Tachycardia hemodynamics detection based on cardiac mechanical sensor signal regularity
First Claim
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1. A method, comprising:
- sensing, within a patient using implantable electrodes, an electrical signal indicative of electrical activity of the patient'"'"'s heart;
identifying a tachycardia event based on the electrical signal;
sensing, within the patient and during the tachycardia event, a mechanical response signal indicative of a mechanical response of the patient'"'"'s heart to the tachycardia;
developing a template indicative of the mechanical response of the patient'"'"'s heart to tachycardia based on the mechanical response signal;
sensing a second mechanical response signal indicative of the mechanical response of the patient'"'"'s heart to a subsequent tachycardia event;
determining regularity of the second mechanical response signal relative to a threshold established for the patient by comparing the template to the second mechanical response signal;
determining a state of patient hemodynamics during the subsequent tachycardia event based at least in part on the regularity of the second mechanical response signal, wherein determining the state comprises determining whether the subsequent tachycardia event comprises a stable tachyarrhythmia or unstable tachyarrhythmia;
selecting one or more therapies to treat the subsequent tachycardia event based at least in part on the determined state of patient hemodynamics; and
delivering the selected one or more therapies to treat the subsequent tachycardia event, wherein the steps of developing the template, determining the regularity, determining the state of hemodynamics, selecting, and delivering are performed at least in part by circuitry.
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Abstract
Systems and methods provide for sensing, within a patient and during an event of tachycardia, a signal indicative of a mechanical response of the patient'"'"'s heart to the tachycardia. Regularity of the signal relative to a threshold established for the patient is determined. A state of patient hemodynamics during the tachycardia event is determined based at least in part on the regularity of the signal. One or more anti-tachycardia therapies to treat the tachycardia may be selected based at least in part on the determined state of patient hemodynamics. The selected one or more anti-tachycardia therapies may be delivered to treat the tachycardia.
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Citations
25 Claims
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1. A method, comprising:
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sensing, within a patient using implantable electrodes, an electrical signal indicative of electrical activity of the patient'"'"'s heart; identifying a tachycardia event based on the electrical signal; sensing, within the patient and during the tachycardia event, a mechanical response signal indicative of a mechanical response of the patient'"'"'s heart to the tachycardia; developing a template indicative of the mechanical response of the patient'"'"'s heart to tachycardia based on the mechanical response signal; sensing a second mechanical response signal indicative of the mechanical response of the patient'"'"'s heart to a subsequent tachycardia event; determining regularity of the second mechanical response signal relative to a threshold established for the patient by comparing the template to the second mechanical response signal; determining a state of patient hemodynamics during the subsequent tachycardia event based at least in part on the regularity of the second mechanical response signal, wherein determining the state comprises determining whether the subsequent tachycardia event comprises a stable tachyarrhythmia or unstable tachyarrhythmia; selecting one or more therapies to treat the subsequent tachycardia event based at least in part on the determined state of patient hemodynamics; and delivering the selected one or more therapies to treat the subsequent tachycardia event, wherein the steps of developing the template, determining the regularity, determining the state of hemodynamics, selecting, and delivering are performed at least in part by circuitry. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method, comprising:
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identifying an event of tachycardia based on an electrical cardiac signal indicative of electrical activity of a patient'"'"'s heart; sensing, within the patient and during the event of tachycardia, a mechanical response signal indicative of a mechanical response of the patient'"'"'s heart to the tachycardia; determining a metric indicative of regularity of the mechanical response signal over a plurality of cardiac cycles of the tachycardia event relative to one or more thresholds established for the patient by computing an entropy estimate of the mechanical response signal'"'"'s regularity; quantizing the regularity metric into one of a plurality of discrete levels of hemodynamic stability for assessing a state of patient hemodynamics during the tachycardia event; and determining whether the tachycardia is stable or unstable based on the quantization of the regularity metric, wherein the steps of identifying, determining the metric, quantizing, and determining tachycardia stability are implemented at least in part by circuitry. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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19. An implantable system, comprising:
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an implantable cardiac mechanical sensor configured to produce a signal indicative of a mechanical response of a patient'"'"'s heart to an event of tachycardia; a lead comprising one or more electrodes configured to receive an electrical signal indicative of electrical activity of the patient'"'"'s heart; detection circuitry coupled to the lead; energy delivery circuitry coupled to the lead; and a processor coupled to the sensor, lead, detection circuitry, and energy delivery circuitry, the processor configured to identify a tachycardia event based on the electrical signal, receive the signal indicative of the mechanical response during the tachycardia event, determine regularity of the signal indicative of the mechanical response over a plurality of cardiac cycles of the tachycardia event relative to a threshold established for the patient by performing singular value decomposition on the signal, and determine a status of patient hemodynamics during the tachycardia event based at least in part on the regularity of the signal by determining whether the tachycardia event is stable tachycardia or unstable tachycardia based on the regularity of the signal, the processor configured to deliver one or more anti-tachycardia therapies associated with the hemodynamic status of the patient. - View Dependent Claims (20, 21, 22, 23, 24)
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25. An implantable system, comprising:
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an implantable cardiac mechanical sensor configured to produce a mechanical response signal indicative of a mechanical response of a patient'"'"'s heart to an event of tachycardia; a lead comprising one or more electrodes configured to receive an electrical signal indicative of electrical activity of the patient'"'"'s heart; detection circuitry coupled to the lead; energy delivery circuitry coupled to the lead; and a processor coupled to the sensor, lead, detection circuitry, and energy delivery circuitry, the processor configured to identify a tachycardia event based on the electrical signal, receive the mechanical response signal indicative of the mechanical response during the tachycardia event, determine regularity of at least a portion of the mechanical response signal that is indicative of the mechanical response of the patient'"'"'s heart to the tachycardia event over multiple cardiac cycles by determining the width of the dominant spectral peak of the mechanical response signal in the frequency domain, determine a status of patient hemodynamics during the tachycardia event by determining whether the tachycardia event is stable tachycardia or unstable tachycardia based on the regularity of the mechanical response signal, and deliver one or more anti-tachycardia therapies based on the hemodynamic status of the patient.
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Specification