System and method for detecting atrial events of a heart

• US 6,041,251 A
• Filed: 07/01/1998
• Issued: 03/21/2000
• Est. Priority Date: 07/01/1998
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kim, Jaeho, Bocek, Joseph M.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US09/108,898
• Time in Patent Office: 629 Days
• Field of Search: 607/4, 607/5, 600/515, 600/518, 600/521
• US Class Current: 600/518
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

A continuous monitoring system monitors atrial activity of a heart and activates an atrial fibrillation detector when atrial fibrillation is suspected. The system includes an A wave detector for detecting A waves of the heart and providing an A wave detection signal indicating each detected A wave. The A wave detector has a first threshold and a selectable second threshold higher than the first threshold. An R wave detector for detecting R waves of the heart is coupled to the A wave detector for selecting the second threshold of the A wave detector during each detected R wave of the heart. An atrial cycle length determining stage determines atrial cycle lengths from the A wave detection signal and a comparator activates atrial fibrillation detection when an atrial cycle length is shorter than a predetermined cycle length.

Claims

1. A system for detecting atrial events of a heart comprising:

A wave detecting means for detecting A waves of the heart and providing an A wave detection signal indicating each detected A wave, the A wave detecting means including a first threshold and means for providing the A wave detection signal when an A wave is detected with the first threshold and a second threshold higher than the first threshold and means for providing the A wave detection signal when an A wave is detected with the second threshold; and

an R wave detector for detecting R waves of the heart and coupled to the A wave detecting means for activating the second threshold of the A wave detecting means during each detected R wave of the heart.

2. A system as defined in claim 1 further including delay means for delaying the A wave detection signal.

3. A system as defined in claim 1 wherein the system further includes an atrial sense amplifier for sensing atrial activity of the heart and providing an electrogram signal and wherein the A wave detecting means include first and second A wave detectors each having an output and an input coupled to the atrial sense amplifier for receiving the electrogram signal, first and second delay circuits each having an output and an input coupled to the first and second A wave detector outputs respectively, a switch having an output for providing the A wave detection signal and being selectively coupled to the first and second delay circuit outputs responsive to the R wave detector.

4. A system for detecting atrial events of a heart comprising:

a first sense amplifier for sensing atrial activity of a heart;

a second sense amplifier for sensing ventricular activity of the heart;

A wave detecting means coupled to the first sense amplifier for providing an output signal indicating each detected A wave, said A wave detecting means having a first threshold and means for providing the output signal when an A wave is detected with the first threshold and a second threshold higher than the first threshold and means for providing the output signal when an A wave is detected with the second threshold;

an R wave detector coupled to the second sense amplifier for detecting R waves from the sensed ventricular activity;

delay means for causing a delay in the output signal; and

switch means coupled to the R wave detector for switching the A wave detecting means from the first threshold to the second threshold during each detected R wave.

5. A continuous monitoring system for monitoring atrial activity of a heart and activating atrial fibrillation detection when atrial fibrillation is suspected, the system comprising:

A wave detecting means for detecting A waves of the heart and providing an A wave detection signal indicating each detected A wave, the A wave detecting means including a first threshold and means for providing the A wave detection signal when an A wave is detected with the first threshold and a second threshold higher than the first threshold and means for providing the A wave detection signal when an A wave is detected with the second threshold;

an R wave detector for detecting R waves of the heart and coupled to the A wave detecting means for activating the second threshold of the A wave detecting means during each detected R wave of the heart;

means for determining an atrial cycle length from the A wave detection signal; and

activation means for activating atrial fibrillation detection responsive to the atrial cycle lengths.

6. A system as defined in claim 5 further including delay means for delaying the A wave detection signal.

7. A system as defined in claim 5 wherein the activation means comprises a comparator.

8. A system as defined in claim 5 wherein the system further includes an atrial sense amplifier for sensing atrial activity of the heart and providing an electrogram signal and wherein the A wave detecting means includes first and second A wave detectors each having an output and an input coupled to the atrial sense amplifier for receiving the electrogram signal, first and second delay circuits each having an output and an input coupled to the first and second A wave detector outputs respectively, a switch having an output for providing the A wave detection signal and being selectively coupled to the first and second delay circuit outputs responsive to the R wave detector.

9. A method of detecting atrial events of a heart, the method including the steps of:

sensing atrial activity of the heart;

sensing ventricular activity of the heart;

detecting R waves from the sensed ventricular activity; and

detecting A waves from the sensed atrial activity with a first threshold and detecting A waves from the sensed atrial activity with a second threshold higher than the first threshold during detected R waves.