Method providing atrial anti-tachyarrhythmia therapy

• US 6,091,991 A
• Filed: 08/07/1998
• Issued: 07/18/2000
• Est. Priority Date: 08/07/1998
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Warren, Jay A.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US09/130,090
• Time in Patent Office: 711 Days
• Field of Search: 607/74, 607/15
• US Class Current: 607/14
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

The device provides anti-tachyarrhythmia therapy, such as a countershock, to an atrium needing treatment, but delays its delivery for a programmable period of time following an indication of susceptibility to ventricular tachyarrhythmia (VT). This reduces the risk of reinducing VT during a period in which the heart is abnormally metabolically vulnerable to VT, including ventricular fibrillation (VF). The delay time may be independently programmed for different indications of VT, and may be synchronized to and delayed from the R-wave. The delay time may be adjusted, such as to exceed one second, or even to exceed several hours, in order to accommodate the metabolic abnormal susceptibility of the particular patient in the wide range of patients needing treatment of atrial tachyarrhythmias.

Claims

1. A method of applying anti-tachyarrhythmia therapy to a heart, the method including the steps of:

detecting, from an atrium of the heart, atrial tachyarrhythmia activity indicative of a need for the anti-tachyarrhythmia therapy;

monitoring ventricular activity of the heart for an indication of abnormal susceptibility to a ventricular tachyarrhythmia; and

applying the anti-tachyarrhythmia therapy to the atrium in response to the detected atrial tachyarrhythmia activity, but delaying the application of the anti-tachyarrhythmia therapy for a first time delay if the indication of abnormal susceptibility to the ventricular tachyarrhythmia is detected.

2. The method of claim 1, further comprising the step of detecting ventricular activations of the heart.

3. The method of claim 2, including synchronizing applying the anti-tachyarrhythmia therapy to one of the detected ventricular activations of the heart.

4. The method of claim 3, including delaying applying the anti-tachyarrhythmia therapy for a second time delay from the one of the detected ventricular activations of the heart.

5. The method of claim 4, including detecting T-waves, determining an interval between the one of the detected ventricular activations of the heart and a T-wave immediately following the one of the detected ventricular activations of the heart, wherein the second time delay is shorter than the interval.

6. The method of claim 1, wherein the first time delay exceeds approximately one second.

7. The method of claim 1, wherein the first time delay exceeds approximately one hour.

8. The method of claim 1, wherein the first time delay exceeds approximately several hours.

9. The method of claim 1, including extending the first time delay past a period in which the ventricle is abnormally susceptible to tachyarrhythmia resulting from the anti-tachyarrhythmia therapy applied to the atrium.

10. The method of claim 1, wherein the first time delay is adjustable.

11. The method of claim 10, including programming the first time delay based upon an abnormal susceptibility of an individual patient to ventricular tachyarrhythmia in response to the anti-tachyarrhythmia therapy applied to the atrium.

12. The method of claim 1, including setting the first time delay based on the type of the indication of abnormal susceptibility to the ventricular tachyarrhythmia.

13. The method of claim 1, wherein the first time delay is adjusted subsequent to the step of applying the anti-tachyarrhythmia therapy to the atrium.

14. The method of claim 1, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia includes at least one premature ventricular contraction.

15. The method of claim 14, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia includes a number of premature ventricular contractions detected over a third period of time.

16. The method of claim 14, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia includes a number of successive premature ventricular contractions.

17. The method of claim 1, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia includes non-sustained ventricular tachycardia.

18. The method of claim 1, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia includes ventricular tachycardia.

19. The method of claim 1, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia includes ventricular fibrillation.

20. The method of claim 1, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia is chemical.

21. The method of claim 1, wherein the indication of abnormal susceptibility to the ventricular tachyarrhythmia is anti-tachyarrhythmia therapy that was previously delivered to the heart.

22. The method of claim 1, wherein the anti-tachyarrhythmia therapy includes an electrical countershock.

23. The method of claim 1, wherein the anti-tachyarrhythmia therapy includes delivery of an anti-tachyarrhythmia drug.

24. The method of claim 1, wherein the anti-tachyarrhythmia therapy includes anti-tachycardia pacing.

25. A method of applying anti-tachyarrhythmia therapy to a heart, the method including the steps of:

detecting, from an atrium of the heart, atrial tachyarrhythmia activity indicative of a need for the anti-tachyarrhythmia therapy;

determining whether a ventricle of the heart is abnormally susceptible to fibrillation; and

applying anti-tachyarrhythmia therapy to the atrium in response to the detected atrial tachyarrhythmia activity, but delaying the application of the anti-tachyarrhythmia therapy for at least a time period in which the ventricle of the heart is abnormally susceptible to fibrillation.