Method and apparatus for detecting tachycardia
First Claim
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1. A method of determining an atrial tachycardia by ensuring that atrial sense events result from intrinsic P-waves originating in the atria and are not far field R-waves comprising the steps of:
- sensing the atrial electrocardiogram from at least one electrode positioned in sensing relation to the patient'"'"'s atria;
detecting an atrial sense event comprising one of the P-wave or far field R-wave in the atrial electrogram;
sensing the ventricular electrogram from at least one electrode positioned in sensing relation to the patient'"'"'s ventricle;
detecting a ventricular sense event comprising the R-wave in the ventricular electrogram;
determining the end of each cardiac cycle from successive ventricular sense events;
during each cardiac cycle, discriminating intrinsic P-waves from far field R-waves in the atrial electrogram using Hidden Markov Modeling (HMM), wherein the P-wave and far-field R-wave can each be characterized as a state separated by state transitions in a hidden state sequence and wherein there are discrete probabilities that the states will transition from one to the other in a predetermined order; and
based on the HMM discrimination of the atrial sense events as intrinsic P-waves or far field R-waves and the timed intervals between intrinsic P-waves in the cardiac cycles, determining the existence of an atrial tachycardia.
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Abstract
A method and apparatus for detecting tachycardia in a patient employs a digitally-sampled electrocardiographic signal input to a digital processor employing a Hidden Markov Modeling algorithm to eliminate confusion between far-field and near-field cardiac events to provide a more accurate measurement of cardiac rate for diagnosis and treatment.
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Citations
4 Claims
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1. A method of determining an atrial tachycardia by ensuring that atrial sense events result from intrinsic P-waves originating in the atria and are not far field R-waves comprising the steps of:
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sensing the atrial electrocardiogram from at least one electrode positioned in sensing relation to the patient'"'"'s atria; detecting an atrial sense event comprising one of the P-wave or far field R-wave in the atrial electrogram; sensing the ventricular electrogram from at least one electrode positioned in sensing relation to the patient'"'"'s ventricle; detecting a ventricular sense event comprising the R-wave in the ventricular electrogram; determining the end of each cardiac cycle from successive ventricular sense events; during each cardiac cycle, discriminating intrinsic P-waves from far field R-waves in the atrial electrogram using Hidden Markov Modeling (HMM), wherein the P-wave and far-field R-wave can each be characterized as a state separated by state transitions in a hidden state sequence and wherein there are discrete probabilities that the states will transition from one to the other in a predetermined order; and based on the HMM discrimination of the atrial sense events as intrinsic P-waves or far field R-waves and the timed intervals between intrinsic P-waves in the cardiac cycles, determining the existence of an atrial tachycardia. - View Dependent Claims (2)
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3. Apparatus for determining an atrial tachycardia by ensuring that atrial sense events result from intrinsic P-waves originating in the atria and are not far field R-waves comprising:
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means for sensing the atrial electrocardiogram from at least one electrode positioned in sensing relation to the patient'"'"'s atria; means for detecting an atrial sense event comprising one of the P-wave or far field R-wave in the atrial electrogram; means for sensing the ventricular electrogram from at least one electrode positioned in sensing relation to the patient'"'"'s ventricle; means for detecting a ventricular sense event comprising the R-wave in the ventricular electrogram; means for determining the end of each cardiac cycle from successive ventricular sense events; means operable during each cardiac cycle for discriminating intrinsic P-waves from far field R-waves in the atrial electrogram using Hidden Markov Modeling (HMM), wherein the P-wave and far-field R-wave can each be characterized as a state separated by state transitions in a hidden state sequence and wherein there are discrete probabilities that the states will transition from one to the other in a predetermined order; and
means for determining the existance of an atrial tachyarrhythmia based on the HMM discrimination of the atrial sense events as intrinsic P-waves or far field R-waves and the timed intervals between intrinsic P-waves in the cardiac cycles. - View Dependent Claims (4)
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Specification