Discrimination of supraventricular tachycardia and ventricular tachycardia events

• US 8,229,552 B2
• Filed: 08/01/2011
• Issued: 07/24/2012
• Est. Priority Date: 03/12/1999
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Marcovecchio, Alan F.
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US13/195,559
• Publication Number:
  US 20110288427A1
• Time in Patent Office: 358 Days
• Field of Search: 600515-518
• US Class Current: 600/515
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

A method and system for discrimination of supraventricular tachycardia and ventricular tachycardia events. Morphological features points are extracted from normal sinus rhythm (NSR) complexes and used to generate a NSR template. A numerical convolution is performed using the NSR template and the feature points for each sensed NSR to give a NSR filter output. Using a plurality of NSR complexes, a median NSR filter output template is determined, where the median NSR filter output template has a median value for each value in the NSR filter output. The median NSR filter output template is then used during a tachycardia event to distinguish tachycardia events as either ventricular tachycardia events or supraventricular tachycardia events.

Claims

1. A method, comprising:

receiving cardiac signals including tachycardia complexes and normal sinus rhythm (NSR) complexes, the tachycardia complexes associated with a tachycardia event;

detecting the tachycardia event using the cardiac signals;

extracting a plurality of tachycardia feature points from each of the tachycardia complexes and a plurality of NSR feature points from each of the NSR complexes;

generating an NSR template using the plurality of NSR feature points extracted from the NSR complexes;

generating an NSR filter output using the NSR template and the plurality of NSR feature points for each of the NSR complexes;

determining an NSR filter output template using the NSR filter outputs each generated for one of the NSR complexes;

generating a tachycardia complex output using the NSR filter output template and the plurality of tachycardia feature points for each of the tachycardia complexes;

classifying the each of the tachycardia complexes as a ventricular tachycardia (VT) complex or a supraventricular tachycardia (SVT) complex using the tachycardia complex output and the NSR filter output template;

declaring a VT event in response to a number of the tachycardia complexes classified as the VT complexes exceeding a predetermined threshold value; and

delivering a ventricular tachycardia therapy in response to the VT event being declared.

2. The method of claim 1, further comprising declaring an SVT event in response to a number of the tachycardia complexes classified as the SVT complexes exceeding a predetermined threshold value.

3. The method of claim 2, further comprising delivering a supraventricular tachycardia therapy in response to the SVT event being declared.

4. The method of claim 2, further comprising continuing to monitor cardiac condition without delivering a therapy to a supraventricular region in response to the SVT event being declared.

5. The method of claim 1, wherein generating the NSR template comprises generating an NSR template including an average value for each feature point of the plurality of NSR feature points.

6. The method of claim 5, wherein generating the NSR filter output comprises convolving the plurality of NSR feature points with the NSR template, and generating the tachycardia complex output comprises convolving the plurality of tachycardia feature points with the NSR filter output template.

7. The method of claim 6, wherein classifying the each of the tachycardia complexes comprises:

comparing the tachycardia complex output to the NSR filter output template to form a differentiation value;

comparing the differentiation value to a predetermined value; and

classifying the each of the tachycardia complexes as the VT complex or the SVT complex using an outcome of the comparison of the differentiation value to the predetermined value.

8. The method of claim 7, further comprising delivering appropriate cardioversion and defibrillation therapy for the classified tachycardia complexes.

9. The method of claim 1, wherein generating the NSR template comprises generating an NSR template including a median value for each feature point of the plurality of NSR feature points.

10. The method of claim 9, wherein generating the NSR filter output comprises convolving the plurality of NSR feature points with the NSR template, and generating the tachycardia complex output comprises convolving the plurality of tachycardia feature points with the NSR filter output template.

11. The method claim 10, wherein classifying the each of the tachycardia complexes comprises:

comparing the tachycardia complex output to the NSR filter output template to form a differentiation value;

comparing the differentiation value to a predetermined value; and

classifying the each of the tachycardia complexes as the VT complex or the SVT complex using an outcome of the comparison of the differentiation value to the predetermined value.

12. The method of claim 1, wherein generating the NSR template comprises generating the NSR template using the plurality of NSR feature points extracted from a programmable number of the NSR complexes.

13. The method of claim 12, further comprising programming the programmable number to a value between 10 and 100.

14. The method of claim 1, further comprising detecting the tachycardia complexes and the NSR complexes from the received cardiac signals, wherein the tachycardia complexes and the NSR complexes are each a QRS-complex.

15. The method of claim 14, wherein generating an NSR filter output using the NSR template and the plurality of NSR feature points for each of the NSR complexes comprises:

creating a filter impulse response using the NSR template;

performing a numerical convolution of the NSR template and the NSR feature points of the plurality of NSR feature points to create the NSR filter output.

16. The method of claim 14, wherein generating the tachycardia complex output comprises performing a numerical convolution of the NSR template with tachycardia feature points.

17. The method of claim 1, further comprising performing the method using an implantable cardioverter defibrillator.