System and method for preventing recurrence of atrial tachyarrhythmia

• US 20050060000A1
• Filed: 10/28/2004
• Published: 03/17/2005
• Est. Priority Date: 09/14/2000
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Morris, Milton M., Seim, Gary T., Chen, Victor T.
• Granted Patent: US 7,421,294 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.

Claims

1-9. -9. (Canceled)

10. A method, comprising:

providing pacing pulses after an atrial defibrillation shock, wherein the pacing pulses have a pacing rate at an initial value that is well above an intrinsic rate;

decreasing the pacing rate from the initial value;

detecting at least one intrinsic atrial contraction;

determining an intrinsic atrial rate from the at least one intrinsic atrial contraction; and

increasing the pacing rate above the intrinsic atrial rate.

11. The method of claim 10, including setting the initial value of the pacing rate in a range of 100 to 200 pacing pulses per minute.

12. The method of claim 10, wherein decreasing the pacing rate includes pacing a set number of cardiac cycles;

decreasing the pacing rate by a set amount; and

repeating providing the set number of pacing pulses and decreasing the pacing rate by the set amount until at least one intrinsic atrial contraction is detected.

13. The method of claim 10, wherein detecting the at least one intrinsic atrial contraction includes detecting the at least one intrinsic atrial contraction after a pacing pulse of the pacing pulses and determining the intrinsic atrial rate includes determining the intrinsic atrial rate from the pacing pulse and the intrinsic atrial contraction.

14. The method of claim 10, including sensing an atrial signal;

detecting an atrial fibrillation from the sensed atrial signal;

providing an atrial defibrillation shock after detecting the atrial fibrillation; and

providing a first pacing pulse of the pacing pulses at a delay after the atrial defibrillation shock.

15. The method of claim 10, wherein decreasing the pacing rate includes increasing an interval between the pacing pulses by a set value in the range of 7.5 to 10 milliseconds.

16. The method of claim 10, wherein increasing the pacing rate includes maintaining the pacing rate at or above the intrinsic rate.

17. The method of claim 16, wherein maintaining the pacing rate at or above the intrinsic rate includes decreasing an interval between the pacing pulses by a set value in the range of 7.5 to 10 milliseconds.

18. The method of claim 10, wherein determining the intrinsic atrial rate from the at least one intrinsic atrial contraction includes determining the intrinsic atrial rate from at least two intrinsic atrial contractions.

19. A method, comprising:

sensing an atrial cardiac signal;

analyzing the atrial cardiac signal to detect an atrial tachyarrhythmia;

providing an atrial defibrillation shock in response to the detected atrial arrhythmia;

providing pacing pulses at a first delay after an atrial defibrillation shock, wherein the pacing pulses have a pacing rate at an initial value that is well above an intrinsic rate, and wherein the pacing pulses have a pacing rate at an initial value that is in a range of 100 to 200 pacing pulses per minute;

decreasing the pacing rate from the initial value, wherein decreasing the pacing rate includes increasing an interval between the pacing pulses by a set value in the range of 7.5 to 10 milliseconds in a repeated manner until at least one intrinsic atrial contraction is detected;

determining the intrinsic atrial rate using the at least one intrinsic atrial contraction; and

increasing the pacing rate above the intrinsic atrial rate.

20. A method, comprising:

sensing an atrial cardiac signal;

analyzing the atrial cardiac signal to detect an atrial tachyarrhythmia;

providing an atrial defibrillation shock in response to the detected atrial arrhythmia;

providing pacing pulses at a first delay after an atrial defibrillation shock, wherein the pacing pulses have a pacing rate at an initial value that is well above an intrinsic rate, and wherein the pacing pulses have a pacing rate at an initial value that is in a range of 100 to 200 pacing pulses per minute;

decreasing the pacing rate from the initial value, wherein decreasing the pacing rate includes increasing an interval between the pacing pulses by a set value in the range of 7.5 to 10 milliseconds in a repeated manner until at least one intrinsic atrial contraction is detected;

determining the intrinsic atrial rate using the at least one intrinsic atrial contraction; and

increasing the pacing rate to just above the intrinsic atrial rate.

21. A method, comprising:

(a) providing pacing pulses at an initial value that is well above an intrinsic rate;

(b) incrementally decreasing the pacing rate from the initial value until at least one intrinsic atrial contraction is detected;

(c) increasing the pacing rate to just above the intrinsic atrial rate; and

(d) repeating acts (b) and (c).

22. The method of claim 21, in which the providing pacing pulses at an initial value that is well above an intrinsic rate is initiated in response to an atrial defibrillation shock.

23. The method of claim 22, in which the providing pacing pulses at an initial value that is well above an intrinsic rate is initiated at a first time delay after an atrial defibrillation shock.