System and method for providing cardioversion therapy and overdrive pacing using an implantable cardiac stimulation device
First Claim
1. An implantable cardiac stimulation device for implant within a patient, wherein the device has a far-field overdrive pacing system and a near-field overdrive pacing system, a method for therapy comprising the steps of:
- delivering far-field overdrive pacing therapy for a predetermined, brief period of time using the far-field overdrive pacing system; and
delivering near-field overdrive therapy immediately following the far-field overdrive therapy for a period of time substantially greater than the predetermined, brief period of time using the near-field overdrive pacing system.
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Abstract
Techniques are provided for coordinating the delivery of cardioversion therapy and overdrive pacing therapy to the heart of a patient, primarily to prevent the re-occurrence of atrial fibrillation (AF) following a cardioversion shock. Included are techniques for modulating the aggressiveness of overdrive pacing by adjusting the magnitude of overdrive pulses or by changing the electrodes with which overdrive pacing pulses are generated. In one example, three phases or “tiers” of AF suppression therapy are provided: cardioversion therapy; far-field dynamic atrial overdrive (DAO) pacing; and near-field DAO pacing. Briefly, a cardioversion shock is delivered to the heart of the patient in response to the detection of AF, then smoothed, far-field overdrive pacing pulses are delivered using widely-spaced electrodes for a period of two minutes while the magnitude of the pulses is gradually reduced. Finally, near-field overdrive pacing pulses are delivered more or les continuously until another episode of AF is detected.
57 Citations
15 Claims
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1. An implantable cardiac stimulation device for implant within a patient, wherein the device has a far-field overdrive pacing system and a near-field overdrive pacing system, a method for therapy comprising the steps of:
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delivering far-field overdrive pacing therapy for a predetermined, brief period of time using the far-field overdrive pacing system; and delivering near-field overdrive therapy immediately following the far-field overdrive therapy for a period of time substantially greater than the predetermined, brief period of time using the near-field overdrive pacing system. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. An implantable cardiac stimulation device for implant within a patient, wherein the device has a far-field overdrive pacing system and a near-field overdrive pacing system, a method for therapy comprising the steps of:
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delivering far-field overdrive pacing therapy using the far-field overdrive pacing system for a predetermined, brief period of time wherein each far-field pulse is smoothed and wherein the magnitude of the far-field pulses is gradually reduced; and delivering near-field overdrive therapy immediately following the far-field overdrive therapy for a period of time substantially greater than the predetermined, brief period of time using the near-field overdrive pacing system.
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13. An implantable cardiac stimulation device for implant within a patient, a system comprising:
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a far-field overdrive pacing system; a near-field overdrive pacing system; and a control system operative to output far-field overdrive pacing for a predetermined, brief period of time, and output near-field overdrive pacing immediately following the far-field overdrive pacing for a period of time substantially greater than the predetermined, brief period of time.
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14. An implantable cardiac stimulation device for implant within a patient, a system comprising:
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a far-field overdrive pacing system; a near-field overdrive pacing system; a pulse smoothing system; a pulse magnitude tapering system; and a control system operative to control the far-field system, the pulse smoothing system and the pulse magnitude tapering system to deliver smoothed, tapered overdrive pacing pulses to the patient during a brief, first overdrive phase and then to control the near-field system to deliver overdrive therapy during a second overdrive phase that immediately follows the first overdrive phase and that is substantially longer than the first overdrive phase.
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15. An implantable cardiac stimulation device for implant within a patient, a system comprising:
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means for delivering far-field dynamic atrial overdrive (DAO) pacing therapy for a predetermined, brief period of time; and means for delivering near-field DAO therapy immediately following the far-field overdrive therapy for a period of time substantially greater than the predetermined, brief period of time.
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Specification