System and method to determine hemodynamic tolerability
First Claim
1. A process of using an implantable medical device, the process comprising:
- detecting a tachyarrhythmia of a heart using electrocardiogram (EGM) data obtained with the implantable medical device;
delivering a non-stimulatory electrical energy to a left ventricle of the heart during the detected tachyarrhythmia using an endovascular lead configured for coupling to the implantable medical device;
determining a myocardial impedance by measuring a response to the non-stimulatory electrical energy at a myocardial tissue site using the endovascular lead, wherein the delivering the non-stimulatory electrical energy includes delivering a current defining a current vector, and wherein measuring a response to the delivered non-stimulatory electrical energy includes measuring a response voltage defining a voltage vector substantially orthogonal to the current vector;
determining, during the detected tachyarrhythmia and using the myocardial impedance, information about perfusion to the heart;
delivering a less aggressive device therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is sufficient perfusion to the heart; and
delivering a more aggressive device therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is insufficient perfusion to the heart.
1 Assignment
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Accused Products
Abstract
An implantable medical device detects a tachyarrhythmia of a heart. During the detected tachyarrhythmia, the device determines a local myocardial impedance. Using the local myocardial impedance, the device determines whether there is sufficient perfusion to the heart. The device can then either deliver a less aggressive device therapy in response to the detected tachyarrhythmia when there is sufficient perfusion to the heart, or deliver a more aggressive device therapy in response to the detected tachyarrhythmia when there is insufficient perfusion to the heart. The perfusion information can also be used to alter tachyarrhythmia detection or classification.
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Citations
30 Claims
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1. A process of using an implantable medical device, the process comprising:
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detecting a tachyarrhythmia of a heart using electrocardiogram (EGM) data obtained with the implantable medical device; delivering a non-stimulatory electrical energy to a left ventricle of the heart during the detected tachyarrhythmia using an endovascular lead configured for coupling to the implantable medical device; determining a myocardial impedance by measuring a response to the non-stimulatory electrical energy at a myocardial tissue site using the endovascular lead, wherein the delivering the non-stimulatory electrical energy includes delivering a current defining a current vector, and wherein measuring a response to the delivered non-stimulatory electrical energy includes measuring a response voltage defining a voltage vector substantially orthogonal to the current vector; determining, during the detected tachyarrhythmia and using the myocardial impedance, information about perfusion to the heart; delivering a less aggressive device therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is sufficient perfusion to the heart; and delivering a more aggressive device therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is insufficient perfusion to the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. An implantable medical device comprising:
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a control circuit; a tachyarrhythmia detection circuit, coupled to the control circuit, the tachyarrhythmia detection circuit configured to detect a tachyarrhythmia of a heart using electrocardiogram (EGM) data; an electrical energy delivery circuit, coupled to the control circuit, the electrical delivery circuit configured to deliver non-stimulatory electrical energy to a heart during a detected tachyarrhythmia; an impedance detection circuit, coupled to the control circuit, the impedance detection circuit configured to detect, when coupled to an endovascular lead, a myocardial impedance by measuring a response to the non-stimulatory electrical energy at a myocardial tissue site using the endovascular lead, wherein the endovascular lead includes a first electrode configured to deliver the non-stimulatory electrical energy to a left ventricle and includes a second electrode to sense the response to the non-stimulatory electrical energy, and wherein the response to the non-stimulatory electrical energy is sensed in a direction orthogonal to a direction of delivery of the non-stimulatory electrical energy; a perfusion measurement circuit, coupled to the control circuit, the perfusion measurement circuit configured to determine, during a detected tachyarrhythmia and using the myocardial impedance, whether there is sufficient perfusion to the heart; and a therapy delivery circuit, the therapy delivery circuit configured to deliver a less aggressive therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is sufficient perfusion to the heart and to deliver a more aggressive therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is insufficient perfusion to the heart. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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29. An implantable medical device comprising:
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means for detecting a tachyarrhythmia of a heart using electrocardiogram (EGM) data obtained by the implantable medical device; means for delivering a non-stimulatory electrical energy to a left ventricle of the heart during the detected tachyarrhythmia using an endovascular lead configured to be coupled to the implantable medical device including delivering a current defining a current vector; means for determining a myocardial impedance by measuring a response to the non-stimulatory electrical energy at a myocardial tissue site of the left ventricle using the endovascular lead including measuring a response voltage defining a voltage vector substantially orthogonal to the current vector; means for determining, during the detected tachyarrhythmia and using the myocardial impedance, information about perfusion to the heart; means for delivering a less aggressive device therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is sufficient perfusion to the heart; and means for delivering a more aggressive device therapy type in response to the detected tachyarrhythmia when the myocardial impedance indicates that there is insufficient perfusion to the heart. - View Dependent Claims (30)
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Specification