Method, device and program to differentiate pacemaker-mediated tachycardia (PMT) from tracking of sinus or atrial tachycardia (AT)
First Claim
1. A method to distinguish pacemaker-mediated tachycardia (PMT) from tracking of sinus or atrial tachycardia (AT) comprising:
- analyzing, using a processor, a response to an extension of a post-ventricular atrial refractory period (PVARP), by classifying the response into responsive patterns including a V-A-V response, a V-A-A-Vs response and a V-A-A-Vp response;
determining, using the processor, a mechanism of a tachycardia based at least upon the classifying; and
providing an alert of the outcome of the determining of the mechanism,wherein a mechanism of a tachycardia is determined as atrial or sinus tachycardia when the response is classified as a V-A-V response,wherein a mechanism of a tachycardia is determined as PMT when the response is classified as a V-A-A-Vs response, andwherein when the response is classified as a V-A-A-Vp response, the method further comprises;
comparing, using the processor, an atrial rate during the tachycardia and an atrial rate after the PVARP extension; and
determining, using the processor, a mechanism of the tachycardia based at least upon the comparison, wherein a mechanism of a tachycardia is determined as PMT when a slower atrial rate after the PVARP extension is observed based on the comparing.
1 Assignment
0 Petitions
Accused Products
Abstract
Dual chamber pacemaker systems can lead to two forms of pacemaker-facilitated tachycardia—pacemaker-mediated tachycardia (PMT) and tracking of sinus or atrial tachycardia. Current pacemaker algorithms can not always differentiate between these two tachycardias. Various embodiments for differentiating these particular mechanisms of pacemaker-facilitated tachycardia, which is based on the specific termination response to PVARP extension are provided. The response to PVARP extension (V-A-A-V vs V-A-V) is a specific method for differentiation and can be used in conjunction with observations of atrial rate and electrogram morphology (or surface P wave morphology) for distinguishing between the two mechanisms of pacemaker-facilitated tachycardia.
-
Citations
19 Claims
-
1. A method to distinguish pacemaker-mediated tachycardia (PMT) from tracking of sinus or atrial tachycardia (AT) comprising:
-
analyzing, using a processor, a response to an extension of a post-ventricular atrial refractory period (PVARP), by classifying the response into responsive patterns including a V-A-V response, a V-A-A-Vs response and a V-A-A-Vp response; determining, using the processor, a mechanism of a tachycardia based at least upon the classifying; and providing an alert of the outcome of the determining of the mechanism, wherein a mechanism of a tachycardia is determined as atrial or sinus tachycardia when the response is classified as a V-A-V response, wherein a mechanism of a tachycardia is determined as PMT when the response is classified as a V-A-A-Vs response, and wherein when the response is classified as a V-A-A-Vp response, the method further comprises; comparing, using the processor, an atrial rate during the tachycardia and an atrial rate after the PVARP extension; and determining, using the processor, a mechanism of the tachycardia based at least upon the comparison, wherein a mechanism of a tachycardia is determined as PMT when a slower atrial rate after the PVARP extension is observed based on the comparing. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
-
-
11. A chronic implantable electronic device (CIED) comprising:
-
a storage device configured to store a computer readable program, a processor, configured to, when executing the computer readable program provide; an analyzing unit configured to analyze a response to an extension of a post ventricular atrial refractory period (PVARP), by classifying the response into responsive patterns including a V-A-V response, a V-A-A-Vs response and a V-A-A-Vp response; a determining unit configured to determine a mechanism of a tachycardia based at least upon the classifying, wherein a mechanism of a tachycardia is determined as atrial or sinus tachycardia when the response is classified as a V-A-V response and wherein a mechanism of a tachycardia is determined as pacemaker-mediated tachycardia (PMT) when the response is classified as a V-A-A-Vs response; and a comparing unit configured to compare an atrial rate during the tachycardia and an atrial rate after the PVARP extension, wherein when the response is classified as a V-A-A-Vp response, the determining unit is further configured to also use a result of the comparing to determine a mechanism of the tachycardia, a mechanism of a tachycardia is determined as PMT when a slower atrial rate after the PVARP extension is observed based on the comparing, wherein the processor further configured to, when executing the computer readable program, adjust at least one control parameter of the CIED when the determined mechanism is PMT. - View Dependent Claims (12, 13, 14, 15, 16)
-
-
17. A chronic implantable electronic device (CIED) comprising:
-
a storage device configured to store a computer readable program, a processor, configured to, when executing the computer readable program provide; an analyzing unit configured to analyze a response to an extension of a post ventricular atrial refractory period (PVARP), by classifying the response into responsive patterns including a V-A-V response, a V-A-A-Vs response and a V-A-A-Vp response; a determining unit configured to determine a mechanism of a tachycardia based at least upon the classifying, wherein a mechanism of a tachycardia is determined as atrial or sinus tachycardia when the response is classified as a V-A-V response and wherein a mechanism of a tachycardia is determined as pacemaker-mediated tachycardia (PMT) when the response is classified as a V-A-A-Vs response; a comparing unit configured to compare an atrial rate during the tachycardia and an atrial rate after the PVARP extension; and a transmitting unit configured to provide an alert of the outcome of the determining of the mechanism, wherein when the response is classified as a V-A-A-Vp response, the determining unit is further configured to also use a result of the comparing to determine a mechanism of the tachycardia, a mechanism of a tachycardia is determined as PMT when a slower atrial rate after the PVARP extension is observed based on the comparing. - View Dependent Claims (18, 19)
-
Specification