Implantable cardiac stimulating device and method for administering synchronized cardioversion shock therapy to provide preemptive depolarization
First Claim
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1. An implantable cardioversion shock therapy system, comprising:
- sensing means for sensing intrinsic R-waves;
pulse generating means for generating a cardioversion shock and for delivering the cardioversion shock to cardiac tissue; and
control means, responsive to the sensing means, for analyzing the R-waves to confirm a tachycardia episode, and for controlling the pulse generating means to trigger the cardioversion shock after a predetermined delay corresponding to a period when the cardiac tissue is repolarized, the predetermined delay being synchronized from a last R-wave following the confirmation of the tachycardia episode so that the cardioversion shock preempts a successive R-wave.
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Abstract
An implantable cardioversion shock therapy system is provided which delays delivery of a cardioversion shock until late in the cardiac cycle to optimize the chance for the vast majority of ventricular myocardial tissue to be non-refractory. The system in intended to increase efficacy and safety by properly synchronizing the cardioversion shock to the appropriate portion of the cardiac cycle to successfully terminate a tachycardia episode. The timing of the cardioversion shock is programmable as either a percentage of measured tachycardia cycle length or fixed delay in milliseconds.
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Citations
31 Claims
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1. An implantable cardioversion shock therapy system, comprising:
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sensing means for sensing intrinsic R-waves; pulse generating means for generating a cardioversion shock and for delivering the cardioversion shock to cardiac tissue; and control means, responsive to the sensing means, for analyzing the R-waves to confirm a tachycardia episode, and for controlling the pulse generating means to trigger the cardioversion shock after a predetermined delay corresponding to a period when the cardiac tissue is repolarized, the predetermined delay being synchronized from a last R-wave following the confirmation of the tachycardia episode so that the cardioversion shock preempts a successive R-wave. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. An implantable system for administering cardioversion shock therapy to cardiac tissue in accordance with a tachycardia rate of a patient to preempt an expected tachycardia beat, the system comprising:
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sensing means for sensing intrinsic R-waves; pulse generating means for generating a cardioversion shock and delivering the cardioversion shock to the cardiac tissue; and control means, responsive to the sensing means, for analyzing the intrinsic R-waves to determine a tachycardia cycle length, and for triggering the pulse generating means to deliver the cardioversion shock after a predetermined time, determined as a function of the tachycardia cycle length, has elapsed following a preceding tachycardia beat to elicit a heartbeat that preempts the expected tachycardia beat. - View Dependent Claims (9, 10)
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11. An implantable cardioversion shock therapy system, comprising:
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cardiac sensing means for sensing naturally occurring cardiac depolarizations in a selected chamber of a patient'"'"'s heart; pulse generator means for providing a cardioversion shock of sufficient energy to terminate a tachycardia episode in the selected chamber of the heart; a shocking lead, coupled to the pulse generator means, for delivering the cardioversion shock to the selected chamber of the heart; and processing means, coupled to the cardiac sensing means and the pulse generator means, for confirming a tachycardia episode based on the sensed cardiac depolarizations and for controlling the pulse generator means to provide the cardioversion shock after a predetermined time interval following confirmation of the tachycardia episode to preempt an expected tachycardia beat. - View Dependent Claims (12, 13, 14, 15, 16)
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17. An implantable cardioversion shock therapy system, comprising:
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means for detecting a tachycardia episode; means for delivering a cardioversion shock to cardiac tissue in response to the tachycardia episode; and means for delaying delivery of the cardioversion shock by a predetermined time interval measured from a preceding tachycardia beat and preemptively before an expected tachycardia beat.
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18. A method of providing cardioversion shock therapy to cardiac tissue, comprising the steps of:
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detecting a tachycardia episode; and delivering a cardioversion shock after a predetermined delay period corresponding to a period between a preceding tachycardia beat and an expected tachycardia beat when the cardiac tissue is non-refractory following detection of the tachycardia episode. - View Dependent Claims (19, 20, 21, 22)
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23. A method of administering cardioversion shock therapy to cardiac tissue to preempt an expected tachycardia beat, comprising the steps of:
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detecting an occurrence of a tachycardia episode; determining a tachycardia cycle length of the tachycardia episode; and delivering a cardioversion shock to the cardiac tissue after a length of time, determined as a function of preceding tachycardia beat so that the cardioversion shock is delivered when the cardiac tissue is repolarized. - View Dependent Claims (24)
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25. An implantable cardioversion shock therapy system, comprising:
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sensing means for sensing intrinsic P-waves; pulse generating means for generating a cardioversion shock and for delivering the cardioversion shock to cardiac tissue; and control means, responsive to the sensing means, for analyzing the P-waves to confirm an atrial tachycardia episode, and for controlling the pulse generating means to trigger the cardioversion shock after a predetermined delay, corresponding to a period when the cardiac tissue is repolarized, the predetermined delay being synchronized from a last P-wave following the confirmation of the atrial tachycardia episode so that the cardioversion shock preempts a successive P-wave. - View Dependent Claims (26, 27, 28, 29, 30, 31)
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Specification