Anti-tachyarrhythmia system with unified atrial tachyarrhythmia rate threshold

• US 8,457,736 B2
• Filed: 06/14/2011
• Issued: 06/04/2013
• Est. Priority Date: 12/20/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Perschbacher, David L., Gilkerson, James O., Kalgren, James
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): VOORHEES, CATHERINE M
• Application Number:
  US13/159,732
• Publication Number:
  US 20110245889A1
• Time in Patent Office: 721 Days
• Field of Search: 607 30- 32, 607/4, 607/9, 607/14, 607/17
• US Class Current: 607/4
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation

Abstract

A cardiac rhythm management (CRM) system includes an implantable cardioverter defibrillator (ICD) and an external system. The ICD includes a plurality of functional modules performing tachyarrhythmia classification and therapy control functions using atrial tachyarrhythmia rate thresholds that are set to a unified value. In one embodiment, the CRM system allows a user to activate and deactivate each of the functional modules and program the unified value using the external system.

Claims

1. A system for programming an implantable cardioverter defibrillator (ICD) including a plurality of functional modules using a plurality of atrial tachyarrhythmia rate thresholds, each functional module of the plurality of functional modules configured to perform a tachyarrhythmia classification or therapy control function using an atrial rate and an atrial tachyarrhythmia rate threshold of the plurality of atrial tachyarrhythmia rate thresholds, the system comprising:

a telemetry circuit configured to communicate with the ICD;

a user interface including;

a presentation device configured to present the tachyarrhythmia classification or therapy control functions to be performed by the plurality of functional modules using a unified threshold value for the plurality of atrial tachyarrhythmia rate thresholds and to present the unified threshold value; and

a user input device configured to receive the unified threshold value and to allow adjustment of the presented unified threshold value; and

a controller coupled to the telemetry circuit and the user interface, the controller configured to program the ICD by transmitting the unified threshold value to the ICD.

2. The system of claim 1, wherein the user input device is further configured to receive a user selection for activating one or more functional modules of the plurality of functional modules, and the controller is further configured to program the ICD using the user selection and the unified threshold value.

3. The system of claim 2, wherein the user interface comprises an interactive screen configured to function as both the presentation device and the user input device.

4. The system of claim 3, wherein the interactive screen is configured to display an activation status for each functional module of the plurality of functional modules and a programming field allowing a user to change the activation status of the each functional module.

5. The system of claim 4, wherein the interactive screen is configured to display a current value of the unified threshold value and a programming field allowing the user to adjust the unified threshold value.

6. The system of claim 4, wherein the plurality of functional modules comprises an atrial fibrillation (AF) detector configured to compare the atrial rate to the unified threshold value and declare a detection of AF in response to the atrial rate exceeding the unified threshold value, and the presentation device is configured to present the function performed by the AF detector.

7. The system of claim 4, wherein the plurality of functional modules comprises an atrial tachyarrhythmia response (ATR) controller configured to adjust delivery of pacing pulses in response to the atrial rate exceeding the unified threshold value, and the presentation device is configured to present the function performed by the ATR controller.

8. The system of claim 4, wherein the plurality of functional modules comprises an atrial flutter response (AFR) controller configured to trigger an AFR window in response to a detection of an intrinsic atrial depolarization, the AFR window set to an atrial tachyarrhythmia interval value corresponding to the unified threshold value and used for controlling detection of intrinsic atrial depolarizations that trigger delivery of ventricular pacing pulses during an atrial tracking pacing mode, and the presentation device is configured to present the function performed by the AFR controller.

9. The system of claim 4, wherein the plurality of functional modules comprises an atrial tachyarrhythmia therapy controller configured to cause delivery of an anti-tachyarrhythmia therapy in response to the atrial rate exceeding the unified threshold value, and the presentation device is configured to present the function performed by the atrial tachyarrhythmia therapy controller.

10. The system of claim 1, wherein the telemetry circuit is configured to communicate with the ICD via an inductive telemetry link.

11. The system of claim 1, wherein the telemetry circuit is configured to communicate with the ICD via a far-field radio-frequency telemetry link.

12. A method for programming an implantable cardioverter defibrillator (ICD) including a plurality of functional modules using a plurality of atrial tachyarrhythmia rate thresholds, each functional module of the plurality of functional modules configured to perform a tachyarrhythmia classification or therapy control function using an atrial rate and an atrial tachyarrhythmia rate threshold of the plurality of atrial tachyarrhythmia rate thresholds, the method comprising:

presenting the tachyarrhythmia classification or therapy control functions to be performed by the plurality of functional modules using a unified threshold value for the plurality of atrial tachyarrhythmia rate thresholds;

presenting the unified threshold value;

receiving the unified threshold value for the plurality of atrial tachyarrhythmia rate thresholds;

allowing adjustment of the presented unified threshold value; and

programming the ICD by transmitting the unified threshold value to the ICD via a telemetry link.

13. The method of claim 12, further comprising receiving a user selection for activating one or more functional modules of the plurality of functional modules, and wherein programming the ICD comprises programming the ICD using the user selection and the unified threshold value via the telemetry link.

14. The method of claim 13, comprising displaying an activation status for each functional module of the plurality of functional modules and a programming field allowing a user to change the activation status of the each functional module.

15. The method of claim 13, comprising displaying a current value of the unified threshold value and a programming field allowing the user to adjust the unified threshold value.

16. The method of claim 12, wherein the plurality of functional modules comprises an atrial fibrillation (AF) detector configured to compare the atrial rate to the unified threshold value and declare a detection of AF in response to the atrial rate exceeding the unified threshold value, and presenting the tachyarrhythmia classification or therapy control functions comprises presenting the function provided by the AF detector.

17. The method of claim 12, wherein the plurality of functional modules comprises an atrial tachyarrhythmia response (ATR) controller configured to adjust delivery of pacing pulses in response to the atrial rate exceeding the unified threshold value, and presenting the tachyarrhythmia classification or therapy control functions comprises presenting the function provided by the ATR controller.

18. The method of claim 12, wherein the plurality of functional modules comprises an atrial flutter response (AFR) controller configured to trigger an AFR window in response to a detection of an intrinsic atrial depolarization, the AFR window set to an atrial tachyarrhythmia interval value corresponding to the unified threshold value and used for controlling detection of intrinsic atrial depolarizations that trigger delivery of ventricular pacing pulses during an atrial tracking pacing mode, and presenting the tachyarrhythmia classification or therapy control functions comprises presenting the function provided by the AFR controller.

19. The method of claim 12, wherein the plurality of functional modules comprises an atrial tachyarrhythmia therapy controller configured to cause delivery of an anti-tachyarrhythmia therapy in response to the atrial rate exceeding the unified threshold value, and presenting the tachyarrhythmia classification or therapy control functions comprises presenting the function provided by the atrial tachyarrhythmia therapy controller.

20. A system for programming an implantable cardioverter defibrillator (ICD) including a plurality of functional modules using a plurality of atrial tachyarrhythmia rate thresholds, each functional module of the plurality of functional modules configured to perform a tachyarrhythmia classification or therapy control function using an atrial rate and an atrial tachyarrhythmia rate threshold of the plurality of atrial tachyarrhythmia rate thresholds, the system comprising:

means for presenting the tachyarrhythmia classification or therapy control functions to be performed by the plurality of functional modules;

means for receiving a unified threshold value for the plurality of atrial tachyarrhythmia rate thresholds to be used by the plurality of functional modules; and

means for programming the ICD by transmitting the unified threshold value to the ICD via a telemetry link.