Method and system for nodal rhythm detection and treatment

• US 6,748,270 B2
• Filed: 04/27/2001
• Issued: 06/08/2004
• Est. Priority Date: 04/27/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Rouw, Mattias, Stoop, Gustaaf A. P.
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US09/842,812
• Publication Number:
  US 20020161409A1
• Time in Patent Office: 1,138 Days
• Field of Search: 607/9, 607/14, 607/25, 600/515, 600/516, 600/518
• US Class Current: 607/9
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay

Abstract

A method and system for nodal rhythm detection and treatment is provided. Detecting consecutive atrial events within a nodal activity window around ventricular events identifies nodal rhythm. Nodal rhythm is treated by calculating and applying a new atrial escape interval adjusted by the interval between the atrial and ventricular events.

Claims

1. A method for nodal rhythm detection and delivery of therapy for a mammalian heart, comprising:

determining whether an atrial event precedes a ventricular event;

counting the consecutive times atrial events occur less than a first time limit before the ventricular event, if the atrial event precedes the ventricular event;

counting the consecutive times atrial events occur less than a second time limit after the ventricular event, if the atrial event follows the ventricular event; and

delivering therapy for nodal rhythm if the number of times consecutive atrial events occur within a time period between the first time limit before a ventricular event and the second time limit after a ventricular event is greater than a nodal treatment activation constant.

2. The method of claim 1, wherein the nodal therapy delivery activation constant is 1 to 10.

3. The method of claim 2, wherein the nodal therapy delivery activation constant is 3.

4. The method of claim 1, wherein the first time limit and the second time limit are determined for a specific patient.

5. The method of claim 1, wherein the first time limit is 60 ms.

6. The method of claim 1, wherein the second time limit is 100 ms.

7. The method of claim 1, further comprising:

determining a mean ventricular rate;

determining a paced AV interval;

determining an AV interval if the atrial event precedes the ventricular event;

determining a VA interval if the atrial event follows the ventricular event;

calculating a new atrial escape interval by subtracting the paced AV interval from the sum of the AV interval and the mean ventricular rate, if the atrial event precedes the ventricular event; and

calculating the new atrial escape interval by subtracting the paced AV interval and the VA interval from the mean ventricular rate, if the atrial event follows the ventricular event.

8. The method of claim 1, wherein said therapy delivery for nodal rhythm comprises delivery of treatment in response to an alarm.

9. The method of claim 1, wherein said therapy delivery for nodal rhythm comprises delivery of treatment by an implantable medical device.

10. An implantable medical system for delivering therapy to a mammalian heart, comprising:

means for determining whether an atrial even precedes a ventricular event;

means for counting the consecutive times atrial events occur less than a first time limit before the ventricular event, if the atrial event precedes the ventricular event;

means for counting the consecutive times atrial events occur less than a second time limit after the ventricular event, if the atrial event follows the ventricular event; and

means for delivering the therapy for nodal rhythm if the number of times consecutive atrial events occur within a time period between the first time limit before a ventricular event and the second time limit after a ventricular event is greater than a nodal treatment activation constant.

11. The system of claim 10, wherein the nodal therapy delivery activation constant is 1 to 10.

12. The system of claim 11, wherein the nodal therapy delivery activation constant is 3.

13. The system of claim 10, wherein the first time limit and the second time limit are determined for a specific patient.

14. The system of claim 10, wherein the first time limit is 60 ms.

15. The system of claim 10, wherein the second time limit is 100 ms.

16. The system of claim 10, further comprising:

means for determining a mean ventricular rate;

means for determining a paced AV interval;

means for determining an AV interval if the atrial event precedes the ventricular event;

means for determining a VA interval if the atrial event follows the ventricular event;

means for calculating a new atrial escape interval by subtracting the paced AV interval from the sum of the AV interval and the mean ventricular rate, if the atrial event precedes the ventridular event; and

means for calculating the new atrial escape interval by subtracting the paced AV interval and the VA interval from the mean ventricular rate, if the atrial event follows the ventricular event.

17. A computer usable medium storing computer readable program code having a program for nodal rhythm detection and treatment for a mammalian heart, comprising:

computer readable program code for determining whether an atrial event precedes a ventricular event;

computer readable program code for counting the consecutive times atrial events occur less than a first time limit before the ventricular event, if the atrial event precedes the ventricular event;

computer readable program code for counting the consecutive times atrial events occur less than a second time limit after the ventricular event, if the atrial event follows the ventricular event; and

computer readable program code for delivering therapy for nodal rhythm if the number of times consecutive atrial events occur within a time period between the first time limit before a ventricular event and the second time limit after a ventricular event is greater than a nodal treatment activation constant.

18. The program of claim 17, wherein the nodal therapy delivery activation constant is 1 to 10.

19. The program of claim 18, wherein the nodal therapy delivery activation constant is 3.

20. The program of claim 17, wherein the first time limit and the second time limit are determined for a specific patient.

21. The program of claim 17, wherein the first time limit is 60 ms.

22. The program of claim 17, wherein the second time limit is 100 ms.

23. The program of claim 17, further comprising:

computer readable program code for determining a mean ventricular rate;

computer readable program code for determining a paced AV interval;

computer readable program code for determining an AV interval if the atrial event precedes the ventricular event;

computer readable program code for determining a VA interval If the atrial event follows the ventricular event;

computer readable program code for calculating a new atrial escape interval by subtracting the paced AV interval from the sum of the AV interval and the mean ventricular rate, if the atrial event precedes the ventricular event; and

computer readable program code for calculating the new atrial escape interval by subtracting the paded AV interval and the VA interval from the mean ventricular rate, if the atrial event follows the ventricular event.