Method and apparatus for tachyarrhythmia detection and treatment

• US 5,383,910 A
• Filed: 02/19/1993
• Issued: 01/24/1995
• Est. Priority Date: 02/19/1993
• Status: Expired due to Term

• Current Assignee: Reed A. Duthler
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: den Dulk, Karel
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US08/019,511
• Time in Patent Office: 704 Days
• Field of Search: 128/705, 128/706, 607/14
• US Class Current: 607/14
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: Y10S 128/925 Neural network

Abstract

A device for detection and treatment of tachycardias, which is able to selectively identify the occurrence of re-entrant AV nodal tachycardia, and to distinguish it from sinus tachycardias. The apparatus monitors the occurrence of atrial and ventricular depolarizations during a detected tachycardia, and, in the event that a series of ventricular depolarizations occur which are each closely preceded or closely followed by an atrial depolarization, at an interval substantially less than would be expected in the case of a sinus tachycardia, re-entrant AV nodal tachycardia is identified, and an appropriate therapy regimen is triggered.

Claims

1. A method of detecting re-entrant A-V nodal tachycardia in a patient'"'"'s heart comprising the steps of:

sensing the atrium and ventricle of the patient'"'"'s heart to detect atrial and ventricular depolarization signals;

measuring the intervals between successive depolarization signals in a chamber of said patient'"'"'s heart;

measuring the time intervals between successive atrial and ventricular depolarization detection signals; and

detecting the presence of re-entrant A-V nodal tachycardia in response to the detection of a series of depolarization signals in a said chamber of said patient'"'"'s heart manifesting a rate in excess of a tachycardia rate criterion, in which successive ventricular depolarization signals are followed by atrial depolarization signals separated from said ventricular depolarization signals by intervals of time which fall within a first predetermined range of intervals substantially less than the expected duration of A-V intervals which would occur in a sinus or other tachycardia at a rate in excess of said tachycardia rate criterion.

3. A method according to claim 1 or claim 2 wherein said detecting step comprises detecting A-V nodal re-entrant tachycardia in response to successive ventricular depolarization signals followed by atrial depolarization signals separated from said ventricular depolarization signals by intervals of time less than a predefined interval, said predefined interval being 100 milliseconds or less.

4. A method according to claim 1 or claim 2, comprising the additional step of detecting slow ventricular tachycardia with 1:

1 retrograde conduction, in response to successive ventricular depolarization signals preceded by atrial depolarization signals by intervals of time within a second predetermined range of intervals greater than the expected duration of A-V intervals which would occur in a sinus tachycardia at a rate in excess of said tachycardia rate criterion.

2. A method of detecting and treating a re-entrant A-V nodal tachycardia in a patient'"'"'s heart comprising the steps of:

sensing the atrium and ventricle of the patient'"'"'s heart to detect atrial and ventricular depolarization signals;

measuring the intervals between successive depolarization signals in a chamber of said patient'"'"'s heart;

measuring the time intervals between successive atrial and ventricular depolarization signals;

detecting the presence of re-entrant A-V nodal tachycardia in response to the detection of a series of depolarization signals in said chamber of said patient'"'"'s heart manifesting a ventricular rate in excess of a tachycardia rate criterion, in which successive ventricular depolarization signals are followed by atrial depolarization signals separated from said ventricular depolarization signals by intervals of time which fall within a first predetermined range of intervals substantially less than the expected duration of A-V intervals which would occur in a sinus or other tachycardia at a rate in excess of said tachycardia rate criterion; and

in response to detection of said re-entrant A-V nodal tachycardia, delivering a predefined antitachycardia therapy.

5. Apparatus for detecting re-entrant A-V nodal tachycardia in a patient'"'"'s heart, comprising:

means for sensing the atrium and ventricle of the patient'"'"'s heart to detect atrial and ventricular depolarization signals;

first measuring means for measuring the intervals between successive depolarization signals in a chamber of said patient'"'"'s heart;

second measuring means for measuring the time intervals between successive atrial and ventricular depolarization signals; and

detecting means, responsive to said first and second measuring means, for detecting the presence of re-entrant A-V nodal tachycardia in response to the detection of a series of depolarization signals in said chamber of said patient'"'"'s heart manifesting a rate in excess of a tachycardia rate criterion, in which successive ventricular depolarization signals are followed by atrial depolarization signals separated from said ventricular depolarization signals by intervals of time which fall within a first predetermined range of intervals substantially less than the expected duration of A-V intervals which would occur in a sinus or other tachycardia at a rate in excess of said tachycardia rate criterion.

7. An apparatus according to claim 5 or claim 6 wherein said detecting means comprises means for detecting A-V nodal re-entrant tachycardia responsive to successive ventricular depolarization signals followed by atrial depolarization signals separated from said ventricular depolarization signals by an interval of time less than a predefined interval, said predefined interval being 100 milliseconds or less.

8. An apparatus according to claim 5 or claim 6, wherein said detecting means further comprises means for detection of slow ventricular tachycardia with 1:

1 retrograde conduction in response to successive ventricular depolarization signals preceded by atrial depolarization signals by intervals of time within a second predetermined range of intervals greater than the expected duration of A-V intervals which would occur in a sinus tachycardia at a rate in excess of said tachycardia rate criterion.

6. Apparatus for detecting and treating a re-entrant A-V nodal tachycardia in a patient'"'"'s heart, comprising:

means for sensing the atrium and ventricle of the patient'"'"'s heart to detect atrial and ventricular depolarization signals;

first measuring means for measuring the intervals between successive ventricular depolarization signals;

second measuring means for measuring the time intervals between successive atrial and ventricular depolarization detection signals;

detecting means, responsive to said first and second measuring means, for detecting the presence of re-entrant A-V nodal tachycardia in response to the detection of a series of depolarization signals in said chamber of said patient'"'"'s heart manifesting a rate in excess of a tachycardia rate criterion, in which successive ventricular depolarization signals are followed by atrial depolarization signals separated from said ventricular depolarization signals by intervals of time which fall within a first predetermined range of intervals substantially less than the expected duration of A-V intervals which would occur in a sinus or other tachycardia at a rate in excess of said tachycardia rate criterion; and

means responsive to detection of said re-entrant A-V nodal tachycardia, for delivering a predefined antitachycardia therapy.