Cardiac rhythm management system with arrhythmia classification and electrode selection
First Claim
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1. An implantable cardiac rhythm management device, comprising:
- a plurality of electrodes, at least a first electrode of the plurality of electrodes configured to electrically couple to a first ventricle and at least a second electrode of the plurality of electrodes configured to electrically couple to a second ventricle;
an energy output circuit, coupled to the first and the second electrodes and configured to deliver electrical energy to the first and second ventricles via the first and second electrodes;
an arrhythmia detection circuit configured to detect a ventricular tachyarrhythmia episode; and
a processor coupled to the arrhythmia detection circuit and configured to control the energy output circuit to deliver anti-tachyarrhythmia pacing (ATP) therapy to the first and second ventricles via the first and second electrodes, wherein delivery of the ATP therapy includes pacing a primary ATP site and pacing at least one secondary ATP site during each cardiac cycle using an ATP offset interval between the primary ATP site and the secondary ATP site, the ATP offset interval based on a time delay between an intrinsic depolarization at the primary ATP site and an intrinsic depolarization at the secondary ATP site during ventricular tachyarrhythmia.
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Abstract
A system, method, or device classifies an arrhythmia according to the temporal order in which a depolarization wave associated with a particular heart contraction is received at a plurality of electrodes. One or more antiarrhythmia therapies is mapped to each arrhythmia classification. When a particularly classified arrhythmia is detected, the correspondingly mapped therapy list is selected and an appropriate antiarrhythmia therapy delivered. In one example, the particular therapy delivered in response to an arrhythmia depends at least in part on its historical success in treating arrhythmias of that classification.
147 Citations
20 Claims
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1. An implantable cardiac rhythm management device, comprising:
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a plurality of electrodes, at least a first electrode of the plurality of electrodes configured to electrically couple to a first ventricle and at least a second electrode of the plurality of electrodes configured to electrically couple to a second ventricle; an energy output circuit, coupled to the first and the second electrodes and configured to deliver electrical energy to the first and second ventricles via the first and second electrodes; an arrhythmia detection circuit configured to detect a ventricular tachyarrhythmia episode; and a processor coupled to the arrhythmia detection circuit and configured to control the energy output circuit to deliver anti-tachyarrhythmia pacing (ATP) therapy to the first and second ventricles via the first and second electrodes, wherein delivery of the ATP therapy includes pacing a primary ATP site and pacing at least one secondary ATP site during each cardiac cycle using an ATP offset interval between the primary ATP site and the secondary ATP site, the ATP offset interval based on a time delay between an intrinsic depolarization at the primary ATP site and an intrinsic depolarization at the secondary ATP site during ventricular tachyarrhythmia. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method of operating an implantable cardiac rhythm management device, comprising:
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detecting a ventricular tachyarrhythmia episode; and delivering ATP therapy to first and second ventricles including delivering a pacing pulse to a primary ATP site and delivering a pacing pulse to the at least one secondary ATP site during one or more cardiac cycles of the tachyarrhythmia episode, the pacing pulse to the primary ATP site and the pacing pulse to the at least one secondary ATP site separated by an ATP offset interval, wherein the ATP offset interval is based on a time delay between an intrinsic depolarization of the primary ATP site and an intrinsic depolarization of the at least one secondary ATP site during ventricular tachyarrhythmia. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification