ELECTROTHERAPY DEVICE FOR TREATING TACHYCARDIAC ARRHYTHMIAS OF A HEART

• US 20090306729A1
• Filed: 06/08/2009
• Published: 12/10/2009
• Est. Priority Date: 06/10/2008
• Status: Active Grant

• Current Assignee: Biotronik SE & Company KG
• Original Assignee: Biotronik CRM Patent AG (Biotronik SE & Company KG)
• Inventors: Doerr, Thomas
• Granted Patent: US 8,532,768 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 1/39622 Pacing therapy

Abstract

An electrotherapy system, particularly an implantable heart stimulator, is configured as an electronic implant for electrical anti-tachycardia therapy of the heart, and includes at least one programmable therapy sequence (i.e. a sequence of several therapies that are delivered, one after the other, to treat a VT/VF episode). The implant has a therapy success memory for storing therapy success statistics for each therapy, as well as a therapy control unit that is configured to automatically undertake adaptation of the order of the therapies within a therapy sequence as a function of currently stored therapy success statistics.

Claims

1. An electrotherapy device for electrical anti-tachycardia therapy of a heart, the device including:

a. a tachycardia registration unit (90);

(1) detecting a tachycardia of an atrium or chamber of the heart, and

(3) recording characteristics of the detected tachycardia;

b. at least one stimulation unit (56, 50) capable of delivering a therapy sequence to the heart, each therapy sequence containing a sequence of anti-tachycardia therapies, wherein;

(1) each anti-tachycardia therapy within the therapy sequence includes the delivery of at least one stimulation/defibrillation pulse to the heart, and

(2) the anti-tachycardia therapies within the therapy sequence differ from one another in one or more therapy characteristics, the therapy characteristics including;

(a) the intensity of the stimulation/defibrillation pulses,

(b) the number of the stimulation/defibrillation pulses, and

(c) the order and timing of the stimulation/defibrillation pulses,

c. a control unit (54) controlling the stimulation unit (56, 50) to deliver the therapy sequence to the heart after detection of a tachycardia;

d. a therapy success memory (96);

e. a therapy success registration unit (90, 92);

(1) storing data in the therapy success memory (96) characterizing

(a) the tachycardia, and

(b) any anti-tachycardia therapy within the therapy sequence resulting in termination of the tachycardia, and

(2) compiling therapy success statistics based on the data stored in the therapy success memory (96),

wherein the control unit (54, 92) revises the order of the anti-tachycardia therapies within the therapy sequence in dependence on how often each anti-tachycardia therapy within the therapy sequence resulted in termination of a tachycardia in comparison with the other anti-tachycardia therapies of the therapy sequence.

2. The electrotherapy device of claim 1 wherein the therapy success statistics include therapy success counter readings stored in the therapy success memory (96).

3. The electrotherapy device of claim 2 in combination with an external programming device separate and spaced from the electrotherapy device, wherein the external programming device can wirelessly access and modify the therapy success counter readings.

4. The electrotherapy device of claim 1 wherein:

a. each anti-tachycardia therapy within the therapy sequence is assigned a therapy success counter, and

b. when one of the anti-tachycardia therapies results in termination of the tachycardia, the corresponding therapy success counter is increased.

5. The electrotherapy device of claim 1 wherein the tachycardia registration unit differentiates detected tachycardias into:

a. stable tachycardias having a stable rhythm, and

b. unstable tachycardias having an unstable rhythm.

6. The electrotherapy device of claim 5 wherein at least one anti-tachycardia therapy within the therapy sequence is assigned:

a. a first therapy success counter reading for stable tachycardias, wherein the first therapy success counter reading is increased if the anti-tachycardia therapy resulted in termination of a stable tachycardia, and

b. a second therapy success counter reading for unstable tachycardias, wherein the second therapy success counter reading is increased if the anti-tachycardia therapy resulted in termination of an unstable tachycardia.

7. The electrotherapy device of claim 1 wherein the tachycardia registration unit differentiates detected tachycardias into discrete tachycardia zones as a function of the heart rate.

8. The electrotherapy device of claim 7 wherein at least one anti-tachycardia therapy within the therapy sequence is assigned multiple therapy success counters, each of these therapy success counters corresponding to one of the tachycardia zones.

9. The electrotherapy device of claim 1 wherein:

a. each anti-tachycardia therapy within the therapy sequence is assigned one or more therapy success counters, and

b. for any anti-tachycardia therapy resulting in an accelerating tachycardia, the corresponding therapy success counters are decreased.

10. The electrotherapy device of claim 1 wherein:

a. a blocking identifier is assigned to any anti-tachycardia therapy resulting in an accelerating tachycardia, and

b. the blocking identifier inhibits subsequent delivery of the corresponding anti-tachycardia therapy by the stimulation unit (56, 50).

11. The electrotherapy device of claim 10 wherein any anti-tachycardia therapy assigned a blocking identifier is removed from the therapy sequence wherein the anti-tachycardia therapy resided.

12. The electrotherapy device of claim 1 in combination with an external programming device separate and spaced from the electrotherapy device, wherein the external programming device can wirelessly receive the therapy success statistics.

13. An electrotherapy device for electrical anti-tachycardia therapy of a heart, the device including:

a. a tachycardia registration unit (90) detecting a tachycardia within the heart;

b. at least one stimulation unit (56, 50) delivering a therapy sequence to the heart after detection of a tachycardia, each therapy sequence containing a sequence of anti-tachycardia therapies, wherein;

(1) each anti-tachycardia therapy within the therapy sequence includes the delivery of at least one stimulation/defibrillation pulse to the heart, and

(2) the anti-tachycardia therapies within the therapy sequence differ in at least some of their stimulation/defibrillation pulses,

c. a therapy success memory (96);

d. a therapy success registration unit (90, 92) storing data in the therapy success memory (96) characterizing how often each anti-tachycardia therapy within the therapy sequence resulted in termination of a tachycardia in comparison with the other anti-tachycardia therapies of the therapy sequence,

wherein the order of the anti-tachycardia therapies within the therapy sequence are revised in dependence on how often each anti-tachycardia therapy within the therapy sequence resulted in termination of a tachycardia in comparison with the other anti-tachycardia therapies of the therapy sequence.

14. The electrotherapy device of claim 13 wherein:

a. each anti-tachycardia therapy within the therapy sequence is assigned one or more therapy success counters, and

b. when one of the anti-tachycardia therapies results in termination of a tachycardia, at least one of the therapy success counters corresponding to the anti-tachycardia therapy is increased.

15. The electrotherapy device of claim 14 wherein when one of the anti-tachycardia therapies results in an accelerating tachycardia, at least one of the therapy success counters corresponding to the anti-tachycardia therapy is decreased.

16. The electrotherapy device of claim 14 wherein when one of the anti-tachycardia therapies results in an accelerating tachycardia, the anti-tachycardia therapy is removed from the therapy sequence.

17. The electrotherapy device of claim 13 wherein each anti-tachycardia therapy within the therapy sequence is assigned:

a. a set of stability therapy success counters, the set including;

(1) a stable tachycardia therapy success counter which is increased when the anti-tachycardia therapy results in termination of a tachycardia having a stable rhythm;

(2) an unstable therapy success counter which is increased when the anti-tachycardia therapy results in termination of a tachycardia having an unstable rhythm;

b. a set of zone therapy success counters, each corresponding to a range of heart rates, each zone therapy success counter being increased when the anti-tachycardia therapy results in termination of a tachycardia occurring within the corresponding range of heart rates.

18. The electrotherapy device of claim 17 wherein when one of the anti-tachycardia therapies results in an accelerating tachycardia, at least one of the following occurs:

a. at least one of the therapy success counters corresponding to the anti-tachycardia therapy is decreased;

b. the stimulation unit (56, 50) is blocked from delivery of the anti-tachycardia therapy; and

c. the anti-tachycardia therapy is removed from the therapy sequence.

19. The electrotherapy device of claim 13 in combination with an external programming device separate and spaced from the electrotherapy device, wherein the external programming device can wirelessly receive the data in the therapy success memory (96) characterizing how often each anti-tachycardia therapy within the therapy sequence resulted in termination of a tachycardia in comparison with the other anti-tachycardia therapies of the therapy sequence.

20. An electrotherapy device for electrical anti-tachycardia therapy of a heart, the device including:

a. a tachycardia registration unit (90) detecting a tachycardia of the heart from an intracardiac detection electrode;

b. at least one stimulation unit (56, 50) delivering a therapy sequence to the heart via an intracardiac stimulation/defibrillation electrode after detection of a tachycardia, each therapy sequence containing a sequence of anti-tachycardia therapies, wherein;

(1) each anti-tachycardia therapy within the therapy sequence includes the delivery of at least one stimulation/defibrillation pulse to the heart,

(2) the anti-tachycardia therapies within the therapy sequence differ in at least some of their stimulation/defibrillation pulses, and

(3) at least some of the anti-tachycardia therapies within the therapy sequence include one or more of;

(a) a set of stability therapy success counters, the set having;

i. a stable tachycardia therapy success counter which is increased when the anti-tachycardia therapy results in termination of a tachycardia having a stable rhythm;

ii. an unstable therapy success counter which is increased when the anti-tachycardia therapy results in termination of a tachycardia having an unstable rhythm;

(b) a set of zone therapy success counters, each zone therapy success counter corresponding to a range of heart rates, each zone therapy success counter being increased when the anti-tachycardia therapy results in termination of a tachycardia occurring within the corresponding range of heart rates.

wherein the device revises the order of the anti-tachycardia therapies within the therapy sequence in dependence on the therapy success counters.