TEMPLATE BASED AV/VA INTERVAL COMPARISON FOR THE DISCRIMINATION OF CARDIAC ARRHYTHMIAS
First Claim
1. A system for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT), the system comprising:
- a sensing circuit to sense an atrial electrogram indicative of atrial depolarizations and a ventricular electrogram indicative of ventricular depolarizations;
a rate detector circuit, coupled to the sensing circuit, to detect an atrial rate based on the atrial electrogram and a ventricular rate based on the ventricular electrogram;
a tachycardia detector circuit, coupled to the rate detector circuit, to detect a tachycardia based on at least one of the atrial rate and the ventricular rate;
a rhythm classifier circuit, coupled to the rate detector circuit and the tachycardia detector circuit, to classify the detected tachycardia as a 1;
1 tachycardia when the atrial rate and the ventricular rate are substantially equal; and
a tachycardia discriminator circuit coupled to the rhythm classifier circuit, the tachycardia discriminator circuit including;
a time interval measurement circuit, coupled to the sensing circuit, to measure a tachycardia time interval between an atrial depolarization and an adjacent ventricular depolarization during the 1;
1 tachycardia; and
a VT comparator circuit coupled to the time interval measurement circuit, the VT comparator circuit having an output adapted to indicate a VT detection when the tachycardia time interval differs from a template time interval by at least a predetermined margin.
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Accused Products
Abstract
An implantable cardioverter/defibrillator includes a tachycardia detection system that detects one-to-one (1:1) tachycardia, which is a tachycardia with a one-to-one relationship between atrial and ventricular contractions. When the 1:1 tachycardia is detected, the system discriminates ventricular tachycardia (VT) from supraventricular tachycardia (SVT) based on analysis of a cardiac time interval. Examples of the cardiac time interval include an atrioventricular interval (AVI) and a ventriculoatrial interval (VAI). A template time interval is created during a known normal sinus rhythm. The system measures a tachycardia time interval after detecting the 1:1 tachycardia, and indicates a VT detection if the tachycardia time interval differs from the template time interval by at least a predetermined percentage of the template time interval.
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Citations
47 Claims
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1. A system for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT), the system comprising:
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a sensing circuit to sense an atrial electrogram indicative of atrial depolarizations and a ventricular electrogram indicative of ventricular depolarizations;
a rate detector circuit, coupled to the sensing circuit, to detect an atrial rate based on the atrial electrogram and a ventricular rate based on the ventricular electrogram;
a tachycardia detector circuit, coupled to the rate detector circuit, to detect a tachycardia based on at least one of the atrial rate and the ventricular rate;
a rhythm classifier circuit, coupled to the rate detector circuit and the tachycardia detector circuit, to classify the detected tachycardia as a 1;
1 tachycardia when the atrial rate and the ventricular rate are substantially equal; and
a tachycardia discriminator circuit coupled to the rhythm classifier circuit, the tachycardia discriminator circuit including;
a time interval measurement circuit, coupled to the sensing circuit, to measure a tachycardia time interval between an atrial depolarization and an adjacent ventricular depolarization during the 1;
1 tachycardia; and
a VT comparator circuit coupled to the time interval measurement circuit, the VT comparator circuit having an output adapted to indicate a VT detection when the tachycardia time interval differs from a template time interval by at least a predetermined margin. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 39, 40, 41, 42, 43, 44, 45, 46)
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18. A cardiac rhythm management (CRM) system, comprising:
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an implantable atrial lead allowing for sensing an atrial electrogram indicative of atrial depolarizations;
an implantable ventricular lead allowing for sensing a ventricular electrogram indicative of ventricular depolarizations; and
an implantable cardioverter/defibrillator (ICD) including;
a sensing circuit, coupled to the implantable atrial lead and the implantable ventricular lead, to sense the atrial electrogram and the ventricular electrogram;
a rate detector circuit, coupled to the sensing circuit, to detect an atrial rate based on the atrial electrogram and a ventricular rate based on the ventricular electrogram;
a tachycardia detector circuit, coupled to the rate detector circuit, to detect a tachycardia based on at least one of the atrial rate and the ventricular rate;
a rhythm classifier circuit, coupled to the rate detector circuit and the tachycardia detector circuit, to classify the detected tachycardia as a 1;
1 tachycardia when the atrial rate and the ventricular rate are substantially equal; and
a tachycardia discriminator circuit coupled to the rhythm classifier circuit, the tachycardia discriminator circuit including;
a time interval measurement circuit, coupled to the sensing circuit, to measure a tachycardia time interval between an atrial depolarization and an adjacent ventricular depolarization during the 1;
1 tachycardia; and
a VT comparator circuit coupled to the time interval measurement circuit, the VT comparator circuit having an output adapted to indicate a detection of VT when the tachycardia time interval differs from a template time interval by at least a predetermined margin and an SVT detection when the tachycardia time interval does not differ from the template time interval by at least the predetermined margin. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30)
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31. A method for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT), the method comprising:
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detecting a ventricular rate being a frequency of ventricular depolarizations;
detecting an atrial rate being a frequency of atrial depolarizations;
detecting a tachycardia based on at least one of the atrial and ventricular rates;
classifying the tachycardia as a 1;
1 tachycardia if the detected atrial rate is substantially the same as the detected ventricular rate;
measuring a tachycardia time interval between adjacent atrial and ventricular depolarizations during the 1;
1 tachycardia;
determining whether the tachycardia time interval differs from a template time interval by at least a predetermined margin; and
indicating a VT detection if the tachycardia time interval differs from the template time interval by at least the predetermined margin. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 47)
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Specification