Systems and methods for employing multiple filters to detect T-wave oversensing and to improve tachyarrhythmia detection within an implantable medical device

• US 8,260,404 B1
• Filed: 07/11/2007
• Issued: 09/04/2012
• Est. Priority Date: 07/11/2007
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Bharmi, Rupinder, Snell, Jeffery D., Bornzin, Gene A., Florio, Joseph J., Boileau, Peter
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Sarcione, Jessica
• Application Number:
  US11/776,275
• Time in Patent Office: 1,882 Days
• Field of Search: 600/515, 600/521, 600508-509
• US Class Current: 600/509
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/725 using specific filters therefor, e.g. Kalman or adaptive filters A61B5/316 take precedence
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation

Abstract

Techniques for detecting tachyarrhythmia and also for preventing T-wave oversensing use signals filtered by a narrowband bradycardia filter in combination with signals filtered by a narrowband tachycardia filter. A separate wideband filter may also be used.

Claims

1. A method comprising:

sensing electrical cardiac signals via leads implanted within a heart of a patient;

filtering the signals using a first filter configured to substantially eliminate signals having frequencies associated with ventricular repolarization events while retaining signals having frequencies associated with at least some ventricular depolarization events;

filtering the signals using a second filter configured to pass signals having frequencies associated with ventricular depolarization events and ventricular repolarization events; and

detecting oversensing of ventricular repolarization events using a processor configured to detect oversensing of ventricular events within signals filtered by the second filter by comparing the signals filtered by the second filter with the signals filtered by the first filter.

2. The method of claim 1 wherein selectively filtering the signals includes:

filtering ventricular channel signals using the first filter and determining a ventricular rate from the first filter; and

filtering ventricular channel signals using the second filter and determining a ventricular rate from the second filter.

3. The method of claim 1 wherein selectively filtering the signals using a first filter and a second filter includes:

filtering ventricular channel signals using the first filter and identifying ventricular events therein; and

filtering ventricular channel signals using the second filter and identifying ventricular events therein.

4. The method of claim 1 wherein detecting oversensing of ventricular repolarization events includes:

identifying possible ventricular depolarization events within signals filtered, respectively, by a wideband filter having a substantially wider bandwidth than bandwidths of the first and second filters, the first filter, and the second filter; and

comparing the timing of the possible ventricular depolarization events identified within the respective filtered signals to identify oversensed ventricular repolarization events.

5. The method of claim 1 further including detecting tachyarrhythmia within the patient using signals filtered by the first filter in combination with signals filtered by the second filter while excluding ventricular repolarization events within the signals filtered by the second filter.

6. The method of claim 5 wherein detecting tachyarrhythmia includes:

detecting a preliminary indication of tachyarrhythmia using signals filtered by the first filter; and

in response, confirming the detection of tachyarrhythmia using signals filtered by the second filter while excluding ventricular repolarization events within the signals filtered by the second filter.

7. The method of claim 5 wherein detecting tachyarrhythmia includes:

filtering ventricular channel signals sensed via the leads using the second filter while also filtering ventricular channel signals sensed via the leads using the first filter; and

comparing the ventricular channel signals filtered by the second filter and the first filter to detect ventricular tachyarrhythmia while excluding ventricular repolarization events within the signals filtered by the second filter.

8. The method of claim 5 wherein detecting tachyarrhythmia includes:

filtering initial ventricular channel signals sensed via the leads using the second filter; and

detecting a preliminary indication of tachyarrhythmia using the initial signals filtered by the second filter; and

in response, confirming the detection of tachyarrhythmia by comparing additional signals filtered by the second filter with additional signals filtered by the first filter while excluding ventricular repolarization events within the signals filtered by the second filter.

9. The method of claim 5 wherein detecting tachyarrhythmia includes:

comparing ventricular channel signals filtered by the first filter with ventricular channel signals filtered by the second filter to distinguish between true ventricular depolarization events and false ventricular depolarization events; and

detecting tachyarrhythmia based on the true ventricular depolarization events.

10. The method of claim 5 wherein detecting tachyarrhythmia includes using signals filtered by a wideband filter having a substantially wider bandwidth than bandwidths of the first and second filters, in combination with signals filters by the first and second filters.

11. The method of claim 1 wherein the first filter is a bradycardia filter and wherein the second filter is a tachycardia filter and wherein detecting oversensing of ventricular repolarization events is performed using signals filtered by the bradycardia filter in combination with signals filtered by the tachycardia filter.

12. The method of claim 1 wherein the first filter has a passband beginning at about 20 Hz and wherein the second filter has a passband beginning at about 10 Hz and wherein detecting oversensing of ventricular repolarization events is performed using signals filtered by the first filter having the passband beginning at about 20 Hz in combination with signals filtered by the second filter having the passband beginning at about 10 Hz.

13. A ventricular repolarization oversensing detection system for use in an implantable medical device having filters for filtering electrical cardiac signals sensed via leads implanted within a heart of a patient, the system comprising:

a first filter operative to substantially eliminate signals having frequencies associated with ventricular repolarization events while retaining signals having frequencies associated with at least some ventricular depolarization events;

a second filter operative to pass signals having frequencies associated with ventricular depolarization events and ventricular repolarization events; and

a combined first filter/second filter-based oversensing detection system operative to detect oversensing of ventricular repolarization events within signals filtered by the second filter by comparing the signals filtered by the second filter with the signals filtered by the first filter.

14. The system of claim 13 wherein the combined first filter/second filter-based oversensing detection system includes:

a comparison unit operative to compare ventricular rate derived from the second filter to ventricular rate derived from the first filter; and

an oversensing detection unit operative to detect oversensing of ventricular repolarization events within signals filtered by the second filter by determining if the ventricular rate derived from the second filter is about twice the ventricular rate derived from the first filter.

15. The system of claim 13 wherein the combined first filter/second filter-based oversensing detection system includes:

a detection unit operative, upon detection of a first ventricular event either in signals filtered by the first filter or in signals filtered by the second filter, to determine whether a second ventricular event is detected in the signals filtered by the second filter within a predetermined time window following the first event; and

an identification unit operative, if a second ventricular event is detected within the predetermined time window, to identify the second event as being a false ventricular depolarization event indicative of oversensing, and operative, if a second ventricular event is not detected within the predetermined time window, to identify the second event as being indicative of a true ventricular depolarization event.

16. The system of claim 13, wherein:

the implantable device additionally includes a wideband filter having a substantially wider bandwidth than bandwidths of the first and second filters; and

the combined first filter/second filter-based oversensing detection system includes an identification unit operative to identify possible ventricular depolarization events within signals filtered, respectively, by the wideband filter, the first filter, and the second filter, and a comparison unit operative to compare the timing of the possible ventricular depolarization events identified within the respective filtered signals to identify oversensed ventricular repolarization events.

17. An implantable medical device comprising:

means for sensing electrical cardiac signals within a patient;

first means for filtering the signals to substantially eliminate signals having frequencies associated with ventricular repolarization events;

second means for filtering the signals to pass signals having frequencies associated with ventricular depolarization events and ventricular repolarization events; and

means for detecting oversensing of ventricular repolarization events based on a comparison of the signals filtered by the second means for filtering and the signals filtered by the first means for filtering.