Arrhythmia detection and confirmation

• US 10,092,760 B2
• Filed: 09/02/2016
• Issued: 10/09/2018
• Est. Priority Date: 09/11/2015
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kane, Michael J., Shuros, Allan Charles, Schmidt, Brian L., Huelskamp, Paul, Haasl, Benjamin J.
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US15/256,039
• Publication Number:
  US 20170072202A1
• Time in Patent Office: 767 Days
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36571 controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

Systems, methods, and devices for detecting or confirming fibrillation are discussed. In one example, a method for detecting a cardiac arrhythmia of a patients'"'"' heart comprises receiving, by a leadless cardiac pacemaker fixed in the patients'"'"' heart, an indication from a remote device that a cardiac arrhythmia is detected, monitoring by the leadless cardiac pacemaker a signal generated by a sensor that is located within the patients'"'"' heart, and based at least in part on the monitored signal, confirming whether a cardiac arrhythmia is occurring or not. In some embodiments, the method may further comprise, if a cardiac arrhythmia is confirmed, delivering a therapy to treat the cardiac arrhythmia.

Claims

1. A method for detecting a cardiac arrhythmia of a patient'"'"'s heart, comprising:

receiving, by a leadless cardiac pacemaker fixed in the patient'"'"'s heart, an indication from a remote device that a cardiac arrhythmia has been identified by the remote device;

monitoring, by the leadless cardiac pacemaker, a signal generated by a sensor that is located within the patients'"'"' heart;

utilizing the monitored signal to provide confirmation that the cardiac arrhythmia identified by the remote device is in fact occurring;

when the cardiac arrhythmia is confirmed, delivering a therapy to treat the cardiac arrhythmia; and

wherein the remote device identifies the cardiac arrhythmia without using the signal generated by the sensor.

2. The method of claim 1, further comprising:

transmitting the monitored signal from the leadless cardiac pacemaker to the remote device; and

the remote device using the transmitted monitored signal to confirm whether a cardiac arrhythmia is occurring or not.

3. The method of claim 1, wherein the leadless cardiac pacemaker confirms whether a cardiac arrhythmia is occurring or not, and when a cardiac arrhythmia is confirmed, the leadless cardiac pacemaker transmits a confirmation message to the remote device.

4. The method of claim 1, wherein the remote device delivers the therapy to treat the cardiac arrhythmia.

5. The method of claim 1, wherein the sensor comprises an accelerometer, and the accelerometer is part of the leadless cardiac pacemaker.

6. The method of claim 1, wherein the sensor comprises one or more of a flow sensor and a pressure sensor.

7. The method of claim 1, wherein confirming whether a cardiac arrhythmia is occurring or not comprises determining whether there is synchronicity between a cardiac electrical signal of the patients'"'"' heart and the monitored signal.

8. The method of claim 7, wherein determining whether there is synchronicity between the cardiac electrical signal of the patients'"'"' heart and the monitored signal comprises:

determining an occurrence of one or more peaks in the monitored signal having an amplitude above a threshold amplitude within a predefined monitoring window after an occurrence of a cardiac event detected in the cardiac electrical signal.

9. The method of claim 1, wherein confirming whether the cardiac arrhythmia is occurring comprises determining whether a frequency of the monitored signal is greater than a threshold frequency.

10. The method of claim 1, wherein determining whether the cardiac arrhythmia is occurring comprises determining whether a maximum amplitude of the signal is below a threshold amplitude.

11. The method of claim 1, wherein monitoring the signal generated by the sensor comprises sampling the signal, and wherein the signal is sampled at a higher sample rate after receiving an indication from the remote device that a cardiac arrhythmia is detected than before receiving an indication from the remote device that a cardiac arrhythmia is detected.

12. A method comprising:

sampling, by a leadless cardiac pacemaker, a signal generated by a sensor in accordance with a first set of sampling parameters;

receiving, by the leadless cardiac pacemaker, an indication from a remote device that a cardiac arrhythmia is detected by the remote device;

after receiving the indication of an occurrence of a cardiac arrhythmia detected by the remote device, sampling by the leadless cardiac pacemaker, the signal generated by the sensor in accordance with a second set of sampling parameters, wherein the second set of sampling parameters are different from the first set of sampling parameters;

confirming, based on the signal sampled according to the second set of sampling parameters, whether a cardiac arrhythmia is occurring or not; and

when a cardiac arrhythmia is confirmed based on the signal sampled by the leadless cardiac pacemaker, delivering a therapy to treat the cardiac arrhythmia.

13. The method of claim 12, further comprising:

transmitting the sampled signal from the leadless cardiac pacemaker to the remote device; and

the remote device using the transmitted sampled signal to confirm whether a cardiac arrhythmia is occurring or not.

14. The method of claim 12, wherein the leadless cardiac pacemaker confirms whether a cardiac arrhythmia is occurring or not, and when a cardiac arrhythmia is confirmed, transmits a confirmation message to the remote device.

15. The method of claim 12, wherein the remote device delivers the therapy to treat the cardiac arrhythmia.

16. The method of claim 12, wherein the sensor comprises an accelerometer, and the accelerometer is part of the leadless cardiac pacemaker.

17. A leadless cardiac pacemaker (LCP) comprising:

a plurality of electrodes;

an accelerometer; and

a controller connected to the plurality of electrodes and the accelerometer, the controller configured to;

receive an indication from another device that an arrhythmia is detected, and in response, confirm whether a cardiac arrhythmia is occurring or not based at least in part on a signal generated by the accelerometer; and

transmit whether a cardiac arrhythmia is confirmed.

18. The leadless cardiac pacemaker (LCP) of claim 17, wherein the controller is further configured to sense one or more cardiac electrical signals via two or more of the electrodes, and confirms whether a cardiac arrhythmia is occurring or not based at least in part on the one or more cardiac electrical signals.

19. The leadless cardiac pacemaker (LCP) of claim 18, wherein the controller is configured to confirm whether a cardiac arrhythmia is occurring or not based at least in part on whether there is synchronicity between the one or more cardiac electrical signals and the signal generated by the accelerometer.

20. The leadless cardiac pacemaker (LCP) of claim 18, wherein the indication from the another device that an arrhythmia is detected is received via two or more of the plurality of electrodes.