Methods and systems for determining if an arrhythmia initiated in an atrium or a ventricle
First Claim
1. For use by an implantable system, a method for discriminating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT), comprising:
- (a) detecting atrial intervals indicative of atrial rate and ventricular intervals indicative of ventricular rate within a window leading up to and following the onset of a tachycardia;
(b) determining whether a valid atrial interval decrease is detected within the window by(b.1) determining whether an atrial interval decrease that is greater than an atrial interval decrease threshold is detected for a pair of consecutive atrial intervals within the window, and(b.2) if the atrial interval decrease is detected, determining whether the detected atrial interval decrease is valid based on atrial intervals before and after the detected atrial interval decrease;
(c) determining whether a valid ventricular interval decrease is detected within the window by(c.1) determining whether a ventricular interval decrease that is greater than a ventricular interval decrease threshold is detected for a pair of consecutive ventricular intervals within the window, and(c.2) if the ventricular interval decrease is detected, determining whether the detected ventricular interval decrease is valid based on ventricular intervals before and after the detected ventricular interval decrease; and
(d) discriminating between VT and SVT based on results of step (b) and (c);
wherein step (d) comprises determining that the detected atrial intervals and the detected ventricular intervals within the window are indicative of SVT if both a valid atrial interval decrease is detected and a valid ventricular interval decrease is detected within the window, and the valid atrial interval change occurs prior to the valid ventricular interval change.
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Abstract
Validated atrial and/or ventricular interval decreases are used to discriminate between VT and SVT. Atrial and/or ventricular intervals are monitored in order to detect decreases in such intervals (which are indicative in increases in rate). The atrial intervals can be, e.g., AA intervals, and the ventricular intervals can be, e.g., VV intervals. A detected atrial and/or ventricular interval decrease can be a decrease that is greater than an interval decrease threshold. Detected atrial and/or ventricular interval decreases can be validated by examining atrial and/or ventricular intervals before and after a detected atrial and/or ventricular interval decrease. The use of the validated atrial and/or ventricular interval decreases to classify an arrhythmia as SVT or VT can be called arrhythmia initiation analysis, since it is believed to determine whether the initiation of the arrhythmia is in an atrium or a ventricle.
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Citations
21 Claims
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1. For use by an implantable system, a method for discriminating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT), comprising:
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(a) detecting atrial intervals indicative of atrial rate and ventricular intervals indicative of ventricular rate within a window leading up to and following the onset of a tachycardia; (b) determining whether a valid atrial interval decrease is detected within the window by (b.1) determining whether an atrial interval decrease that is greater than an atrial interval decrease threshold is detected for a pair of consecutive atrial intervals within the window, and (b.2) if the atrial interval decrease is detected, determining whether the detected atrial interval decrease is valid based on atrial intervals before and after the detected atrial interval decrease; (c) determining whether a valid ventricular interval decrease is detected within the window by (c.1) determining whether a ventricular interval decrease that is greater than a ventricular interval decrease threshold is detected for a pair of consecutive ventricular intervals within the window, and (c.2) if the ventricular interval decrease is detected, determining whether the detected ventricular interval decrease is valid based on ventricular intervals before and after the detected ventricular interval decrease; and (d) discriminating between VT and SVT based on results of step (b) and (c); wherein step (d) comprises determining that the detected atrial intervals and the detected ventricular intervals within the window are indicative of SVT if both a valid atrial interval decrease is detected and a valid ventricular interval decrease is detected within the window, and the valid atrial interval change occurs prior to the valid ventricular interval change. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 16)
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12. For use by an implantable system, a method for discriminating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT), comprising:
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(a) detecting atrial intervals indicative of atrial rate and ventricular intervals indicative of ventricular rate within a window leading up to and following the onset of a tachycardia; (b) determining whether a valid atrial interval decrease is detected within the window by (b.1) determining whether an atrial interval decrease that is greater than an atrial interval decrease threshold is detected for a pair of consecutive atrial intervals within the window, and (b.2) if the atrial interval decrease is detected, determining whether the detected atrial interval decrease is valid based on atrial intervals before and after the detected atrial interval decrease; (c) determining whether a valid ventricular interval decrease is detected within the window by (c.1) determining whether a ventricular interval decrease that is greater than a ventricular interval decrease threshold is detected for a pair of consecutive ventricular intervals within the window, and (c.2) if the ventricular interval decrease is detected, determining whether the detected ventricular interval decrease is valid based on ventricular intervals before and after the detected ventricular interval decrease; and (d) discriminating between VT and SVT based on results of step (b) and (c); wherein step (d) comprises determining that the detected atrial intervals and the detected ventricular intervals within the window are indicative of VT if both a valid atrial interval decrease is detected and a valid ventricular interval decrease is detected within the window, and the valid ventricular interval change occurs prior to the valid atrial interval change.
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13. An implantable system capable of discriminating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT), comprising:
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a monitor configured to detect atrial intervals indicative of atrial rate and ventricular intervals indicative of ventricular rate within a window leading up to and following the onset of a tachycardia; and an arrhythmia discriminator configured to; determine whether a valid atrial interval decrease is detected within the window by determining whether an atrial interval decrease that is greater than an atrial interval decrease threshold is detected for a pair of consecutive atrial intervals within the window, if the atrial interval decrease is detected, determine whether the detected atrial interval decrease is valid based on atrial intervals before and after the detected atrial interval decrease, determine whether a valid ventricular interval decrease is detected within the window by determining whether a ventricular interval decrease that is greater than a ventricular interval decrease threshold is detected for a pair of consecutive ventricular intervals within the window, if the ventricular interval decrease is detected, determine whether the detected ventricular interval decrease is valid based on ventricular intervals before and after the detected ventricular interval decrease, and discriminate between VT and SVT based on the determinations; wherein the arrhythmia detector is configured to determine that the detected atrial intervals and the detected ventricular intervals within the window are indicative of SVT if both a valid atrial interval decrease is detected and a valid ventricular interval decrease is detected within the window, and the valid atrial interval change occurs prior to the valid ventricular interval change.
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14. An implantable system capable of discriminating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT), comprising:
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a monitor configured to detect atrial intervals indicative of atrial rate and ventricular intervals indicative of ventricular rate within a window leading up to and following the onset of a tachycardia; and an arrhythmia discriminator configured to; determine whether a valid atrial interval decrease is detected within the window by determining whether an atrial interval decrease that is greater than an atrial interval decrease threshold is detected for a pair of consecutive atrial intervals within the window, if the atrial interval decrease is detected, determine whether the detected atrial interval decrease is valid based on atrial intervals before and after the detected atrial interval decrease, determine whether a valid ventricular interval decrease is detected within the window by determining whether a ventricular interval decrease that is greater than a ventricular interval decrease threshold is detected for a pair of consecutive ventricular intervals within the window, if the ventricular interval decrease is detected, determine whether the detected ventricular interval decrease is valid based on ventricular intervals before and after the detected ventricular interval decrease, and discriminate between VT and SVT based on the determinations; wherein the arrhythmia detector is configured to determine that the detected atrial intervals and the detected ventricular intervals within the window are indicative of VT if both a valid atrial interval decrease is detected and a valid ventricular interval decrease is detected within the window, and the valid ventricular interval change occurs prior to the valid atrial interval change. - View Dependent Claims (15, 17, 18, 19, 20, 21)
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Specification