ATRIAL ARRYTHMIA DETECTION USING A PRESSURE SIGNAL IN AN IMPLANTABLE MEDICAL DEVICE AND MEDICAL SYSTEM

• US 20170112390A1
• Filed: 10/22/2015
• Published: 04/27/2017
• Est. Priority Date: 10/22/2015
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cho, Yong K., Hill, Michael R.S.
• Application Number:
  US14/919,854
• Publication Number:
  US 20170112390A1
• Time in Patent Office: Days
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

A medical device system and method for monitoring a cardiovascular pressure signal to identify an atrial arrhythmia that includes a sensor sensing a cardiovascular pressure signal and a pressure analysis module that is configured to determine at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal, compare the at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal to a dispersion threshold, and determine whether the atrial arrhythmia is occurring in response to the comparing

Claims

1. A medical device system for monitoring a cardiovascular pressure signal to identify an atrial arrhythmia, comprising:

a sensor sensing a cardiovascular pressure signal;

a pressure analysis module configured to determine at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal, compare the at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal to a dispersion threshold, and determine whether the atrial arrhythmia is occurring in response to the comparing.

2. The medical device system of claim 1, wherein the pressure analysis module is configured to determine the at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal for each of a first plurality of data collection sessions, compare a number of data collection sessions of the first plurality of data collection sessions for which the atrial arrhythmia is determined to occur to a persistent atrial arrhythmia threshold, and identify a persistent atrial arrhythmia in response to the number of data collection sessions of the first plurality of data collection sessions for which the atrial arrhythmia is determined to occur satisfying the persistent atrial arrhythmia threshold.

3. The medical device system of claim 2, wherein the first plurality of data collection sessions comprises eight data collection sessions per day and identifying a persistent atrial fibrillation in response to determining the atrial arrhythmia is occurring for six data collection sessions of the eight data collection sessions.

4. The medical device system of claim 2, wherein the pressure analysis module is configured to adjust the first plurality of data collection sessions to an adjusted number of data collections per day in response to the atrial arrhythmia being determined for a data collection session of the adjusted plurality of data collection sessions.

5. The medical device system of claim 4, wherein the first plurality of data collection sessions comprises eight data collection sessions per day and the adjusted plurality of data collection sessions comprises more than eight collection sessions per day.

6. The medical device system of claim 5, wherein the pressure analysis module is configured to identify a persistent atrial arrhythmia in response to the atrial arrhythmia being determined for three consecutive data collection sessions of the adjusted plurality of data collection sessions.

7. The medical device system of claim 4, wherein the pressure analysis module is configured to adjust the data collection sessions from the adjusted plurality of data collection sessions to the first plurality of data collection sessions in response to an arrhythmia not being determined for one data collection session of the adjusted data collections sessions.

8. A medical device system for monitoring a cardiovascular pressure signal to identify an atrial arrhythmia, comprising:

a sensor sensing a cardiovascular pressure signal;

a pressure analysis module configured to determine at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal, compare the at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal to a dispersion threshold, and determine whether the atrial arrhythmia is occurring in response to the comparing;

an implantable medical device to monitor a cardiac signal; and

a telemetry module to transmit the determination as to whether the atrial arrhythmia is occurring from the sensor to the implantable medical device, wherein an atrial arrhythmia therapy is adjusted by the implantable medical device in response to the transmitted determination.

9. The medical device system of claim 8, wherein the arrhythmia therapy comprises one of an ablation therapy, a pacing therapy, or ingestion of a medication.

10. The medical device system of claim 8, wherein the implantable medical device is one of an implantable cardioverter defibrillator, a subcutaneously implantable monitoring device, or an implantable cardiac defibrillator coupled to an extravascular lead.

11. The medical device system of claim 8, wherein the pressure analysis module is configured to determine the at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal for each of a first plurality of data collection sessions, compare a number of data collection sessions of the first plurality of data collection sessions for which the atrial arrhythmia is determined to occur to a persistent atrial arrhythmia threshold, and identify a persistent atrial arrhythmia in response to the number of data collection sessions of the first plurality of data collection sessions for which the atrial arrhythmia is determined to occur satisfying the persistent atrial arrhythmia threshold.

12. The medical device system of claim 11, wherein the first plurality of data collection sessions comprises eight data collection sessions per day and identifying a persistent atrial fibrillation in response to determining the atrial arrhythmia is occurring for six data collection sessions of the eight data collection sessions.

13. The medical device system of claim 11, wherein the pressure analysis module is configured to adjust the first plurality of data collection sessions to an adjusted number of data collections per day in response to the atrial arrhythmia being determined for a data collection session of the adjusted plurality of data collection sessions.

14. The medical device system of claim 13, wherein the first plurality of data collection sessions comprises eight data collection sessions per day and the adjusted plurality of data collection sessions comprises more than eight collection sessions per day.

15. The medical device system of claim 14, wherein the pressure analysis module is configured to identify a persistent atrial arrhythmia in response to the atrial arrhythmia being determined for three consecutive data collection sessions of the adjusted plurality of data collection sessions.

16. The medical device system of claim 13, wherein the pressure analysis module is configured to adjust the data collection sessions from the adjusted plurality of data collection sessions to the first plurality of data collection sessions in response to an arrhythmia not being determined for one data collection session of the adjusted data collections sessions.

17. A method of monitoring a cardiovascular pressure signal to identify an atrial arrhythmia, comprising:

sensing a cardiovascular pressure signal;

determining at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal;

comparing the at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal to a dispersion threshold; and

determining whether the atrial arrhythmia is occurring in response to the comparing.

18. The method of claim 17, further comprising;

determining the at least one of an interval dispersion and an amplitude dispersion of the sensed pressure signal for each of a first plurality of data collection sessions;

comparing a number of data collection sessions of the first plurality of data collection sessions for which the atrial arrhythmia is determined to occur to a persistent atrial arrhythmia threshold; and

identifying a persistent atrial arrhythmia in response to the number of data collection sessions of the first plurality of data collection sessions for which the atrial arrhythmia is determined to occur satisfying the persistent atrial arrhythmia threshold.

19. The method of claim 18, wherein the first plurality of data collection sessions comprises eight data collection sessions per day and identifying a persistent atrial fibrillation in response to determining the atrial arrhythmia is occurring for six data collection sessions of the eight data collection sessions.

20. The method of claim 18, further comprising adjusting the first plurality of data collection sessions to an adjusted number of data collections per day in response to the atrial arrhythmia being determined for a data collection session of the adjusted plurality of data collection sessions.

21. The method of claim 20, wherein the first plurality of data collection sessions comprises eight data collection sessions per day and the adjusted plurality of data collection sessions comprises more than eight collection sessions per day.

22. The method of claim 21, further comprising identifying a persistent atrial arrhythmia in response to the atrial arrhythmia being determined for three consecutive data collection sessions of the adjusted plurality of data collection sessions.

23. The method of claim 20, further comprising adjusting the data collection sessions from the adjusted plurality of data collection sessions to the first plurality of data collection sessions in response to an arrhythmia not being determined for one data collection session of the adjusted data collections sessions.