Arrhythmia discrimination

• US 7,139,607 B1
• Filed: 06/11/2003
• Issued: 11/21/2006
• Est. Priority Date: 06/12/2002
• Status: Expired due to Fees

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Shelchuk, Anne M.
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US10/460,597
• Time in Patent Office: 1,259 Days
• Field of Search: 607/4, 607/9, 607/14, 607/17, 607/25
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

Various exemplary methods include altering conduction and/or operation of the AV node and/or AV bundle to help classify arrhythmias.

Claims

1. A method comprising:

detecting a first ventricular rate;

stimulating a parasympathetic nerve associated with the atrio-ventricular node, wherein the stimulating occurs postinspiration only;

detecting a second ventricular rate; and

classifying the first ventricular rate based on the first ventricular rate and the second ventricular rate.

2. The method of claim 1, wherein the stimulating includes initiating the stimulating based on a cardiac event.

3. The method of claim 2, wherein the cardiac event comprises an R wave.

4. The method of claim 1, wherein the stimulating includes stimulating at a site selected from one or more sites of the group consisting of superior vena cava, inferior vena cava, and coronary sinus.

5. The method of claim 1, further comprising determining whether the first ventricular rate is abnormal prior to the stimulating.

6. The method of claim 1, further comprising applying antiarrhythmia therapy in response to the classifying.

7. The method of claim 1, wherein the classifying includes classifying the first ventricular rate as characteristic of a supraventricular arrhythmia if the first ventricular rate is greater than the second ventricular rate.

8. The method of claim 1, wherein the classifying includes classifying the first ventricular rate as characteristic of a ventricular arrhythmia if the first ventricular rate is equal to or less than the second ventricular rate.

9. A method comprising:

detecting a first ventricular rate;

stimulating a parasympathetic nerve associated with the atrio-ventricular node;

detecting a second ventricular rate; and

classifying the first ventricular rate based on the first ventricular rate and the second ventricular rate; and

wherein the stimulating includes stimulating at a site proximate to an epicardial plexus or subplexus.

10. A method comprising:

stimulating a parasympathetic nerve associated with the atrio-ventricular node to thereby decrease conduction of the atrio-ventricular node;

detecting a ventricular rate;

repeating the stimulating and the detecting until the ventricular rate decreases; and

classifying the cardiac activity as characteristic of a supraventricular arrhythmia.

11. The method of claim 10, wherein the stimulating includes stimulating the parasympathetic nerve postinspiration only.

12. The method of claim 10, wherein the stimulating includes initiating the stimulating based on a cardiac event.

13. A method comprising:

detecting a first ventricular rate;

delivering stimulation at a first site in an effort to decrease AV nodal conduction;

detecting a second ventricular rate; and

if the first ventricular rate exceeds the second ventricular rate, classifying the first ventricular rate as characteristic of a supraventricular arrhythmia;

otherwise, delivering stimulation at a second site in an effort to decrease AV nodal conduction.

14. The method of claim 13, further comprising applying antiarrhythmia therapy in response to the classifying.

15. The method of claim 13, wherein the delivering includes delivering stimulation to one or more parasympathetic nerves.

16. The method of claim 13, wherein the delivering includes delivering a stimulation pulse to the AV node.

17. The method of claim 13, wherein the stimulating includes stimulating the parasympathetic nerve postinspiration only.

18. The method of claim 13, wherein the stimulating includes initiating the stimulating based on a cardiac event.

19. An apparatus comprising:

means for detecting a first ventricular rate;

means for decreasing conduction of the atrio-ventricular node by stimulating a parasympathetic nerve associated with the atrioventricular node at a site proximate to an epicardial plexus or subplexus;

means for detecting a second ventricular rate; and

means for classifying the first ventricular rate based on the first ventricular rate and the second ventricular rate.