SYSTEMS AND METHODS FOR TREATING CARDIAC ARRHYTHMIAS

• US 20150196756A1
• Filed: 01/08/2015
• Published: 07/16/2015
• Est. Priority Date: 01/10/2014
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Simms, Howard D. Jr., Maile, Keith R., Kane, Michael J., Linder, William J.
• Granted Patent: US 10,449,361 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• 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

Abstract

Systems and methods for coordinating treatment of abnormal heart activity using multiple implanted devices within a patient. In one example, abnormal heart activity may be sensed by a medical device system. One of the devices of the system may determine to deliver anti-tachycardia pacing therapy to the heart of the patient, and may communicate an instruction to another of the devices of the medical device system to deliver anti-tachycardia pacing (ATP) therapy to the heart. The receiving medical device may then deliver ATP therapy to the heart of the patient.

Claims

1. A method for delivering anti-tachycardia pacing therapy to a heart of a patient, the method comprising:

in a first one of a plurality of implantable medical devices, determining to deliver anti-tachycardia pacing therapy to the heart of the patient;

communicating a message from the first one of the plurality of implantable medical devices to a second one of the plurality of implantable medical devices, the message instructing the second one of the plurality of implantable medical devices to deliver anti-tachycardia pacing therapy to the heart; and

in response to receiving the message, the second one of the plurality of implantable medical devices delivering anti-tachycardia pacing therapy to the heart of the patient.

2. The method of claim 1, wherein the message is a trigger.

3. The method of claim 1, wherein the first one of the plurality of implantable medical devices comprises a subcutaneous implantable cardioverter-defibrillator (SICD), and the second one of the plurality of implantable medical devices comprises a leadless pacemaker (LCP).

4. The method of claim 1, wherein delivering anti-tachycardia pacing therapy by the second one of the plurality of implantable medical devices comprises delivering a single electrical stimulation pulse by the second one of the plurality of implantable medical devices in response to the received message to deliver anti-tachycardia pacing therapy.

5. The method of claim 1, wherein delivering anti-tachycardia pacing therapy by the second one of the plurality of implantable medical devices comprises delivering multiple electrical stimulation pulses by the second one of the plurality of implantable medical devices in response to the received message to deliver anti-tachycardia pacing therapy.

6. The method of claim 1, wherein delivering anti-tachycardia pacing therapy by the second one of the plurality of implantable medical devices comprises delivering anti-tachycardia pacing therapy in accordance with an anti-tachycardia pacing therapy protocol.

7. The method of claim 1, further comprising communicating one or more anti-tachycardia pacing therapy parameters from the first one of a plurality of implantable medical devices to the second one of a plurality of implantable medical devices prior to the delivering step.

8. The method of claim 7, wherein the one or more anti-tachycardia pacing therapy parameters include one or more of:

a number of electrical stimulation pulses to deliver during delivery of anti-tachycardia pacing therapy;

a width of electrical stimulation pulses to deliver during delivery of anti-tachycardia pacing therapy;

an amplitude of electrical stimulation pulses to deliver during delivery of anti-tachycardia pacing therapy;

a time period between electrical stimulation pulses to deliver during delivery of anti-tachycardia pacing therapy;

a shape of electrical stimulation pulses to deliver during delivery of anti-tachycardia pacing therapy;

a coupling interval; and

a specific anti-tachycardia pacing therapy protocol.

9. The method of claim 1, wherein delivering anti-tachycardia pacing therapy by the second one of the plurality of implantable medical devices comprises beginning to deliver anti-tachycardia pacing therapy during a non-refractory period of the heart.

10. The method of claim 1, wherein delivering anti-tachycardia pacing therapy by the second one of the plurality of implantable medical devices comprises beginning to deliver anti-tachycardia pacing therapy after a predefined amount of time following a first QRS wave that is detected after receiving the message to deliver anti-tachycardia pacing therapy.

11. The method of claim 1, further comprising determining, by the second one of the plurality of implantable medical devices, a presence of an arrhythmia before delivering anti-tachycardia pacing therapy to the heart of the patient.

12. The method of claim 1, wherein the second one of the plurality of implantable medical devices delivers tachycardia pacing therapy to the heart of the patient in synchrony with the rhythm of the heart of the patient.

13. The method of claim 1, wherein a communication link of the second one of the plurality of implantable medical devices is inactive until the second one of the plurality of implantable medical devices determines a presence of an arrhythmia or a predetermined heart rate.

14. The method of claim 1, wherein the communication by the first one of the plurality of implantable medical devices to the second one of the plurality of implantable medical devices is via conducted communication signals.

15. An implantable medical device system for delivering anti-tachycardia pacing therapy to a heart of a patient, the system comprising:

a first implantable medical device;

a second implantable medical device, wherein the first implantable medical device and the second implantable medical device are communicatively coupled;

wherein at least one of the first implantable medical device and the second implantable medical device is configured to deliver anti-tachycardia pacing therapy to the heart of the patient;

wherein the first implantable medical device is configured to determine to deliver anti-tachycardia pacing therapy to the heart of the patient;

wherein the first implantable medical device is configured to communicate a message to the second implantable medical device to deliver anti-tachycardia pacing therapy to the heart of the patient; and

the second implantable medical device is configured to deliver anti-tachycardia pacing therapy to the heart in response to receiving the message.

16. The system of claim 15, wherein the message received by the second implantable medical device to deliver anti-tachycardia pacing therapy to the heart of the patient causes the second implantable medical device to deliver one anti-tachycardia pacing pulse;

and

wherein the first implantable medical device is configured to communicate multiple messages to the second implantable medical device wherein each message causes the second implantable medical device to deliver a corresponding anti-tachycardia pacing pulse.

17. The system of claim 15, wherein the first implantable medical device is further configured to communicate one or more parameters of the anti-tachycardia pacing therapy to the second implantable medical device.

18. The system of claim 15, wherein the first implantable medical device comprises a subcutaneous implantable cardioverter-defibrillator (SICD), and the second implantable medical device comprises a leadless pacemaker (LCP).

19. A method of delivering electrical stimulation therapy to a heart of a patient, the method comprising:

determining, by a first one of a plurality of implantable medical devices, a presence of an arrhythmia, the first one of a plurality of implantable medical devices includes a subcutaneous implantable cardioverter-defibrillator (SICD);

determining, by the first one of the plurality of implantable medical devices, to deliver anti-tachycardia pacing therapy to the heart of the patient in response to determining a presence of an arrhythmia;

charging, by the first one of the plurality of implantable medical devices, a capacitor of a shock channel of the first one of the plurality of implantable medical device;

communicating, by the first one of the plurality of implantable medical devices to a second one of the plurality of implantable medical devices, a message to deliver anti-tachycardia pacing therapy, wherein the second one of the plurality of implantable medical devices includes a leadless pacemaker; and

delivering anti-tachycardia pacing therapy to the heart of the patient by the second one of the plurality of implantable medical devices during the charging of the capacitor of the first one of the plurality of implantable medical devices.

20. The method of claim 19, wherein the first one of the plurality of implantable medical devices is configured to determine a presence of an arrhythmia or a predetermined heart rate after the second one of the plurality of implantable medical devices begins to deliver anti-tachycardia pacing therapy to the heart of the patient;

and

if the first one of the plurality of implantable medical devices determines a presence of an arrhythmia or a predetermined heart rate, the first one of the plurality of implantable medical devices is configured to deliver a defibrillation pulse to the heart of the patient via the shock channel.