Dual chamber method and apparatus for diagnosis and treatment of arrhythmias
First Claim
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1. An implantable medical device, comprising:
- means for sensing cardiac events;
means for applying interval only logic steps to determine cardiac rhythms in response to the sensed cardiac events;
means for combining morphology based considerations of the cardiac rhythms with the interval only logic steps to achieve improved specificity in arrhythmia detection of the apparatus without loss of sensitivity;
means for generating a VT (ventricular tachycardia) count; and
means for delivering therapy in response to the means for combining, wherein, in response to interval only logic steps corresponding to SVT (supraventricular tachycardia) rejection not being satisfied, the combining means determines whether the cardiac rhythms have a morphology that corresponds to sinus rhythm, therapy is delivered by the delivery means in response to the cardiac rhythms having a morphology that does not correspond to sinus rhythm and therapy is withheld by the delivery means in response to the cardiac rhythms having a morphology that corresponds to sinus rhythm, and wherein the generating means resets the VT count in response to the therapy being withheld by the delivery means in response to the cardiac rhythms having a morphology that corresponds to sinus rhythm.
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Abstract
A method and apparatus are provided for improving the detection of certain cardiac rhythms by combining dual chamber interval-related detection methods with electrogram morphology analysis. A prioritized set of rules are defined wherein each rule is directed at identifying a particular arrhythmia or type of arrhythmia. Each rule includes clauses that may be related to sensed event intervals and interval patterns and at least one rule includes at least one clause relating to the EGM morphology.
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Citations
18 Claims
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1. An implantable medical device, comprising:
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means for sensing cardiac events; means for applying interval only logic steps to determine cardiac rhythms in response to the sensed cardiac events; means for combining morphology based considerations of the cardiac rhythms with the interval only logic steps to achieve improved specificity in arrhythmia detection of the apparatus without loss of sensitivity; means for generating a VT (ventricular tachycardia) count; and means for delivering therapy in response to the means for combining, wherein, in response to interval only logic steps corresponding to SVT (supraventricular tachycardia) rejection not being satisfied, the combining means determines whether the cardiac rhythms have a morphology that corresponds to sinus rhythm, therapy is delivered by the delivery means in response to the cardiac rhythms having a morphology that does not correspond to sinus rhythm and therapy is withheld by the delivery means in response to the cardiac rhythms having a morphology that corresponds to sinus rhythm, and wherein the generating means resets the VT count in response to the therapy being withheld by the delivery means in response to the cardiac rhythms having a morphology that corresponds to sinus rhythm. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. An implantable medical device, comprising:
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means for sensing cardiac events; means for applying interval only logic steps to determine cardiac rhythms in response to the sensed cardiac events; means for combining morphology based considerations of the cardiac rhythms with the interval only logic steps to achieve improved specificity in arrhythmia detection of the apparatus without loss of sensitivity; and
means for delivering therapy in response to the means for combining, wherein combining means determines that morphology of the cardiac rhythms does not corresponds to sinus rhythm in response to a first predetermined number of beats out of a second predetermined number of beats being wide beats and the first predetermined number is one of 6, 7 and 8 and the second predetermined number is eight.
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12. An implantable medical device, comprising:
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means for sensing cardiac events; means for applying interval only logic steps to determine cardiac rhythms in response to the sensed cardiac events; means for combining interval only logic steps for determining whether the cardiac rhythms correspond to a double tachycardia and morphology of the cardiac rhythms to determine whether the cardiac rhythms correspond to a double tachycardia, combining interval only logic steps for sinus tachycardia or other 1;
1 SVT (supraventricular tachycardia) and morphology of the cardiac rhythms to determine whether VF/FVT/VT (ventricular fibrillation/fast ventricular tachycardia/ventricular tachycardia) with 1;
1 VA (ventricular atrial) is satisfied, and determining whether the cardiac rhythms have a morphology that corresponds to sinus rhythm and whether an RR interval is greater than or equal to a PP interval; andmeans for delivering therapy in response to the means for combining, wherein the morphology based considerations correspond to one of an EGM width corresponding to the cardiac rhythms and a wavelet transform corresponding to the cardiac rhythms, combining means determines that morphology of the cardiac rhythms does not corresponds to sinus rhythm in response to a first predetermined number of beats out of a second predetermined number of beats being wide beats, and the first predetermined number is one of 6, 7 and 8 and the second predetermined number is eight. - View Dependent Claims (13, 14, 15, 16, 17, 18)
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Specification