Discrimination of ventricular tachycardia from supraventricular tachycardia

• US 8,280,500 B2
• Filed: 06/02/2009
• Issued: 10/02/2012
• Est. Priority Date: 06/02/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Chow, Theodore
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/476,811
• Publication Number:
  US 20090299205A1
• Time in Patent Office: 1,218 Days
• Field of Search: 600/518
• US Class Current: 600/518
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• 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: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/36592 controlled by the heart rate variability
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

This disclosure describes various techniques for discriminating supraventricular tachycardia (SVT) from ventricular tachycardia (VT). As one example, a method includes detecting a tachycardia rhythm, identifying a rate of change in heart rate corresponding to the tachycardia rhythm, identifying a rate of change in heart rate variability corresponding to the tachycardia rhythm, and classifying the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability.

Claims

1. A method comprising:

detecting a tachycardia rhythm;

identifying a rate of change in heart rate corresponding to the tachycardia rhythm;

identifying a rate of change in heart rate variability corresponding to the tachycardia rhythm; and

classifying the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability, wherein classifying the tachycardia rhythm comprises;

classifying the tachycardia rhythm as ventricular tachycardia if the rate of change in heart rate variability exceeds both a first and second threshold; and

classifying the tachycardia rhythm as supraventricular tachycardia if the rate of change in heart rate variability does not exceed both the first and second threshold.

2. The method of claim 1, wherein classifying the tachycardia rhythm as supraventricular tachycardia comprises:

classifying the tachycardia rhythm as sinus tachycardia if the rate of change in heart rate variability does not exceed either of the first and second thresholds; and

classifying the tachycardia rhythm as atrial tachycardia if the rate of change in heart rate variability exceeds the first threshold but not the second threshold.

3. The method of claim 1, wherein values of the first and second thresholds are defined based on clinician input.

4. The method of claim 1, further comprising identifying a type of supraventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability.

5. A method comprising:

recording heart rate data for a patient over a period of time;

recording heart rate variability data for the patient over the period of time;

identifying a relationship between heart rate and heart rate variability for the patient based on the recorded data;

detecting a tachycardia rhythm of the patient;

identifying a rate of change in heart rate corresponding to the tachycardia rhythm;

identifying a rate of change in heart rate variability corresponding to the tachycardia rhythm; and

classifying the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on each of the rate of change in heart rate, the rate of change in heart rate variability, and the relationship.

6. A system comprising:

a sensor configured to sense activity of a heart of a patient; and

a processor configured to detect a tachycardia rhythm based on the sensed activity, identify a rate of change in heart rate corresponding to the tachycardia rhythm, identify a rate of change in heart rate variability corresponding to the tachycardia rhythm, and classify the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability,

wherein the processor is configured to classify the tachycardia rhythm as ventricular tachycardia if the rate of change in heart rate variability exceeds both a first and second threshold and classify the tachycardia rhythm as supraventricular tachycardia if the rate of change in heart rate variability does not exceed both the first and second threshold.

7. The system of claim 6, wherein the processor is configured to classify the tachycardia rhythm as sinus tachycardia if the rate of change in heart rate variability does not exceed either of the first and second thresholds and classify the tachycardia rhythm as atrial tachycardia if the rate of change in heart rate variability exceeds the first threshold but not the second threshold.

8. The system of claim 6, wherein values of the first and second thresholds are defined based on clinician input.

9. The system of claim 6, wherein the processor is configured to identify a type of supraventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability.

10. The system of claim 6, further comprising a medical device, wherein the medical device comprises at least one of the sensor or the processor.

11. The system of claim 10, wherein the medical device comprises an implantable medical device.

12. The system of claim 10, wherein the sensor comprises one or more electrodes coupled to the medical device via one or more leads.

13. A system comprising,

a sensor configured to sense activity of a heart of a patient;

and

a processor configured to detect a tachycardia rhythm based on the sensed activity, identify a rate of change in heart rate corresponding to the tachycardia rhythm, identify a rate of change in heart rate variability corresponding to the tachycardia rhythm, and classify the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability,

wherein the processor is configured to record heart rate data for the patient over a period of time based on the sensed activity, record heart rate variability data for the patient over the period of time based on the sensed activity, identify a relationship between heart rate and heart rate variability for the patient based on the recorded data, and classify the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on each of the rate of change in heart rate, rate of change in heart rate variability, and the relationship.

14. A system comprising:

means for detecting a tachycardia rhythm;

means for identifying a rate of change in heart rate corresponding to the tachycardia rhythm;

means for identifying a rate of change in heart rate variability corresponding to the tachycardia rhythm; and

means for classifying the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability, wherein the means for classifying the tachycardia rhythm comprises;

means for classifying the tachycardia rhythm as ventricular tachycardia if the rate of change in heart rate variability exceeds both a first and second threshold; and

means for classifying the tachycardia rhythm as supraventricular tachycardia if the rate of change in heart rate variability does not exceed both the first and second threshold.

15. A method comprising:

recording heart rate data for a patient over a period of time;

recording heart rate variability data for the patient over the period of time;

identifying a relationship between heart rate and heart rate variability for the patient based on the recorded data;

subsequently detecting a tachycardia rhythm in the patient; and

classifying the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the relationship.

16. The method of claim 15, wherein classifying the tachycardia rhythm comprises classifying the tachycardia rhythm as supraventricular tachycardia or ventricular tachycardia based on whether a heart rate associated with the tachycardia rhythm and a heart rate variability associated with the tachycardia rhythm are within a tolerance value of the relationship.

17. A system comprising:

a sensor configured to sense activity of a heart of a patient; and

a processor configured to record heart rate data for the patient over a period of time based on the sensed activity, record heart rate variability data for the patient over the period of time based on the sensed activity, identify a relationship between heart rate and heart rate variability for the patient based on the recorded data, subsequently detect a tachycardia rhythm in the patient based on the sensed activity, and classify the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the relationship.

18. The system of claim 17, wherein the processor is configured to classify the tachycardia rhythm based on whether a heart rate associated with the tachycardia rhythm and a heart rate variability associated with the tachycardia rhythm are within a tolerance value of the relationship.

19. The system of claim 17, further comprising a medical device, wherein the medical device comprises at least one of the sensor or the processor.

20. The system of claim 19, wherein the medical device comprises an implantable medical device.

21. The system of claim 19, wherein the sensor comprises one or more electrodes coupled to the medical device via one or more leads.

22. A system comprising:

means for recording heart rate data for a patient over a period of time;

means for recording heart rate variability data for the patient over the period of time;

means for identifying a relationship between heart rate and heart rate variability for the patient based on the recorded data;

means for subsequently detecting a tachycardia rhythm in the patient; and

means for classifying the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the relationship.