Method and apparatus for treating cardiac tachyarrhythmia
First Claim
1. A method for treating a cardiac tachyarrhythmia in a patient'"'"'s heart comprising:
- (a) sensing an EGG signal from said patient'"'"'s heart to provide a sensed ECG signal, said sensed ECG signal including a series of sensed cardiac features;
(b) detecting tachyarrhythmia; and
(c) delivering in sequence a plurality of electrical pulses to said patient'"'"'s heart, wherein at least two of said pulses being delivered are synchronous with at least two of said sensed cardiac features and wherein said sequence of electrical pulses is delivered before a determination is made as to whether said tachyarrhythmia has been terminated.
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Accused Products
Abstract
The present invention provides an apparatus and method for cardiac defibrillation which utilizes a lower voltage defibrillation output to depolarize the myocardial cells by providing a rapid sequence of defibrillation shocks synchronized with sensed sequential cardiac events or features during an arrhythmia. Each shock may be a conventional monophasic or biphasic pulse. Each of the shocks may be relatively short in duration, i.e. on the order of 0.5 to 3 milliseconds or may be relatively long, i.e. up to about 100 milliseconds. The amplifiers of the sensing circuitry are particularly adapted quickly recover to after each shock is delivered to allow synchronization of the next shock to the next cardiac feature. This is accomplished by using broad band amplifiers which have DC-baseline restoration capability in order to eliminate offsets caused by a preceding shock. A microprocessor in the pulse generator delivers a programmed number of pulses synchronized to the ECG. If a first sequence fails to terminate the arrhythmia, another sequence is delivered at a higher voltage and/or additional pulses are added to the sequence.
190 Citations
29 Claims
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1. A method for treating a cardiac tachyarrhythmia in a patient'"'"'s heart comprising:
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(a) sensing an EGG signal from said patient'"'"'s heart to provide a sensed ECG signal, said sensed ECG signal including a series of sensed cardiac features; (b) detecting tachyarrhythmia; and (c) delivering in sequence a plurality of electrical pulses to said patient'"'"'s heart, wherein at least two of said pulses being delivered are synchronous with at least two of said sensed cardiac features and wherein said sequence of electrical pulses is delivered before a determination is made as to whether said tachyarrhythmia has been terminated. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A medical device for electrically stimulating a patient'"'"'s heart comprising:
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a sensing lead for sensing ECG signals of said patient'"'"'s heart, said ECG signals including a series of cardiac features; an ECG signal analyzer for detecting a tachyarrhythmia; and pulse delivery circuitry coupled to said signal analyzer and for delivering a plurality of electrical pulses to said patient'"'"'s heart such that at least two of said electrical pulses are delivered synchronous with at least two of said cardiac features before a reduction is made of a possible tachyarrhythmia. - View Dependent Claims (22, 23)
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24. A medical device for electrically stimulating a patient'"'"'s heart comprising:
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a sensor for sensing electrical signals of said patient'"'"'s heart, said sensed signals including a sequence of sensed cardiac features; a pulse generator adapted to generate a sequence of pulses wherein at least two of said pulses are synchronous with at least two of said cardiac features; and delivery means coupled to said pulse generator for delivering said pulses to said patient'"'"'s heart after a first sensed tachyarrhythmia and prior to a next sensed tachyarrhythmia. - View Dependent Claims (25, 26)
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27. An implantable medical device for the electrical termination of tachyarrhythmia comprising:
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sensing means responsive to cardiac depolarizations for producing a sense signal indicative of naturally occurring cardiac activity; detection means responsive to said sensing means for detecting cardiac tachyarrhythmia and for producing a tachyarrhythmia signal indicative of such tachyarrhythmia; trigger signal generating means responsive to said detection means for generating a trigger signal concurrent with each of said cardiac depolarizations; and pulse generator means responsive to said trigger signals for delivering a sequence of synchronous electrical pulses to cardiac tissue in response to said trigger signals. - View Dependent Claims (28)
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29. A method for treating a cardiac tachyarrhythmia in a patient'"'"'s heart comprising:
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(a) sensing an ECG signal from said patient'"'"'s heart, said ECG signal including a series of cardiac features; (b) detecting a tachyarrhythmia; and (c) delivering in sequence three or more electrical pulses to said patient'"'"'s heart, at least two of said pulses being delivered synchronous with at least two of said cardiac features and wherein said sequence of electrical pulses is delivered before a determination is made as to whether said tachyarrhythmia has been terminated.
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Specification