Apparatus and method for multi-site anti-tachycardia pacing
First Claim
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1. A method for operating a cardiac rhythm management device, comprising:
- detecting senses from multiple ventricular sites, where a sense corresponds to an intrinsic depolarization occurring at the site;
detecting a ventricular tachycardia when a time interval between successive senses detected from one of the sites meets a specified rate criterion;
pacing one of the sites designated as the primary anti-tachycardia pacing (ATP) site with an anti-tachycardia pacing sequence in accordance with an ATP protocol when a ventricular tachycardia is detected, wherein the sequence is delivered at a selected coupling interval with respect to detection of a sense at the primary ATP site;
pacing one or more of the other sites, designated as secondary ATP sites, at a selected ATP offset interval with respect to a pace delivered to the primary ATP site in the anti-tachycardia pacing sequence; and
, reverting to a ventricular resynchronization paging mode when the ventricular tachycardia is terminated, wherein in the resynchronization mode one of the sites is designated as the rate site and paced with a bradycardia pacing mode and one or more of the other sites are paced at specified resynchronization offset intervals with respect to paces delivered to the rate site.
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Abstract
An apparatus and method for treating ventricular tachycardia in which paces are delivered to the ventricles at multiple pacing sites in accordance with an anti-tachycardia pacing protocol. Paces are delivered at a selected offset interval in a manner that both resynchronizes ventricular contractions and increases the probability of terminating the tachycardia.
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Citations
18 Claims
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1. A method for operating a cardiac rhythm management device, comprising:
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detecting senses from multiple ventricular sites, where a sense corresponds to an intrinsic depolarization occurring at the site;
detecting a ventricular tachycardia when a time interval between successive senses detected from one of the sites meets a specified rate criterion;
pacing one of the sites designated as the primary anti-tachycardia pacing (ATP) site with an anti-tachycardia pacing sequence in accordance with an ATP protocol when a ventricular tachycardia is detected, wherein the sequence is delivered at a selected coupling interval with respect to detection of a sense at the primary ATP site;
pacing one or more of the other sites, designated as secondary ATP sites, at a selected ATP offset interval with respect to a pace delivered to the primary ATP site in the anti-tachycardia pacing sequence; and
,reverting to a ventricular resynchronization paging mode when the ventricular tachycardia is terminated, wherein in the resynchronization mode one of the sites is designated as the rate site and paced with a bradycardia pacing mode and one or more of the other sites are paced at specified resynchronization offset intervals with respect to paces delivered to the rate site. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A cardiac rhythm management device, comprising:
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sensing channels for detecting senses from multiple ventricular sites, where a sense corresponds to an intrinsic depolarization occurring at the site;
pacing channels for delivering paces to the multiple ventricular sites;
a controller for controlling the delivery of paces in accordance with a programmed pacing mode; and
,wherein the controller is programmed to;
detect a ventricular tachycardia when a time interval between successive senses at a site meets a specified rate criterion;
pace one of the sites designated as the primary ATP site with an anti-tachycardia pacing sequence in accordance with an anti-tachycardia pacing protocol when a ventricular tachycardia is detected, wherein the sequence is delivered at a selected coupling interval with respect to detection of a sense at the primary ATP site;
pace one or more of the other sites, designated as secondary ATP sites, at a selected ATP offset interval with respect to a pace delivered to the primary ATP site in the anti-tachycardia pacing sequence; and
,revert to a ventricular resynchronization pacing mode when the ventricular tachycardia is terminated, wherein in the resynchronization mode one of the sites is designated as the rate site and paced with a bradycardia pacing mode and one more of the other sites are paced at specified resynchronization offset intervals with respect to paces delivered to the rate site. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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Specification