Neurostimulation and neurosensing techniques to optimize atrial anti-tachycardia pacing for termination of atrial tachyarrhythmias
First Claim
1. In an implantable system that includes a plurality of atrial electrodes for one or both of sensing atrial fibrillation (AF) and delivering atrial antitachycardia pacing (AATP) and a plurality of electrodes for one or both of monitoring and stimulating atrial vagal fat pads, a method for terminating AF, the method comprising:
- (a) monitoring at least one of the atrial electrodes for AF;
(b) monitoring at least two of the atrial vagal fat pads for hyperactivity; and
(c) in response to detecting AF and detecting at least two hyperactive atrial vagal fat pads(c.1) selecting, for delivering AATP, the atrial electrode that is closest to the hyperactive atrial vagal pad that is selected from the group consisting ofthe hyperactive atrial vagal fat pad having a longest duration of hyperactivity,the hyperactive atrial vagal fat pad having a most intense action potential, andthe hyperactive atrial vagal fat pad with a most irregular hyperactivity;
(c.2) stimulating at least one of the atrial vagal fat pads; and
(c.3) delivering AATP using the atrial electrode selected at step (c.1), to thereby terminate AF.
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Abstract
Implantable systems, and method for use therewith, are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments, as will be described below, are for use with an implantable device that include one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering AATP and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.
67 Citations
17 Claims
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1. In an implantable system that includes a plurality of atrial electrodes for one or both of sensing atrial fibrillation (AF) and delivering atrial antitachycardia pacing (AATP) and a plurality of electrodes for one or both of monitoring and stimulating atrial vagal fat pads, a method for terminating AF, the method comprising:
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(a) monitoring at least one of the atrial electrodes for AF; (b) monitoring at least two of the atrial vagal fat pads for hyperactivity; and (c) in response to detecting AF and detecting at least two hyperactive atrial vagal fat pads (c.1) selecting, for delivering AATP, the atrial electrode that is closest to the hyperactive atrial vagal pad that is selected from the group consisting of the hyperactive atrial vagal fat pad having a longest duration of hyperactivity, the hyperactive atrial vagal fat pad having a most intense action potential, and the hyperactive atrial vagal fat pad with a most irregular hyperactivity; (c.2) stimulating at least one of the atrial vagal fat pads; and (c.3) delivering AATP using the atrial electrode selected at step (c.1), to thereby terminate AF. - View Dependent Claims (2, 3, 4, 5, 9, 12, 13, 14, 15, 16, 17)
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6. An implantable system, comprising:
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a plurality of atrial electrodes for one or both of sensing atrial fibrillation (AF) and delivering atrial antitachycardia pacing (AATP); a plurality of electrodes for one or both of monitoring and stimulating atrial vagal fat pads; an AF monitor to monitor at least one of the atrial electrodes for AF; a vagal fat pad monitor to monitor at least one of the atrial vagal fat pads for hyperactivity; and a selector to select at least one of the atrial electrodes for delivering atrial anti-tachycardia pacing (AATP), in response to detecting AF, based on an output of the vagal fat pad monitor; a vagal fat pad stimulation controller to stimulate at least one of the atrial vagal fat pads, in response to detecting AF; and an AATP controller to deliver AATP using the selected at least one of the atrial electrodes, to thereby terminate AF; wherein when the AF monitor detects AF and the vagal fad pad monitor detects at least two hyperactive atrial vagal fat pads, the AATP controller selects, for delivering AATP, the atrial electrode that is closest to the hyperactive atrial vagal pad that is selected from the group consisting of the hyperactive atrial vagal fat pad having a longest duration of hyperactivity, the hyperactive atrial vagal fat pad having a most intense action potential, and the hyperactive atrial vagal fat pad with a most irregular hyperactivity. - View Dependent Claims (10)
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7. A method for terminating atrial fibrillation (AF) comprising:
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(a) monitoring for AF using atrial electrodes; (b) monitoring atrial vagal fat pads for hyperactivity; and (c) in response to detecting AF and detecting at least two hyperactive atrial vagal fat pads (c.1) selecting, for delivering atrial anti-tachycardia pacing (AATP), the atrial electrode that is closest to the hyperactive atrial vagal pad that is selected from the group consisting of the hyperactive atrial vagal fat pad having a longest duration of hyperactivity, the hyperactive atrial vagal fat pad having a most intense action potential, and the hyperactive atrial vagal fat pad with a most irregular hyperactivity; (c.2) stimulating at least one of the atrial vagal fat pads; and (c.3) delivering AATP using the atrial electrode selected at step (c.1), to thereby terminate AF. - View Dependent Claims (8, 11)
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Specification