Automated Assessment Of Atrioventricular And Ventriculoatrial Conduction
First Claim
1. A method, comprising:
- a) providing, under conditions so as to generate ventricular electrical signals;
i) a first set of atrial pacing bursts having a first cycle length; and
ii) a second set of atrial pacing bursts, wherein said second atrial pacing bursts have a second cycle length; and
b) detecting said ventricular electrical signals generated in response to said second set of atrial pacing bursts, wherein said second atrial pacing burst cycle length is shorter than said first atrial pacing burst cycle length;
c) repeating step b) until said ventricular electrical signals are not detected, wherein the penultimate second atrial pacing burst establishes a minimum atrioventricular cycle length value.
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Abstract
A method discriminates between ventricular arrhythmia and supraventricular arrhythmia by determining the direction of an electrical signal conducted through the atrioventricular node. An implantable cardiac defibrillator provides atrioventricular and ventriculoatrial pacing bursts to determine if an arrhythmia with a 1:1 atrial to ventricular relationship is due to ventricular tachycardia or supraventricular tachycardia. This discrimination capability reduces the incidence of inappropriate shocks from dual-chamber implantable cardiac defibrillators to near zero and provides a method to differentially diagnose supraventricular tachycardia from ventricular tachycardia.
70 Citations
25 Claims
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1. A method, comprising:
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a) providing, under conditions so as to generate ventricular electrical signals; i) a first set of atrial pacing bursts having a first cycle length; and ii) a second set of atrial pacing bursts, wherein said second atrial pacing bursts have a second cycle length; and b) detecting said ventricular electrical signals generated in response to said second set of atrial pacing bursts, wherein said second atrial pacing burst cycle length is shorter than said first atrial pacing burst cycle length; c) repeating step b) until said ventricular electrical signals are not detected, wherein the penultimate second atrial pacing burst establishes a minimum atrioventricular cycle length value. - View Dependent Claims (2, 3, 4, 5)
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6. A method, comprising:
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a) providing, under conditions so as to generate atrial electrical signals; i) a first set of ventricular pacing bursts having a first cycle length; and, ii) a second set of ventricular pacing bursts, wherein said second ventricular pacing bursts have a second cycle length; b) detecting said atrial electrical signals generated in response to said second set of ventricular pacing bursts, wherein said second ventricular pacing burst cycle length is shorter than said first ventricular pacing burst cycle length; c) repeating step b) until said atrial electrical signals are not detected, wherein the penultimate second ventricular pacing burst establishes a minimum ventriculoatrial cycle length value. - View Dependent Claims (7, 8, 9, 10)
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11. A method, comprising:
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a) providing; i) a patient diagnosed with a cardiac arrhythmia, said arrhythmia having a cycle length; ii) a microprocessor comprising an atrioventricular cycle length value and a ventriculoatrial cycle length value, wherein said microprocessor is configured to receive said atrioventricular conduction signal and a ventriculoatrial conduction signal; b) determining whether said atrioventricular conduction signal and said ventriculoatrial conduction signal are present. - View Dependent Claims (12, 13, 14, 15, 16, 17)
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18. A method, comprising:
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a) providing a patient comprising atrial leads and ventricular leads, wherein said leads are connected to a pacemaker/defibrillator device; b) sending a pacing burst signal to said atrial leads by said pacemaker/defibrillator; c) sending a pacing burst signal to said ventricular leads by said pacemaker/defibrillator; d) detecting an earliest arriving ventricular electrical signal following said atrial pacing burst signal under conditions that determine a minimum atrioventricular cycle length value; and e) detecting an earliest arriving atrial electrical signal following said ventricular pacing burst signal under conditions that determine a minimum ventriculoatrial cycle length value. - View Dependent Claims (19, 20)
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21. A device, comprising:
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a) a defibrillator element comprising a microprocessor, wherein said microprocessor is capable of comparing a stored cardiac cycle length with an input cardiac cycle length; b) a pacemaker element connected to said defibrillator element; and c) a plurality of atrial and ventricular sensing leads connected to said pacemaker, wherein said leads provide said input cardiac cycle length to said microprocessor. - View Dependent Claims (22, 23, 24, 25)
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Specification