Pacemaker with improved detection of atrial fibrillation
First Claim
1. An implantable pacemaker comprising:
- at least one atrial sensor for sensing atrial signals;
a ventricular sensor for sensing ventricular signals;
a pacing generator for generating at least one of a ventricular and atrial pacing signals in accordance with a command signal;
an atrial processor receiving said atrial signals, said atrial processor including an analyzer for determining peak amplitudes of said atrial signals and a normal sinus rhythm value of said peak amplitudes, and for determining a change in a variability and deviation of said normal rhythm value, said atrial processor being further provided to detect new state of the atrium by analyzing said change in variability and deviation of said normal sinus rhythm value;
a controller receiving indication of said atrial and ventricular signals and said new atrial state and generating in response said command signal on the basis of said new atrial state.
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Accused Products
Abstract
In a dual chamber implantable pacemaker, the peak amplitude of the atrial intrinsic signals are monitored and used to generate a short term and a long term indicia indicative of the intrinsic signals'"'"' variability and deviation from normal sinus rhythm peak amplitudes. The two indicia are combined to generate a single indicia which is then used to categorize the state of the atrium as one of several conditions such as flutter/flubber, coarse atrial fibrillation or fine atrial fibrillation. The categorization is used by a microcontroller for generating the proper pacing pulses and may also be used as a criteria for mode switching between a first mode wherein synchrony between the atrium and ventricle is maintained and a second mode pacing is performed at a fixed rate or one determined by the metabolic indicator.
140 Citations
17 Claims
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1. An implantable pacemaker comprising:
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at least one atrial sensor for sensing atrial signals; a ventricular sensor for sensing ventricular signals; a pacing generator for generating at least one of a ventricular and atrial pacing signals in accordance with a command signal; an atrial processor receiving said atrial signals, said atrial processor including an analyzer for determining peak amplitudes of said atrial signals and a normal sinus rhythm value of said peak amplitudes, and for determining a change in a variability and deviation of said normal rhythm value, said atrial processor being further provided to detect new state of the atrium by analyzing said change in variability and deviation of said normal sinus rhythm value; a controller receiving indication of said atrial and ventricular signals and said new atrial state and generating in response said command signal on the basis of said new atrial state. - View Dependent Claims (2, 3, 4, 5)
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6. An implantable pacemaker comprising:
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an atrial sensor for sensing atrial signals, said atrial signals having peak amplitudes and including sinus rhythm atrial signals and non-sinus rhythm atrial signals; a ventricular sensor for sensing ventricular signals; a first analyzer for determining a short term variability and deviation of said non-sinus rhythm signals from said sinus rhythm atrial signals and for generating a first indicia, said first indicia being dependent on said short term peak amplitude variability and deviation; a second analyzer for determining a long term variability of said atrial signals and for generating a second indicia, said second indicia being dependent on said long term variability; a categorizer for categorizing a new state of the atrium as a pathological state by combining said first and second indicia; a pulse generator for generating atrial and ventricular pulses in response to a command signals; and a controller for generating said command signals in response to said atrial and ventricular signals and said new state of the atrium. - View Dependent Claims (7, 8, 9, 10)
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11. In an implantable pacemaker of the kind having atrial and ventricular sensors for sensing atrial and ventricular events and a pulse generator for generating atrial and ventricular events and a pulse generator for generating atrial and ventricular pulses on demand, a method of classifying cardiac arrhythmia from said atrial events comprising the steps of:
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sensing a predetermined number of atrial events and generating corresponding atrial signals; measuring an amplitude of each of said atrial signals; determining a short term variability and deviation of said amplitudes; determining a long term variability and deviation of said amplitudes; generating a first indicative of said short term variability and deviation of said amplitudes; generating a second indicia indicative of said long term variation and deviation of said amplitudes; combining said first and second indicia into a third indicia; and categorizing said cardiac arrhythmia in accordance with said third indicia. - View Dependent Claims (12, 13, 14, 15, 16, 17)
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Specification