Discrimination of supraventricular tachycardia and ventricular tachycardia events

• US 6,484,055 B1
• Filed: 09/20/2000
• Issued: 11/19/2002
• Est. Priority Date: 03/12/1999
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Marcovecchio, Alan F.
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US09/666,868
• Time in Patent Office: 790 Days
• Field of Search: 607/4, 607/5, 607/9, 607/14, 600/518, 600/515
• US Class Current: 607/5
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

A method and system for discrimination of supraventricular tachycardia and ventricular tachycardia events. Morphological features points are extracted from normal sinus rhythm (NSR) complexes and used to generate a NSR template. A numerical convolution is performed using the NSR template and the feature points for each sensed NSR to give a NSR filter output. Using a plurality of NSR complexes, a median NSR filter output template is determined, where the median NSR filter output template has a median value for each value in the NSR filter output. The median NSR filter output template is then used during a tachycardia event to distinguish tachycardia events as either ventricular tachycardia events or supraventricular tachycardia events.

Claims

1. A system comprising:

an endocardial lead including at least one defibrillation coil electrode and at least one pacing electrode; and

an implantable cardioverter defibrillator, wherein the endocardial lead is physically and electrically coupled to the implantable cardioverter defibrillator and wherein the implantable cardioverter defibrillator includes;

input circuitry electrically coupled to the at least one defibrillation coil electrode and the at least one pacing electrode for receiving cardiac complexes,

a signal morphology analyzing circuit coupled to the input circuitry, wherein the signal morphology analyzing circuitry is adapted for extracting a plurality of feature points from the cardiac complexes,

a template generating circuit coupled to the signal morphology analyzing circuit for receiving a plurality of normal feature points from normal sinus rhythm (NSR) cardiac complexes and generating a normal sinus rhythm (NSR) template from the plurality of feature points,

a filter output response circuit coupled to the template generating circuit for performing a numerical convolution of the NSR template and the plurality of feature points for each of the plurality of the NSR complexes to create a normal sinus rhythm filter output, and for determining a median NSR output template from the plurality of NSR complexes, and

wherein the input circuitry is adapted for receiving a QRS-complex from a tachycardia complex, the signal morphology analyzing circuit is adapted for locating a plurality of feature points on the QRS-complex, the filter output response circuit is adapted for performing a numerical convolution of the NSR template with the plurality of feature points on the QRS-complex to give a tachycardia complex output and for determining a sum of residual (SOR) value by summing a numerical difference between the values of the tachycardia complex output and the median NSR output template.

2. The system of claim 1, wherein the implantable cardioverter defibrillator includes a microprocessor for receiving the SOR value from the filter output response circuit and classifying the tachycardiac complex as a ventricular tachycardia complex if the SOR value is greater than or equal to a sum of residual threshold value.

3. The system of claim 2, wherein the microprocessor is adapted for classifying the tachycardia complex as a supraventricular tachycardia complex if the SOR value is less than the sum of residual threshold value.

4. The system of claim 3, wherein the microprocessor is adapted for declaring a ventricular tachycardia event if the number of ventricular tachycardia complexes exceeds a predetermined threshold value.

5. The system of claim 4, wherein the implantable cardioverter defibrillatior includes a cardioversion/defibrillation output circuit, and the microprocessor is adapted for providing a signal to the cardioversion/defibrillation output circuit to deliver ventricular tachycardia therapy to a heart if the microprocessor declares a ventricular tachycardia event.

6. The system of claim 4, wherein the implantable cardioverter defibrillator includes a cardioversion/defibrillation output circuit, and the microprocessor is adapted for declaring a supraventricular tachycardia event if a number of supra ventricular tachycardia complexes exceeds a predetermined threshold value, and for providing a signal to the cardioversion/defibrillation output circuit to deliver supraventricular tachycardia therapy to a heart if the microprocessor declares a supraventricular tachycardia event.