Discriminating polymorphic and monomorphic cardiac rhythms using template generation
First Claim
1. A method of arrhythmia discrimination for implementation by an implantable cardiac rhythm management device, comprising:
- detecting cardiac beats associated with an arrhythmia episode;
forming a plurality of templates of the arrhythmia episode using morphological features of the cardiac beats of the arrhythmia episode, wherein forming the plurality of templates includes;
forming at least one template of the arrhythmia episode;
measuring similarity between morphological features of a cardiac beat of the arrhythmia episode and each previously formed template of the arrhythmia episode;
using the cardiac beat to modify a previously formed template of the arrhythmia episode in response to a measure of similarity between the cardiac beat and the previously formed template being greater than a similarity threshold; and
forming an additional template of the arrhythmia episode in response to measures of similarity between the cardiac beat and each previously formed template being less than a similarity threshold;
determining the number of templates formed from the arrhythmia episode; and
discriminating between monomorphic tachyarrhythmia and polymorphic tachyarrhythmia based on the number of templates determined to be formed using the cardiac beats of the arrhythmia episode.
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Abstract
Cardiac arrhythmias are classified based on the morphology of the arrhythmia episode beats. Templates are formed using morphological features of the cardiac beats of the episode. The arrhythmia episode is classified as a monomorphic tachyarrhythmia or polymorphic tachyarrhythmia based on the one or more templates. The arrhythmia episode may be classified based on a number templates formed from the arrhythmia episode. The templates are formed by determining a measure of similarity between morphological features of a cardiac beat to a template. The similarities can be determined based on a pairing rule that determines which beat morphologies are compared. Selection of therapy for treating the arrhythmia episode may depend on the historical success of a therapy at mitigating previous arrhythmias of the same type as the arrhythmia episode.
146 Citations
22 Claims
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1. A method of arrhythmia discrimination for implementation by an implantable cardiac rhythm management device, comprising:
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detecting cardiac beats associated with an arrhythmia episode; forming a plurality of templates of the arrhythmia episode using morphological features of the cardiac beats of the arrhythmia episode, wherein forming the plurality of templates includes; forming at least one template of the arrhythmia episode; measuring similarity between morphological features of a cardiac beat of the arrhythmia episode and each previously formed template of the arrhythmia episode; using the cardiac beat to modify a previously formed template of the arrhythmia episode in response to a measure of similarity between the cardiac beat and the previously formed template being greater than a similarity threshold; and forming an additional template of the arrhythmia episode in response to measures of similarity between the cardiac beat and each previously formed template being less than a similarity threshold; determining the number of templates formed from the arrhythmia episode; and discriminating between monomorphic tachyarrhythmia and polymorphic tachyarrhythmia based on the number of templates determined to be formed using the cardiac beats of the arrhythmia episode. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An implantable medical device, comprising:
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sensor circuitry comprising electrodes for electrically coupling to a heart, the sensor circuitry configured to detect cardiac beats associated with an cardiac arrhythmia episode; a template generator coupled to the sensor circuitry and configured to form a plurality of templates of the arrhythmia episode using the detected cardiac beats, wherein the template generator includes; circuitry configured to form at least one template of the arrhythmia episode; circuitry configured to measure a similarity between morphological features of a cardiac beat of the arrhythmia episode and each previously formed template of the arrhythmia episode; circuitry configured to use the cardiac beat to modify a previously formed template of the arrhythmia episode in response to a measure of similarity between the cardiac beat and the previously formed template being greater than a similarity threshold; and circuitry configured to form an additional template of the arrhythmia episode in response to measures of similarity between the cardiac beat and each previously formed template being less than a similarity threshold; and an arrhythmia processor coupled to the template generator, the arrhythmia processor configured to determine the number of templates formed from the arrhythmia episode and discriminate between monomorphic tachyarrhythmia and polymorphic tachyarrhythmia based on the number of templates determined to be formed using the cardiac beats of the arrhythmia episode. - View Dependent Claims (14, 15, 16, 17, 18)
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19. A system for arrhythmia discrimination, comprising:
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means for detecting cardiac beats associated with an arrhythmia episode; means for forming a plurality of templates of the arrhythmia episode using morphological features of the cardiac beats of the arrhythmia episode, wherein forming the plurality of templates includes; means for forming at least one template of the arrhythmia episode; means for measuring similarity between morphological features of a cardiac beat of the arrhythmia episode and each previously formed template of the arrhythmia episode; means for using the cardiac beat to modify a previously formed template of the arrhythmia episode in response to a measure of similarity between the cardiac beat and the previously formed template being greater than a similarity threshold; and means for forming an additional template of the arrhythmia episode in response to measures of similarity between the cardiac beat and each previously formed template being less than a similarity threshold; means for determining the number of templates formed from the arrhythmia episode; and means for discriminating between monomorphic tachyarrhythmia and polymorphic tachyarrhythmia based on the number of templates determined to be formed using the cardiac beats of the arrhythmia episode. - View Dependent Claims (20, 21, 22)
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Specification