Implantable medical device sensing and selecting wireless ECG and intracardiac electrogram
First Claim
1. A cardiac rhythm management (CRM) system, comprising:
- an implantable medical device including;
a sensing circuit including an electrogram sensing circuit to sense one or more intracardiac electrograms and a wireless electrocardiogram (ECG) sensing circuit to sense one or more subcutaneous ECGs;
a processing circuit to receive and process at least one signal selected from the one or more intracardiac electrograms and the one or more subcutaneous ECGs based on a selection signal; and
a signal selection circuit coupled to the processing circuit, the signal selection circuit including a signal quality assessment circuit and a selection signal generator, the signal quality assessment circuit adapted to produce quality parameters by analyzing each of the one or more intracardiac electrograms and the one or more subcutaneous ECGs during a specified cardiac rhythm including a normal sinus rhythm or a cardiac arrhythmia, the quality parameters each being a measure of quality of one cardiac signal of the one or more intracardiac electrograms and the one or more subcutaneous ECGs, the quality parameters including at least a first quality parameter generated by analyzing morphology of one of the one or more intracardiac electrograms and at least a second quality parameter generated by analyzing morphology of one of the one or more subcutaneous ECGs, the selection signal generator adapted to produce the selection signal based on at least a comparison between the at least the first quality parameter and the at least the second quality parameter; and
a plurality of implantable subcutaneous electrodes coupled to the sensing circuit.
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Abstract
A CRM system enhances intracardiac electrogram-based arrhythmia detection using a wireless electrocardiogram (ECG), which is a signal sensed with implantable electrodes and approximating a surface ECG. In one embodiment, an intracardiac electrogram allows for detection of an arrhythmia, and the wireless ECG allows for classification of the detected arrhythmia by locating its origin. In another embodiment, the wireless ECG is sensed as a substitute signal for the intracardiac electrogram when the sensing of the intracardiac electrogram becomes unreliable. In another embodiment, a cardiac signal needed for a particular purpose is selected from one or more intracardiac electrograms and one or more wireless ECGs based on a desirable signal quality. In another embodiment, intracardiac electrogram-based arrhythmia detection and wireless ECG-based arrhythmia detection confirm with each other before indicating a detection of arrhythmia of a certain type.
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Citations
20 Claims
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1. A cardiac rhythm management (CRM) system, comprising:
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an implantable medical device including; a sensing circuit including an electrogram sensing circuit to sense one or more intracardiac electrograms and a wireless electrocardiogram (ECG) sensing circuit to sense one or more subcutaneous ECGs; a processing circuit to receive and process at least one signal selected from the one or more intracardiac electrograms and the one or more subcutaneous ECGs based on a selection signal; and a signal selection circuit coupled to the processing circuit, the signal selection circuit including a signal quality assessment circuit and a selection signal generator, the signal quality assessment circuit adapted to produce quality parameters by analyzing each of the one or more intracardiac electrograms and the one or more subcutaneous ECGs during a specified cardiac rhythm including a normal sinus rhythm or a cardiac arrhythmia, the quality parameters each being a measure of quality of one cardiac signal of the one or more intracardiac electrograms and the one or more subcutaneous ECGs, the quality parameters including at least a first quality parameter generated by analyzing morphology of one of the one or more intracardiac electrograms and at least a second quality parameter generated by analyzing morphology of one of the one or more subcutaneous ECGs, the selection signal generator adapted to produce the selection signal based on at least a comparison between the at least the first quality parameter and the at least the second quality parameter; and a plurality of implantable subcutaneous electrodes coupled to the sensing circuit. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method for operating a cardiac rhythm management (CRM) system, the method comprising:
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sensing a plurality of cardiac signals using an implantable medical device and a plurality of implantable subcutaneous electrodes, the cardiac signals including one or more intracardiac electrograms and one or more subcutaneous electrocardiograms (ECGS) during a specified cardiac rhythm including a normal sinus rhythm or a cardiac arrhythmia; producing quality parameters by analyzing each of the one or more intracardiac electrograms and the one or more subcutaneous ECGs, the quality parameters each being a measure of quality of one cardiac signal of the plurality of cardiac signals using the implantable medical device, the quality parameters including at least a first quality parameter generated by analyzing morphology of one of the one or more intracardiac electrograms and at least a second quality parameter generated by analyzing morphology of one of the one or more subcutaneous ECGs; selecting at least one cardiac signal from the plurality of cardiac signals based on at least a comparison between the at least the first quality parameter and the at least the second quality parameter using the implantable medical device; and detecting an arrhythmia based on the selected at least one cardiac signal using the implantable medical device. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20)
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Specification