System and method for distinguishing electrical events originating in the atria from far-field electrical events originating in the ventricles as detected by an implantable medical device

• US 6,516,225 B1
• Filed: 09/15/2000
• Issued: 02/04/2003
• Est. Priority Date: 12/28/1999
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Florio, Joseph J.
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US09/662,440
• Time in Patent Office: 872 Days
• Field of Search: 607/4-27, 600/509, 600/510
• US Class Current: 607/9
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

The system and method discriminates P-waves or other electrical events originating in the atria from R-waves or other electrical events originating in the ventricles. In one example, far-field R-waves in the atria are distinguished from true P-waves using both a post-ventricular atrial blanking (PVAB) interval and a separate pre-ventricular blanking interval (pre-VAB) interval. Insofar as the pre-VAB interval is concerned, upon detection of a P-wave in the atria, the implantable medical device begins tracking a pre-VAB interval. If an R-wave is then detected in the ventricles during the pre-VAB interval, the P-wave is rejected as being a far-field R-wave. A PVAB interval may also be employed to filter out any P-waves detected in the atria immediately following detection of an R-wave in the ventricles. In another example, far-field R-waves are distinguished from true P-waves using template matching. P-waves detected in the atria are compared against a template representative of true P-waves. If the P-wave substantially matches the template, the P-wave is deemed to be a true P-wave; otherwise, the P-wave is rejected as being a far-field R-wave or other anomalous electrical event. In both examples, the techniques are applicable to other types of electrical events detected within the heart besides P-waves and R-waves, such as electrical events occurring during fibrillation or flutter when discrete P-waves and R-waves may not be detectable.

Claims

1. A method for discriminating electrical events originating in the atria from electrical events originating with the ventricles of a heart using an implantable medical device receiving signals detected from within an atrium of the heart and receiving signals detected from within a ventricle of the heart, the method comprising the steps of:

detecting an electrical event within the atrium;

detecting an electrical event within the ventricle; and

determining whether the electrical event occurring within the ventricle was detected within a predetermined pre-ventricular blanking interval following detection of the electrical event occurring within the atrium and, if so, rejecting the electrical event of the atrium as being a far-field electrical event of the ventricle.

2. The method of claim 1, further comprising the step of:

determining whether the electrical event of the atrium was detected within a predetermined post-ventricular blanking interval following detection of the electrical event of the ventricle and, if so, rejecting the electrical event of the atrium as being a far-field electrical event of the ventricle.

3. The method of claim 1, wherein the electrical event of the atrium is a P-wave.

4. The method of claim 1, wherein the electrical event of the ventricle is an R-wave.

5. The method of claim 1, further comprising the step of:

administering therapy based upon the detected events of the ventricles in combination with the detected events of the atrium not rejected as being far-field events of the ventricle.

6. The method of claim 5, wherein the step of administering therapy includes the steps of:

identifying an dysrhythmia, if any, in the heart;

determining therapy to be applied to remedy the dysrhythmia; and

applying the therapy to the heart.

7. The method of claim 6, wherein the dysrhythmia is bradycardia, tachycardia, fibrillation or flutter.

8. The method of claim 1, further comprising the step of performing functions based, in part, on the detected events of the atrium not rejected as being far-field events of the ventricle.

9. The method of claim 8, wherein the step of performing functions includes the steps of performing mode switching functions, pre-ventricular contraction detection functions, PV tracking functions, 2:

1 blocking functions, and Wenkebach mode functions.

10. A system for discriminating electrical events originating in the atria from electrical events originating with the ventricles of a heart using an implantable medical device receiving signals detected from within an atrium of the heart and receiving signals detected from within a ventricle of the heart, the system comprising:

means for detecting an electrical event occurring within the atrium;

means for detecting an electrical event occurring within the ventricle; and

means for determining whether the electrical event occurring within the ventricle was detected within a predetermined pre-ventricular blanking interval following detection of the electrical event occurring within the atrium and, if so, for rejecting the electrical event occurring within the atrium as being a far-field electrical event of the ventricle.

11. The system of claim 10, further comprising:

means for determining whether the electrical event of the atrium was detected within a predetermined post-ventricular blanking interval following detection of the electrical event of the ventricle; and

means, responsive to a determination that the electrical event of the atrium was detected within the predetermined post-ventricular blanking interval, for rejecting the electrical event of the atrium as being a far-field electrical event of the ventricle.

12. The system of claim 10, further comprising means for administering therapy based upon the detected events of the ventricles in combination with the detected events of the atrium not rejected as being far-field events of the ventricle.

13. A system for discriminating electrical events originating in the atria from electrical events originating with the ventricles of a heart using an implantable medical device receiving signals detected from within an atrium of the heart and receiving signals detected from within a ventricle of the heart, the system comprising:

an atrial sense amplifier for detecting an electrical event occurring within the atrium;

an ventricular sense amplifier for detecting an electrical event occurring within the ventricle; and

a controller for determining whether the electrical event occurring with the ventricle was detected within a predetermined pre-ventricular blanking interval following detection of the electrical event occurring within the atrium and, if so, rejecting the electrical event of the atrium as being a far-field electrical event of the ventricle.

14. The system of claim 13, wherein the controller also determines whether the electrical event of the atrium was detected within a predetermined post-ventricular blanking interval following detection of the electrical event of the ventricle and, if so, rejects the electrical event of the atrium as being a far-field electrical event of the ventricle.

15. The system of claim 13, wherein the controller also generates therapy for applying to the heart based upon the detected events of the ventricles in combination with the detected events of the atrium not rejected as being far-field events of the ventricle.