Arrhythmia-detection criteria process for a cardioverter/defibrillator
First Claim
1. An improved arrhythmia-detection criteria process for detecting a tachycardia/fibrillation cardiac arrhythmia in a human patient by a cardioverter defibrillator device connected to at least two implanted electrodes located in the human patient that can selectively deliver cardioversion/defibrillation cardiac arrhythmia-correcting electrical intervention therapy comprised of one or more electrical pulses of greater than about 0.1 Joules, the process including the device-implemented steps of:
- (a) continually receiving a plurality of cardiac variables representing sensed values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/ fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps of follows;
(b1) using one or more chosen mathematical algebraic functions relating two or more of the cardiac variables to generate a threshold criterion that is at least a threshold curve; and
(b2) using the threshold curve to define a boundary above which a tachycardia/fibrillation cardiac arrhythmia is deemed to be present.
5 Assignments
0 Petitions
Accused Products
Abstract
A major shortcoming in the prior art for detecting cardiac arrhythmias for the purpose of making an electrical intervention decision has been that each variable sensed was given in effect a "veto" over intervention on the basis of its own particular predetermined threshold value, and irrespective of the values of companion variables. The present invention overcomes this prior art problem by generating a function of relevant variables, and assigning a threshold value to the function. As a result, an individual variable can range widely for a positive intervention decision, depending upon the values of the companion variables. Thus, the intervention exploits features often described as those associated with fuzzy logic. The functions chosen for this purpose can be as one desires, with the choice depending upon the current state of advancing knowledge. Even further flexibility can be achieved by employing the principles of the neural net, wherein functional values can themselves be combined, with another threshold value assigned to the result of that combination, and so on.
89 Citations
18 Claims
-
1. An improved arrhythmia-detection criteria process for detecting a tachycardia/fibrillation cardiac arrhythmia in a human patient by a cardioverter defibrillator device connected to at least two implanted electrodes located in the human patient that can selectively deliver cardioversion/defibrillation cardiac arrhythmia-correcting electrical intervention therapy comprised of one or more electrical pulses of greater than about 0.1 Joules, the process including the device-implemented steps of:
- (a) continually receiving a plurality of cardiac variables representing sensed values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/ fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps of follows;
(b1) using one or more chosen mathematical algebraic functions relating two or more of the cardiac variables to generate a threshold criterion that is at least a threshold curve; and (b2) using the threshold curve to define a boundary above which a tachycardia/fibrillation cardiac arrhythmia is deemed to be present. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
- (a) continually receiving a plurality of cardiac variables representing sensed values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/ fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps of follows;
-
10. An improved arrhythmia-detection criteria process for detecting a tachycardia/fibrillation cardiac arrhythmia in a human patient by a cardioverter defibrillator device connected to at least two implanted electrodes located in the human patient that can selectively deliver cardioversion/defibrillation cardiac arrhythmia-correcting electrical intervention therapy comprised of one or more electrical pulses of greater than about 0.1 Joules, the process including the device-implemented steps of:
- (a) continually receiving a plurality of cardiac variables representing sensed values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps as follows;
(b1) selecting an explicit and well-defined threshold intervention criteria which is at least a threshold curve defined by one or more mathematical algebraic functions relating two or more of the cardiac variables; (b2) using the threshold curve to define a boundary above which a tachycardia/fibrillation cardiac arrhythmia is deemed to be present by permitting individual cardiac variables to vary within wide limits at threshold conditions, depending upon the values of companion variables.
- (a) continually receiving a plurality of cardiac variables representing sensed values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps as follows;
-
11. An improved arrhythmia-detection criteria process for detecting a tachycardia/fibrillation cardiac arrhythmia in a human patient by a cardioverter defibrillator device connected to at least two implanted electrodes located in the human patient that can selectively deliver cardioversion/defibrillation cardiac arrhythmia-correcting electrical intervention therapy comprised of one or more electrical pulses of greater than about 0.1 Joules, the process including the device-implemented steps of:
- (a) continually receiving a plurality of cardiac variables representing sensed values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps as follows;
(b1) using two or more functions, each function relating two or more of the cardiac variables, to generate a threshold criterion; and (b2) combining the threshold criterion generated in step (b1) by using a mathematical algebraic function that relates the threshold criterion in terms of inputs to a neural-network, an output of which defines a boundary above which a tachycardia/fibrillation cardiac arrhythmia is deemed to be present. - View Dependent Claims (12, 13, 14, 15)
- (a) continually receiving a plurality of cardiac variables representing sensed values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps as follows;
-
16. An improved arrhythmia-detection criteria process for detecting a tachycardia/fibrillation cardiac arrhythmia in a human patient by a cardioverter defibrillator device connected to at least two implanted electrodes located in the human patient that can selectively delivery cardioversion/defibrillation cardiac arrhythmia-correcting electrical intervention therapy comprised of one or more electrical pulses of greater than about 0.1 Joules, the process including the device-implemented steps of:
- (a) continually receiving a plurality of cardiac variables representing senses values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps as follows;
(b1) using one or more mathematical algebraic functions, each function relating two or more of the cardiac variables and being implemented as a neural network, to generate at least a threshold curve; and (b2) using the threshold curve to define a boundary above which a tachycardia/fibrillation cardiac arrhythmia is deemed to be present. - View Dependent Claims (17, 18)
- (a) continually receiving a plurality of cardiac variables representing senses values in the human patient, (b) evaluating the plurality of cardiac variables to determine whether a tachycardia/fibrillation cardiac arrhythmia is present, and (c) if such an arrhythmia is present, determining an appropriate therapy to be delivered to treat the arrhythmia, the improvement comprising the device-implemented sub-steps as follows;
Specification