Apparatus and method for antitachycardia pacing in a arrhythmia control systems

• US 5,144,947 A
• Filed: 03/22/1991
• Issued: 09/08/1992
• Est. Priority Date: 04/03/1990
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Telectronics Pacing Systems, Inc (Abbott Laboratories Incorporated)
• Inventors: Wilson, Stephen G.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): JASTRZAB, JEFFREY R
• Application Number:
  US07/673,900
• Time in Patent Office: 536 Days
• Field of Search: 128/419 PG
• US Class Current: 607/15
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate

Abstract

A method and apparatus for treating tachycardias are disclosed which utilize tachycardia cycle lengths in connection with selecting the type of antitachycardia pacing to be used in such treatment. A range of tachycardia cycle lengths is selected for which antitachycardia pacing treatment is indicated. This range is divided into a plurality of sub-ranges of tachycardia cycle lengths, and corresponding storage locations are established for each of the tachycardia cycle length sub-ranges. Antitachycardia pacing parameters which have been successful in reverting previous tachycardias are stored in their corresponding storage locations, and subsequent tachycardias are treated using antitachycardia pacing parameters selected from storage locations that correspond to, or are closest to correspondence with, the storage locations corresponding to the tachycardias to be treated.

Claims

1. A method of treating tachycardias comprising the steps of:

A) selecting a range of tachycardia cycle lengths for which antitachycardia pacing treatment is desired;

B) selecting a plurality of sub-ranges of tachycardia cycle lengths from said range of tachycardia cycle lengths;

C) providing a plurality of storage locations corresponding to said tachycardia cycle length sub-ranges;

D) storing, in corresponding ones of said storage locations, corresponding antitachycardia pacing parameters which have been successful in reverting previous tachycardias having cycle lengths that fall in said corresponding tachycardia cycle length sub-ranges; and

,

E) treating subsequent tachycardias using antitachycardia pacing parameters selected from storage locations that correspond to, or are closest to correspondence with, tachycardia sub-ranges corresponding to the tachycardias to be treated.

2. A method according to claim 1, including the further steps of utilizing a range of antitachycardia pacing parameters in the treatment of tachycardias over a period of time, and correlating successful antitachycardia pacing parameters in such range with the tachycardia cycle lengths of the tachycardias they successfully revert.

3. A method according to claim 2, including the further step of over-riding earlier successful antitachycardia pacing parameters that may be stored in given storage locations with later successful antitachycardia pacing parameters that correspond to such storage locations.

4. A method according to claim 1, wherein said storage locations comprise a first set of storage locations, and wherein said antitachycardia pacing parameters comprise a first set of antitachycardia pacing parameters, and further including the steps of providing a second plurality of storage locations corresponding to said tachycardia cycle length sub-ranges, and storing, in corresponding ones of said second plurality of storage locations, corresponding ones of a second set of antitachycardia pacing parameters which have been used in conjunction with said first set of antitachycardia pacing parameters in successfully reverting previous tachycardias having cycle lengths that fall in said corresponding tachycardia cycle length sub-ranges.

5. A method according to claim 4, including the further steps of utilizing said first and second ranges of antitachycardia pacing parameters in the treatment of tachycardias over a period of time, and correlating successful antitachycardia pacing parameters in such ranges with the tachycardia cycle lengths of the tachycardias they successfully revert.

6. A method according to claim 5, including the further steps of over-riding earlier successful antitachycardia pacing parameters that may be stored in given storage locations in said first and second sets of storage locations with later successful antitachycardia pacing parameters that correspond to such storage locations.

7. A method according to claim 6 further comprising the step of scanning at least said first plurality of storage locations to select a set of antitachycardia pacing parameters for use in reverting said tachycardia, said scanning initiating at a storage location containing a set of antitachycardia pacing parameters and corresponding to a tachycardia cycle length closest to that being treated.

8. A method of claim 7 further comprising the step of initiating scanning at the smaller of (Sm-Sn) Mod_N or (Sn-Sm) Mod_N if said storage location corresponding to said tachycardia being treated contains no such antitachycardia pacing parameters and is located midway between Sm and Sn where Sm and Sn are storage locations that contain antitachycardia pacing parameters, and all storage locations therebetween contain no antitachycardia pacing parameters, N being the total number of storage locations to be scanned.

9. A method of claim 8 further including the step of telemetrically reading at least one of said sets of antitachycardia pacing parameters to determine trends in tachycardia treatment.

10. A method of claim 9 further including the step of overriding a selected storage location and thereby not treating the tachycardia with the parameters stored therein if said selected storage location corresponds to a tachycardia cycle length sub-range that differs by at least a predetermined value from that of the tachycardia being treated.

11. A method according to claim 10 further including the step of varying the predetermined value.

12. A method of claim 11 further comprising the step of telemetrically preloading antitachycardia pacing parameters not yet shown to be successful in treating said tachycardia.

13. Apparatus for treating tachycardias having cycle lengths within a predetermined range of tachycardia cycle lengths, comprising:

A) means for establishing a plurality of storage locations each of which corresponds to a generally different sub-range of tachycardia cycle lengths within said range of tachycardia cycle lengths;

B) means for storing, in corresponding ones of said storage locations, corresponding antitachycardia pacing parameters which have been successful in reverting previous tachycardias having cycle lengths that fall in said corresponding tachycardia cycle length sub-ranges; and

C) means for treating subsequent tachycardias using antitachycardia pacing parameters selected from storage locations that correspond to, or are closest to correspondence with, the tachycardia sub-ranges corresponding to the tachycardias to be treated.

14. Apparatus according to claim 13, further including means for utilizing a range of antitachycardia pacing parameters in the treatment of tachycardias over a period of time, and means for correlating successful antitachycardia pacing parameters in such range with the tachycardia cycle lengths of the tachycardias they successfully revert.

15. Apparatus according to claim 14, further including means for over-riding earlier successful antitachycardia pacing parameters that may be stored in given storage locations with later successful antitachycardia pacing parameters that correspond to such storage locations.

16. Apparatus according to claim 15, wherein said storage locations comprise a first set of storage locations, and wherein said antitachycardia pacing parameters comprise a first set of antitachycardia pacing parameters, and further including means for establishing a second plurality of storage locations corresponding to said tachycardia cycle length sub-ranges, and means for storing, in corresponding ones of said second plurality of storage locations, corresponding ones of a second set of antitachycariia pacing parameters which have been used in conjunction with said first set of antitachycardia pacing parameters in successfully reverting previous tachycardias having cycle lengths that fall in said corresponding tachycardia cycle length sub-ranges.

17. Apparatus according to claim 16, further including means for utilizing first and second ranges of antitachycardia pacing parameters in the treatment of tachycardias over a period of time, and means for correlating successful antitachycardia pacing parameters in such ranges with the tachycardia cycle lengths of the tachycardias they successfully revert.

18. Apparatus according to claim 17, further including means for over-riding earlier successful antitachycardia pacing parameters that may be stored in given storage locations in said first and second sets of storage locations with later successful antitachycardia pacing parameters that correspond to such storage locations.

19. Apparatus according to claim 18 further comprising means for scanning at least said first plurality of storage locations to determine a set of antitachycardia pacing parameters, said scanning initiating at a storage location containing a set of antitachycardia pacing parameters and corresponding to a tachycardia cycle length closest to that being treated.

20. Apparatus of claim 19 further comprising means for initiating scanning at the smaller of (Sm-Sn) Mod_N or (Sn-Sm) Mod_N if said storage location corresponding to said tachycardia being treated contains no such antitachycardia pacing parameters and is located midway between Sm and Sn, where Sm and Sn are storage locations that contain antitachycardia pacing parameters, and all storage locations therebetween contain no antitachycardia parameters, N being the total number of storage locations to be scanned

21. Apparatus according to claim 20 further including means for telemetrically reading the stored scanning parameters and determining trends in tachycardia treatment therefrom.

22. Apparatus according to claim 21 further including means for overriding a selected storage location and thereby not treating the tachycardia with parameters stored therein if said selected storage location corresponds to a tachycardia cycle length sub-range that differs by at least a predetermined value from the tachycardia being treated.

23. Apparatus according to claim 22 further including means for varying the predetermined value.