Cross chamber interval correlation
First Claim
1. A system for determining a direction of conduction of an arrhythmia episode between a first cardiac region and a second cardiac region, the system comprising:
- a first electrode to sense a first signal indicative of first contractions in the first cardiac region;
a second electrode to sense a second signal indicative of second contractions in the second cardiac region;
a first contraction detector circuit, coupled to the first electrode, to detect the first contractions;
a second contraction detector circuit, coupled to the second electrode, to detect the second contractions;
a cardiac data analyzing circuit coupled to the first contraction detector circuit and the second contraction detector circuit, the cardiac data analyzing circuit adapted to;
determine first cycle lengths each being a time interval between two successively sensed first contractions;
determine second cycle lengths each being a time interval between two successively sensed second contractions; and
analyze the first and second contractions to determine an occurrence of an arrhythmia episode having a one-to-one association of the first contractions to the second contractions;
a cycle length pairing circuit coupled to the cardiac data analyzing circuit, the cycle length pairing circuit adapted to pair the first cycle lengths with the second cycle lengths in first and second directions during the arrhythmia episode having the one-to-one association of the first contractions to the second contractions, the first direction corresponding to a direction of conduction of the arrhythmia episode from the first cardiac region to the second cardiac region, the second direction corresponding to a direction of conduction of the arrhythmia episode from the second cardiac region to the first cardiac region; and
a processor coupled to the cycle length pairing circuit, the processor adapted to;
determine correlation coefficients each for the first cycle lengths paired with the second cycle lengths in one of the first and second directions; and
determine the direction of the conduction of the arrhythmia episode based on the correlation coefficients.
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Abstract
A system and method for discriminating cardiac rhythms occurring in an antegrade direction from cardiac rhythms occurring in a retrograde direction. Atrial and ventricular contractions are sensed, from which atrial and ventricular cycle lengths are determined. Ventricular contractions are also analyzed to determine the occurrence of a tachycardia episode that has a one-to-one association of atrial contractions to ventricular contractions. During a tachycardia episode having a one-to-one association of atrial contractions to ventricular contractions, the atrial cycle lengths are paired with the ventricular cycle lengths, where for each of the atrial cycle lengths the atrial cycle length is paired with at least one ventricular cycle length started before the first atrial contraction of each of the atrial cycle lengths and paired with at least one ventricular cycle length started after the first atrial contraction of each of the atrial cycle lengths. A retrograde correlation coefficient is then determined for the atrial cycle lengths paired with the ventricular cycle lengths started before the first atrial contraction, and an antegrade correlation coefficient is determined for the atrial cycle lengths paired with the ventricular cycle lengths started after the first atrial contraction. The tachycardiac episode is then classified based on a comparison of the antegrade correlation coefficient and the retrograde correlation coefficient.
107 Citations
34 Claims
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1. A system for determining a direction of conduction of an arrhythmia episode between a first cardiac region and a second cardiac region, the system comprising:
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a first electrode to sense a first signal indicative of first contractions in the first cardiac region;
a second electrode to sense a second signal indicative of second contractions in the second cardiac region;
a first contraction detector circuit, coupled to the first electrode, to detect the first contractions;
a second contraction detector circuit, coupled to the second electrode, to detect the second contractions;
a cardiac data analyzing circuit coupled to the first contraction detector circuit and the second contraction detector circuit, the cardiac data analyzing circuit adapted to;
determine first cycle lengths each being a time interval between two successively sensed first contractions;
determine second cycle lengths each being a time interval between two successively sensed second contractions; and
analyze the first and second contractions to determine an occurrence of an arrhythmia episode having a one-to-one association of the first contractions to the second contractions;
a cycle length pairing circuit coupled to the cardiac data analyzing circuit, the cycle length pairing circuit adapted to pair the first cycle lengths with the second cycle lengths in first and second directions during the arrhythmia episode having the one-to-one association of the first contractions to the second contractions, the first direction corresponding to a direction of conduction of the arrhythmia episode from the first cardiac region to the second cardiac region, the second direction corresponding to a direction of conduction of the arrhythmia episode from the second cardiac region to the first cardiac region; and
a processor coupled to the cycle length pairing circuit, the processor adapted to;
determine correlation coefficients each for the first cycle lengths paired with the second cycle lengths in one of the first and second directions; and
determine the direction of the conduction of the arrhythmia episode based on the correlation coefficients. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method for determining a direction of conduction of an arrhythmia episode between a first cardiac region and a second cardiac region, the method comprising:
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sensing first contractions from the first cardiac region and second contractions from the second cardiac region;
determining first cycle lengths from the first contractions;
determining second cycle lengths from the second contractions;
analyzing the first and second contractions for an occurrence of an arrhythmia episode that has a one-to-one association of the first contractions to the second contractions;
analyzing correlations between the first cycle lengths and the second cycle lengths during the arrhythmia episode; and
determining the direction of the conduction of the arrhythmia episode based on the correlations. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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25. A method, comprising:
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sensing atrial contractions and ventricular contractions;
determining atrial cycle lengths each being a time interval between a sensed first atrial contraction and a successively sensed second atrial contraction;
determining ventricular cycle lengths each being a time interval between a sensed first ventricular contraction and a successively sensed second ventricular contraction;
analyzing the atrial contractions and ventricular contractions for an occurrence of a tachycardia episode having an one-to-one association of atrial contractions to ventricular contractions;
determining atrial timing difference values each between a first atrial cycle length and a succeeding second atrial cycle length during the tachycardia episode;
determining ventricular timing difference values each between a first ventricular cycle length and a succeeding second ventricular cycle length during the tachycardia episode; and
analyzing correlations between the atrial timing difference and the ventricular timing difference during the tachycardia episode; and
classifying the tachycardia episode based on the correlations. - View Dependent Claims (26, 27, 28, 29, 30, 31)
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32. A system, comprising:
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means for determining atrial cycle lengths each being a time interval between two successively sensed atrial contractions and determining ventricular cycle lengths each being a time interval between two successively sensed ventricular contractions;
means for detecting an occurrence of a tachycardia episode having an one-to-one association of the atrial contractions to the ventricular contractions;
means for analyzing correlations between the atrial cycle lengths and the ventricular cycle lengths during the tachycardia episode, the means for analyzing the correlations including;
means for pairing the atrial cycle lengths with the ventricular cycle lengths in an antegrade direction and pairing the atrial cycle lengths with the ventricular cycle lengths in a retrograde direction; and
means for determining an antegrade correlation coefficient for the atrial cycle lengths paired with the ventricular cycle lengths in the antegrade direction and determining a retrograde correlation coefficient for the atrial cycle lengths paired with the ventricular cycle lengths in the retrograde direction. - View Dependent Claims (33, 34)
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Specification