Method and apparatus for treating irregular ventricular contractions such as during atrial arrhythmia
First Claim
1. A method, including:
- obtaining V—
V intervals between ventricular beats;
computing a first indicated pacing interval, for both a most recent V—
V interval concluded by a paced beat and for a most recent V—
V interval concluded by a sensed beat, by summing a first addend that includes a most recent V—
V interval duration with a second addend that includes a stored previously-computed value of the first indicated pacing interval; and
providing pacing therapy, based on the first indicated pacing interval.
1 Assignment
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Accused Products
Abstract
A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V—V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable.
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Citations
91 Claims
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1. A method, including:
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obtaining V—
V intervals between ventricular beats;
computing a first indicated pacing interval, for both a most recent V—
V interval concluded by a paced beat and for a most recent V—
V interval concluded by a sensed beat, by summing a first addend that includes a most recent V—
V interval duration with a second addend that includes a stored previously-computed value of the first indicated pacing interval; and
providing pacing therapy, based on the first indicated pacing interval. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. A method, including:
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detecting an atrial tachyarrhythmia;
triggering a rate stabilization mode, when the atrial tachyarrhythmia is present, that includes computing a first indicated pacing interval value;
obtaining V—
V intervals between ventricular beats;
computing the first indicated pacing interval by summing a first addend that includes a most recent V—
V interval duration with a second addend that includes a previous value of the first indicated pacing interval; and
providing pacing therapy, based on the first indicated pacing interval, when the atrial tachyarrhythmia is present. - View Dependent Claims (29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54)
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55. A method of providing pacing therapy to a heart, the method including:
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detecting an atrial fibrillation;
obtaining V—
V intervals between ventricular beats;
computing a first indicated pacing interval (Tn) according to;
Tn=a·
w·
VVn+(1−
w)·
Tn-1, if VVn is concluded by an intrinsic beat, otherwise computing Tn according to Tn=b·
w·
VVn+(1−
w)·
Tn-1, if VVn is concluded by a paced beat, where a, b, and w are coefficients, VVn is a most recent V—
V interval duration, and Tn-1 is a previous value of the first indicated pacing interval; and
providing pacing therapy, based on the first indicated pacing interval, when the atrial fibrillation is present. - View Dependent Claims (56, 57)
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58. A cardiac rhythm management system, including:
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a ventricular sensing circuit for sensing ventricular beats;
a controller, obtaining V—
V intervals between ventricular beats and computing a first indicated pacing interval, for both a most recent V—
V interval concluded by a paced beat and for a most recent V—
V interval concluded by a sensed beat, by summing a first addend that includes a most recent V—
V interval duration with a second addend that includes a stored previously-computed value of the first indicated pacing interval; and
a ventricular therapy circuit, providing pacing therapy based on the first indicated pacing interval. - View Dependent Claims (59, 60, 61, 62)
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63. A cardiac rhythm management system, including:
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a ventricular sensing circuit;
a controller, the controller including;
a V—
V interval timer;
a first register, for storing a first indicated pacing interval; and
a filter, updating the first indicated pacing interval, for both a most recent V—
V interval concluded by a paced beat and for a most recent V—
V interval concluded by a sensed beat, by summing a first addend including the most recent V—
V interval stored in the V—
V interval timer with a second addend including the previously-computed stored value of first indicated pacing interval stored in the first register; and
a ventricular therapy circuit, providing pacing therapy based at least partially on the first indicated pacing interval. - View Dependent Claims (64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89)
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90. An implantable cardiac rhythm management device, including:
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a ventricular sensing circuit;
an atrial sensing circuit, for detecting an atrial tachyarrhythmia;
a sensor;
a controller, the controller including;
a V—
V interval timer;
a first register, for storing a first indicated pacing interval;
an infinite impulse response (IIR) filter that updates the first indicated pacing interval (Tn) according to;
Tn=A·
VVn+B·
Tn-1, if VVn is concluded by an intrinsic beat, otherwise is updated according to Tn=C·
VVn+D·
Tn-1, if VVn is concluded by a paced beat, where A, B, C and D are coefficients, and VVn is the V—
V interval duration provided by the V—
V interval timer, and Tn-1 is the previous value of the first indicated pacing interval;
a second register, for storing a second indicated pacing interval that is based on a signal received from the sensor; and
a selection module, selecting the shorter of the first and second indicated pacing intervals, when an atrial tachyarrhythmia is detected, to provide a selected indicated pacing interval, and selecting the second indicated pacing interval, when no atrial tachyarrhythmia is detected; and
a ventricular therapy circuit, providing pacing therapy based on the selected indicated pacing interval.
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91. A cardiac rhythm management system, including:
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a ventricular sensing circuit;
a controller, the controller including;
a V—
V interval timer;
a first register, for storing a first indicated pacing interval;
means for updating the first indicated pacing interval, for both a most recent V—
V interval concluded by a paced and for a most recent V—
V interval concluded by a sensed beat, by summing a first addend including a most recent V—
V interval duration with a second addend including a stored previously-computed value of the first indicated pacing interval; and
a ventricular therapy circuit, providing pacing therapy based at least partially on the first indicated pacing interval.
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Specification