SYSTEMS AND METHODS FOR LEADLESS PACING AND SHOCK THERAPY

• US 20140214104A1
• Filed: 02/12/2014
• Published: 07/31/2014
• Est. Priority Date: 01/31/2013
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Zhang, Xusheng, Demmer, Wade M, Jackson, Troy E, Reinke, James D, Greenhut, Saul E, Nehls, Robert J, Olson, Walter H
• Granted Patent: US 9,072,914 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

Claims

1. A method comprising:

determining, by a subcutaneous implantable cardioverter defibrillator (SICD) and based on a detected tachyarrhythmia, to deliver anti-tachyarrhythmia therapy to a patient to treat the detected arrhythmia;

receiving, by a pacing device (PD) implanted within the heart of the patient, communication from the SICD requesting the PD deliver anti-tachyarrhythmia therapy to the patient;

determining, by the PD, not to deliver anti-tachyarrhythmia therapy to the patient;

wherein the method further comprises, in response to the determining not to deliver anti-tachyarrhythmia therapy, transmitting, by the LPD to the SICD, communication identifying the determination not to deliver anti-tachyarrhythmia therapy;

receiving, by the SICD, the communication identifying the determination not to deliver anti-tachyarrhythmia therapy; and

overturning, based on the received communication identifying the determination not to deliver anti-tachycardia pacing, the determination of the SICD to deliver anti-tachyarrhythmia therapy to the patient.

2. The method of claim 1, wherein determining by the PD not to deliver anti-tachyarrhythmia therapy comprises determining not to deliver anti-tachycardia pacing.

3. The method of claim 1, wherein determining by the SICD to deliver anti-tachyarrhythmia therapy comprises determining to deliver anti-tachycardia pacing.

4. The method of claim 1, wherein determining by the SICD to deliver anti-tachyarrhythmia therapy comprises determining to deliver high voltage shock therapy.

5. The method of claim 1, further comprising:

in response to receiving, the communication from the SICD requesting the PD deliver anti-tachyarrhythmia therapy to the patient and in the absence of a determination not to deliver anti-tachyarrhythmia therapy,

delivering, by the PD, anti-tachyarrhythmia therapy as requested by the SICD

6. A method comprising:

determining, by a subcutaneous implantable cardioverter defibrillator (SICD) and based on a detected tachyarrhythmia, to deliver anti-tachyarrhythmia therapy to a patient to treat the detected arrhythmia;

receiving, by a pacing device (PD) implanted within the heart of the patient, communication from the SICD requesting the PD deliver anti-tachyarrhythmia therapy to the patient;

determining, by the PD, not to deliver anti-tachyarrhythmia therapy to the patient;

determining, by the SICD, that the PD did not deliver anti-tachyarrhythmia therapy; and

adjusting, by the SICD and based on the non-delivery of anti-tachyarrhythmia therapy, at least one of a tachyarrhythmia detection criteria and a therapy parameter.

7. The method of claim 6, wherein determining by the PD to deliver anti-tachyarrhythmia therapy comprises determining to deliver anti-tachycardia pacing.

8. The method of claim 6, wherein determining by the SICD to deliver anti-tachyarrhythmia therapy comprises determining to deliver anti-tachycardia pacing.

9. The method of claim 6, wherein determining by the SICD to deliver anti-tachyarrhythmia therapy comprises determining to deliver high voltage shock therapy.

10. The method of claim 6, further comprising:

in response to receiving, the communication from the SICD requesting the PD deliver anti-tachyarrhythmia therapy to the patient and in the absence of a determination not to deliver anti-tachyarrhythmia therapy,

delivering, by the PD, anti-tachyarrhythmia therapy as requested by the SICD

11. The method of claim 6, wherein adjusting, by the SICD and based on the non-delivery of anti-tachyarrhythmia therapy, comprises adjusting a detection parameter and further comprising:

subsequently determining, by the (SICD) and based on a tachyarrhythmia detected using the adjusted detection parameter to deliver anti-tachyarrhythmia therapy to the patient.

12. A method comprising:

determining, by a subcutaneous implantable cardioverter defibrillator (SICD) and based on a detected tachyarrhythmia, to deliver anti-tachyarrhythmia therapy to a patient to treat the detected arrhythmia;

receiving, by a pacing device (PD) implanted within the heart of the patient, communication from the SICD requesting the PD deliver anti-tachyarrhythmia therapy to the patient;

delivering, by the PD, anti-tachyarrhythmia therapy to the patient;

detecting, by SICD, the delivered anti-tachyarrhythmia therapy;

transmitting, by the SICD to the PD, communication identifying that the delivered anti-tachyarrhythmia therapy has not captured a rhythm of the heart; and

determining, by the PD, at least one updated parameter value that at least partially defines additional anti-tachyarrhythmia therapy.

13. The method of claim 12, wherein delivering anti-tachyarrhythmia therapy by the PD comprises delivering anti-tachycardia pacing.

14. The method of claim 12, wherein determining by the SICD to deliver anti-tachyarrhythmia therapy comprises determining to deliver anti-tachycardia pacing.

15. The method of claim 12, wherein determining by the SICD to deliver anti-tachyarrhythmia therapy comprises determining to deliver high voltage shock therapy.

16. The method of claim 12, further comprising:

subsequent to delivering anti-tachyarrhythmia therapy that has not captured a rhythm of the heart, delivering, by the PD, anti-tachyarrhythmia therapy defined at least partially by the determined updated parameter value.