Method and apparatus for reducing early recurrence of atrial fibrillation with defibrillation shock therapy

• US 6,847,842 B1
• Filed: 05/15/2000
• Issued: 01/25/2005
• Est. Priority Date: 05/15/2000
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Rodenhiser, Kristen, Schwartz, Mark
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Assistant Examiner(s): Oropeza, Frances P.
• Application Number:
  US09/570,645
• Time in Patent Office: 1,716 Days
• Field of Search: 600/515, 600/516, 600/518, 600/519, 600/521, 607/2, 607/4, 607/5, 607/7, 607/9, 607/11, 607/14, 607/15, 607/17, 607/25, 607/27
• US Class Current: 607/5
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation in which atrial defibrillation pulses are delivered within a maximum pre-shock R—R synchronization interval. The method has been found to reduce the incidence of early recurrence of atrial fibrillation (ERAF).

Claims

1. A method for delivering atrial defibrillation therapy, comprising:

detecting an episode of atrial fibrillation;

sensing ventricular depolarizations (R waves);

delivering a first ventricular pacing pulse after a sensed R wave; and

delivering an atrial defibrillation shock without an accompanying second ventricular pacing pulse at a specified time after the first ventricular pacing pulse but inhibiting the atrial defibrillation shock if a second R wave subsequent to the first ventricular pacing pulse occurs before the specified time.

2. The method of claim 1 wherein the specified time for delivering the atrial defibrillation shock is less than 800 milliseconds.

3. The method of claim 1 wherein the specified time for delivering the atrial defibrillation shock is greater than 500 milliseconds and less than 800 milliseconds.

4. The method of claim 1 wherein the first ventricular pacing pulse is preceded by one or more additional ventricular pacing pulses delivered after the sensed R wave at a rate greater than the measured intrinsic rate.

5. The method of claim 1 wherein the specified time for delivering the atrial defibrillation shock is less than 800 milliseconds.

6. The method of claim 5 wherein the specified time for delivering the atrial defibrillation shock is greater than 500 milliseconds and less than 800 milliseconds.

7. The method of claim 1 wherein the first ventricular pacing pulse is delivered after the sensed R wave at a rate above an intrinsic ventricular rate.

8. An apparatus for delivering atrial defibrillation therapy to an atrium, comprising:

sensing channels for sensing atrial and ventricular depolarizations (R waves);

a ventricular pacing channel for delivering ventricular pacing pulses;

an atrial defibrillation pulse generator and electrodes disposed in proximity to the atrium; and

a controller for detecting atrial fibrillation and for controlling delivery of atrial defibrillation shocks and ventricular pacing pulses, wherein, upon detection of atrial fibrillation, the controller is configured to;

deliver a first ventricular pacing pulse after a sensed R wave; and

deliver an atrial defibrillation shock without an accompanying second ventricular pacing pulse at a specified time after the first ventricular pacing pulse but inhibit the atrial defibrillation shock if an R wave subsequent to the first ventricular pacing pulse occurs before the specified time.

9. The apparatus of claim 8 wherein the specified time for delivering the atrial defibrillation shock is less than 800 milliseconds.

10. The apparatus of claim 8 wherein the specified time for delivering the atrial defibrillation shock is greater than 500 milliseconds and less than 800 milliseconds.

11. The apparatus of claim 8 wherein the controller is configured to deliver the first ventricular pacing pulse preceded by one or more additional ventricular pacing pulses delivered after the sensed R wave at a rate greater than the measured intrinsic rate.

12. The apparatus of claim 8 wherein the first ventricular pacing pulse is delivered after the sensed R wave at a rate above an intrinsic ventricular rate.