Prioritized rule based apparatus for diagnosis and treatment of arrhythmias

• US 5,991,656 A
• Filed: 09/22/1998
• Issued: 11/23/1999
• Est. Priority Date: 03/30/1995
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Kaemmerer, William F., Olson, Walter H.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US09/158,699
• Time in Patent Office: 427 Days
• Field of Search: 607/4, 607/5, 607/9, 607/14
• US Class Current: 607/4
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

An implantable antiarrhythmia device which detects and classifies arrhythmias of the human heart, and delivers appropriate therapy. The device employs a method of arrhythmia classification based on a set of prioritized rules, each of the rules defining a plurality of criteria based upon characteristics of sensed depolarizations of heart tissue, each rule being met when the criteria associated with the rule are met. Some rules, when met, trigger delivery of antiarrhythmia therapy. Other rules, when met, inhibit delivery of antiarrhythmia therapy. The rules may be met simultaneously, and if so, the highest priority rule governs the behavior of the device.

Claims

1. An anti-arrhythmia device, comprising:

means for sensing depolarizations of heart tissue;

means for defining a set of prioritized rules which may be simultaneously met, including a first rule indicating the need for delivery of anti-arrhythmia therapy and a second rule which indicates that an anti-arrhythmia therapy is not needed, each of said prioritized rules defining at least one criterion based upon characteristics of said sensed depolarizations of heart tissue, each of said prioritized rules being met responsive to a said criterion of said prioritized rule being met;

analyzing means for determining which of said prioritized rules are met, comprising means for determining whether sensed depolarizations continue to meet a said criterion of one of said prioritized rules over a sequence of said sensed depolarizations and means responsive to said sensed depolarizations continuing to meet said criterion of said one of said prioritized rules over said sequence of sensed depolarizations for determining which of said prioritized rules are met;

means for determining the highest priority one of said prioritized rules which are met;

means responsive to the first rule being the highest priority rule met, for delivering an anti-arrhythmia therapy; and

means responsive to the second rule being the highest priority rule met, for preventing delivery of an anti-arrhythmia therapy.

2. A device according to claim 1, wherein a said criterion for meeting one of said prioritized rules comprises a said criterion for meeting another of said prioritized rules.

3. A device according to claim 1, wherein a said criterion for meeting one of said prioritized rules comprises the degree to which a said criterion of another of said prioritized rules is met.

4. A device according to claim 1, wherein a said criterion for meeting one of said prioritized rules comprises failure of said sensed depolarizations to meet another of said prioritized rules.

5. An anti-arrhythmia device, comprising:

means for sensing depolarizations of heart tissue;

means for defining a set of prioritized rules which may be simultaneously met, including a first rule indicating the need for delivery of anti-arrhythmia therapy and a second rule which indicates that an anti-arrhythmia therapy is not needed, each of said prioritized rules defining at least one criterion based upon characteristics of said sensed depolarizations of heart tissue, each said prioritized rule being met responsive to a said criterion of said prioritized rule being met, wherein a said criterion for meeting one of said prioritized rules comprises a said criterion for meeting another of said prioritized rules;

means for analyzing said characteristics of said sensed depolarizations to determine which of said prioritized rules are met;

means for determining the highest priority one of said prioritized rules which are met;

means responsive to said first rule being the highest priority rule met, for delivering an anti-arrhythmia therapy; and

means responsive to said second rule being the highest priority rule met, for preventing delivery of an anti-arrhythmia therapy.

6. An anti-arrhythmia device, comprising:

means for sensing depolarizations of heart tissue;

means for defining a set of prioritized rules which may be simultaneously met, including a first rule indicating the need for delivery of anti-arrhythmia therapy and a second rule which indicates that an anti-arrhythmia therapy is not needed, each of said prioritized rules defining at least one criterion based upon characteristics of said sensed depolarizations of heart tissue, each said prioritized rule being met responsive to a said criterion of said prioritized rule being met, wherein a said criterion for meeting one of said prioritized rules comprises the degree to which a said criterion of another of said prioritized rules is met;

means for analyzing said characteristics of said sensed depolarizations to determine which of said prioritized rules are met;

means for determining the highest priority one of said prioritized rules which are met;

means responsive to said first rule being the highest priority rule met, for delivering an anti-arrhythmia therapy; and

means responsive to said second rule being the highest priority rule met, for preventing delivery of an anti-arrhythmia therapy.

7. An anti-arrhythmia device, comprising:

means for sensing depolarizations of heart tissue;

means for defining a set of prioritized rules which may be simultaneously met, including a first rule indicating the need for delivery of anti-arrhythmia therapy and a second rule which indicates that an anti-arrhythmia therapy is not needed, each of said prioritized rules defining at least one criterion based upon characteristics of said sensed depolarizations of heart tissue, each said prioritized rule being met responsive to a said criterion of said prioritized rule being met, wherein a said criterion for meeting one of said prioritized rules comprises failure of said sensed depolarizations to meet another of said prioritized rules;

means for analyzing said characteristics of said sensed depolarizations to determine which of said prioritized rules are met;

means for determining the highest priority one of said prioritized rules which are met;

means responsive to said first rule being the highest priority rule met, for delivering an anti-arrhythmia therapy; and

means responsive to said second rule being the highest priority rule met, for preventing delivery of an anti-arrhythmia therapy.