Methods and apparatuses for arrhythmia detection and classification using wireless ECG
First Claim
1. A cardiac rhythm management (CRM) system, comprising:
- an implantable medical device including;
an electrogram sensing circuit to sense an intracardiac electrogram;
a wireless electrocardiogram (ECG) sensing circuit to sense a subcutaneous ECG;
a first arrhythmia detection circuit, coupled to the electrogram sensing circuit, to detect an arrhythmia based on the intracardiac electrogram; and
an arrhythmia classification circuit, coupled to the wireless ECG sensing circuit and the arrhythmia detection circuit, to classify the detected arrhythmia based on at least the subcutaneous ECG; and
a plurality of implantable subcutaneous electrodes coupled to the wireless ECG sensing circuit.
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Accused Products
Abstract
A CRM system enhances intracardiac electrogram-based arrhythmia detection using a wireless electrocardiogram (ECG), which is a signal sensed with implantable electrodes and approximating a surface ECG. In one embodiment, an intracardiac electrogram allows for detection of an arrhythmia, and the wireless ECG allows for classification of the detected arrhythmia by locating its origin. In another embodiment, the wireless ECG is sensed as a substitute signal for the intracardiac electrogram when the sensing of the intracardiac electrogram becomes unreliable. In another embodiment, a cardiac signal needed for a particular purpose is selected from one or more intracardiac electrograms and one or more wireless ECGs based on a desirable signal quality. In another embodiment, intracardiac electrogram-based arrhythmia detection and wireless ECG-based arrhythmia detection confirm with each other before indicating a detection of arrhythmia of a certain type.
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Citations
75 Claims
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1. A cardiac rhythm management (CRM) system, comprising:
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an implantable medical device including;
an electrogram sensing circuit to sense an intracardiac electrogram;
a wireless electrocardiogram (ECG) sensing circuit to sense a subcutaneous ECG;
a first arrhythmia detection circuit, coupled to the electrogram sensing circuit, to detect an arrhythmia based on the intracardiac electrogram; and
an arrhythmia classification circuit, coupled to the wireless ECG sensing circuit and the arrhythmia detection circuit, to classify the detected arrhythmia based on at least the subcutaneous ECG; and
a plurality of implantable subcutaneous electrodes coupled to the wireless ECG sensing circuit. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method for analyzing cardiac rhythm, comprising:
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sensing an intracardiac electrogram;
sensing a subcutaneous electrocardiogram (ECG) using implantable subcutaneous electrodes;
detecting an arrhythmia based on the intracardiac electrogram; and
classifying the detected arrhythmia based on at least the subcutaneous ECG. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A cardiac rhythm management (CRM) system, comprising:
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an implantable medical device including;
a primary sensing circuit including an electrogram sensing circuit to sense an intracardiac electrogram;
an auxiliary sensing circuit including a wireless electrocardiogram (ECG) sensing circuit to sense a subcutaneous ECG;
a processing circuit having an input to receive a first signal being one of the intracardiac electrogram and the subcutaneous ECG;
a switch circuit coupled to the input of the processing circuit, the switch circuit configured to receive a selection signal and to connect the input of the processing circuit to one of the primary sensing circuit and the auxiliary sensing circuit according to the selection signal; and
a selection circuit coupled to the switch circuit, the selection circuit adapted to produce the selection signal; and
a plurality of implantable subcutaneous electrodes coupled to the auxiliary sensing circuit. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29)
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30. A method, comprising:
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sensing an intracardiac electrogram through an implantable lead;
detecting a failure signal indicating a failure in sensing the intracardiac electrogram; and
sensing a subcutaneous electrocardiogram (ECG) as a substitute for the intracardiac electrogram if the failure signal is detected. - View Dependent Claims (31, 32, 33, 34, 35)
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36. A cardiac rhythm management (CRM) system, comprising:
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an implantable medical device including;
a sensing circuit including an electrogram sensing circuit to sense one or more intracardiac electrograms and a wireless electrocardiogram (ECG) sensing circuit to sense one or more subcutaneous ECGs;
a processing circuit to receive and process at least one signal selected from the one or more intracardiac electrograms and the one or more wireless ECGs based on a selection signal; and
a signal selection circuit coupled to the processing circuit, the signal selection circuit including a signal quality assessment circuit and a selection signal generator, the signal quality assessment circuit adapted to produce quality parameters each being a measure of quality of one cardiac signal of the one or more intracardiac electrograms and the one or more wireless ECGs, the selection signal generator adapted to produce the selection signal based on at least the quality parameters; and
a plurality of implantable subcutaneous electrodes coupled to the sensing circuit. - View Dependent Claims (37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47)
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48. A method, comprising:
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sensing a plurality of cardiac signals including one or more intracardiac electrograms and one or more subcutaneous electrocardiograms (ECGs);
producing quality parameters each being a measure of quality of one cardiac signal of the plurality of cardiac signals;
selecting at least one cardiac signal from the plurality of cardiac signals based on at least the quality parameters; and
detecting an arrhythmia based on the selected at least one cardiac signal. - View Dependent Claims (49, 50, 51, 52, 53, 54, 55)
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56. A cardiac rhythm management (CRM) system, comprising:
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an implantable medical device including;
an electrogram sensing circuit to sense an intracardiac electrogram;
a wireless electrocardiogram (ECG) sensing circuit to sense a subcutaneous ECG;
a first arrhythmia detection circuit adapted to receive the intracardiac electrogram and to detect an arrhythmia from the intracardiac electrogram;
a second arrhythmia detection circuit adapted to receive the subcutaneous ECG and to detect the arrhythmia from the subcutaneous ECG; and
an arrhythmia detection confirmation circuit coupled to the first arrhythmia detection circuit and the second arrhythmia detection circuit, the arrhythmia detection confirmation circuit adapted to indicate a detection of the arrhythmia based on whether the arrhythmia is detected by the first arrhythmia detection circuit and whether the arrhythmia is detected by the second arrhythmia detection circuit; and
a plurality of implantable subcutaneous electrodes coupled to the wireless ECG sensing circuit. - View Dependent Claims (57, 58, 59, 60, 61, 62, 63)
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64. A method, comprising:
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sensing an intracardiac electrogram;
sensing a subcutaneous electrocardiogram (ECG);
detecting an arrhythmia based on the intracardiac electrogram;
detecting the arrhythmia based on the subcutaneous ECG; and
indicating a detection of the arrhythmia based on whether the arrhythmia is detected based on the intracardiac electrogram and whether the arrhythmia is detected based on the subcutaneous ECG. - View Dependent Claims (65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75)
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Specification