Method and apparatus for detection and treatment of tachycardia and fibrillation
First Claim
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1. Apparatus for treating tachyarrhythmias, comprising:
- means for delivering a first therapy to a patient'"'"'s heart to treat tachycardia and a second therapy to said patient'"'"'s heart to treat fibrillation;
means for sensing an electrical signal from said patient'"'"'s heart indicative of a depolarization of a chamber or chambers of said patient'"'"'s heart;
means for measuring a time interval between depolarizations;
means for storing the measured depolarization intervals;
means for detecting an occurrence of a tachyarrhythmia based upon the measured depolarization intervals; and
means responsive to the detection of an occurrence of a tachyarrhythmia for discriminating between tachycardia and fibrillation and for selecting between said first and second therapies;
said discrimination and therapy selection means including;
(i) means for sorting a predetermined number of the measured depolarization intervals into a plurality of interval range bins;
(ii) means for determining the number of measured depolarization intervals within each of the interval range bins;
(iii) means for defining a discrimination criterion based on determining whether designated ones of the plurality of interval range bins have at least a predetermined threshold number of measured depolarization intervals within them, wherein the threshold number is set as a value which decreases as a function of the length of the intervals between depolarizations; and
(iv) means for triggering delivery of the first therapy if the discrimination criterion is met and for triggering delivery of the second therapy if the discrimination criterion is not met.
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Abstract
The invention relates to devices that detect and/or treat tachyarrhythmias. The invention includes software systems that distinguish among various tachyarrhythmias in order to provide treatment for specific tachyarrhythmias. One aspect of the invention employs a methodology to provisionally detect ventricular tachycardia and/or fibrillation and thereafter apply a discrimination function to a series of measured intervals preceding the provisional detection. Discrimination is accomplished by sorting the intervals preceding provisional detection into bins corresponding to interval ranges and examining the relative distribution of the intervals within the bins.
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Citations
8 Claims
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1. Apparatus for treating tachyarrhythmias, comprising:
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means for delivering a first therapy to a patient'"'"'s heart to treat tachycardia and a second therapy to said patient'"'"'s heart to treat fibrillation;
means for sensing an electrical signal from said patient'"'"'s heart indicative of a depolarization of a chamber or chambers of said patient'"'"'s heart;
means for measuring a time interval between depolarizations;
means for storing the measured depolarization intervals;
means for detecting an occurrence of a tachyarrhythmia based upon the measured depolarization intervals; and
means responsive to the detection of an occurrence of a tachyarrhythmia for discriminating between tachycardia and fibrillation and for selecting between said first and second therapies;
said discrimination and therapy selection means including;
(i) means for sorting a predetermined number of the measured depolarization intervals into a plurality of interval range bins;
(ii) means for determining the number of measured depolarization intervals within each of the interval range bins;
(iii) means for defining a discrimination criterion based on determining whether designated ones of the plurality of interval range bins have at least a predetermined threshold number of measured depolarization intervals within them, wherein the threshold number is set as a value which decreases as a function of the length of the intervals between depolarizations; and
(iv) means for triggering delivery of the first therapy if the discrimination criterion is met and for triggering delivery of the second therapy if the discrimination criterion is not met. - View Dependent Claims (2, 3, 4, 5, 6)
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7. Apparatus for treating tachyarrhythmias, comprising:
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means for delivering a first therapy to a patient'"'"'s heart to treat tachycardia and a second therapy to said patient'"'"'s heart to treat fibrillation;
means for sensing an electrical signal from said patient'"'"'s heart indicative of a depolarization of a chamber or chambers of said patient'"'"'s heart;
means for measuring a time interval between depolarizations;
means for storing the measured depolarization intervals;
means for detecting an occurrence of a tachyarrhythmia based upon the measured depolarization intervals; and
means responsive to the detection of an occurrence of a tachyarrhythmia for discriminating between tachycardia and fibrillation and for selecting between said first and second therapies;
said discrimination and therapy selection means including;
(i) means for sorting a predetermined number of the measured depolarization intervals into a plurality of interval range bins;
(ii) means for determining the number of measured depolarization intervals within each of the interval range bins;
(iii) means for defining a discrimination criterion based on determining whether designated ones of the plurality of interval range bins have at least a predetermined threshold number of measured depolarization intervals within them, wherein the threshold number is set as a value which increases as an inverse function of a defined percentile of the length of intervals over a sequence of a predetermined number of intervals between depolarization; and
(iv) means for triggering delivery of the first therapy if the discrimination criterion is met and for triggering delivery of the second therapy if the discrimination criterion is not met.
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8. Apparatus for treating tachyarrhythmias, comprising:
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means for delivering a first therapy to a patient'"'"'s heart to treat tachycardia and a second therapy to said patient'"'"'s heart to treat fibrillation;
means for sensing an electrical signal from said patient'"'"'s heart indicative of a depolarization of a chamber or chambers of said patient'"'"'s heart;
means for measuring a time interval between depolarizations;
means for storing the measured depolarization intervals;
means for detecting an occurrence of a tachyarrhythmia based upon the measured depolarization intervals; and
means responsive to the detection of an occurrence of a tachyarrhythmia for discriminating between tachycardia and fibrillation and for selecting between said first and second therapies;
said discrimination and therapy selection means including;
(i) means for sorting a predetermined number of the measured depolarization intervals into a plurality of interval range bins;
(ii) means for determining the number of measured depolarization intervals within each of the interval range bins;
(iii) means for defining a discrimination criterion based on determining whether designated ones of the plurality of interval range bins have at least a predetermined threshold number of measured depolarization intervals within them, wherein the threshold number is set as a value which increases as an inverse function of the 75th percentile of the length of intervals over a sequence of a predetermined number of intervals between depolarizations; and
(iv) means for triggering delivery of the first therapy if the discrimination criterion is met and for triggering delivery of the second therapy if the discrimination criterion is not met.
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Specification