Non-sustained tachyarrhythmia analysis to identify lead related condition

• US 8,260,419 B2
• Filed: 10/27/2009
• Issued: 09/04/2012
• Est. Priority Date: 10/27/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gunderson, Bruce D.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/606,899
• Publication Number:
  US 20110098766A1
• Time in Patent Office: 1,043 Days
• Field of Search: 607/14, 607/2, 607/16
• US Class Current: 607/14
• CPC Class Codes: A61B 2560/0276 Determining malfunction
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/276 Protection against electrode failure
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

Techniques for determining whether a lead related condition exists based on analysis of a cardiac electrical signal associated with a non-sustained tachyarrhythmia (NST) are described. In some examples, the techniques include determining the duration of intervals between consecutive cardiac events, e.g., R-R intervals, during an NST. The techniques may further include determining one or more metrics based on the durations of the intervals during the NST. Examples of metrics include an average, a minimum, a maximum, a range, a median, a mode, or a mean. A lead related condition is identified based on the values of the one or more metrics, e.g., by comparison to respective thresholds. In some examples, an alert is provided or a therapy modification is suggested if a lead related condition is identified.

Claims

1. A method comprising, with one or more processors:

detecting a plurality of cardiac events based on a cardiac electrical signal;

measuring a plurality of intervals between consecutive ones of the detected cardiac events;

detecting a non-sustained tachyarrhythmia based on a subset of the measured intervals meeting a non-sustained tachyarrhythmia criterion;

after detecting the non-sustained tachyarrhythmia, calculating at least one metric based on the subset of the measured intervals, wherein the at least one metric comprises at least one of a range of the subset of measured intervals or a minimum of the subset of measured intervals; and

identifying a lead related condition based on the at least one metric by at least comparing the at least one metric to a predetermined threshold and identifying the lead related condition based on the comparison.

2. The method of claim 1, further comprising providing an alert in response to identifying the lead related condition.

3. The method of claim 1, further comprising modifying a therapy in response to identifying the lead related condition.

4. The method of claim 1, further comprising modifying at least one parameter associated with detection of the cardiac events based on detecting the lead related condition.

5. The method of claim 1, wherein the at least one metric comprises a plurality of metrics.

6. The method of claim 1, wherein the cardiac events comprise R-waves, and the intervals comprise R-R intervals.

7. A system comprising:

an electrical sensing module that receives a cardiac electrical signal from a plurality of electrodes, and detects a plurality of cardiac events based on the cardiac electrical signal;

an interval measurement module that measures a plurality of intervals between consecutive ones of the detected cardiac events;

a non-sustained tachyarrhythmia detection module that detects a non-sustained tachyarrhythmia based on a subset of the measured intervals meeting a non-sustained tachyarrhythmia criterion;

a calculation module that calculates at least one metric based on the subset of the measured intervals after the detection of the non-sustained tachyarrhythmia, wherein the at least one metric comprises at least one of a range of the subset of measured intervals or a minimum of the subset of measured intervals; and

a lead integrity evaluation module that identifies a lead related condition based on the metric by at least comparing the at least one metric to a predetermined threshold and identifying the lead related condition based on the comparison.

8. The system of claim 7, further comprising a signal generator, and wherein the lead integrity evaluation modifies delivery of therapy by the signal generator in response to identification of the lead related condition.

9. The system of claim 7, wherein the lead integrity evaluation module modifies at least one parameter associated with detection of the cardiac events by the electrical sensing module based on the identification of the lead related condition.

10. The system of claim 7, further comprising a telemetry module that transmits information regarding at least one of an alert, a therapy modification, or a sensing modification if a lead related condition exists.

11. The system of claim 7, wherein the non-sustained tachyarrhythmia detection module identifies a plurality of events in the cardiac electrical signal as cardiac depolarizations, determines a rate of at least some of the events, and detects the non-sustained tachyarrhythmia based on the rate.

12. The system of claim 7, wherein the cardiac events comprise R-waves, and the intervals comprise R-R intervals.

13. The system of claim 7, further comprising an implantable medical device that comprises the electrical sensing module.

14. The system of claim 13, wherein the implantable medical device comprises the interval measurement module, the non-sustained tachyarrhythmia detection module, the calculation module, and the lead integrity evaluation module.

15. A system comprising:

means for detecting a plurality of cardiac events based on a cardiac electrical signal;

means for measuring a plurality of intervals between consecutive ones of the detected cardiac events;

means for detecting a non-sustained tachyarrhythmia based on a subset of the measured intervals meeting a non-sustained tachyarrhythmia criterion;

means for calculating at least one metric based on the subset of the measured intervals after detecting the non-sustained tachyarrhythmia, wherein the at least one metric comprises at least one of a range of the subset of measured intervals or a minimum of the subset of measured intervals; and

means for identifying a lead related condition based on the at least one metric, wherein the means for identifying a lead related condition comprises means for comparing the at least one metric to a predetermined threshold and means for identifying the lead related condition based on the comparison.

16. The system of claim 15, further comprising means for providing an alert in response to identifying the lead related condition.

17. A computer readable storage medium comprising instructions that cause one or more processors to:

detect a plurality of cardiac events based on a cardiac electrical signal;

measure a plurality of intervals between consecutive ones of the detected cardiac events;

detect a non-sustained tachyarrhythmia based on a subset of the measured intervals meeting a non-sustained tachyarrhythmia criterion;

after detecting the non-sustained tachyarrhythmia, calculate at least one metric based on the subset of the measured intervals, wherein the at least one metric comprises at least one of a range of the subset of measured intervals or a minimum of the subset of measured intervals; and

identify a lead related condition based on the at least one metric by at least comparing the at least one metric to a predetermined threshold and identifying the lead related condition based on the comparison.

18. The computer-readable storage medium of claim 17, further comprising instructions that cause the one or more processors to provide an alert in response to identifying the lead related condition.