Reconfirmation prior to shock for implantable defibrillation
First Claim
1. An apparatus for treating a tachyarrhythmia of the heart comprising:
- detection means for detecting a tachyarrhythmia;
shock means for delivering a shock to the heart; and
reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said reconfirmation means confirming the presence of said tachyarrhythmia at a first predetermined time after detection of said tachyarrhythmia by said detection means, and reconfirming the presence of said tachyarrhythmia at a second time after detection by said detection means, said second time being no greater than a second predetermined time after said first time.
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Accused Products
Abstract
A multiprogrammable, telemetric, implantable defibrillator contains a high energy shock system to revert VT/VF'"'"'s to normal sinus rhythm and a multi-programmable VVI bradycardia support system. When the apparatus is in an automatic shock sequence, there are two points of reconfirmation: at the programmed minimum time to shock and after the full charge has been reached, or at thirty seconds, whichever comes first. Reconfirmation involves testing the tachycardia detection output (TDO). If the TDO is high, reconfirmation occurs. If the TDO is low, reconfirmation will not occur and the device will subsequently dump the discharge. Two reconfirmations must occur before a shock is delivered to the patient. If the TDO is low at either reconfirmation, the charge will be dumped.
105 Citations
14 Claims
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1. An apparatus for treating a tachyarrhythmia of the heart comprising:
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detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said reconfirmation means confirming the presence of said tachyarrhythmia at a first predetermined time after detection of said tachyarrhythmia by said detection means, and reconfirming the presence of said tachyarrhythmia at a second time after detection by said detection means, said second time being no greater than a second predetermined time after said first time. - View Dependent Claims (2)
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3. An apparatus for treating a tachyarrhythmia of the heart comprising:
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detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said detection means comprising; means for defining a tachycardia detection window for sensed events; means for determining whether at least a predetermined portion of said sensed events fall within said window; and means for providing an output signal to said reconfirmation means when at least said predetermined portion of sensed events fall within said window. - View Dependent Claims (4)
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5. A method for treating tachyarrhythmias of the heart comprising the steps of:
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a) detecting a tachyarrhythmia; b) reconfirming whether said tachyarrhythmia exists at at least one time after detecting said tachyarrhythmia; and c) delivering a shock to the heart only if at said step of reconfirming whether said tachyarrhythmia exists, a presence of said tachyarrhythmia is reconfirmed, one of said at least one times being immediately prior to delivering said shock, said method further comprising the steps of; commencing charging of a capacitor when said tachyarrhythmia is detected; reconfirming the presence of said tachyarrhythmia at a first predetermined time; and discharging the charge on said capacitor to a load other than the heart if said presence of said tachyarrhythmia is not confirmed at said first time, said method still further comprising the steps of; again reconfirming the presence of said tachyarrhythmia at a second time, said second time being a shorter of a second predetermined time or the time required for said capacitor to charge to a predetermined energy level, and supplying a shock to the patient by discharging said capacitor into the heart if said tachyarrhythmia is present at said first time and at said second time. - View Dependent Claims (6, 7, 8, 9, 10)
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11. A method for treating tachyarrhythmias of the heart comprising the steps of:
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a) detecting a tachyarrhythmia; b) reconfirming whether said tachyarrhythmia exists at at least one time after detecting said tachyarrhythmia; and c) delivering a shock to the heart only if at said step of reconfirming whether said tachyarrhythmia exists, a presence of said tachyarrhythmia is confirmed, one of said at least one times being immediately prior to delivering said shock, said step of confirming whether a tachyarrhythmia exists comprising; sensing a series of events of the heart; defining a tachycardia window during which a number of sensed events of the heart occurs; and recognizing the presence of a tachyarrhythmia if a predetermined portion of said sensed evens occur within said tachycardia window. - View Dependent Claims (12)
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13. An apparatus for treating a tachyarrhythmia of the heart comprising:
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detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said shock means including; an energy storage means; a discharge means for discharging to the heart energy stored in said storage means; and means for supplying energy to said energy storage means; said apparatus further comprising; monitoring means for monitoring a value of energy supplied to said energy storage means; and comparison means for comparing said value to a predetermined value, said comparison means being for controlling said reconfirmation means to reconfirm the presence of the tachyarrhythmia when said value of energy supplied to said energy storage means reaches said predetermined value.
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14. An apparatus for treating a tachyarrhythmia of the heart comprising:
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detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of the tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said detection means continuously detecting for said tachyarrhythmia and continuously providing an output indicative of detection thereof, and said reconfirmation means being responsive to said continuously provided output to determine whether a tachyarrhythmia is still present.
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Specification