Ischemia detection and classification
First Claim
1. A system comprising:
- a first electrode and a second electrode both implanted within a heart of a patient;
a third electrode outside of the heart;
a processor configured to generate an endocardial electrogram of the heart with an endocardial electrode vector between the first electrode and the second electrode during a time period and generate a non-endocardial electrogram of the heart with an epicardial electrode vector comprising the third electrode during the time period; and
an ischemia detection module configured to detect a change in at least one electrogram metric of at least one of the non-endocardial electrogram or the endocardial electrogram, and classify an ischemia of the heart during the time period as one of a plurality of ischemia types based on the detection.
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Abstract
Techniques for detecting ischemia and classifying a type of ischemia are described. Electrograms of cardiac activity may be generated using implanted or external electrodes, e.g., electrodes carried on vascular leads within the heart and a housing electrode. In some examples, ischemia is detected and classified as benign or malignant based on whether a change an electrogram metric is detected, or first detected, in an endocardial electrogram or a non-endocardial electrogram. The relative timing of the change in the electrogram metric and a change in heart rate or patient activity may also be considered. In some examples, the system may create a stress test for detecting ischemia by instructing the patient to exercise or increasing the cardiac pacing rate.
31 Citations
24 Claims
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1. A system comprising:
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a first electrode and a second electrode both implanted within a heart of a patient; a third electrode outside of the heart; a processor configured to generate an endocardial electrogram of the heart with an endocardial electrode vector between the first electrode and the second electrode during a time period and generate a non-endocardial electrogram of the heart with an epicardial electrode vector comprising the third electrode during the time period; and an ischemia detection module configured to detect a change in at least one electrogram metric of at least one of the non-endocardial electrogram or the endocardial electrogram, and classify an ischemia of the heart during the time period as one of a plurality of ischemia types based on the detection. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 15)
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13. A system comprising:
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means for generating a endocardial electrogram of a heart with an endocardial electrode vector within a patient during a time period and generating a non-endocardial electrogram of the heart with an epicardial electrode vector during the time period; means for detecting a change in at least one electrogram metric of at least one of the non-endocardial electrogram or the endocardial electrogram; and means for classifying an ischemia of the heart during the time period as one of a plurality of ischemia types based on the detection. - View Dependent Claims (14)
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16. A method comprising:
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generating, by a processor, a endocardial electrogram of a heart during a period of time with an endocardial electrode vector between a first electrode implanted within the heart and a second electrode implanted within the heart; generating, by the processor, a non-endocardial electrogram of the heart during the period of time with an epicardial electrode vector comprising a third electrode outside of the heart; detecting, by an ischemia detection module, a change in at least one electrogram metric of at least one of the non-endocardial electrogram or the endocardial electrogram; and classifying, by the ischemia detection module, an ischemia of the heart during the time period as one of a plurality of ischemia types based on the detection. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23, 24)
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Specification