Systems and methods for detecting cardiac arrhythmias

• US 9,592,391 B2
• Filed: 01/08/2015
• Issued: 03/14/2017
• Est. Priority Date: 01/10/2014
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Simms, Howard D. Jr., Maile, Keith R., Kane, Michael J., Linder, William J.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US14/592,698
• Publication Number:
  US 20150196758A1
• Time in Patent Office: 796 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

Systems and methods for coordinating detection and/or treatment of abnormal heart activity using multiple implanted devices within a patient. In one example, cardiac activity may be sensed by two or more medical device, including a leadless cardiac pacemaker. Cardiac activity sensed by one of the implanted devices may be communicated to another one of the implanted devices. Abnormal heart activity may then be determined based on the cardiac activity of both of the medical device.

Claims

1. A method of identifying a tachyarrhythmia of a heart of a patient, the method comprising:

sensing cardiac activity by a first implantable medical device;

sensing cardiac activity by a second implantable medical device, wherein the second implantable medical device is spaced from the first implantable medical device and communicatively coupled to the first implantable medical device via conducted communication through a communication pathway that includes the body of the patient;

communicating sensed cardiac activity by the first implantable medical device to the second implantable medical device, the communicated sensed cardiac activity including sensed cardiac activity other than a determination or provisional determination of a tachyarrhythmia; and

determining by the second implantable medical device if a tachyarrhythmia is occurring based, at least in part, on both the cardiac activity sensed by the second implantable medical device and the cardiac activity sensed by the first implantable medical device including at least some of the communicated sensed cardiac activity other than a determination or provisional determination of a tachyarrhythmia from the first implantable medical device.

2. The method of claim 1, wherein the first implantable medical device comprises a first leadless cardiac pacemaker and the second implantable medical device comprises a second leadless cardiac pacemaker, and wherein the first leadless cardiac pacemaker is implanted at an atrium of the heart and the second leadless cardiac pacemaker is implanted at a ventricle of the heart.

3. The method of claim 1, wherein the first implantable medical device comprises a first leadless cardiac pacemaker and the second implantable medical device comprises a second leadless cardiac pacemaker, and wherein the first leadless cardiac pacemaker is implanted at a left ventricle of the heart and the second leadless cardiac pacemaker is implanted at a right ventricle of the heart.

4. The method of claim 1, wherein the first implantable medical device comprises a first leadless cardiac pacemaker and the second implantable medical device comprises a second leadless cardiac pacemaker, and wherein the second leadless cardiac pacemaker is implanted on an endocardial surface of the heart and the first leadless cardiac pacemaker is implanted on an epicardial surface of the heart.

5. The method of claim 1, wherein:

the first implantable medical device comprises a leadless cardiac pacemaker and the second implantable medical device comprises a subcutaneous cardioverter-defibrillator (S-ICD);

or

the second implantable medical device comprises a leadless cardiac pacemaker and the first implantable medical device comprises a subcutaneous cardioverter-defibrillator (S-ICD).

6. The method of claim 1, wherein the communicated sensed cardiac activity other than a determination or provisional determination of a tachyarrhythmia comprises one or more sensed cardiac electrical signals and/or sensed physiological parameters.

7. The method of claim 1, wherein the communicated sensed cardiac activity further includes a provisional determination of tachyarrhythmia determined by the first implantable medical device.

8. The method of claim 1, wherein the first implantable medical device comprises one of a leadless cardiac pacemaker, an implantable pulse generator, and a diagnostic-only medical device.

9. The method of claim 1, wherein one of the first implantable medical device and the second implantable medical device is a master device and wherein the other of the first implantable medical device and the second implantable medical device is a slave device.

10. The method of claim 1, further comprising, upon determining an occurrence of a tachyarrhythmia by the second implantable nedical device, delivering anti-tachycardia pacing (ATP) therapy to the heart.

11. A medical system for identifying a tachyarrhythmia in a heart of a patient, the medical system comprising:

a plurality of leadless cardiac pacemakers configured to detect cardiac activity at corresponding locations of the heart; and

an Implantable Cardioverter Defibrillator (ICD) communicatively coupled to each of the plurality of leadless cardiac pacemakers via a communication pathway that includes the body of the patient, the ICD determining if a tachyarrhythmia is occurring based, at least in part, on the cardiac activity detected by two or more of the plurality of leadless cardiac pacemakers.

12. The medical system of claim 11, wherein the ICD is a sub-cutaneous ICD with one or more sub-cutaneous electrodes.

13. The medical system of claim 11, wherein the cardiac activity that is detected by the two or more of the plurality of leadless cardiac pacemakers includes detecting a tachyarrhythmia at the corresponding location of the heart.

14. The medical system of claim 13, wherein the ICD determines that a tachyarrhythmia is occurring if a majority of the two or more of the plurality of leadless cardiac pacemakers determine that a tachyarrhythmia is occurring.

15. The medical system of claim 11, wherein the two or more of the plurality of leadless cardiac pacemakers are disposed at multiple ventricular sites in the heart.

16. The medical system of claim 11, wherein the ICD is also configured to detect cardiac activity of the heart, and wherein the ICD is configured to determine if a tachyarrhythmia is occurring based, at least in part, on the cardiac activity detected by two or more of the plurality of leadless cardiac pacemakers and the cardiac activity detected by the ICD.

17. The medical system of claim 11, wherein the ICD determines which of the plurality of leadless cardiac pacemakers deliver ATP therapy when the ICD determines that a tachyarrhythmia is occurring.

18. A method of identifying a tachyarrhythmia of a heart of a patient, the method comprising:

sensing cardiac activity by a medical device;

sensing cardiac activity by a first leadless cardiac pacemaker, wherein the first leadless cardiac pacemaker is communicatively coupled to the medical device via a communication pathway that includes the body of the patient;

determining, by one or more of the medical device and the first leadless cardiac pacemaker, if a tachyarrhythmia is occurring based, at least in part, on the cardiac activity sensed by the medical device and/or the cardiac activity sensed by the first leadless cardiac pacemaker; and

after determining a tachyarrhythmia is occurring, determining, by one or more of the medical device and the first leadless cardiac pacemaker, a type of the tachyarrhythmia based, at least in part, on both the cardiac activity sensed by the medical device and the cardiac activity sensed by the first leadless cardiac pacemaker.

19. The method of claim 18, wherein a type of the tachyarrhythmia comprises one of:

a ventricular tachyarrhythmia or an atrial tachyarrhythmia.

20. The method of claim 18, further comprising:

delivering a first therapy to the heart based on a determined first type of tachyarrhythmia; and

delivering a second therapy to the heart based on a determined second type of tachyarrhythmia.