Tachyarrhythmia detection and discrimination based on curvature parameters

• US 8,409,107 B2
• Filed: 08/11/2010
• Issued: 04/02/2013
• Est. Priority Date: 06/27/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Sweeney, Robert J., Ricci, Carlos
• Primary Examiner(s): STOKLOSA, JOSEPH A
• Application Number:
  US12/854,557
• Publication Number:
  US 20100305645A1
• Time in Patent Office: 965 Days
• Field of Search: 600/508, 600/515
• US Class Current: 600/508
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• 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 1/3629 in combination with non-electric therapy
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: G06F 2218/08 Feature extraction

Abstract

Estimating a frequency of a sampled cardiac rhythm signal and classifying the rhythm. The received signal is sampled and transformed into a curvature series. A lobe in the curvature series corresponds to a characteristic point in the sampled series. Characteristic points are selected based on a time of a lobe in the curvature series and, in one embodiment, an amplitude of the signal at the time of the lobe. A frequency of the sampled series is estimated by autocorrelating a function of the series of the characteristic points. In one embodiment, the function is a time difference function. The rhythm is classified by plotting the timewise proximity of characteristic points derived from an atrial signal with characteristic points derived from a ventricular signal. Regions of the plot are associated with a particular rhythm and the grouping of the data corresponds to the classification.

Claims

1. An implantable cardiac rhythm management device comprising:

a ventricular channel input circuit to receive a sampled ventricular input signal for an epoch;

an atrial channel input circuit to receive a sampled atrial input signal for the epoch;

a controller coupled to the ventricular channel input circuit and coupled to the atrial channel input circuit, the controller adapted to determine relative timing between ventricular characteristic points and atrial characteristic points, each characteristic point determined based on a curvature series generated as a function of the input signals, each characteristic point having a time of a lobe in the curvature series; and

a discriminator circuit coupled to the controller and adapted to classify the epoch based on a comparison of a first function of the atrial characteristic points and a second function of the ventricular characteristic points,

wherein the controller is adapted to compute a ventricular curvature series using the sampled ventricular input signal for the epoch and an atrial curvature series using the sampled atrial input signals for the epoch, identify lobes using a curvature threshold value in each of the ventricular curvature series and the atrial curvature series, generate the ventricular characteristic points each associated with a lobe of the identified lobes in the ventricular curvature series, and generate the atrial characteristic points each associated with a lobe of the identified lobes in the atrial curvature series, wherein the ventricular curvature series includes curvatures each computed as a non-linear function of first and second derivatives of the sampled ventricular input signal, and the atrial curvature series includes curvatures each computed as a non-linear function of first and second derivatives of the sampled atrial input signal.

2. The device of claim 1 wherein the discriminator circuit is adapted to generate a plot of the first function of the atrial characteristic points and the second function of the ventricular characteristic points.

3. The device of claim 2 wherein the discriminator circuit is adapted to establish a separating contour in the plot.

4. The device of claim 2 wherein the discriminator circuit is adapted to classify the epoch by establishing a separating line in the plot.

5. The device of claim 4 wherein the discriminator circuit is adapted to establish a separating region proximate the separating line.

6. The device of claim 1 wherein the controller is adapted to determine relative timing by generating a window prior to each ventricular characteristic point.

7. The device of claim 6 wherein a dimension of the window is remotely selectable.

8. The device of claim 6 wherein a dimension of the window is varied according to a measured parameter.

9. The device of claim 1 wherein the discriminator circuit is adapted to determine a backward count based on a number of ventricular characteristic points having at least one atrial characteristic point in the window and adapted to determine a forward count based on a number of atrial characteristic points located within at least one window of a ventricular characteristic point.

10. The device of claim 9 wherein each characteristic point includes a size determined as a function of an area of the lobe, and wherein the discriminator circuit is adapted to classify the epoch as a function of the size of each characteristic point.

11. The device of claim 1 further including a memory coupled to the controller and adapted to store the classification of the epoch.

12. The device of claim 1 further including a telemetry circuit coupled to the controller and adapted to communicate with a programmer.

13. The device of claim 1 further including a therapy circuit coupled to the controller and adapted to deliver electrical stimulation as a function of a signal received from the controller.

14. The device of claim 1, wherein the controller is adapted to identify the lobes each being an excursion of more than the curvature threshold value from a baseline in the each of the ventricular curvature series and the atrial curvature series.

15. The device of claim 14, wherein the controller is adapted to determine each lobe of the identified lobes is a positive or negative excursion from the baseline.

16. The device of claim 1, wherein the controller is adapted to determine an appropriate therapy using the classification of the epoch.

17. The device of claim 16, comprising a pacemaker.

18. The device of claim 16, comprising a cardioverter/defibrillator.

19. The device of claim 16, comprising a drug delivery device.