1, wherein the measuring step is triggered based on at least a one of:

a predetermined part of a QRS ventricular depolarization complex, a portion of a T-wave, a portion of a P-wave, a detected activation event, a detected depolarization-recovery event.

5. A method according to claim 1, further comprising storing the classification of the unknown cardiac beat.

6. A method according to claim 1, further comprising storing the classification of the unknown cardiac beat on a beat-to-beat basis.

7. A method according to claim 1, further comprising storing the classification of the unknown cardiac beat in an aggregate classification-specific storage location with other cardiac beats having the same classification.

8. A method according to claim 1, wherein said measuring step is performed between a pair of electrodes, a first of said pair of electrodes comprising at least a one of:

a distal tip electrode, a ring electrode, a coil electrode, a can electrode, a subcutaneous electrode, a surface electrode, a percutaneous electrode.

9. A method according to claim 8, wherein said first of said pair of electrodes is adapted to be disposed in communication with a one of:

a ventricular chamber, an atrial chamber, a coronary sinus, a portion of a great vein, an epi-cardial location, an intrathoracic location, a transthoracic location, a superior vena cava location, a portion of a peripheral limb of a patient, a portion of a thorax of a patient.

10. A method for controlling a cardiac electrical stimulation therapy, comprising:

storing a reference activation recovery interval-related parameter associated with a known cardiac beat;

measuring an activation recovery interval-related parameter of an unknown cardiac beat;

comparing the measured parameter to the reference parameter;

classifying the unknown cardiac beat according to the comparison made between the measured activation recovery interval-related parameter and the reference activation recovery interval-related parameter; and

delivering, or withholding delivery of, a cardiac stimulation therapy based on the cardiac beat classification.

11. A method according to claim 10, wherein the cardiac stimulation therapy comprises at least a one of:

a single-chamber therapy, a double-chamber therapy, a triple-chamber therapy, a quadruple-chamber therapy.

12. A method according to claim 10, wherein the cardiac stimulation therapy comprises at a one of the following pacing modalities:

a DDD/R pacing modality, a DDI/R pacing modality, a VVI/R pacing modality, an AAI/R pacing modality, an ADI/R pacing modality, a DDD pacing modality, a DDD pacing modality, an AAI pacing modality, an ADI pacing modality, a VVI pacing modality.

13. A method according to claim 10, wherein the cardiac stimulation therapy comprises a bi-ventricular pacing modality.

14. A method according to claim 10, wherein the cardiac stimulation therapy comprises a bi-ventricular, cardiac resynchronization pacing modality.

15. A method according to claim 10, wherein the cardiac stimulation therapy comprises a dual chamber post extra-systolic potentiation pacing modality, wherein a extra-systolic stimulation pulse is delivered to a ventricle following a refractory period of said ventricle ends.

16. A method according to claim 15, wherein the measuring step is triggered based upon delivery of an extra-systolic stimulation pulse.

17. A method according to claim 10, wherein the measured parameter and the stored parameter comprise at least a one of:

a spatial dispersion of activation time, a recovery time, an activation-recovery interval.

18. A method according to claim 10, wherein the classification relates to at least a one of:

a loss of pacing capture event, a pacing capture event, a tachycardia event, a bradycardia event, a normal sinus event, a non-normal sinus event, a premature ventricular contraction event, a premature atrial event, an ectopic focus depolarization event, a reentry circuit event.

19. A method according to claim 10, wherein the measuring step is triggered based on at least a one of:

a predetermined part of a QRS ventricular depolarization complex, a portion of a T-wave, a portion of a P-wave, a detected activation event, a detected depolarization-recovery event, delivery of a cardiac stimulation pulse.

20. A computer readable medium for storing executable instructions for controlling a processor to perform a method, said medium comprising:

instructions for storing a reference activation recovery interval-related parameter associated with a known cardiac beat;

instructions for measuring an activation recovery interval-related parameter of an unknown cardiac beat;

instructions for comparing the measured parameter to the reference parameter;

instructions for classifying the unknown cardiac beat according to the comparison made between the measured activation recovery interval-related parameter and the reference activation recovery interval-related parameter; and

delivering, or withholding delivery of, a cardiac stimulation therapy based on the cardiac beat classification.

21. A medium according to claim 20, wherein the cardiac stimulation therapy comprises at least a one of:

a single-chamber therapy, a double-chamber therapy, a triple-chamber therapy, a quadruple-chamber therapy.

22. A medium according to claim 20, wherein the cardiac stimulation therapy comprises at a one of the following pacing modalities:

a DDD/R pacing modality, a DDI/R pacing modality, a VVI/R pacing modality, an AAI/R pacing modality, an ADI/R pacing modality, a DDD pacing modality, a DDD pacing modality, an AAI pacing modality, an ADI pacing modality, a VVI pacing modality.

23. A medium according to claim 20, wherein the cardiac stimulation therapy comprises a bi-ventricular pacing modality.

24. A medium according to claim 20, wherein the cardiac stimulation therapy comprises a bi-ventricular, cardiac resynchronization pacing modality.

25. A medium according to claim 20, wherein the cardiac stimulation therapy comprises a dual chamber post extra-systolic potentiation pacing modality, wherein a extra-systolic stimulation pulse is delivered to a ventricle following a refractory period of said ventricle ends.

26. A medium according to claim 25, wherein the measuring step is triggered based upon delivery of an extra-systolic stimulation pulse.

27. A medium according to claim 20, wherein the measured parameter and the stored parameter comprise at least a one of:

a spatial dispersion of activation time, a recovery time, an activation-recovery interval.

28. A medium according to claim 20, wherein the classification relates to at least a one of:

a loss of pacing capture event, a pacing capture event, a tachycardia event, a bradycardia event, a normal sinus event, a non-normal sinus event, a premature ventricular contraction event, a premature atrial contraction event, an ectopic focus depolarization event, a reentry circuit event.

29. A medium according to claim 20, wherein the measuring step is triggered based on at least a one of:

a predetermined part of a QRS ventricular depolarization complex, a portion of a T-wave, a portion of a P-wave, a detected activation event, a detected depolarization-recovery event, a delivered cardiac stimulation pulse.