Implantable multi-chamber cardiac stimulation device with sensing vectors
First Claim
1. A method of accurately detecting cardiac events, for use in a multi-chamber cardiac stimulation device, comprising the steps of:
- sensing cardiac signals from passive sensing electrodes placed in at least three cardiac chambers;
establishing a plurality of sensing vectors from the cardiac signals;
detecting a cardiac depolarization from the sensing vectors by comparing a sensing vector to a detection threshold; and
selectively delivering a stimulation energy based on a detected cardiac depolarization indicative of a change in a heart function parameter.
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Abstract
An implantable multi-chamber cardiac stimulation device and method are provided for accurately sensing cardiac activity from three or four heart chambers using passive sensing electrodes placed in each heart chamber. Multiple intra-chamber or inter-chamber sensing vectors are established between passive sensing electrodes. Sampled sensing vector signals are processed such that a cardiac depolarization may be accurately detected, as well as its origin and direction of propagation. Time intervals between detected depolarization signals may be used to determine conduction time or heart rate. Diagnostic indicators of heart failure condition normally obtained from a 12-lead surface ECG study, such as P-wave or R-wave duration, may also be determined from the sensing vectors. Based on precise and detailed evaluation of sensing vector signals, stimulation therapy may be provided immediately upon a detected change in heart rhythm or heart failure condition.
59 Citations
40 Claims
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1. A method of accurately detecting cardiac events, for use in a multi-chamber cardiac stimulation device, comprising the steps of:
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sensing cardiac signals from passive sensing electrodes placed in at least three cardiac chambers;
establishing a plurality of sensing vectors from the cardiac signals;
detecting a cardiac depolarization from the sensing vectors by comparing a sensing vector to a detection threshold; and
selectively delivering a stimulation energy based on a detected cardiac depolarization indicative of a change in a heart function parameter. - 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)
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27. A multi-chamber cardiac stimulation device that accurately detects cardiac events, comprising:
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passive sensing electrodes placed in at least three cardiac chambers;
sensing circuits, connected to the sensing electrodes, that sense cardiac signals;
control circuit that establishes a plurality of sensing vectors from the cardiac signals, and that detects a cardiac depolarization from the sensing vectors by comparing a sensing vector to a detection threshold; and
a pulse generator that selectively delivers a stimulation energy based on a detected cardiac depolarization indicative of a change in a heart function parameter. - View Dependent Claims (28, 29, 30, 31, 32, 33)
a vector between a right atrium and a left atrium;
a vector between a right atrium and a right ventricle;
a vector between a right atrium and a left ventricle;
a vector between a left atrium and a right ventricle;
a vector between a left atrium and a left ventricle; and
a vector between a right ventricle and a left ventricle.
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33. The device of claim 27, wherein the pulse generator delivers the stimulation energy to a heart chamber at a predetermined time interval following the detected cardiac depolarization.
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34. A multi-chamber cardiac stimulation device that accurately detects cardiac events, comprising:
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means for passively sensing cardiac signals;
means for establishing a plurality of sensing vectors from the cardiac signals;
means for detecting a cardiac depolarization from the sensing vectors by comparing a sensing vector to a detection threshold; and
means for selectively delivering a stimulation energy based on a detected cardiac depolarization indicative of a change in a heart function parameter. - View Dependent Claims (35, 36, 37, 38, 39, 40)
a vector between a right atrium and a left atrium;
a vector between a right atrium and a right ventricle;
a vector between a right atrium and a left ventricle;
a vector between a left atrium and a right ventricle;
a vector between a left atrium and a left ventricle; and
a vector between a right ventricle and a left ventricle.
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40. The device of claim 34, wherein the pulse generator delivers the stimulation energy in response to a change in the conduction time at a predetermined time interval following the detected cardiac depolarization.
Specification