Arrhythmia prediction based on heart rate turbulence

• US 9,907,962 B2
• Filed: 10/29/2009
• Issued: 03/06/2018
• Est. Priority Date: 10/29/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Kornet, Lilian, Schneider, Raphael
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Morales, Jon Eric C
• Application Number:
  US12/608,855
• Publication Number:
  US 20110106195A1
• Time in Patent Office: 3,050 Days
• Field of Search: 607 25, 607 14, 607 17, 607 44, 600519
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/6801 specially adapted to be attached to or worn on the body surface
• 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 1/36592 controlled by the heart rate variability

Abstract

In general, the disclosure describes techniques for predicting the occurrence of an arrhythmia based on an indication of heart rate turbulence. An example method comprises sensing a parameter indicative of heart rate turbulence, measuring heart rate turbulence based on the sensed parameter, and predicting an occurrence of an arrhythmia based on the measured heart rate turbulence.

Claims

1. A method comprising:

sensing cardiac contractility of a heart;

deriving a plurality of values of an interval between cardiac contractions of the heart from the sensed cardiac contractility;

measuring heart rate turbulence based on the interval values derived from the sensed cardiac contractility;

predicting an occurrence of a tachyarrhythmia based on the measured heart rate turbulence; and

delivering a cardiac stimulation therapy to the heart in response to predicting the occurrence of the tachyarrhythmia, wherein the cardiac stimulation therapy is configured to prevent the occurrence of the tachyarrhythmia.

2. The method of claim 1, further comprising

charging a therapy delivery circuit in response to predicting the occurrence of the tachyarrhythmia.

3. The method of claim 2, wherein the therapy delivery circuit comprises a circuit for delivery of a cardioversion.

4. The method of claim 3, wherein charging of the therapy delivery circuit occurs in response to the predicting of the occurrence of the tachyarrhythmia.

5. The method of claim 1, further comprising

identifying an abnormal heartbeat, wherein measuring heart rate turbulence comprises measuring heart rate turbulence resulting from the abnormal heartbeat.

6. The method of claim 5, further comprising delivering a signal configured to induce the abnormal heartbeat, wherein identifying the abnormal heart beat comprises identifying the abnormal heartbeat induced by the signal.

7. The method of claim 5, wherein the abnormal heartbeat comprises at least one of a premature atrial contraction or a premature ventricular contraction.

8. The method of claim 5, wherein measuring heart rate turbulence comprises calculating at least one of turbulence onset or turbulence slope.

9. The method of claim 5, further comprising comparing the measured heart rate turbulence to a threshold value, wherein predicting the occurrence of the tachyarrhythmia comprises predicting the occurrence of the tachyarrhythmia based on the comparison.

10. The method of claim 5, wherein identification of the abnormal heartbeat comprises identification of a naturally occurring heartbeat.

11. The method of claim 1, wherein the sensed cardiac contractility is sensed using one or more of:

a sensor intracardiac or intravascular pressure, an accelerometer or other sensor capable of detecting heart or blood sounds, vibrations, or motion, an intra-cardiac or intra-arterial impedance, optical or ultrasonic sensor capable of detecting changes in blood flow associated with cardiac contractions, or an optical sensor capable of detecting oxygen saturation changes associated with cardiac contractions.

12. The method of claim 1 wherein the cardiac contractility is sensed using a sensor responsive to physical contractions of the heart.

13. The method of claim 1, wherein the therapy is configured to reduce an effect of the tachyarrhythmia or terminate the tachyarrhythmia if the tachyarrhythmia occurs.

14. A system comprising:

a sensing module that monitors cardiac contractility of a heart, the cardiac contractility being indicative of heart rate turbulence;

a processor that derives a plurality of values of an interval between cardiac contractions from the sensed cardiac contractility, measures the heart rate turbulence based on the interval values, and predicts an occurrence of a tachyarrhythmia based on the measured heart rate turbulence; and

a signal generator that provides a cardiac stimulation therapy in response to predicting the occurrence of the tachyarrhythmia, wherein the cardiac stimulation therapy is configured to prevent the occurrence of the tachyarrhythmia.

15. The system of claim 14, further comprising

a therapy delivery circuit, wherein the processer charges the therapy delivery circuit in response to predicting the occurrence of the tachyarrhythmia.

16. The system of claim 15, wherein the therapy delivery circuit comprises a circuit for delivery of cardioversion.

17. The system of claim 16, wherein charging of the therapy delivery circuit occurs in response to the predicting of the occurrence of the tachyarrhythmia.

18. The system of claim 14,

wherein the processor identifies an abnormal heartbeat and measures heart rate turbulence resulting from the abnormal heartbeat.

19. The system of claim 18, wherein identification of the abnormal heartbeat comprises identification of a naturally occurring heartbeat.

20. The system of claim 18, wherein the abnormal heartbeat comprises at least one of a premature atrial contraction or a premature ventricular contraction.

21. The system of claim 18, wherein the processor calculates at least one of turbulence onset or turbulence slope.

22. The system of claim 18, wherein the processor compares the measured heart rate turbulence to a threshold value and predicts the occurrence of the tachyarrhythmia based on the comparison.

23. The system of claim 18, wherein the processor comprises a processor of a programming device.

24. The system of claim 18, wherein the processor comprises a processor of a medical device.

25. The system of claim 24, wherein the medical device comprises an implantable medical device.

26. The system of claim 24, wherein the medical device comprises an external medical device.

27. The system of claim 14, wherein the sensing module comprises one or more of:

a sensor intracardiac or intravascular pressure, an accelerometer or other sensor capable of detecting heart or blood sounds, vibrations, or motion, an intra-cardiac or intra-arterial impedance, optical or ultrasonic sensor capable of detecting changes in blood flow associated with cardiac contractions, or an optical sensor capable of detecting oxygen saturation changes associated with cardiac contractions.

28. The system of claim 14 wherein the sensing module comprises a sensor responsive to physical contractions of the heart.

29. The system of claim 14, wherein the signal generator provides the therapy configured to reduce an effect of the tachyarrhythmia or terminate the tachyarrhythmia if the tachyarrhythmia occurs.