Cardiac function management integrating cardiac contractility modulation
First Claim
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1. An apparatus comprising:
- an implantable cardiac rhythm/function management device comprising;
a cardiac contractility modulation (CCM) therapy circuit configured to deliver a CCM therapy including a non-stimulatory electrical energy during a refractory period of the heart;
a tachyarrhythmia circuit, configured to perform a tachyarrhythmia function comprising;
detecting a tachyarrhythmia using an intrinsic cardiac signal morphology analysis circuit configured to compare an intrinsic cardiac signal morphology to a CCM morphology template or a non-CCM morphology template; and
delivering tachyarrhythmia therapy; and
a controller circuit, coupled to the CCM therapy circuit and the tachyarrhythmia circuit, the controller circuit configured to obtain or provide information about the CCM therapy and information about the tachyarrhythmia therapy, the controller circuit configured to adjust at least one of the CCM therapy or the tachyarrhythmia therapy using the information obtained by the controller circuit including information about whether the other of the CCM therapy or the tachyarrhythmia therapy is being delivered or has been scheduled to be delivered, wherein the controller is configured to adjust a morphology analysis using information from the CCM therapy circuit about whether a CCM condition is present, the controller being configured to direct the intrinsic cardiac signal morphology analysis circuit to compare;
an intrinsic cardiac signal morphology to the CCM morphology template if a CCM condition is present;
oran intrinsic cardiac signal morphology to the non-CCM morphology template if a CCM condition is not present.
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Abstract
An implantable cardiac rhythm/function management system integrates cardiac contractility modulation (CCM) and one or more other therapies, such as to preserve device safety, improve efficacy, enhance sensing and detection, or enhance therapy effectiveness and delivery. Examples of the one or more other therapies can include pacing, defibrillation/cardioversion, cardiac resynchronization therapy (CRT), or neurostimulation.
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Citations
15 Claims
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1. An apparatus comprising:
an implantable cardiac rhythm/function management device comprising; a cardiac contractility modulation (CCM) therapy circuit configured to deliver a CCM therapy including a non-stimulatory electrical energy during a refractory period of the heart; a tachyarrhythmia circuit, configured to perform a tachyarrhythmia function comprising; detecting a tachyarrhythmia using an intrinsic cardiac signal morphology analysis circuit configured to compare an intrinsic cardiac signal morphology to a CCM morphology template or a non-CCM morphology template; and delivering tachyarrhythmia therapy; and a controller circuit, coupled to the CCM therapy circuit and the tachyarrhythmia circuit, the controller circuit configured to obtain or provide information about the CCM therapy and information about the tachyarrhythmia therapy, the controller circuit configured to adjust at least one of the CCM therapy or the tachyarrhythmia therapy using the information obtained by the controller circuit including information about whether the other of the CCM therapy or the tachyarrhythmia therapy is being delivered or has been scheduled to be delivered, wherein the controller is configured to adjust a morphology analysis using information from the CCM therapy circuit about whether a CCM condition is present, the controller being configured to direct the intrinsic cardiac signal morphology analysis circuit to compare; an intrinsic cardiac signal morphology to the CCM morphology template if a CCM condition is present;
oran intrinsic cardiac signal morphology to the non-CCM morphology template if a CCM condition is not present. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. An apparatus comprising:
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an implantable cardiac rhythm/function management device comprising; a cardiac contractility modulation (CCM) therapy circuit configured to deliver a CCM therapy including a non-stimulatory electrical energy during a refractory period of the heart; a tachyarrhythmia circuit, configured to perform a tachyarrhythmia function comprising; detecting a tachyarrhythmia using an intrinsic cardiac signal morphology analysis circuit configured to compare an intrinsic cardiac signal morphology to a CCM morphology template or a non-CCM morphology template; and delivering tachyarrhythmia therapy; and a controller circuit, coupled to the CCM therapy circuit and the tachyarrhythmia circuit, the controller circuit configured to obtain or provide information about the CCM therapy and information about the tachyarrhythmia therapy, the controller circuit configured to adjust at least one of the CCM therapy or the tachyarrhythmia therapy using the information obtained by the controller circuit including information about whether the other of the CCM therapy or the tachyarrhythmia therapy is being delivered or has been scheduled to be delivered; wherein the tachyarrhythmia circuit comprises a shock therapy circuit configured to deliver shock therapy; and
wherein the controller circuit is configured to isolate the CCM therapy circuit from shock therapy circuit during shock therapy delivery; andwherein the controller circuit is configured to adjust a morphology analysis using information about whether a CCM condition is present;
wherein a CCM condition is deemed present if (a) CCM has been delivered within a specified preceding time period or (b) CCM is enabled; and
wherein the controller circuit is configured to select a morphology template based on whether a CCM condition is present, the controller being configured to direct the intrinsic cardiac signal morphology analysis circuit to compare;an intrinsic cardiac signal morphology to the CCM morphology template if a CCM condition is present;
oran intrinsic cardiac signal morphology to the non-CCM morphology template if a CCM condition is not present. - View Dependent Claims (9)
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10. A method comprising:
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delivering a cardiac contractility modulation (CCM) therapy, wherein delivering the CCM therapy comprises delivering a non-stimulatory electrical energy during a refractory period of the heart; performing a tachyarrhythmia function comprising; detecting a tachyarrhythmia using an intrinsic cardiac signal morphology analysis circuit; and delivering tachyarrhythmia therapy; and obtaining or providing information about the CCM therapy and information about the tachyarrhythmia therapy, the information obtained or provided by a controller circuit, adjusting at least one of the CCM therapy or the tachyarrhythmia therapy using the information obtained by the controller circuit including information about whether the other of the CCM therapy or the tachyarrhythmia therapy is being delivered or has been scheduled to be delivered, wherein adjusting at least one of the CCM therapy or the tachyarrhythmia therapy includes adjusting a morphology analysis using information from the CCM therapy circuit about whether a CCM condition is present, wherein detecting the tachyarrhythmia includes comparing; an intrinsic cardiac signal morphology to a CCM morphology template if a CCM condition is present;
oran intrinsic cardiac signal morphology to a non-CCM morphology template if a CCM condition is not present. - View Dependent Claims (11, 12, 13, 14, 15)
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Specification