Delay to therapy following patient controlled atrial shock therapy request

• US 20060079939A1
• Filed: 11/15/2005
• Published: 04/13/2006
• Est. Priority Date: 04/20/2001
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Favet, Michael L., Seim, Gary T., Ricci, Carlos, Chen, Victor T., Propp, Hal
• Granted Patent: US 7,761,152 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

Claims

1. An implantable device for providing atrial shock therapy controllable by a patient using an external activator, the implantable device comprising:

an atrial arrhythmia detector to detect an atrial arrhythmia;

an atrial cardioverter/defibrillator to provide an atrial shock;

a receiver/transmitter to receive a patient therapy request signal from the external activator via a telemetry link; and

a processor adapted to time a delay period in response to the patient therapy request signal and adapted to control the atrial cardioverter/defibrillator to provide the atrial shock therapy after the delay period expires.

2. The implantable device of claim 1, wherein the processor is adapted to generate a confirmation message indicating that the patient therapy request has been received.

3. The implantable device of claim 2, wherein the receiver/transmitter is adapted to transmit the confirmation message to the external activator.

4. The implantable device of claim 2, further comprising tone generation circuitry and a speaker to produce a tone indicating that the patient therapy request has been received, the tone audible by the patient.

5. The implantable device of claim 1, wherein the processor is adapted to confirm a presence of the atrial arrhythmia before the providing of the atrial shock.

6. The implantable device of claim 1, wherein the telemetry link comprises an RF telemetry link.

7. An external activator for communicating with an implantable cardiac device, the activator comprising:

patient input circuitry adapted to receive a patient request for a delayed delivery of an atrial shock and adapted to receive a patient request for withholding the delivery of the delayed atrial shock;

a processor to generate a command signal in response to each of the patient request for the delayed delivery of the atrial shock and the patient request for withholding the delivery of the delayed atrial shock; and

a receiver/transmitter to transmit the command signal to the implantable cardiac device via a telemetry link.

8. The activator of claim 7, wherein the telemetry link is an RF telemetry link.

9. The activator of claim 8, wherein the patient input circuitry is adapted to receive a value of a delayed period associated with the delayed delivery of the atrial shock.

10. The activator of claim 8, wherein the patient input circuitry is adapted to receive a patient request for an immediate atrial shock.

11. The activator of claim 8, wherein the receiver/transmitter is adapted to receive a message from the implantable cardiac device, and wherein the processor is adapted to generate an indication of the message, and further comprising a display to present the indication of the message.

12. The activator of claim 11, wherein the display is adapted to present a visual indication of the message.

13. The activator of claim 11, wherein the display is adapted to present an audible indication of the message.

14. A system for patient controllable atrial shock therapy, the system comprising:

an implantable device including;

a signal detector to provide cardiac activity signals;

an atrial cardioverter/defibrillator to deliver an atrial shock;

an implantable device processor, coupled to the signal detector and the atrial cardioverter/defibrillator, to control the delivery of the atrial shock, the implantable device processor adapted to initiate a delay period in response to a patient therapy request and initiate a delivery of the atrial shock after the delay period expires; and

an implantable device receiver/transmitter to receive the patient therapy request via a telemetry link; and

an external patient activator including;

patient input circuitry to receive the patient therapy request; and

an activator receiver/transmitter to transmit the patient therapy request to the implantable device receiver/transmitter via the telemetry link.

15. The system of claim 14, wherein the implantable device further comprises a message generator coupled to the implantable device processor, the message generator adapted to generate a confirmation message confirming receipt of the patient therapy request.

16. The system of claim 15, wherein the external patient activator further comprises a display, coupled to the activator processor, to present a visual indication confirming the receipt of the patient therapy request by the implantable device.

17. The system of claim 16, wherein the patient input circuitry is adapted to receive a request for withholding the delivery of the electrical energy.

18. The system of claim 17, wherein the external patient input circuitry is adapted to receive a request for an immediate delivery of the electrical energy.

19. The system of claim 15, wherein the external patient input circuitry is adapted to receive a value of the delay period.

20. A method for operating an implantable cardiac device, the method comprising:

detecting an atrial arrhythmia using the implantable cardiac device;

receiving an external patient therapy request signal transmitted from an external activator to the implantable cardiac device via a telemetry link;

timing a delay period in response to receipt of the patient therapy request signal; and

providing an atrial shock after the delay period expires.

21. The method of claim 20, further comprising confirming a presence of the atrial arrhythmia before the providing of the atrial shock therapy.

22. The method of claim 20, further comprising generating a confirmation message indicating the receipt of the patient therapy request by the implantable cardiac device.

23. The method of claim 22, further comprising presenting an audible tone using a speaker of the implantable cardiac device, the audible tone indicating the receipt of the patient therapy request by the implantable cardiac device.

24. The method of claim 22, further comprising:

transmitting the confirmation message from the implantable cardiac device to the external activator; and

presenting the confirmation message visually using the external activator.

25. The method of claim 20, wherein receiving the external patient therapy request signal transmitted from the external activator to the implantable cardiac device via the telemetry link comprises receiving the external patient therapy request signal transmitted from the external activator to the implantable cardiac device via an RF telemetry link.

26. The method of claim 25, further comprising receiving an external patient request for withholding the providing of the atrial shock during the delay period.

27. The method of claim 25, further comprising receiving a value the delay period from the external activator via the telemetry link.