Delivery of CRT therapy during AT/AF termination
First Claim
1. A method for operating a cardiac rhythm management device, comprising:
- sensing atrial depolarizations through an implanted atrial electrode;
administering a sequential cardiac resynchronization therapy (CRT) pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion;
detecting an atrial arrhythmia in response to the sensed atrial depolarizations according to a first threshold for determination of atrial arrhythmia;
switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode in response to detecting the atrial arrhythmia according to the first threshold;
administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion; and
analyzing the sensed atrial depolarizations during the simultaneous CRT pacing therapy to confirm the presence of the detected atrial arrhythmia according to a second threshold for determination of the atrial arrhythmia, the second threshold higher than the first threshold.
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Abstract
In some embodiments, a method for operating a cardiac rhythm management device may include one or more of the following steps: (a) sensing atrial depolarizations through an implanted atrial electrode, (b) administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion, (c) switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode, (d) administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion, (e) analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia, (f) analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia, and (g) sensing ventricular depolarizations of the left and the right ventricle.
39 Citations
22 Claims
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1. A method for operating a cardiac rhythm management device, comprising:
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sensing atrial depolarizations through an implanted atrial electrode; administering a sequential cardiac resynchronization therapy (CRT) pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion; detecting an atrial arrhythmia in response to the sensed atrial depolarizations according to a first threshold for determination of atrial arrhythmia; switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode in response to detecting the atrial arrhythmia according to the first threshold; administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion; and analyzing the sensed atrial depolarizations during the simultaneous CRT pacing therapy to confirm the presence of the detected atrial arrhythmia according to a second threshold for determination of the atrial arrhythmia, the second threshold higher than the first threshold. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method for operating a cardiac rhythm management device, comprising:
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administering a sequential cardiac resynchronization therapy (CRT) pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion; detecting an atrial arrhythmia according to a first threshold for determination of atrial arrhythmia; switching from the sequential CRT pacing mode to a modified CRT pacing mode in response to the detected atrial arrhythmia; administering a modified CRT pacing therapy in the modified CRT pacing mode, the modified CRT pacing therapy being one of a simultaneous CRT pacing therapy and a single-sided pacing therapy, the simultaneous CRT pacing therapy being administered to the left and right ventricle in a simultaneous bi-ventricular fashion, the single-sided CRT pacing therapy being administered to one of the left and right ventricles; confirming the detected atrial arrhythmia according to a second threshold for determination of atrial arrhythmia during administration of the modified CRT therapy, the second threshold higher than the first threshold; and administering an atrial electrical stimulation therapy via an implanted atrial electrode to an atrium of the patient in the presence of an atrial arrhythmia. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. A system for operating a cardiac rhythm management device, comprising:
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means for sensing atrial depolarizations through an implanted atrial electrode; means for administering a sequential cardiac resynchronization therapy (CRT) pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion; means for detecting an atrial arrhythmia according to a first threshold for determination of atrial arrhythmia; means for switching from the sequential CRT pacing mode to a single-sided CRT pacing mode in response to the detected atrial arrhythmia; means for administering a single-sided CRT pacing therapy in the single-sided CRT pacing mode to one of the left and right ventricle; and means for analyzing the sensed atrial depolarizations during the single-sided CRT pacing therapy to confirm the presence of the detected atrial arrhythmia according to a second threshold for determination of the atrial arrhythmia, the second threshold higher than the first threshold. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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22. A method for operating a cardiac rhythm management device, comprising:
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sensing atrial depolarizations through an implanted atrial electrode; administering a sequential cardiac resynchronization therapy (CRT) pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion; detecting an atrial arrhythmia in response to the sensed atrial depolarizations according to a first threshold for determination of the atrial arrhythmia; switching from the sequential CRT pacing mode to a modified CRT pacing mode in response to detecting the atrial arrhythmia, the modified CRT pacing mode corresponding to a reduced total atrial blanking period; administering the modified CRT pacing therapy; and analyzing the sensed atrial depolarizations during the modified CRT pacing mode to confirm the presence of the detected atrial arrhythmia according to a second threshold for determination of the atrial arrhythmia, the second threshold higher than the first threshold.
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Specification