Dynamic discrimination utilizing anti-tachy pacing therapy in an implantable medical device

• US 7,317,942 B2
• Filed: 05/05/2004
• Issued: 01/08/2008
• Est. Priority Date: 05/05/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Brown, Mark L.
• Primary Examiner(s): Layno; Carl
• Assistant Examiner(s): JOHNSON, SHEVON ELIZABETH
• Application Number:
  US10/839,634
• Publication Number:
  US 20050251217A1
• Time in Patent Office: 1,343 Days
• Field of Search: 607/4, 607/9, 607/14, 607/15
• US Class Current: 607/14
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A method and medical device for discriminating an arrhythmia that includes an input circuit sensing cardiac signals and a microprocessor identifying an event associated with the sensed cardiac signals as a first arrhythmia event. A first circuit delivers a first therapy, substantially simultaneous with coupling of a charging circuit and an energy storage device to generate stored energy on the energy storage device, in response to the first arrhythmia event, and a control circuit controls delivery of the first therapy by the first circuit. The microprocessor evaluates a physiologic response to the delivered first therapy and determines the event is other than the first arrhythmia event in response to the evaluated physiologic response.

Claims

1. A medical device for discriminating arrhythmia events, comprising:

an input circuit sensing cardiac signals;

a microprocessor identifying an event associated with the sensed cardiac signals as a first arrhythmia event;

a first circuit delivering a first therapy, substantially simultaneous with coupling of a charging circuit and an energy storage device to generate stored energy on the energy storage device, in response to the first arrhythmia event; and

a control circuit controlling delivery of the first therapy by the first circuit, wherein the microprocessor evaluates a physiologic response to the delivered first therapy and determines the event is other than the first arrhythmia event in response to the evaluated physiologic response, wherein the microprocessor determines whether an interval pattern during the first arrhythmia event corresponds to a predetermined pattern, and determines whether a difference between a cycle length corresponding to sensed cardiac signals during the first arrhythmia event prior to delivery of the first therapy and a cycle length corresponding to sensed cardiac signals during delivery of the first therapy is less than or equal to a predetermined threshold.

2. The device of claim 1, wherein the predetermined pattern corresponds to one of a 1:

1 atrioventricular pattern that is supraventricular in origin, a 1;

1 atrioventricular pattern that is ventricular in origin, a greater than 1;

1 atrioventricular pattern that is supraventricular in origin, and a greater than 1;

1 atrioventricular pattern that is simultaneous supraventricular and ventricular in origin.

3. A medical device for discriminating arrhythmia events, comprising:

an input circuit sensing cardiac signals;

a microprocessor identifying an event associated with the sensed cardiac signals as a first arrhythmia event;

a first circuit delivering a first therapy;

a second circuit for delivering a second therapy, the second circuit including an energy storage device to store energy associated with the second therapy and a charging circuit selectively coupled to the energy storage device to generate the stored energy; and

a control circuit controlling the first circuit and the second circuit to deliver the first therapy substantially simultaneous with coupling of the charging circuit and the energy storage device in response to the first arrhythmia event, wherein the microprocessor evaluates a physiologic response to the delivered first therapy and determines the event is other than the first arrhythmia event in response to the evaluated physiologic response and the control circuit decouples the charging circuit and the energy storage device in response to the event being other than the first arrhythmia event, wherein the microprocessor determines whether an interval pattern during the first arrhythmia event corresponds to a predetermined pattern, and determines whether a difference between a cycle length corresponding to sensed cardiac signals during the first arrhythmia event prior to delivery of the first therapy and a cycle length corresponding to sensed cardiac signals during delivery of the first therapy is less than or equal to a predetermined threshold.

4. The device of claim 3, wherein the predetermined pattern corresponds to one of a 1:

1 atrioventricular pattern that is supraventricular in origin, a 1;

1 atrioventricular pattern that is ventricular in origin, a greater than 1;

1 atrioventricular pattern that is supraventricular in origin, and a greater than 1;

1 atrioventricular pattern that is simultaneous supraventricular and ventricular in origin.

5. A method for discriminating arrhythmia events, comprising:

sensing cardiac signals;

identifying an event associated with the sensed cardiac signals as a first arrhythmia event;

delivering a first therapy, substantially simultaneous with coupling of a charging circuit and an energy storage device to generate stored energy on the energy storage device, in response to the first arrhythmia event;

evaluating a physiologic response to the delivered first therapy; and

determining the event is other than the first arrhythmia event in response to the evaluated physiologic response, wherein evaluating a physiologic response comprises;

determining whether an interval pattern during the first arrhythmia event corresponds to a predetermined pattern; and

determining whether a difference between cycle length corresponding to sensed cardiac signals during the first arrhythmia event prior to delivery of the first therapy and a cycle length corresponding to sensed cardiac signals during delivery of the first therapy is less than or equal to a predetermined threshold.

6. The method of claim 5, wherein the predetermined pattern corresponds to one of a 1:

1 atrioventricular pattern that is supraventricular in origin, a 1;

1 atrioventricular pattern that is ventricular in origin, a greater than 1;

1 atrioventricular pattern that is supraventricular in origin, and a greater than 1;

1 atrioventricular pattern that is simultaneous supraventricular and ventricular in origin.

7. A computer readable medium having computer executable instructions for performing a method comprising:

sensing cardiac signals;

identifying an event associated with the sensed cardiac signals as a first arrhythmia event;

delivering a first therapy, substantially simultaneous with coupling of a charging circuit and an energy storage device to generate stored energy on the energy storage device, in response to the first arrhythmia event;

evaluating a physiologic response to the delivered first therapy; and

determining the event is other than the first arrhythmia event in response to the evaluated physiologic response, wherein evaluating a physiologic response comprises;

determining whether an interval pattern during the first arrhythmia event corresponds to a predetermined pattern; and

determining whether a difference between cycle length corresponding to sensed cardiac signals during the first arrhythmia event prior to delivery of the first therapy and a cycle length corresponding to sensed cardiac signals during delivery of the first therapy is less than or equal to a predetermined threshold.

8. A medical device system for discriminating arrhythmia events, comprising:

means for sensing cardiac signals;

means for identifying an event associated with the sensed cardiac signals as a first arrhythmia event;

means for delivering a first therapy, substantially simultaneous with coupling of a charging circuit and an enemy storage device to generate stored energy on the energy storage device, in response to the first arrhythmia event;

means for evaluating a physiologic response to the delivered first therapy; and

means for determining the event is other than the first arrhythmia event in response to the evaluated physiologic response, wherein means for evaluating a physiologic response comprises;

means for determining whether an interval pattern during the first arrhythmia event corresponds to a predetermined pattern; and

means for determining whether a difference between cycle length corresponding to sensed cardiac signals during the first arrhythmia event prior to delivery of the first therapy and a cycle length corresponding to sensed cardiac signals during delivery of the first therapy is less than or equal to a predetermined threshold.

9. The medical device system of claim 8, wherein the predetermined pattern corresponds to one of a 1:

1 atrioventricular pattern that is supraventricular in origin, a 1;

1 atrioventricular pattern that is ventricular in origin, a greater than 1;

1 atrioventricular pattern that is supraventricular in origin, and a greater than 1;

1 atrioventricular pattern that is simultaneous supraventricular and ventricular in origin.