Temporary disablement feature for implantable device with anti-tachyarrhythmia functions

• US 20050096703A1
• Filed: 10/30/2003
• Published: 05/05/2005
• Est. Priority Date: 10/30/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Sanders, Richard S.
• Granted Patent: US 7,583,995 B2
• Time in Patent Office: Days
• US Class Current: 607/14
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/37254 Pacemaker or defibrillator security, e.g. to prevent or inhibit programming alterations by hackers or unauthorised individuals

Abstract

An implantable cardiac rhythm management device for delivering anti-tachyarrhythmia therapy is provided with a temporary disablement feature so that the delivery of anti-tachyarrhythmia therapy may be conveniently disabled and re-enabled. The feature is particularly useful to patients who are undergoing imaging procedures or surgical procedures where electro-cauterizing instruments may cause inadvertent triggering of cardioversion/defibrillation shocks and/or anti-tachycardia pacing.

Claims

1. An implantable cardiac rhythm management device, comprising:

a sensing channel for sensing an electrogram signal representing cardiac electrical activity and circuitry for generating a chamber sense when the electrogram signal exceeds a specified threshold;

one or more stimulation channels for delivering electrical stimulation to a subject'"'"'s heart;

a controller programmed to detect a tachyarrhythmia from the rate at which chamber senses are generated and to cause delivery of anti-tachyarrhythmia therapy through one or more of the stimulation channels upon detection of a tachyarrhythmia;

a telemetry interface by which the controller may communicate with an external device; and

,

wherein the controller is programmed to disable the delivery of anti-tachyarrhythmia therapy for a specified time interval upon receipt of a temporary suspend command from the external device via the telemetry interface and to re-enable the delivery of anti-tachyarrhythmia therapy upon expiration of the specified time interval.

2. The device of claim 1 wherein the specified time interval for which the delivery of anti-tachyarrhythmia therapy is disabled is communicated to the implantable device by the external device via the telemetry interface.

3. The device of claim 1 wherein delivery of anti-tachyarrhythmia therapy is re-enabled before expiration of the specified time interval by receipt of a resume command from the external device via the telemetry interface.

4. The device of claim 1 further comprising a magnetic switch actuated by application of a magnetic field and wherein delivery of anti-tachyarrhythmia therapy is re-enabled before expiration of the specified time interval by actuation of the magnetic switch.

5. The device of claim 3 further comprising an activity sensor for measuring an activity level and wherein delivery of anti-tachyarrhythmia therapy is re-enabled before expiration of the specified time interval upon measurement of an activity level above a specified threshold value.

6. The device of claim 1 wherein the controller is further programmed to disable the delivery of anti-tachyarrhythmia therapy indefinitely upon receipt of an indefinite suspend command from the external device via the telemetry interface and to re-enable the delivery of anti-tachyarrhythmia therapy upon receipt of a resume command.

7. The device of claim 6 further comprising a magnetic switch actuated by application of a magnetic field and wherein the resume command is communicated to the implantable device by actuation of the magnetic switch.

8. The device of claim 6 further comprising an activity sensor for measuring an activity level and wherein the resume command is generated upon measurement of an activity level above a specified threshold value.

9. The device of claim 1 further comprising an activity sensor for measuring an activity level and wherein the controller is further programmed to disable the delivery of anti-tachyarrhythmia therapy indefinitely upon receipt of an indefinite suspend with activity re-enable command from the external device and to re-enable the delivery of anti-tachyarrhythmia therapy upon measurement of an activity level above a specified threshold value.

10. The device of claim 1 further comprising a magnetic switch actuated by application of a magnetic field and wherein the controller is further programmed to disable the delivery of anti-tachyarrhythmia therapy indefinitely upon receipt of an indefinite suspend with magnetic re-enable command from the external device and to re-enable the delivery of anti-tachyarrhythmia therapy upon actuation of the magnetic switch.

11. The device of claim 1 wherein the one or more stimulation channels include a pacing channel for delivering anti-tachycardia pacing and wherein the controller is programmed to cause delivery of anti-tachyarrhythmia therapy in the form of anti-tachycardia pacing upon detection of a tachyarrhythmia.

12. The device of claim 1 wherein the one or more stimulation channels include a shock channel for delivering cardioversion/defibrillation shocks and wherein the controller is programmed to cause delivery of anti-tachyarrhythmia therapy in the form of a cardioversion/defibrillation shock upon detection of a tachyarrhythmia.

13. The device of claim 1 wherein the one or more stimulation channels include a pacing channel for delivering anti-tachycardia pacing and a shock channel for delivering cardioversion/defibrillation shocks, and wherein the controller is programmed to cause delivery of anti-tachyarrhythmia therapy in the form of anti-tachycardia pacing upon detection of a tachyarrhythmia in a tachycardia zone and in the form of a cardioversion/defibrillation shock upon detection of a tachyarrhythmia in a fibrillation zone.

14. The device of claim 1 wherein the controller is programmed to disable anti-tachyarrhythmia therapy by disabling one or more sensing channels.

15. The device of claim 1 wherein the one or more stimulation channels include a pacing channel for delivering bradycardia pacing in an inhibited demand mode and further wherein the controller is programmed to disable anti-tachyarrhythmia therapy by disabling one or more sensing channels which thereby also causes the device to revert to an asynchronous pacing mode.

16. An implantable cardiac rhythm management device, comprising:

a sensing channel for sensing an electrogram signal representing cardiac electrical activity and circuitry for generating a chamber sense when the electrogram signal exceeds a specified threshold;

one or more stimulation channels for delivering electrical stimulation to a subject'"'"'s heart;

a controller programmed to detect a tachyarrhythmia from the rate at which chamber senses are generated and to cause delivery of anti-tachyarrhythmia therapy through one or more of the stimulation channels upon detection of a tachyarrhythmia;

a magnetic switch interfaced to the controller which is actuated by application of a magnetic field;

a telemetry interface by which the controller may communicate with an external device; and

,

wherein the controller is programmed to disable the delivery of anti-tachyarrhythmia therapy indefinitely upon receipt of an indefinite suspend with magnetic re-enable command from the external device and to re-enable the delivery of anti-tachyarrhythmia therapy upon actuation of the magnetic switch.

17. The device of claim 16 wherein the one or more stimulation channels include a pacing channel for delivering bradycardia pacing in an inhibited demand mode and further wherein the controller is programmed to disable anti-tachyarrhythmia therapy by disabling the sensing channel which thereby also causes the device to revert to an asynchronous pacing mode.

18. An implantable cardiac rhythm management device, comprising:

a sensing channel for sensing an electrogram signal representing cardiac electrical activity and circuitry for generating a chamber sense when the electrogram signal exceeds a specified threshold;

one or more stimulation channels for delivering electrical stimulation to a subject'"'"'s heart;

a controller programmed to detect a tachyarrhythmia from the rate at which chamber senses are generated and to cause delivery of anti-tachyarrhythmia therapy through one or more of the stimulation channels upon detection of a tachyarrhythmia;

an activity sensor interfaced to the controller for measuring an activity level;

a telemetry interface by which the controller may communicate with an external device; and

,

wherein the controller is programmed to disable the delivery of the anti-tachyarrhythmia therapy indefinitely upon receipt of an indefinite suspend with activity re-enable command from the external device and to re-enable the delivery of anti-tachyarrhythmia therapy upon measurement of an activity level above a specified threshold value.

19. The device of claim 18 wherein the one or more stimulation channels include a pacing channel for delivering bradycardia pacing in an inhibited demand mode and further wherein the controller is programmed to disable anti-tachyarrhythmia therapy by disabling the sensing channel which thereby also causes the device to revert to an asynchronous pacing mode.