Apparatus and method for identifying atrial arrhythmia by far-field sensing
First Claim
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1. A method of treating a patient with an implanted cardioverter-defibrillator comprising:
- the implanted cardioverter-defibrillator capturing far-field cardiac signals from electrodes disposed beneath the skin and outside of a patient'"'"'s ribcage;
the implanted cardioverter-defibrillator identifying the patient'"'"'s P-wave in the far-field cardiac signals;
the implanted cardioverter-defibrillator monitoring the patient'"'"'s P-wave to determine whether the patient'"'"'s P-wave abruptly changes; and
the implanted cardioverter-defibrillator if the patient'"'"'s P-wave abruptly changes, determining that the patient is experiencing atrial fibrillation and withholding cardiac stimulus that would otherwise be delivered to the patient.
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Abstract
In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameters such as rate, QRS pulse width, cardiac QRS slew rate, amplitude and stability measures of these parameters from the filtered cardiac signal information are measured, processed and integrated to determine if the cardioverter/defibrillator needs to initiate therapeutic action.
33 Citations
20 Claims
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1. A method of treating a patient with an implanted cardioverter-defibrillator comprising:
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the implanted cardioverter-defibrillator capturing far-field cardiac signals from electrodes disposed beneath the skin and outside of a patient'"'"'s ribcage; the implanted cardioverter-defibrillator identifying the patient'"'"'s P-wave in the far-field cardiac signals; the implanted cardioverter-defibrillator monitoring the patient'"'"'s P-wave to determine whether the patient'"'"'s P-wave abruptly changes; and the implanted cardioverter-defibrillator if the patient'"'"'s P-wave abruptly changes, determining that the patient is experiencing atrial fibrillation and withholding cardiac stimulus that would otherwise be delivered to the patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. An implantable cardioverter defibrillator (ICD) comprising a housing containing operational circuitry that is coupled to a plurality of electrodes for implantation in a patient, wherein the operational circuitry is configured to perform the following method of cardiac signal analysis while implanted in a patient:
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capturing far-field cardiac signals from electrodes disposed beneath the skin and outside of a patient'"'"'s ribcage; identifying the patient'"'"'s P-wave in the far-field cardiac signals; monitoring the patient'"'"'s P-wave to determine whether the patient'"'"'s P-wave abruptly changes; and if the patient'"'"'s P-wave abruptly changes, determining that the patient is experiencing atrial fibrillation and withholding cardiac stimulus that would otherwise be delivered to the patient. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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20. A method of treating a patient with a defibrillator comprising a housing containing operational circuitry and a lead having electrodes thereon coupled to the housing comprising implanting the housing beneath the skin and outside of the patients ribcage and implanting the lead beneath the skin and outside of the patients ribcage such without accessing the vasculature or heart of the patient;
- wherein the defibrillator'"'"'s operational circuitry is configured, once implanted, to perform a method of cardiac signal analysis comprising;
capturing far-field cardiac signals from at least one electrode of the lead; identifying the patient'"'"'s P-wave in the far-field cardiac signals; monitoring the patient'"'"'s P-wave to determine whether the patient'"'"'s P-wave abruptly changes; and if the patient'"'"'s P-wave abruptly changes, determining that the patient is experiencing atrial fibrillation and withholding cardiac stimulus that would otherwise be delivered to the patient.
- wherein the defibrillator'"'"'s operational circuitry is configured, once implanted, to perform a method of cardiac signal analysis comprising;
Specification