Atrial arrhythmia detection for an active implantable medical device
First Claim
1. An active implantable medical device for monitoring cardiac activity in a patient having means for detecting ventricular events, means for detecting atrial events, means for indicating a delivery of a ventricular stimulation pulse and a delivery of an atrial stimulation pulse, means for inhibiting the atrial event detection means from detecting atrial events for a first post-ventricular atrial absolute refractory period in response to a detection of a ventricular event, the atrial event detecting means further comprising a sensitivity and a detection threshold and means for protecting against a detection of atrial signals not corresponding to an atrial event that has actually occurred;
- wherein the improvement comprises;
first means for temporarily raising the detection threshold of the atrial event detecting means by a first increment for a first length of time in response to the ventricular means detecting a ventricular event without the atrial detecting means detecting a preceding atrial event during the same cycle; and
second means for temporarily raising the detection threshold by a second increment for a second length of time in response to the ventricular detecting means detecting a ventricular event and the atrial detecting means detecting a preceding spontaneous atrial event during the same cycle.
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Accused Products
Abstract
Apparatus for detecting atrial arrhythmias in the treatment of disorders of the heartbeat rate in active implantable medical devices of the pacemaker, cardioverter, defribillator and/or multisite type. This device includes conventional systems, circuits and control algorithm for detecting spontaneous and stimulated ventricular events (R, V) and atrial events (P, A), indicating the delivery of a ventricular and/or atrial event, and inhibiting the detection of atrial events after detection of a ventricular event throughout a post-ventricular atrial absolute refractory period (PVAARP). Detecting atrial events includes protecting against the detection of atrial signals that do not correspond to an atrial event that has actually occurred, in particular protecting against atrial detection of far-field signals caused by a ventricular event. The protection operates by a dynamic adjustment of the sensitivity of detection by temporarily raising (t1, t2) a detection threshold (ΔS1, ΔS2) after detection of a ventricular event without detection of a preceding (spontaneous or stimulated) atrial event during the same cardiac cycle.
31 Citations
18 Claims
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1. An active implantable medical device for monitoring cardiac activity in a patient having means for detecting ventricular events, means for detecting atrial events, means for indicating a delivery of a ventricular stimulation pulse and a delivery of an atrial stimulation pulse, means for inhibiting the atrial event detection means from detecting atrial events for a first post-ventricular atrial absolute refractory period in response to a detection of a ventricular event, the atrial event detecting means further comprising a sensitivity and a detection threshold and means for protecting against a detection of atrial signals not corresponding to an atrial event that has actually occurred;
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wherein the improvement comprises; first means for temporarily raising the detection threshold of the atrial event detecting means by a first increment for a first length of time in response to the ventricular means detecting a ventricular event without the atrial detecting means detecting a preceding atrial event during the same cycle; and second means for temporarily raising the detection threshold by a second increment for a second length of time in response to the ventricular detecting means detecting a ventricular event and the atrial detecting means detecting a preceding spontaneous atrial event during the same cycle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. An apparatus for detecting cardiac activity in an active implantable medical device comprising:
- a system for monitoring electrical activity in an atrium and a ventricle of a patient including an atrial detection circuit to receive electrical signals from the atrium and convert the received signals to digital values, a ventricular detection circuit to receive electrical signals from a ventricle and convert the received signals to digital values, a controller having a microprocessor, a memory, and an algorithm to process the digital values and identify therefrom atrial events and ventricular events, including stimulated and detected events, and events corresponding to a same cardiac cycle;
said atrial detection circuit having a sensitivity and a corresponding detection threshold wherein electrical signals greater than said detection threshold correspond to an identified atrial event;
said algorithm including a post ventricular atrial absolute refractory period wherein said system operates to apply said post ventricular atrial absolute refractory period in response to an identified ventricular event to inhibit said atrial detection circuit from detecting atrium events during said period; and
means for dynamically adjusting the detection threshold by a first increment for a first length of time in response to an identified ventricular event without an identified atrial event preceding said identified ventricular event in said same cardiac cycle;wherein said dynamically adjusting means further comprises means for temporarily incrementing the detection threshold a second increment for a second length of time in response to an identified ventricular event and an identified detected atrial event preceding said ventricular event during a same cardiac cycle. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18)
- a system for monitoring electrical activity in an atrium and a ventricle of a patient including an atrial detection circuit to receive electrical signals from the atrium and convert the received signals to digital values, a ventricular detection circuit to receive electrical signals from a ventricle and convert the received signals to digital values, a controller having a microprocessor, a memory, and an algorithm to process the digital values and identify therefrom atrial events and ventricular events, including stimulated and detected events, and events corresponding to a same cardiac cycle;
Specification