Method and apparatus for using atrial discrimination algorithms to determine optimal pacing therapy and therapy timing
First Claim
1. A method for providing pacing therapy to a heart, comprising:
- establishing discrimination criteria for distinguishing at least two different types of supraventricular tachycardia having regular rapid supraventricular heart rates;
sensing activity of at least one atria of the heart to provide an atrial activity signal;
comparing at least one characteristic of the atrial activity signal to the discrimination criteria to identify one of the at least two different types of supraventricular tachycardia having regular rapid supraventricular heart rates; and
controlling pacing of the heart to provide atrial antitachycardia pacing in response to an identified first one of the at least two different types of supraventricular tachycardia and to provide ventricular pacing in response to an identified second one of the at least two different types of supraventricular tachycardia.
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Accused Products
Abstract
A system and method which employs atrial discrimination algorithms to distinguish between different atrial arrhythmias occurring in a patient for selecting an optimal pacing therapy corresponding to the type of arrhythmia identified. The invention may be implemented in a bradycardia pacemaker or other implantable cardiac device. In response to the detection of an atrial rate above the atrial tracking rate, discrimination criteria are applied to a detected atrial activity signal to distinguish between different types of supraventricular tachycardia, such as fast atrial flutter and other atrial flutter at a relatively slower rate, which may be occurring in the patient. The discrimination criteria may be, for example, rate-based or morphology based. The pacer is controlled to provide pacing therapy to a heart in a manner corresponding to the type of supraventricular tachycardia identified. For example, antitachycardia pacing may be provided to the heart in response to the detection of a relatively lower rate supraventricular tachycardia/other atrial flutter, whereas another pacing control, e.g., ventricular pacing, such as ventricular rate regulation or Rate Smoothing, may be applied if a more rapid rate supraventricular tachycardia/fast atrial flutter is identified. The output of an atrial discrimination algorithm may be tracked and the trend thereof used to improve therapy timing.
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Citations
37 Claims
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1. A method for providing pacing therapy to a heart, comprising:
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establishing discrimination criteria for distinguishing at least two different types of supraventricular tachycardia having regular rapid supraventricular heart rates;
sensing activity of at least one atria of the heart to provide an atrial activity signal;
comparing at least one characteristic of the atrial activity signal to the discrimination criteria to identify one of the at least two different types of supraventricular tachycardia having regular rapid supraventricular heart rates; and
controlling pacing of the heart to provide atrial antitachycardia pacing in response to an identified first one of the at least two different types of supraventricular tachycardia and to provide ventricular pacing in response to an identified second one of the at least two different types of supraventricular tachycardia. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method for providing pacing therapy to a heart, comprising:
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establishing discrimination criteria for distinguishing between regular rapid supraventricular heart rates, the regular rapid supraventricular heart rates including fast atrial flutter and a slower rate supraventricular tachycardia;
sensing activity of at least one atria of the heart to provide an atrial activity signal;
comparing at least one characteristic of the atrial activity signal to the discrimination criteria to identify whether a sensed regular rapid supraventricular heart rate is a fast atrial flutter of a slower rate supraventricular tachycardia; and
controlling pacing of the heart to provide atrial antitachycardia pacing if a slower rate supraventricular tachycardia is identified as occurring and to provide ventricular pacing if a fast atrial flutter is identified as occurring. - View Dependent Claims (12, 13, 14, 15, 16, 17)
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18. A cardiac pacing device, comprising:
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sensing means for sensing activity of at least one atrium of a heart;
signal detection means coupled to the sensing means for generating an atrial activity signal based on the sensed activity of the at least one a atrium of the heart;
a pacer for providing pacing pulses to the heart; and
a processor coupled to the signal detection means for receiving the atrial activity signal and to the pacer for comparing at least one characteristic of the atrial activity signal to discrimination criteria for distinguishing at least two different types of regular rapid heart rates to identify a type of regular supraventricular tachycardia occurring and for controlling the pacer to provide an atrial antitachycardia pacing therapy to the heart for a first type of regular supraventricular tachycardia and a ventricular pacing therapy to the heart for a second type of regular supraventricular tachycardia. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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29. A cardiac pacing device, comprising:
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sensing means for sensing activity of at least one of the atria of a heart;
signal detection means coupled to the sensing means for generating an atrial activity signal based on the sensed activity of the heart;
a pacer for providing pacing pulses to the heart; and
a processor coupled to the signal detection means for receiving the atrial activity signal and to the pacer for comparing at least one characteristic of the atrial activity signal to discrimination criteria for distinguishing between regular rapid supraventricular heart rates, including distinguishing between fast atrial flutter and a slower rate supraventricular tachycardia to identify whether a fast atrial flutter or a slower rate supraventricular tachycardia is occurring and for controlling the pacer to provide atrial antitachycardia pacing to the heart if a slower rate supraventricular tachycardia is identified as occurring and to provide ventricular pacing if a fast atrial flutter is identified as occurring. - View Dependent Claims (30, 31, 32, 33, 34, 35, 36)
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37. A cardiac pacing device, comprising:
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at least one sensor to sense atrial activity of a heart;
a signal detector connected to the at least one sensor to generate an activity signal based on the sensed atrial activity of the heart;
a pacer for providing pacing pulses to the heart; and
a processor coupled to the signal detector to receive the atrial activity signal and coupled to the pacer to compare at least one characteristic of the atrial activity signal to discrimination criteria for distinguishing between regular rapid supraventricular heart rates, including distinguishing between fast atrial flutter and a slower rate supraventricular tachycardia to identify whether a fast atrial flutter or a slower rate supraventricular tachycardia is occurring and for controlling the pacer to provide atrial antitachycardia pacing to the heart for an identified slower rate supraventricular tachycardia and to provide ventricular pacing for an identified fast atrial flutter.
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Specification