Arrhythmia classification and therapy selection

• US 8,185,195 B2
• Filed: 02/18/2010
• Issued: 05/22/2012
• Est. Priority Date: 09/30/2004
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kim, Jaeho, Bocek, Joseph, Lovett, Eric G.
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/708,106
• Publication Number:
  US 20100145400A1
• Time in Patent Office: 824 Days
• Field of Search: 600/515, 607/4, 607/9
• US Class Current: 607/4
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Different types of cardiac arrhythmia are classified based on the morphology of the arrhythmic beats. Cardiac beats associated with an arrhythmic episode are compared to a plurality of representative beat morphologies, each representative beat morphology characterizing a type of arrhythmia of the heart. An arrhythmic episode may be classified as a particular type of arrhythmia if the morphology of the arrhythmic cardiac beats matches a representative beat morphology characterizing the particular type of arrhythmia. An appropriate therapy for the particular type of arrhythmia may be selected based on the arrhythmia classification. A particular type of arrhythmia may be associated with one or more therapies used to treat the arrhythmia. The therapy used to treat the arrhythmia may comprise a therapy identified as a previously successful therapy.

Claims

1. A method for delivering cardiac therapy to a patient, comprising:

associating one or more cardiac therapies respectively with one or more of a plurality of types of cardiac arrhythmia;

detecting cardiac beats of an arrhythmic episode;

comparing a morphology of each cardiac beat to a plurality of representative beat morphologies respectively associated with the plurality of types of cardiac arrhythmia;

classifying the arrhythmic episode as a particular type of cardiac arrhythmia if the morphologies of the cardiac beats are consistent with a representative beat morphology of the particular type of cardiac arrhythmia; and

delivering one or more particular therapies associated with the particular type of cardiac arrhythmia if the arrhythmic episode is classified as the particular type of cardiac arrhythmia;

wherein delivering the one or more particular therapies comprises delivering the one or more particular therapies in a selected order; and

wherein delivering the one or more particular therapies in the selected order comprises delivering the one or more particular therapies based on a history of effectiveness of the one or more particular therapies.

2. The method of claim 1, further comprising:

classifying the arrhythmic episode as an unknown type of cardiac arrhythmia if the morphology of the cardiac beats is not consistent with any of the plurality of representative beat morphologies; and

delivering one or more selected therapies to treat the unknown arrhythmia if the arrhythmic episode is classified as the unknown type of cardiac arrhythmia.

3. The method of claim 1, wherein associating the one or more cardiac therapies respectively with the one or more of a plurality of types of cardiac arrhythmia comprises associating at least one cardiac therapy with an arrhythmia that was successfully treated using the at least one cardiac therapy.

4. The method of claim 1, wherein:

associating the one or more cardiac therapies respectively with the one or more types of cardiac arrhythmia comprises associating one or more previously successful cardiac therapies with each of the one or more types of cardiac arrhythmia; and

delivering the one or more particular therapies comprises delivering the one or more previously successful cardiac therapies.

5. A method for delivering cardiac therapy to a patient, comprising:

associating one or more cardiac therapies respectively with one or more of a plurality of types of cardiac arrhythmia;

detecting cardiac beats of an arrhythmic episode;

comparing a morphology of each cardiac beat to a plurality of representative beat morphologies respectively associated with the plurality of types of cardiac arrhythmia;

classifying the arrhythmic episode as a particular type of cardiac arrhythmia if the morphologies of the cardiac beats are consistent with a representative beat morphology of the particular type of cardiac arrhythmia;

delivering one or more particular therapies associated with the particular type of cardiac arrhythmia if the arrhythmic episode is classified as the particular type of cardiac arrhythmia;

classifying the arrhythmic episode as an unknown type of cardiac arrhythmia if the morphologies of the cardiac beats are not consistent with any of the plurality of representative beat morphologies;

attempting to acquire a new representative beat morphology associated with the unknown type of cardiac arrhythmia;

associating the new representative beat morphology with a new type of cardiac arrhythmia if the new representative beat morphology is acquired;

delivering one or more selected therapies to terminate the new type of cardiac arrhythmia;

determining if a particular one of the selected therapies is successful; and

associating the successful therapy with the new type of cardiac arrhythmia.

6. The method of claim 5, further comprising:

determining that the cardiac beats are an uncharacterizable cardiac arrhythmia if the representative beat morphology is not acquired.

7. The method of claim 6, further comprising:

delivering one or more selected therapies to terminate the uncharacterizable cardiac arrhythmia;

determining if a particular one of the one or more selected therapies to terminate the uncharacterizable arrhythmia is successful; and

associating the particular therapy that successfully terminates the uncharacterizable arrhythmia with the uncharacterizable cardiac arrhythmia.

8. A cardiac therapy system, comprising:

a sensor system comprising electrodes for electrically coupling to a heart, the sensor system configured to detect cardiac beats of an arrhythmic episode of the heart;

an arrhythmia classification processor coupled to the sensor system, the arrhythmia classification processor configured to compare a morphology of each of the detected cardiac beats to a plurality of representative beat morphologies respectively associated with a plurality of types of arrhythmia and classify the arrhythmic episode as a particular type of arrhythmia if the morphologies of the detected cardiac beats are consistent with a representative beat morphology of the particular type of arrhythmia; and

a therapy unit coupled to the arrhythmia classification processor, the therapy unit configured to associate one or more cardiac therapies respectively with the one or more types of arrhythmia and deliver one or more particular therapies associated with the particular type of arrhythmia if the cardiac beats are characterized as the particular type of arrhythmia;

wherein the arrhythmia classification processor is further configured to;

classify the arrhythmic episode as an unknown type of arrhythmia if the morphologies of the cardiac beats are not consistent with any of the plurality of representative beat morphologies;

attempt to acquire a representative beat morphology associated with the unknown type of arrhythmia;

associate the representative beat morphology with a new type of arrhythmia if the representative beat morphology is acquired; and

classify the arrhythmic episode as the new type of arrhythmia if the representative beat morphology is acquired; and

wherein the therapy unit is configured to;

deliver one or more selected therapies to terminate the new type of arrhythmia; and

determine whether a particular one of the selected therapies is successful, and if a particular one is successful, associate the successful therapy with the new type of arrhythmia.

9. The system of claim 8, wherein the therapy unit is configured to deliver one or more selected therapies to treat the unknown arrhythmia if the arrhythmic episode is classified as the unknown type of arrhythmia.

10. The system of claim 8, wherein the therapy unit is configured to associate one or more previously successful cardiac therapies with each of the one or more types of arrhythmia.

11. The system of claim 8, wherein the therapy unit is configured to deliver the one or more particular therapies in a selected order.

12. The system of claim 8, wherein the arrhythmia classification processor is further configured to determine that the arrhythmic episode comprises an uncharacterizable arrhythmia if the representative beat morphology is not acquired.

13. The system of claim 12, wherein the therapy unit is configured to:

deliver one or more selected therapies to terminate the uncharacterizable arrhythmia; and

determine whether a particular one of the one or more selected therapies to terminate the uncharacterizable arrhythmia is successful, and if a particular one is successful, associate the particular therapy that successfully terminates the uncharacterizable arrhythmia with the uncharacterizable arrhythmia.

14. A system for delivering cardiac therapy to a patient, comprising:

means for associating one or more cardiac therapies respectively with one or more types of arrhythmia;

means for detecting cardiac beats associated with an arrhythmic episode of one or more heart chambers;

means for comparing a morphology of each cardiac beat to plurality of representative beat morphologies respectively associated with the plurality of types of arrhythmia;

means for classifying the arrhythmic episode as a particular type of arrhythmia if the morphologies of the cardiac beats are consistent with a representative beat morphology of the particular type of arrhythmia;

means for delivering one or more particular therapies associated with the particular type of arrhythmia if the arrhythmic episode is classified as the particular type of arrhythmia;

means for classifying the arrhythmic episode as an unknown type of arrhythmia if the morphologies of the cardiac beats are not consistent with any of the plurality of representative beat morphologies;

means for attempting to acquire a representative beat morphology associated with the unknown type of arrhythmia;

means for associating the representative beat morphology with a new type of arrhythmia if the representative beat morphology is acquired;

means for classifying the arrhythmic episode as the new type of arrhythmia if the representative beat morphology is acquired;

means for delivering one or more selected therapies to terminate the new type of arrhythmia;

means for determining whether a particular one of the selected therapies is successful, and if a particular one is successful, associating the successful therapy with the new type of arrhythmia.

15. The system of claim 14, further comprising:

means for determining that the arrhythmic episode comprises an uncharacterizable arrhythmia if the representative beat morphology is not acquired.

16. The system of claim 15, further comprising:

means for delivering one or more selected therapies to terminate the uncharacterizable arrhythmia;

means for determining whether a particular one of the one or more selected therapies to terminate the uncharacterizable arrhythmia is successful, and if a particular one is successful, associating the particular therapy that successfully terminates the uncharacterizable arrhythmia with the uncharacterizable arrhythmia.