Delivery of CRT therapy during AT/AF termination

• US 20060224193A1
• Filed: 03/31/2005
• Published: 10/05/2006
• Est. Priority Date: 03/31/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Hess, Michael F.
• Granted Patent: US 7,515,959 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

In some embodiments, a method for operating a cardiac rhythm management device may include one or more of the following steps: (a) sensing atrial depolarizations through an implanted atrial electrode, (b) administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion, (c) switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode, (d) administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion, (e) analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia, (f) analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia, and (g) sensing ventricular depolarizations of the left and the right ventricle.

Claims

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

sensing atrial depolarizations through an implanted atrial electrode;

administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion;

switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode;

administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion; and

analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia.

2. The method of claim 1, further including analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia.

3. The method of claim 1, further including sensing ventricular depolarizations of the left and the right ventricle.

4. The method of claim 1, further including providing an atrial pacing therapy when no atrial depolarizations are sensed for a predetermined amount of time.

5. The method of claim 1, further including switching from the simultaneous CRT pacing mode to the sequential CRT pacing mode when the presence of atrial arrhythmia is not detected.

6. The method of claim 1, further including switching from the simultaneous CRT pacing mode to the sequential CRT pacing mode when the presence of atrial arrhythmia is detected.

7. A method for operating a cardiac rhythm management device, comprising:

administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion;

switching from the sequential CRT pacing mode to a modified CRT pacing mode;

administering a modified CRT pacing therapy in the modified CRT pacing mode, the modified CRT pacing therapy being one of a simultaneous CRT pacing therapy and a single-sided pacing therapy, the simultaneous CRT pacing therapy being administered to the left and right ventricle in a simultaneous bi-ventricular fashion, the single-sided CRT pacing therapy being administered to one of the left and right ventricles; and

administering an atrial electrical stimulation therapy via an implanted atrial electrode to an atrium of the patient in the presence of an atrial arrhythmia.

8. The method of claim 7, wherein the atrial electrical stimulation therapy includes at least one of anti-tachy pacing, atrial cardioversion, and atrial defibrillation.

9. The method of claim 7, further including sensing atrial depolarizations.

10. The method of claim 7, wherein switching from the sequential CRT pacing mode to the modified CRT pacing mode occurs before administering the atrial electrical stimulation therapy.

11. The method of claim 7, further including sensing ventricular depolarizations of the left and the right ventricle, and wherein the sequential CRT pacing therapy is applied upon sensing depolarization of the right or left ventricle.

12. The method of claim 7, further including sensing ventricular depolarizations of the ventricles, and wherein one of the sequential CRT pacing therapy and the modified pacing therapy is administered when no ventricular depolarizations are sensed for a predetermined amount of time.

13. The method of claim 7, further including switching from the modified CRT pacing mode to the sequential CRT pacing mode after administering the electrical atrial stimulation therapy.

14. A system for operating a cardiac rhythm management device, comprising:

means for sensing atrial depolarizations through an implanted atrial electrode;

means for administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion;

means for switching from the sequential CRT pacing mode to a single-sided CRT pacing mode;

means for administering a single-sided CRT pacing therapy in the single-sided CRT pacing mode to one of the left and right ventricle; and

means for analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia.

15. The system of claim 14, further including means for analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia.

16. The system of claim 15, wherein the analysis to detect the presence of an atrial arrhythmia while in the sequential CRT pacing mode is a preliminary detection analysis.

17. The system of claim 14, further including sensing ventricular depolarizations of the ventricles.

18. The system of claim 14, further including providing an atrial pacing therapy when no atrial depolarizations are sensed for a predetermined amount of time.

19. The system of claim 14, further including switching from the single-sided CRT pacing mode to the sequential CRT pacing mode when the presence of atrial arrhythmia is not detected.

20. The system of claim 14, further including switching from the single-sided CRT pacing mode to the sequential CRT pacing mode when the presence of atrial arrhythmia is detected.