Adapative anti-tachycardia therapy apparatus and method

• US 20060052829A1
• Filed: 11/03/2005
• Published: 03/09/2006
• Est. Priority Date: 04/10/2000
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: KenKnight, Bruce H., Manicka, Yatheendhar, Sun, Weimin, Tze, Martin
• Granted Patent: US 7,729,762 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A method and apparatus for delivering anti-tachycardia pacing in an adaptive manner is disclosed. A cardiac rhythm management device, such as an implantable pacemaker, having anti-tachycardia pacing capability delivers anti-tachycardia pacing therapy in accordance with a selected pacing protocol upon detection of a terminable arrhythmia. The protocol is selected from a library of available protocols. A record of the successes and failures of each available protocol in converting tachyarrhythmias is maintained in a result table for use in selecting the protocol.

Claims

1. A method for operating a cardiac device, comprising:

sensing a cardiac electrical signal;

detecting tachyarrhythmia using the cardiac signal; and

selecting one or more therapies to treat tachyarrhythmia based on ratings of history of success associated with the one or more therapies.

2. The method of claim 1, wherein:

detecting tachyarrhythmia comprises determining a type of tachyarrhythmia; and

selecting the one or more therapies comprises selecting the one or more therapies based on the ratings of history of success associated with the one or more therapies at treating the type of tachyarrhythmia.

3. The method of claim 2, wherein determining the type of tachyarrhythmia comprises determining the type of tachyarrhythmia based on morphology of the cardiac signal.

4. The method of claim 2, wherein determining the type of tachyarrhythmia comprises classifying the morphology of the cardiac signal.

5. The method of claim 2, wherein determining the type of tachyarrhythmia comprises analyzing the cardiac signal using correlation.

6. The method of claim 2, wherein determining the type of tachyarrhythmia comprises determining the type of tachyarrhythmia based on cardiac rate of the type of tachyarrhythmia.

7. The method of claim 6, wherein determining the type of tachyarrhythmia comprises determining if the cardiac rate of the type of tachyarrhythmia falls within one of a plurality of rate zones.

8. The method of claim 1, further comprising delivering the selected one or more therapies to treat the detected tachyarrhythmia in order of the ratings.

9. The method of claim 8, further comprising updating ratings of the selected one or more therapies based on success of the selected one or more therapies at terminating the detected tachyarrhythmia.

10. The method of claim 1, wherein the one or more therapies comprises an anti-tachycardia pacing therapy.

11. The method of claim 1, wherein the one or more therapies comprises a defibrillation therapy.

12. The method of claim 1, wherein the one or more therapies comprises a cardioversion therapy.

13. The method of claim 1, wherein the one or more therapies comprises at least two of an anti-tachycardia pacing therapy, a cardioversion therapy, and a defibrillation therapy.

14. A cardiac rhythm management device, comprising:

a sensing unit configured to sense a cardiac electrical signal;

a pulse generator configured to deliver electrical stimulation energy to a heart; and

a control processor configured detect tachyarrhythmia using the cardiac signal and to select one or more therapies deliverable via the pulse generator to treat tachyarrhythmia based on ratings of history of success associated with the one or more therapies.

15. The device of claim 14, wherein the pulse generator is configured to deliver anti-tachycardia pacing pulses to the heart.

16. The device of claim 14, wherein the pulse generator is configured to deliver one or both of cardioversion energy and defibrillation energy to the heart.

17. The device of claim 14, wherein the control processor is configured to determine a type of tachyarrhythmia and to select the one or more therapies to treat the type of tachyarrhythmia.

18. The device of claim 14, wherein the control processor is configured to determine the cardiac rate using the cardiac signal and to determine the type of tachyarrhythmia based on the cardiac rate.

19. The device of claim 14, wherein the control processor is configured to determine the type of tachyarrhythmia based on morphology of the cardiac signal.

20. The device of claim 14, further comprising a memory coupled to the control unit, the memory configured to store a library of available therapies, each available therapy associated with a rating of history of success of the available therapy.

21. The device of claim 20, wherein the control processor is configured to select the one or more therapies from the library of available therapies based on the ratings of the selected one or more therapies.

22. A cardiac device, comprising:

a sensing system configured to sense a cardiac electrical signal;

means for detecting tachyarrhythmia using the cardiac signal;

means for selecting one or more therapies to treat tachyarrhythmia based on ratings of history of success associated with the one or more therapies; and

a pulse generator configured to deliver the selected one or more therapies.

23. The device of claim 22, further comprising:

means for determining a type of tachyarrhythmia; and

means for selecting the one or more therapies to treat the type of tachyarrhythmia.

24. The device of claim 22, further comprising means for analyzing morphology of the cardiac signal to determine a type of tachyarrhythmia.

25. The device of claim 22, further comprising:

a memory for storing available therapies; and

means for selecting the one or more therapies from the available therapies based on the ratings associated with the one or more selected therapies.

26. The device of claim 25, further comprising means for updating the ratings of the selected one or more therapies based on success of the selected one or more therapies at terminating the detected tachyarrhythmia.