Method and apparatus for anti-tachycardia pacing and defibrillation
First Claim
1. A cardiac rhythm management system comprising:
- a sensing circuit to sense a cardiac signal;
a pacing circuit to deliver an anti-tachycardia pacing (ATP);
a defibrillation circuit to deliver a shock, the defibrillation circuit including;
a defibrillation capacitor to store an electrical energy for the shock; and
a capacitor charging circuit to charge the defibrillation capacitor in response to a charging signal;
a ventricular tachycardia (VT) detector to detect a VT based on at least the cardiac signal;
a VT verification module adapted to receive a first VT verification command and a second VT verification command and perform a VT verification test to determine whether the VT sustains based on at least the cardiac signal after one of the first and second VT verification commands is received; and
a controller coupled to the pacing circuit, the defibrillation circuit, the VT detector, and the VT verification module, the controller including;
an ATP activator to receive an ATP activation command and produce an ATP activation signal in response to a receipt of the ATP activation command;
a first VT verification controller to issue the first VT verification command after the VT is detected and produce a first VT verification signal if the VT sustains after being detected;
an ATP controller to detect a presence of the ATP activation signal and, if the ATP activation signal is present, to receive the first VT verification signal and control an ATP delivery after the first VT verification signal is received;
a second VT verification controller to issue the second VT verification command after the ATP delivery and produce a second VT verification signal if the VT sustains after the ATP delivery;
a charging controller to detect the presence of the ATP activation signal and, if the ATP activation signal is present, receive the second VT verification signal and produce the charging signal after the second VT verification signal is received, and if the ATP activation signal is not present, receive the first VT verification signal and produce the charging signal after the first VT verification signal is received; and
a defibrillation controller to control a delivery of the shock after the charging of the defibrillation capacitor is completed.
1 Assignment
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Accused Products
Abstract
An implantable cardioverter/defibrillator (ICD) includes an Anti-Tachycardia Pacing Before Charge (ATP-BC) mode according to which one or more high-voltage capacitors for storing defibrillation energy are charged in preparation of delivering a defibrillation shock only if a ventricular tachycardia (VT) sustains after an ATP delivery. Fast ATP delivery and effect verification methods are applied to avoid significant delay in delivering the defibrillation shock when found necessary to terminate the VT. A switch is provided such that a user decides whether to activate the ATP-BC mode or to deliver the defibrillation shock without delivering the ATP.
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Citations
43 Claims
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1. A cardiac rhythm management system comprising:
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a sensing circuit to sense a cardiac signal;
a pacing circuit to deliver an anti-tachycardia pacing (ATP);
a defibrillation circuit to deliver a shock, the defibrillation circuit including;
a defibrillation capacitor to store an electrical energy for the shock; and
a capacitor charging circuit to charge the defibrillation capacitor in response to a charging signal;
a ventricular tachycardia (VT) detector to detect a VT based on at least the cardiac signal;
a VT verification module adapted to receive a first VT verification command and a second VT verification command and perform a VT verification test to determine whether the VT sustains based on at least the cardiac signal after one of the first and second VT verification commands is received; and
a controller coupled to the pacing circuit, the defibrillation circuit, the VT detector, and the VT verification module, the controller including;
an ATP activator to receive an ATP activation command and produce an ATP activation signal in response to a receipt of the ATP activation command;
a first VT verification controller to issue the first VT verification command after the VT is detected and produce a first VT verification signal if the VT sustains after being detected;
an ATP controller to detect a presence of the ATP activation signal and, if the ATP activation signal is present, to receive the first VT verification signal and control an ATP delivery after the first VT verification signal is received;
a second VT verification controller to issue the second VT verification command after the ATP delivery and produce a second VT verification signal if the VT sustains after the ATP delivery;
a charging controller to detect the presence of the ATP activation signal and, if the ATP activation signal is present, receive the second VT verification signal and produce the charging signal after the second VT verification signal is received, and if the ATP activation signal is not present, receive the first VT verification signal and produce the charging signal after the first VT verification signal is received; and
a defibrillation controller to control a delivery of the shock after the charging of the defibrillation capacitor is completed. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method for operating an implantable cardioverter/defibrillator (ICD), comprising;
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receiving an anti-tachycardia pacing (ATP) activation command activating a feature including delivering an ATP;
detecting a ventricular tachycardia (VT);
determining whether the VT sustains after being detected;
delivering the ATP if the ATP activation command is received and the VT sustains after being detected;
charging a capacitor if the ATP activation command is not received and the VT sustains after being detected;
determining whether the VT sustains after the delivering the ATP;
charging the capacitor if the VT sustains after the ATP is delivered; and
delivering a defibrillation shock after the capacitor is charged. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43)
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Specification