Method and apparatus to control delivery of high-voltage and anti-tachy pacing therapy in an implantable medical device
First Claim
1. A system for use in controlling electrical therapy delivered to a heart, comprising:
- a first circuit that is charged to deliver high-voltage electrical stimulation to the heart;
a second circuit to deliver anti-tachy pacing (ATP) therapy to the heart;
a control circuit coupled to the first and second circuits to adjust a time of charging of the first circuit relative to a time of delivering ATP therapy based on predetermined criteria;
means for operating in an ATP-DCC mode to initiate charging of the first circuit during delivery of the ATP therapy;
means for operating in an ATP-DCC mode to initiate charging of the first circuit after the delivery of the ATP therapy; and
means for transitioning between the ATP-BCC mode and the ATP-DCC mode based on predetermined criteria related to the effectiveness of the previously-delivered ATP therapy.
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Abstract
A system and method for delivering both anti-tachy pacing (ATP) therapy and high-voltage shock therapy in response to detection of abnormal cardiac rhythms is disclosed. The system controls the time between delivering ATP therapy and the charging of high-voltage capacitors in preparation for shock delivery based on a predetermined set of criteria. In one embodiment, the inventive system operates in an ATP During Capacitor Charging (ATP-DCC) mode wherein all, or substantially all, of the ATP therapy is delivered during charging of the high-voltage capacitors. Based on evaluation of the predetermined set of criteria, the system may switch to an additional ATP Before Capacitor Charging (ATP-BCC) mode, wherein substantially all of the ATP therapy is delivered prior to charging of the high-voltage capacitor. According to one aspect of the invention, the predetermined set of criteria is based, at least in part, on the effectiveness of previously-delivered ATP therapy.
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Citations
28 Claims
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1. A system for use in controlling electrical therapy delivered to a heart, comprising:
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a first circuit that is charged to deliver high-voltage electrical stimulation to the heart;
a second circuit to deliver anti-tachy pacing (ATP) therapy to the heart;
a control circuit coupled to the first and second circuits to adjust a time of charging of the first circuit relative to a time of delivering ATP therapy based on predetermined criteria;
means for operating in an ATP-DCC mode to initiate charging of the first circuit during delivery of the ATP therapy;
means for operating in an ATP-DCC mode to initiate charging of the first circuit after the delivery of the ATP therapy; and
means for transitioning between the ATP-BCC mode and the ATP-DCC mode based on predetermined criteria related to the effectiveness of the previously-delivered ATP therapy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 28)
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17. A method for use in delivering electrical stimulation to a heart, comprising the steps of:
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a.) delivering anti-tachy pacing (ATP) therapy to a patient'"'"'s heart;
b.) charging a high-voltage capacitor in preparation to deliver high-voltage electrical stimulation to the heart; and
c.) controlling a time of performing step b.) in relation to a time of performing step a.) based on a predetermined set of criteria, wherein step c.) includes operating in a ATP-DCC mode wherein substantially all of step a.) is performed during step b.), and wherein step c.) includes switching from the ATP-DCC mode to a ATP-BCC mode wherein substantially all of step a.) is performed before step b.) is performed, the switching being based on the predetermined set of criteria. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
monitoring effectiveness of the ATP therapy in terminating abnormal cardiac rhythms; - and
wherein step c.) is performed based on the predetermined set of criteria, which takes into account the effectiveness of the ATP therapy in terminating abnormal cardiac rhythms.
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20. The method of claim 19, wherein step c.) further includes switching from the ATP-BCC mode to the ATP-DCC mode based on the predetermined set of criteria.
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21. The method of claim 20, wherein the switching from the ATP-BCC mode to the ATP-DCC mode occurs after unsuccessfully delivering ATP therapy a first predetermined number of times while in the ATP-BCC mode.
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22. The method of claim 21, wherein the switching from the ATP-DCC mode to the ATP-BCC mode occurs after successfully delivering ATP therapy a second predetermined number of times while in the ATP-BCC mode.
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23. The method of claim 17, and further including analyzing morphology of cardiac rhythms detected in the heart;
- and wherein the predetermined set of criteria in step c.) is based on the morphology of cardiac rhythms detected in the heart.
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24. The method of claim 23, wherein step c.) further includes switching from the ATP-DCC mode to the ATP-BCC mode based on a frequency of occurrence of predetermined ones of the cardiac rhythms detected in the heart.
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25. The method of claim 24, wherein step c.) further includes switching from the ATP-DCC mode to the ATP-BCC mode based on detection of VT storms, wherein a predetermined number of ventricular tachycardia (VT) episodes are detected within a predetermined period of time.
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26. The method of claim 23, wherein step c.) further includes switching from the ATP-BCC mode to the ATP-DCC mode based on a change in the morphology of the cardiac rhythms detected in the heart.
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27. The method of claim 19, and further including discontinuing step a.) after unsuccessfully delivering ATP therapy a predetermined number of times.
Specification