Implantable cardioversion device with a self-adjusting threshold for therapy selection
First Claim
1. An implantable cardiac stimulation device for providing therapy to a patient'"'"'s heart, the device comprising:
- a sense amplifier that senses signals from the patient'"'"'s heart and generates signals related to the patient'"'"'s heart rate;
a memory circuit for storing threshold settings for determining the type of antiarrhythmic therapy to be applied to the patient'"'"'s heart for a range of heart rates defined by the stored threshold settings;
a control and timing circuit coupled to the sense amplifier and the memory circuit that generates control signals responsive to the sense signals and the threshold settings, the control signals defining one of a plurality of antiarrhythmic therapies, wherein the therapy is selected in accordance with the relationship of the sensed heart rate and the stored threshold settings;
a pulse generator that generates therapeutic pulses to the patient'"'"'s heart in response to the control signals; and
a rate threshold adjusting circuit being adapted to adjust the threshold settings stored in the memory circuit in accordance with the response of the patient to the selected antiarrhythmic therapy.
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Accused Products
Abstract
In an implantable cardioversion device, the condition of the patient'"'"'s heart is determined from an intrinsic ventricular parameter, such as the ventricular rate, and therapy is provided with a shock or pulse generator, including, for instance, antitachycardia pacing therapy or defibrillation shocks. Initially, the conditions, i.e., ventricular tachycardia or fibrillation/flutter, are determined using predetermined values for a set of thresholds defining the various conditions. Thereafter, the thresholds are changed by increasing or decreasing the therapy thresholds from the predetermined values based on the success rate of the corresponding therapy.
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Citations
39 Claims
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1. An implantable cardiac stimulation device for providing therapy to a patient'"'"'s heart, the device comprising:
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a sense amplifier that senses signals from the patient'"'"'s heart and generates signals related to the patient'"'"'s heart rate;
a memory circuit for storing threshold settings for determining the type of antiarrhythmic therapy to be applied to the patient'"'"'s heart for a range of heart rates defined by the stored threshold settings;
a control and timing circuit coupled to the sense amplifier and the memory circuit that generates control signals responsive to the sense signals and the threshold settings, the control signals defining one of a plurality of antiarrhythmic therapies, wherein the therapy is selected in accordance with the relationship of the sensed heart rate and the stored threshold settings;
a pulse generator that generates therapeutic pulses to the patient'"'"'s heart in response to the control signals; and
a rate threshold adjusting circuit being adapted to adjust the threshold settings stored in the memory circuit in accordance with the response of the patient to the selected antiarrhythmic therapy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. An implantable cardioversion device generating antitachyarrhythmic therapy for a patient'"'"'s heart, the device comprising:
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a sense amplifier receiving intrinsic signals indicative of ventricular activity and generating corresponding sense signals;
a condition detector receiving the sense signals and generating patient condition signals indicative of the condition of the patient based on the sense signals and a set of thresholds;
a threshold level setting circuit that generates the thresholds;
a timing and control circuit that generates command signals based on the patient condition signals and the sense signals, the command signals defining a therapy for the patient corresponding to the patient condition signals;
an output signal generator receiving the commands and responsively generating therapeutic pulses to revert the patient condition to a sinus state;
a therapy success detector that analyzes the therapeutic pulses to determine a success rate at which said therapeutic pulses have reverted the patient condition to a sinus state; and
whereinthe threshold setting circuit is coupled to the therapy success detector to adjust the threshold levels in accordance with the determined success rate. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. In an implantable cardioversion device which includes a sensor for sensing cardiac activity in a patient'"'"'s heart, a patient condition detector that identifies the patient'"'"'s cardiac condition based on the cardiac activity and a set of thresholds, and a pulse generator configured for generating antitachyarrhythmic signals in accordance with the output of the patient condition detector, a process of dynamically adjusting the set of thresholds comprising the steps of:
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setting the set of thresholds to predetermined values;
operating the device using the predetermined values; and
adjusting the thresholds dynamically by changing the predetermined threshold values in accordance with the cardiac activity resulting in response to the antitachyarrhythmic signals. - View Dependent Claims (29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39)
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Specification