Arrhythmia control system employing arrhythmia recognition algorithm
First Claim
1. A cardioverting device for reverting tachycardia in a patient'"'"'s heart, said device including means for sensing the ventricular waveform of the heart, means for storing data corresponding to said waveform, and means for delivering cardioversion shock therapy to the heart, said device further comprising:
- means for detecting event peaks in said waveform and establishing event data windows extending for predetermined time periods relative to each of said event peaks;
means responsive to the detection of an event peak in said waveform for determining the morphology of that portion of said waveform which occurs within said event data window;
means for classifying each of said events based on said morphology, said means outputting in real time at least one of a plurality of different values corresponding to at least one of a plurality of different heart rate categories, including at least a normal rate, a tachycardia rate and a ventricular fibrillation rate;
means for summing the output of said event classifying means during a predetermined number of events, said means outputting in real time at least one of a plurality of different rhythm signals based on said summing and corresponding at least to a non-pathological rhythm, a pathological ventricular tachycardia rhythm and a pathological ventricular fibrillation rhythm; and
,means responsive to said output summing means for delivering appropriate therapy to the heart when said rhythm signal corresponds to one of said pathological rhythms.
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Abstract
An arrhythmia control method and device are disclosed which monitor the cardiac state of a patient, utilize an arrhythmia recognition algorithm to detect and distinguish among bradycardia, sinus rhythm, supraventricular tachycardia and ventricular fibrillation, and deliver therapy in the form of electrical energy to cardiac tissue to revert selected arrhythmias and restore normal sinus rhythm. In its preferred form the device is an implantable combined dual chamber pacing and cardioverting device that is adapted to be electrically connected to the atrium and ventricle for sensing the atrial and ventricular waveforms and deliverying shock therapy thereto as required. The arrhythmia recognition algorithm utilizes the sensed atrial and ventricular waveform data for, among other things, distinguishing between ventricular tachycardia and supraventricular tachycardia.
136 Citations
31 Claims
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1. A cardioverting device for reverting tachycardia in a patient'"'"'s heart, said device including means for sensing the ventricular waveform of the heart, means for storing data corresponding to said waveform, and means for delivering cardioversion shock therapy to the heart, said device further comprising:
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means for detecting event peaks in said waveform and establishing event data windows extending for predetermined time periods relative to each of said event peaks; means responsive to the detection of an event peak in said waveform for determining the morphology of that portion of said waveform which occurs within said event data window; means for classifying each of said events based on said morphology, said means outputting in real time at least one of a plurality of different values corresponding to at least one of a plurality of different heart rate categories, including at least a normal rate, a tachycardia rate and a ventricular fibrillation rate; means for summing the output of said event classifying means during a predetermined number of events, said means outputting in real time at least one of a plurality of different rhythm signals based on said summing and corresponding at least to a non-pathological rhythm, a pathological ventricular tachycardia rhythm and a pathological ventricular fibrillation rhythm; and
,means responsive to said output summing means for delivering appropriate therapy to the heart when said rhythm signal corresponds to one of said pathological rhythms. - View Dependent Claims (2, 3, 7, 8, 9, 10)
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4. An implantable combined dual chamber pacing and cardioverting device adapted to be electrically connected to the atrium and ventricle of a patient'"'"'s heart for the reversion of tachycardias, said device including means for sensing the atrial and ventricular waveforms of the heart, means for storing data relating to said waveforms, and means for delivering cardioversion shock therapy to the heart, said device further comprising:
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means for detecting event peaks in said ventricular waveform and establishing event data windows extending for predetermined time periods relative to each of said event peaks; means responsive to the detection of an event peak in said waveform for determining the morphology of that portion of said ventricular waveform which occurs within said event data window; means for classifying each of said events based on said morphology, said means outputting in real time at least one of a plurality of different values corresponding to at least one of a plurality of different heart rate categories, including at least a normal rate, a tachycardia rate and a ventricular fibrillation rate; means for summing the outputs of said event classifying means during a predetermined number of events, said means outputting in real time at least one of a plurality of different rhythm signals based on said summing and corresponding to nonpathological rhythm, a pathological ventricular tachycardia rhythm and a pathological ventricular fibrillation rhythm; and means responsive to said output summing means for delivering appropriate therapy to the heart when said rhythm signal corresponds to one of said pathological rhythms.
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5. An implantable combined dual chamber pacing and cardioverting device adapted to be electrically connected to the atrium and ventricle of a patient'"'"'s heart for the reversion of tachycardias, said device including means for sensing the atrial and ventricular waveforms of the heart, means for storing data relating to said waveforms, and means for delivering cardioversion shock therapy to the heart, said device further comprising:
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means for detecting event peaks in said ventricular waveform and establishing event data windows extending for predetermined time periods relative to each of said event peaks; means responsive to the detection of an event peak in said waveform for determining the morphology of that portion of said ventricular waveform which occurs within said event data window; means for classifying each of said events based on said morphology, said means outputting in real time at least one of a plurality of different values corresponding to at least one of a plurality of different heart rate categories, including at least a normal rate, a tachycardia rate and a ventricular fibrillation rate; means for summing the outputs of said event classifying means during a predetermined number of events, said means outputting in real time at least one of a plurality of different rhythm signals based on said summing and corresponding to a non-pathological rhythm, a pathological ventricular tachycardia rhythm and a pathological ventricular fibrillation rhythm; and
,means responsive to said output summing means for delivering appropriate therapy to the heart when said rhythm signal corresponds to one of said pathological rhythms. - View Dependent Claims (6, 11, 12, 13, 14, 15, 16, 17)
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18. A method of reverting tachycardia in the heart of a patient, comprising the following steps:
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sensing the ventricular waveform of the heart; storing data corresponding to said ventricular waveform; detecting event peaks in said ventricular waveform and establishing event data windows extending for predetermined time periods with respect to each of said event peaks; in response to the detection of an event peak in said waveform, determining the morphology of that portion of said ventricular waveform which occurs within said event data window; classifying each of said events based on said morphology and providing in real time a plurality of different rate signals corresponding to at least one of a plurality of different heart rate categories, including at least a normal rate, a tachycardia rate and a ventricular fibrillation rate; summing said rate signals during a predetermined number of events and providing in real time at least one of a plurality of different rhythm signals based on said summing and corresponding at least to a non-pathological rhythm, a pathological ventricular tachycardia rhythm and a pathological ventricular fibrillation rhythm; and delivering appropriate electrical shock therapy to the heart when said rhythm signal corresponds to one of said pathological signals. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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Specification