Apparatus and method for setting the parameters of an alert window used for timing the delivery of ETC signals to a heart under varying cardiac conditions
First Claim
1. An excitable tissue control device for setting on a beat by beat basis the parameters of an alert time window under a plurality of different cardiac conditions of a heart of a patient, said device is operatively connectable to a plurality of electrodes implanted in or about said heart, the device comprising:
- detection circuitry for detecting electrical events associated with myocardial activation of a first cardiac site in a signal sensed through at least a first electrode disposed in or about said first cardiac site, and for detecting electrical events associated with myocardial activation of a second cardiac site, in a signal sensed through at least a second electrode disposed in or about said second cardiac site;
an excitable tissue control unit for delivering non-excitatory excitable tissue control signals to at least part of said second cardiac site through one or more electrodes of said plurality of electrodes;
a memory unit for storing a set of data, said set of data comprises a plurality of sets of alert time window parameters, each set of alert time window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of said plurality of different cardiac conditions, each set of alert time window parameters comprises at least a set of timing parameters usable for obtaining a beginning time point and an ending time point for said alert time window, each set of alert time window parameters is obtained by processing data collected from a plurality of cardiac beats of said heart of said patient under said plurality of different cardiac conditions within a data collection session performed in said patient;
a processor unit operatively connected to said detection circuitry, said excitable tissue control unit and said memory unit, for receiving signals from said detection circuitry, for controlling said excitable tissue control unit by using said signals received from said detection circuitry, for updating in a current beat cycle of said heart the values of a plurality of cardiac condition defining variables corresponding to said cardiac condition defining parameters, for automatically selecting for said current beat cycle a current set of alert time window parameters of said plurality of sets of alert time window parameters based on the current values of said cardiac condition defining variables, for applying said current set of alert time window parameters to initiate said alert time window within said current beat cycle upon detecting a first event at or about said first cardiac site, and for initiating the delivery of a delayed excitable tissue control signal at or about said second cardiac site upon detecting within the duration of said alert time window an electrical event associated with myocardial activation at or about said second cardiac site of said heart; and
a power source for providing power to said detection circuitry, said processor unit said memory unit, and said excitable tissue control unit.
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Abstract
A method for setting the parameters of an alert time window in an excitable tissue control device operative under a plurality of different cardiac conditions of a heart of a patient. The method includes providing said excitable tissue control device with a set of data including a plurality of sets of alert time window parameters. Each set of window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of the different cardiac conditions. Each set of window parameters includes at least a set of timing parameters usable for obtaining a beginning time point and an ending time point of the alert window. The sets of window parameters are obtained by processing data collected within a data collection session from a plurality of cardiac beats of the same patient under the different cardiac conditions.
124 Citations
46 Claims
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1. An excitable tissue control device for setting on a beat by beat basis the parameters of an alert time window under a plurality of different cardiac conditions of a heart of a patient, said device is operatively connectable to a plurality of electrodes implanted in or about said heart, the device comprising:
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detection circuitry for detecting electrical events associated with myocardial activation of a first cardiac site in a signal sensed through at least a first electrode disposed in or about said first cardiac site, and for detecting electrical events associated with myocardial activation of a second cardiac site, in a signal sensed through at least a second electrode disposed in or about said second cardiac site;
an excitable tissue control unit for delivering non-excitatory excitable tissue control signals to at least part of said second cardiac site through one or more electrodes of said plurality of electrodes;
a memory unit for storing a set of data, said set of data comprises a plurality of sets of alert time window parameters, each set of alert time window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of said plurality of different cardiac conditions, each set of alert time window parameters comprises at least a set of timing parameters usable for obtaining a beginning time point and an ending time point for said alert time window, each set of alert time window parameters is obtained by processing data collected from a plurality of cardiac beats of said heart of said patient under said plurality of different cardiac conditions within a data collection session performed in said patient;
a processor unit operatively connected to said detection circuitry, said excitable tissue control unit and said memory unit, for receiving signals from said detection circuitry, for controlling said excitable tissue control unit by using said signals received from said detection circuitry, for updating in a current beat cycle of said heart the values of a plurality of cardiac condition defining variables corresponding to said cardiac condition defining parameters, for automatically selecting for said current beat cycle a current set of alert time window parameters of said plurality of sets of alert time window parameters based on the current values of said cardiac condition defining variables, for applying said current set of alert time window parameters to initiate said alert time window within said current beat cycle upon detecting a first event at or about said first cardiac site, and for initiating the delivery of a delayed excitable tissue control signal at or about said second cardiac site upon detecting within the duration of said alert time window an electrical event associated with myocardial activation at or about said second cardiac site of said heart; and
a power source for providing power to said detection circuitry, said processor unit said memory unit, and said excitable tissue control unit. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30)
at least a first sense amplifier connectable to said at least first electrode for amplifying an electrical signal sensed through said at least first electrode to generate a first amplified signal;
at least a second sense amplifier connectable to said at least second electrode for amplifying an electrical signal sensed through said at least second electrode to generate a second amplified signal;
at least a first sensing unit operatively connected to said at least first sense amplifier and to said processing unit, for detecting in said first amplified signal electrical events associated with myocardial activation of said first cardiac site and for providing said processing unit with trigger signals indicative of an electrical event associated with myocardial activation of said first cardiac site detected in said first amplified signal; and
at least a second sensing unit operatively connected to said at least second sense amplifier and to said processing unit, for detecting in said second amplified signal electrical events associated with myocardial activation of said second cardiac site and for providing said processing unit with trigger signals indicative of an electrical event associated with myocardial activation of said second cardiac site detected in said second amplified signal.
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30. The device according to claim 29 wherein said processing unit is a controller unit.
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31. An excitable tissue control device for setting on a beat by beat basis the parameters of an alert time window under a plurality of different cardiac conditions of a heart of a patient, the device is operatively connectable to a plurality of electrodes implanted in or about said heart, the device comprising:
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means for detecting electrical events associated with myocardial activation of a first cardiac site through at least a first electrode of said plurality of electrodes, said at least first electrode is disposed in or about said first cardiac site, and for detecting electrical events associated with myocardial activation of a second cardiac site through at least a second electrode of said plurality of electrodes, said at least second electrode is disposed in or about said second cardiac site;
excitable tissue control means for delivering non-excitatory excitable tissue control signals to at least part of said second cardiac site through one or more electrodes of said plurality of electrodes;
memory means for storing a set of data, said set of data comprises a plurality of sets of alert time window parameters, each set of alert time window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of said plurality of different cardiac conditions, each set of alert time window parameters comprises at least a set of timing parameters usable for obtaining a beginning time point and an ending time point for said alert time window, each set of alert time window parameters is obtained by processing data collected from a plurality of cardiac beats of said heart of said patient under said plurality of different cardiac conditions within a data collection session performed in said patient;
processing means operatively connected to said detection means, said excitable tissue control means and said memory means, for receiving detection signals from said detection means, for controlling said excitable tissue control means by using the received detection signals, for updating in a current beat cycle of said heart the values of a plurality of cardiac condition defining variables corresponding to said cardiac condition defining parameters, for automatically selecting for said current beat cycle a current set of alert time window parameters of said plurality of sets of alert time window parameters based on the current values of said cardiac condition defining variables, for applying said current set of alert time window parameters to initiate said alert time window within said current beat cycle upon detecting an electrical event associated with myocardial activation at or about said first cardiac site, and for initiating the delivery of a delayed excitable tissue control signal at or about said second cardiac site upon detecting within the duration of said alert time window an electrical event associated with myocardial activation at or about said second cardiac site of said heart; and
energizing means for providing power to at least said detection means, said processing means said memory means and said excitable tissue control means. - View Dependent Claims (32, 33)
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34. An excitable tissue control device for setting on a beat by beat basis the parameters of an alert time window under a plurality of different cardiac conditions of a heart of a patient, the device is operatively connectable to a plurality of electrodes implanted in or about said heart, the device comprising:
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means for detecting electrical events associated with myocardial activation of a first cardiac site of said heart, and for detecting electrical events associated with myocardial activation of a second cardiac site of said heart;
means for delivering non-excitatory excitable tissue control signals to at least part of said second cardiac site;
means for storing a set of data, said set of data comprises a plurality of sets of alert time window parameters, each set of alert time window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of said plurality of different cardiac conditions, each set of alert time window parameters comprises at least a set of timing parameters usable for obtaining a beginning time point and an ending time point for said alert time window;
means for processing, operatively connected to said means for detecting, said means for delivering non-excitatory excitable tissue control signals, and said means for storing, said means for processing is configured for receiving detection signals associated with the detecting of said electrical events from said means for detecting, for controlling said means for delivering non-excitatory excitable tissue control signals by using said detection signals, for updating in a current beat cycle of said heart the values of a plurality of cardiac condition defining variables corresponding to said cardiac condition defining parameters, for automatically selecting for said current beat cycle a current set of alert time window parameters of said plurality of sets of alert time window parameters based on the current values of said cardiac condition defining variables, for applying said current set of alert time window parameters to initiate said alert time window within said current beat cycle upon detecting a first electrical event associated with myocardial activation at or about said first cardiac site, and for controlling the delivery of a delayed excitable tissue control signal, by said means for delivering non-excitatory excitable tissue control signals, at or about said second cardiac site upon detecting, within the duration of said alert time window, an electrical event associated with myocardial activation at or about said second cardiac site of said heart; and
means for providing power to at least said means for detecting, said means for processing, said means for storing, and said means for delivering non-excitatory excitable tissue control signals. - View Dependent Claims (35, 36, 37)
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38. An excitable tissue control device for setting on a beat by beat basis the parameters of an alert time window under a plurality of different cardiac conditions of a heart of a patient, the device is operatively connectable to a plurality of electrodes implanted in or about said heart, the device comprising:
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a detecting unit for detecting electrical events associated with myocardial activation of a first cardiac site of said heart, and for detecting electrical events associated with myocardial activation of a second cardiac site of said heart;
an excitable tissue control unit for delivering non-excitatory excitable tissue control signals to at least part of said second cardiac site;
a memory unit for storing a set of data, said set of data comprises a plurality of sets of alert time window parameters, each set of alert time window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of said plurality of different cardiac conditions, each set of alert time window parameters comprises at least a set of timing parameters usable for obtaining a beginning time point and an ending time point for said alert time window;
a processing unit, operatively connected to said detecting unit, said excitable tissue control unit, and said memory unit, said processing unit is configured for receiving from said detecting unit detection signals associated with the detecting of said electrical events, for controlling said excitable tissue control unit by using said detection signals, for updating in a current beat cycle of said heart the values of a plurality of cardiac condition defining variables corresponding to said cardiac condition defining parameters, for automatically selecting for said current beat cycle a current set of alert time window parameters of said plurality of sets of alert time window parameters based on the current values of said cardiac condition defining variables, for applying said current set of alert time window parameters to initiate said alert time window within said current beat cycle upon detecting a first electrical event associated with myocardial activation at or about said first cardiac site, and for controlling the delivery of a delayed excitable tissue control signal, by said excitable tissue control unit, at or about said second cardiac site upon detecting within the duration of said alert time window an electrical event associated with myocardial activation at or about said second cardiac site of said heart; and
a power source, operatively connected to at least said detecting unit, said processing unit, said memory unit, and said excitable tissue control unit, for providing power thereto. - View Dependent Claims (39, 40, 41)
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42. An excitable tissue control device for setting on a beat by beat basis the parameters of an alert time window under a plurality of different cardiac conditions of a heart of a patient, said device is operatively connectable to a plurality of electrodes implanted in or about said heart, the device comprising:
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sensing circuitry for sensing electrical events associated with myocardial activation of a first cardiac site in a signal sensed through at least a first electrode disposed in or about said first cardiac site, and for sensing electrical events associated with myocardial activation of a second cardiac site, in a signal sensed through at least a second electrode disposed in or about said second cardiac site;
an excitable tissue control unit for delivering non-excitatory excitable tissue control signals to at least part of said second cardiac site through one or more electrodes of said plurality of electrodes;
a memory unit for storing a set of data, said set of data comprises a plurality of sets of alert time window parameters, each set of alert time window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of said plurality of different cardiac conditions, each set of alert time window parameters comprises at least a set of timing parameters usable for obtaining a beginning time point and an ending time point for said alert time window, each set of alert time window parameters is obtained by processing data collected from a plurality of cardiac beats of said heart of said patient under said plurality of different cardiac conditions within a data collection session performed in said patient;
a processor unit operatively connected to said sensing circuitry, said excitable tissue control unit and said memory unit, for receiving signals from said sensing circuitry, for processing said signals received from said sensing circuitry to detect electrical events associated with myocardial activation at said first cardiac site and at said second cardiac site, for controlling said excitable tissue control unit based on the detection of said electrical events, for updating in a current beat cycle of said heart the values of a plurality of cardiac condition defining variables corresponding to said cardiac condition defining parameters, for automatically selecting for said current beat cycle a current set of alert time window parameters of said plurality of sets of alert time window parameters based on the current values of said cardiac condition defining variables, for applying said current set of alert time window parameters to initiate said alert time window within said current beat cycle after detecting a first electrical event associated with myocardial activation at or about said first cardiac site, and for initiating the delivery of a delayed excitable tissue control signal to said second cardiac site upon detecting within the duration of said alert time window an electrical event associated with myocardial activation at or about said second cardiac site of said heart; and
a power source for providing power to said sensing circuitry, said processor unit, said memory unit, and said excitable tissue control unit. - View Dependent Claims (43, 44, 45, 46)
a front end unit connectable to said at least first electrode for pre-conditioning an electrical signal sensed through said at least first electrode to generate a first pre-conditioned signal, said front end unit is also connectable to said at least second electrode for pre-conditioning an electrical signal sensed through said at least second electrode to generate a second pre-conditioned signal; and
at least one analog to digital converter unit operatively connected to said front end unit and to said processing unit, for receiving said first pre-conditioned signal and said second pre-conditioned signal from said front end unit and for digitizing said first pre-conditioned signal and said second pre-conditioned signal, to provide digitized signals to said processing unit.
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44. The device according to claim 43 wherein the combination of said sensing circuitry and said processing unit is operative as a detection unit configured for being controllably switched between a plurality of different detection sensitivity levels, and wherein each set of alert time window parameters of said plurality of sets of alert time window parameters further comprises at least one detection sensitivity parameter having a value representing one of said plurality of detection sensitivity levels of said detection unit, and wherein said processor unit is adapted for using said value of said at least one detection sensitivity parameter of said current beat cycle to switch said detection unit to a detection sensitivity level represented by said at least one detection sensitivity parameter of said current beat cycle.
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45. The device according to claim 44 wherein said detection unit is adapted for being switched between a plurality of voltage threshold levels and said at least one detection sensitivity parameter comprises a voltage threshold level.
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46. The device according to claim 44 wherein said detection unit is adapted for performing event detection based on a morphological detection method and wherein said at least one detection sensitivity parameter comprises at least one morphological detection parameter.
Specification