Method, device, implantable stimulator and dual chamber cardiac therapy system
First Claim
1. A device for a dual chamber cardiac stimulator for controlling the delivery of stimulation pulses to a human heart, wherein the stimulator is connectable to a lead arrangement arranged for sensing atrial electrical activity and atrial mechanical activity, the device comprising processing circuitry configured to:
- receive a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity representative of atrial mechanical contractions;
determine if said electrical activity indicates atrial tachyarrhythmia, if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia;
calculate, from said second signal, the frequency of mechanical activity, and compare said calculated mechanical frequency with a threshold value for determining if atrial tachyarrhythmia is indicated, compare said calculated mechanical frequency with an upper threshold value, with a lower threshold value, or both, determine that atrial tachyarrhythmia based on said mechanical activity is indicated if the calculated mechanical frequency is higher than said upper threshold value, or lower than said lower threshold value; and
effectuate a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events.
1 Assignment
0 Petitions
Accused Products
Abstract
In a device and method in a dual chamber pacing system operating in an atrial synchronized mode, the cardiac stimulator is connectable to a lead arrangement arranged for sensing atrial electrical and mechanical activity. Upon detection of an atrial arrhythmia based on either of sensed atrial mechanical activity, atrial electrical activity, or a combination thereof, a mode switch from an atrial synchronized ventricle stimulating mode to a non-atrial synchronized mode is triggered.
23 Citations
25 Claims
-
1. A device for a dual chamber cardiac stimulator for controlling the delivery of stimulation pulses to a human heart, wherein the stimulator is connectable to a lead arrangement arranged for sensing atrial electrical activity and atrial mechanical activity, the device comprising processing circuitry configured to:
-
receive a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity representative of atrial mechanical contractions; determine if said electrical activity indicates atrial tachyarrhythmia, if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia; calculate, from said second signal, the frequency of mechanical activity, and compare said calculated mechanical frequency with a threshold value for determining if atrial tachyarrhythmia is indicated, compare said calculated mechanical frequency with an upper threshold value, with a lower threshold value, or both, determine that atrial tachyarrhythmia based on said mechanical activity is indicated if the calculated mechanical frequency is higher than said upper threshold value, or lower than said lower threshold value; and effectuate a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events. - View Dependent Claims (2, 3, 11)
-
-
4. A device for a dual chamber cardiac stimulator for controlling the delivery of stimulation pulses to a human heart, wherein the stimulator is connectable to a lead arrangement arranged for sensing atrial electrical activity and atrial mechanical activity, the device comprising processing circuitry configured to:
-
receive a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity representative of atrial mechanical contractions; determine if said electrical activity indicates atrial tachyarrhythmia, if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia; effectuate a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events; calculate from said first signal the frequency of atrial electrical activity; calculate from said second signal the frequency of atrial mechanical activity; calculate a quotient between said electrical frequency and said mechanical frequency; compare said quotient to a threshold range; and determine that atrial tachyarrhythmia is indicated based on said electrical activity if the quotient falls outside said threshold range.
-
-
5. A device for a dual chamber cardiac stimulator for controlling the delivery of stimulation pulses to a human heart, wherein the stimulator is connectable to a lead arrangement arranged for sensing atrial electrical activity and atrial mechanical activity, the device comprising processing circuitry configured to:
-
receive a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity; determine if said electrical activity indicates atrial tachyarrhythmia, if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia; effectuate a mode switch, as soon as either of said electrical, mechanical, or combination of electrical and mechanical activity indicates atrial tachyarrhythmia, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events; and obtain the morphology or selected indicative features of said second signal, and evaluate said morphology or selected indicative features for determining if atrial tachyarrhythmia may be indicated. - View Dependent Claims (6, 7)
-
-
8. A device for a dual chamber cardiac stimulator for controlling the delivery of stimulation pulses to a human heart, wherein the stimulator is connectable to a lead arrangement arranged for sensing atrial electrical activity and atrial mechanical activity, the device comprising processing circuitry configured to:
-
receive a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity representative of mechanical activity, wherein said atrial mechanical activity is atrial pressure changes detected by a pressure sensor, said pressure changes being representative of atrial contraction; determine if said electrical activity indicates atrial tachyarrhythmia, if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia; and effectuate a mode switch, as soon as either of said electrical, mechanical, or combination of electrical and mechanical activity indicates atrial tachyarrhythmia, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events. - View Dependent Claims (9)
-
-
10. A device for a dual chamber cardiac stimulator for controlling the delivery of stimulation pulses to a human heart, wherein the stimulator is connectable to a lead arrangement arranged for sensing atrial electrical activity and atrial mechanical activity, the device comprising processing circuitry configured to:
-
receive a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity, wherein said atrial mechanical activity is atrial wall movements detected by an accelerometer, said atrial wall movements being representative of atrial contraction; determine if said electrical activity indicates atrial tachyarrhythmia, if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia; and effectuate a mode switch, as soon as either of said electrical, mechanical, or combination of electrical and mechanical activity indicates atrial tachyarrhythmia, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events.
-
-
12. A dual chamber cardiac therapy system for delivering stimulation pulses to a human heart, comprising:
-
a pulse generator for generating said stimulation pulses; control circuitry configured to receive a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity, determine if said electrical activity indicates atrial tachyarrhythmia, if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia, and effectuate a mode switch, as soon as either of said electrical, mechanical, or combination of electrical and mechanical activity indicates atrial tachyarrhythmia, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events; and a cardiac lead arrangement for conducting said stimulation pulses to the heart, and for conducting electrical signals from the heart to the control circuitry, said lead arrangement comprising an implantable lead arranged for sensing atrial electrical activity and atrial mechanical activity, said cardiac lead arrangement comprising a mechanical sensor that senses said atrial mechanical activity. - View Dependent Claims (13, 14)
-
-
15. A method for detecting an atrial arrhythmia for activating a pacing mode switch in a dual chamber cardiac stimulator, comprising the steps of:
-
receiving a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity, representing atrial mechanical contractions; determining if said electrical activity indicates atrial tachyarrhythmia;
if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia;calculating from said second signal the frequency of mechanical activity; comparing said calculated mechanical frequency with a threshold value for determining if atrial tachyarrhythmia is indicated; comparing said calculated mechanical frequency with an upper threshold value, with a lower threshold value, or both; determining that atrial tachyarrhythmia is indicated if the calculated mechanical frequency is higher than said upper threshold value, or lower than said lower threshold value; and effectuating a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events. - View Dependent Claims (16, 17, 25)
-
-
18. A method for detecting an atrial arrhythmia for activating a pacing mode switch in a dual chamber cardiac stimulator, comprising the steps of:
-
receiving a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity, representing atrial mechanical contractions; determining if said electrical activity indicates atrial tachyarrhythmia;
if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia;calculating from said first signal the frequency of atrial electrical activity; calculating from said second signal the frequency of atrial mechanical activity; calculating a quotient between said electrical frequency and said mechanical frequency; comparing said quotient to a threshold range; determining that atrial tachyarrhythmia is indicated if the quotient falls outside said threshold range; and effectuating a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events.
-
-
19. A method for detecting an atrial arrhythmia for activating a pacing mode switch in a dual chamber cardiac stimulator, comprising the steps of:
-
receiving a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity, representing atrial mechanical contractions; determining if said electrical activity indicates atrial tachyarrhythmia;
if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia;obtaining the morphology or selected indicative features of said second signal; evaluating said morphology or selected indicative features for determining if atrial tachyarrhythmia may be indicated; and effectuating a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events. - View Dependent Claims (20, 21)
-
-
22. A method for detecting an atrial arrhythmia for activating a pacing mode switch in a dual chamber cardiac stimulator, comprising the steps of:
-
receiving a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity, representing atrial mechanical contractions, wherein said atrial mechanical activity is atrial pressure changes detected by a pressure sensor, said pressure changes being representative of atrial contraction;
wherein said atrial mechanical activity is atrial pressure changes detected by a pressure sensor, said pressure changes being representative of atrial contraction;determining if said electrical activity indicates atrial tachyarrhythmia;
if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia;effectuating a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events. - View Dependent Claims (23)
-
-
24. A method for detecting an atrial arrhythmia for activating a pacing mode switch in a dual chamber cardiac stimulator, comprising the steps of:
-
receiving a first signal representative of atrial electrical activity, and a second signal representative of atrial mechanical activity, representing atrial mechanical contractions, wherein said atrial mechanical activity is atrial wall movements detected by an accelerometer, said atrial wall movements being representative of atrial contraction; determining if said electrical activity indicates atrial tachyarrhythmia;
if said mechanical activity indicates atrial tachyarrhythmia, and if a combination of said electrical and mechanical activity indicates atrial tachyarrhythmia;effectuating a mode switch, as soon as at least said indication of atrial tachyarrhythmia based on said mechanical activity, from a first mode where delivery of ventricular stimulation pulses is synchronized to detected atrial events, to a second mode where delivery of ventricular stimulation pulses is unsynchronized to detected atrial events.
-
Specification