Systems, devices, and methods for tachyarrhythmia discrimination or therapy decisions
First Claim
1. A system comprising:
- an atrial contraction detector circuit, including an atrial rate detector circuit to detect an atrial rate between atrial contractions of a heart;
a ventricular contraction detector circuit, including a ventricular rate detector circuit to detect a ventricular rate between ventricular contractions of the heart; and
a processor, coupled to the atrial and ventricular rate detector circuits, the processor including;
a tachyarrhythmia detection module; and
a tachyarrhythmia classification module including a first comparator for determining if the ventricular rate exceeds the atrial rate by a threshold value, in which the threshold value varies as a function of at least one of the atrial rate and the ventricular rate, and in which if the ventricular rate exceeds the atrial rate by the threshold value corresponding to the at least one of the atrial rate and the ventricular rate, then deeming the tachyarrhythmia to be a ventricular tachyarrhythmia.
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Abstract
This document discusses, among other things, systems, devices, and methods for detecting or classifying tachyarrhythmias or making a therapy decision. In one example, a rate-dependent threshold is used for comparing atrial and ventricular rates for classifying a tachyarrhythmia as a ventricular tachyarrhythmia (VT) or a supraventricular tachyarrhythmia (SVT). In another example, the classification uses an atrial rate cutoff value, a ventricular rate cutoff value, or both. In another example, a tachyarrhythmia detection is tested over a time window with a duration that is automatically adjusted as a substantially continuously monotonically decreasing function of duration vs. rate. These techniques improve the specificity of arrhythmia detection or classification, allow anti-tachyarrhythmia therapy to be better tailored to the particular tachyarrhythmia, or provide more automatic operation making it easier for a physician to use an implantable device.
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Citations
54 Claims
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1. A system comprising:
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an atrial contraction detector circuit, including an atrial rate detector circuit to detect an atrial rate between atrial contractions of a heart;
a ventricular contraction detector circuit, including a ventricular rate detector circuit to detect a ventricular rate between ventricular contractions of the heart; and
a processor, coupled to the atrial and ventricular rate detector circuits, the processor including;
a tachyarrhythmia detection module; and
a tachyarrhythmia classification module including a first comparator for determining if the ventricular rate exceeds the atrial rate by a threshold value, in which the threshold value varies as a function of at least one of the atrial rate and the ventricular rate, and in which if the ventricular rate exceeds the atrial rate by the threshold value corresponding to the at least one of the atrial rate and the ventricular rate, then deeming the tachyarrhythmia to be a ventricular tachyarrhythmia. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method comprising:
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detecting atrial heart contractions and an atrial rate between the atrial heart contractions of an atrium of a heart;
detecting ventricular heart contractions and a ventricular rate between the ventricular heart contractions of a ventricle of the heart;
detecting a tachyarrhythmia;
determining if the ventricular rate exceeds the atrial rate by a threshold value, in which the threshold value varies as a function of at least one of the atrial rate and the ventricular rate; and
if the ventricular rate exceeds the atrial rate by the threshold value corresponding to the at least one of the atrial rate and the ventricular rate, then deeming the tachyarrhythmia to be a ventricular tachyarrhythmia. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. A system comprising:
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an atrial contraction detector circuit, including an atrial rate detector circuit to detect an atrial rate between atrial contractions of a heart;
a ventricular contraction detector circuit, including a ventricular rate detector circuit to detect a ventricular rate between ventricular contractions of the heart;
an anti-tachyarrhythmia therapy circuit; and
a processor, coupled to the atrial and ventricular rate detector circuits and the anti-tachyarrhythmia therapy circuit, the processor including;
a tachyarrhythmia detection module; and
a tachyarrhythmia therapy module, including a first comparator for determining if the ventricular rate exceeds the atrial rate by a threshold value, in which the threshold value varies as a function of at least one of the atrial rate and the ventricular rate, and triggering the delivering an anti-tachyarrhythmia therapy to the ventricle by the anti-tachyarrhythmia therapy circuit only if the ventricular rate exceeds the atrial rate by the threshold value corresponding to the at least one of the atrial rate and the ventricular rate. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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22. A method comprising:
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detecting atrial heart contractions and an atrial rate between the atrial heart contractions of an atrium of a heart;
detecting ventricular heart contractions and a ventricular rate between the ventricular heart contractions of a ventricle of the heart;
detecting a tachyarrhythmia;
determining if the ventricular rate exceeds the atrial rate by a threshold value, in which the threshold value varies as a function of at least one of the atrial rate and the ventricular rate; and
delivering an anti-tachyarrhythmia therapy to the ventricle only if the ventricular rate exceeds the atrial rate by the threshold value corresponding to the at least one of the atrial rate and the ventricular rate. - View Dependent Claims (23, 24, 25, 26, 27, 28)
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29. A system comprising:
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an atrial contraction detector circuit, including an atrial rate detector circuit to detect an atrial rate between atrial contractions of a heart;
a ventricular contraction detector circuit, including a ventricular rate detector circuit to detect a ventricular rate between ventricular contractions of the heart; and
a processor, coupled to the atrial and ventricular rate detector circuits, the processor including;
a tachyarrhythmia detection module; and
a tacharrhythmia classification module, including a first comparator for classifying a tachyarrhythmia as an atrial tachyarrhythmia if an atrial rate exceeds an atrial rate cutoff value, and including a second comparator for otherwise determining if the ventricular rate exceeds the atrial rate by a threshold value, and in which if the ventricular rate exceeds the atrial rate by the threshold value, then deeming the tachyarrhythmia to be a ventricular tachyarrhythmia unless the atrial rate exceeds the atrial rate cutoff value. - View Dependent Claims (30, 31, 32, 33)
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34. A method comprising:
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detecting atrial heart contractions and an atrial rate between the atrial heart contractions of an atrium of a heart;
detecting ventricular heart contractions and a ventricular rate between the ventricular heart contractions of a ventricle of the heart;
detecting a tachyarrhythmia; and
if the atrial rate exceeds a cutoff value, then deeming the tachyarrhythmia to be an atrial tachyarrhythmia and not a ventricular tachyarrhythmia, and otherwise determining if the ventricular rate exceeds the atrial rate by a threshold value, and if the ventricular rate exceeds the atrial rate by the threshold value, then deeming the tachyarrhythmia to be a ventricular tachyarrhythmia. - View Dependent Claims (35, 36, 37, 38)
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39. A system comprising:
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an atrial contraction detector circuit, including an atrial rate detector circuit to detect an atrial rate between atrial contractions of a heart;
a ventricular contraction detector circuit, including a ventricular rate detector circuit to detect a ventricular rate between ventricular contractions of the heart;
an anti-tachyarrhythmia therapy circuit; and
a processor, coupled to the atrial and ventricular rate detector circuits and the anti-tachyarrhythmia therapy circuit, the processor including;
a tachyarrhythmia detection module; and
a tacharrhythmia therapy module, including a first comparator for classifying a tachyarrhythmia as an atrial tachyarrhythmia if an atrial rate exceeds an atrial rate cutoff value, and including a second comparator for otherwise determining if the ventricular rate exceeds the atrial rate by a threshold value, and triggering the delivering of anti-tachyarrhythmia therapy to the ventricle only if the ventricular rate exceeds the atrial rate by the threshold value and the atrial rate is below the atrial rate cutoff value. - View Dependent Claims (40, 41, 42, 43)
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44. A method comprising:
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detecting atrial heart contractions and an atrial rate between the atrial heart contractions of an atrium of a heart;
detecting ventricular heart contractions and a ventricular rate between the ventricular heart contractions of a ventricle of the heart;
detecting a tachyarrhythmia; and
triggering a delivering of anti-tachyarrhythmia therapy to the ventricle only if the atrial rate is less than a cutoff value and the ventricular rate exceeds the atrial rate by a threshold value. - View Dependent Claims (45, 46, 47, 48)
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49. A system comprising:
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a ventricular contraction detector circuit, including a ventricular rate detector circuit to detect a ventricular rate between ventricular contractions of a heart;
an anti-tachyarrhythmia therapy circuit; and
a processor, coupled to the atrial and ventricular rate detector circuits and the anti-tachyarrhythmia therapy circuit, the processor including;
a tachyarrhythmia detection module; and
a tacharrhythmia therapy module, including an initial tachyarrhythmia detection indication and a duration timer measuring a subsequent first duration period that is substantially continuously decreasing monotonically with increasing ventricular rate, and triggering a delivering of ventricular anti-tachyarrhythmia therapy only if the initial tachyarrhythmia indication is detected and during the subsequent first duration period, a second tachyarrhythmia indication is detected using at least one tachyarrhythmia detection criterion. - View Dependent Claims (50, 51)
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52. A method comprising:
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detecting ventricular heart contractions and a ventricular rate between the ventricular heart contractions of a ventricle of a heart;
detecting an initial tachyarrhythmia indication;
if the initial tachyarrhythmia indication is detected, then detecting, during a first duration period, a second tachyarrhythmia indication using at least one tachyarrhythmia criterion, the first duration period substantially continuously decreasing monotonically with increasing ventricular rate; and
if the second tachyarrhythmia indication is detected, then delivering an anti-tachyarrhythmia therapy to the heart. - View Dependent Claims (53, 54)
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Specification