Systems and methods for treating cardiac arrhythmias

• US 9,669,230 B2
• Filed: 02/01/2016
• Issued: 06/06/2017
• Est. Priority Date: 02/06/2015
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation), GM Global Technology Operations LLC (General Motors Company)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Koop, Brendan E.
• Primary Examiner(s): VOORHEES, CATHERINE M
• Application Number:
  US15/012,443
• Publication Number:
  US 20160228718A1
• Time in Patent Office: 491 Days
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• 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 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Systems and methods for treating cardiac arrhythmias are disclosed. In one embodiment, an SICD comprises two or more electrodes, a charge storage device, and a controller operatively coupled to two or more of the electrodes and the charge storage device. In some embodiments, the controller is configured to monitor cardiac activity of the heart of the patient, detect an occurrence of a cardiac arrhythmia based on the cardiac activity, and determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias. If the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, the controller sends an instruction for reception by an LCP to initiate the application of ATP therapy by the LCP. If the determined type of cardiac arrhythmia is not one of the first set cardiac arrhythmia types, the controller does not send the instruction.

Claims

1. A subcutaneous implantable cardioverter defibrillator (SICD) for delivering a defibrillation shock to a heart of a patient, the SICD comprising:

two or more electrodes;

a charge storage device for storing a charge that can be delivered to shock the heart via two or more of the electrodes;

a controller operatively coupled to two or more of the electrodes and the charge storage device, the controller configured to;

monitor cardiac activity of the heart of the patient via cardiac signals received via two or more of the electrodes;

detect an occurrence of a cardiac arrhythmia based on the cardiac activity;

determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias;

in response to finding that the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, sending an instruction via two or more of the electrodes for reception by a Leadless Cardiac Pacemaker (LCP) to initiate the application of Anti-Tachycardia Pacing (ATP) therapy by the LCP;

in response to finding that the determined type of cardiac arrhythmia is not one of the first set of cardiac arrhythmia types, not sending the instruction;

in response to finding that the determined type of the cardiac arrhythmia is one of a second set of cardiac arrhythmia types, initiate charging of the charge storage device;

in response to finding that the determined type of the cardiac arrhythmia is not one of the second set of cardiac arrhythmia types, waiting to initiate charging of the charge storage device; and

wherein when an instruction was sent to initiate the application of ATP therapy by the LCP, the controller is further configured to determine when the application of the ATP therapy by the LCP was successful in terminating the cardiac arrhythmia, and when the application of the ATP therapy by the LCP was successful, not initiating charging of the charge storage device when the determined type of the cardiac arrhythmia is not one of the second set of cardiac arrhythmia types.

2. The SICD of claim 1, wherein the instruction also includes one or more ATP parameters that define one or more characteristics of the ATP therapy.

3. The SICD of claim 2, wherein the one or more characteristics of the ATP therapy comprise a method of ATP therapy.

4. The SICD of claim 1, wherein when an instruction was sent to initiate the application of ATP therapy by the LCP, the controller is further configured to determine when the application of the ATP therapy by the LCP was successful in terminating the cardiac arrhythmia, and when the application of the ATP therapy by the LCP was successful, terminating the charging of the charge storage device when the determined type of the cardiac arrhythmia is one of the second set of cardiac arrhythmia types.

5. An implantable cardioverter defibrillator (ICD) for delivering a defibrillation shock to a heart of a patient, the ICD comprising:

a charge storage device for storing a charge that can be delivered to shock the heart;

a controller operatively coupled to the charge storage device, the controller configured to;

monitor cardiac activity of the heart of the patient;

detect an occurrence of a cardiac arrhythmia based on the cardiac activity;

determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias;

in response to finding that the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, sending an instruction for reception by a Leadless Cardiac Pacemaker (LCP) to initiate the application of Anti-Tachycardia Pacing (ATP) therapy by the LCP;

in response to finding that the determined type of cardiac arrhythmia is not one of the first set of cardiac arrhythmia types, not sending the instruction;

in response to finding that the determined type of the cardiac arrhythmia is one of a second set of cardiac arrhythmia types, initiate charging of the charge storage device;

in response to finding that the determined type of the cardiac arrhythmia is not one of the second set of cardiac arrhythmia types, waiting to initiate charging of the charge storage device; and

wherein when an instruction was sent to initiate the application of ATP therapy by the LCP, the controller is further configured to determine when the application of the ATP therapy by the LCP was successful in terminating the cardiac arrhythmia, and when the application of the ATP therapy by the LCP was successful, not initiating charging of the charge storage device when the determined type of the cardiac arrhythmia is not one of the second set of cardiac arrhythmia types.

6. The ICD of claim 5, wherein the instruction includes one or more ATP parameters that define one or more characteristics of the ATP therapy.

7. The ICD of claim 6, wherein the one or more characteristics of the ATP therapy comprise a method of ATP therapy.

8. The ICD of claim 5, wherein when an instruction was sent to initiate the application of ATP therapy by the LCP, the controller is further configured to determine when the application of the ATP therapy by the LCP was successful in terminating the cardiac arrhythmia, and when the application of the ATP therapy by the LCP was successful, terminating the charging of the charge storage device when the determined type of the cardiac arrhythmia is one of the second set of cardiac arrhythmia types.

9. A method implemented by an implantable cardioverter defibrillator (ICD), the method comprising:

determining an occurrence of a cardiac arrhythmia;

determining a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias;

in response to finding that the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, sending an instruction for reception by a Leadless Cardiac Pacemaker (LCP) to initiate the application of Anti-Tachycardia Pacing (ATP) therapy by the LCP; and

in response to finding that the determined type of cardiac arrhythmia is not one of the first set of cardiac arrhythmia types, not sending the instruction to the LCP.

10. The method of claim 9 further comprises:

in response to finding that the determined type of the cardiac arrhythmia is one of a second set of cardiac arrhythmia types, charging the charge storage device; and

in response to finding that the determined type of the cardiac arrhythmia is not one of the second set of cardiac arrhythmia types, waiting to charge the charge storage device.