Method and apparatus for controlling arrhythmia detection and treatment based on patient posture

• US 20070179539A1
• Filed: 01/31/2006
• Published: 08/02/2007
• Est. Priority Date: 01/31/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Flickinger, William, Smits, Karel, Degroot, Paul
• Granted Patent: US 8,478,399 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

An implantable medical device and method are provided for determining if a patient is in a substantially horizontal position and delaying a programmed cardioversion/defibrillation shock therapy in response to determining the patient is in a substantially horizontal position. In various embodiments, the shock therapy may be delayed by adjusting tachycardia detection criteria or scheduling the shock therapy after a maximum tachycardia episode duration.

Claims

1. A method for determining delivery of a therapy in a medical device, comprising:

determining if a patient is in a substantially horizontal position; and

delaying a programmed cardioversion/defibrillation shock therapy in response to determining that the patient is in a substantially horizontal position.

2. The method of claim 1 further including detecting a tachycardia and delivering an anti-tachycardia pacing therapy in response to delaying the programmed shock therapy.

3. The method of claim 1 further including detecting a tachycardia and performing tachycardia discrimination procedures in response to delaying the programmed shock therapy.

4. The method of claim 1 wherein delaying a programmed shock therapy includes adjusting a tachycardia detection criteria in response to determining the patient is in a substantially horizontal position.

5. The method of claim 4 wherein adjusting a tachycardia detection criteria includes adjusting a number of tachycardia intervals required to detect the tachycardia.

6. The method of claim 1 wherein delaying a programmed shock therapy includes adjusting a scheduled shock time.

7. The method of claim 1 wherein delaying the programmed shock therapy includes delaying the shock therapy for a maximum episode duration.

8. The method of claim 1 further including detecting a termination of the tachycardia and canceling the delayed programmed shock therapy in response to detecting the tachycardia termination.

9. The method of claim 1 further including determining a position change from the determined substantially horizontal patient position and terminating the shock therapy delay in response to the determined position change.

10. The method of claim 1 further including initiating high voltage capacitor charging during the shock therapy delay.

11. An implantable medical device, comprising:

a sensor to detect a tachycardia;

an output circuit to generate a shock pulse;

an electrode to deliver the shock pulse;

a sensor to determine a patient position; and

a control circuit delaying the delivery of the shock pulse in response to determining the patient is in a substantially horizontal position.

12. The device of claim 11 further comprising a low-voltage output circuit to deliver an anti-tachycardia pacing therapy in response to detecting a tachycardia and the delaying of the delivery of the shock pulse.

13. The device of claim 11 further comprising a processor to discriminate the detected tachycardia in response to the delaying of the delivery of the shock pulse.

14. The device of claim 11 wherein the control circuit adjusts a tachycardia detection criteria in response to determining the patient is in a substantially horizontal position.

15. The device of claim 14 wherein the control circuit adjusts a number of intervals required to detect the tachycardia.

16. The device of claim 11 wherein the control circuit adjusts a scheduled shock time in response to determining the patient is in a substantially horizontal position.

17. The device of claim 11 wherein the control circuit determines a position change from the determined substantially horizontal patient position and terminates the shock therapy delay in response to the determined position change.

18. The device of claim 11 wherein the output circuit includes a high voltage capacitor and the control circuit initiates charging of the high voltage capacitor during the shock pulse delay.

23. The computer readable medium of claim 15 wherein delaying the programmed cardioversion/defibrillation includes adjusting a scheduled shock time.

19. A computer readable medium for storing a set of instructions, which when implemented in an implantable medical device cause the device to perform a method, the method comprising:

determining if a patient is in a substantially horizontal position; and

delaying a programmed cardioversion/defibrillation shock therapy in response to determining the patient is in a substantially horizontal position.

20. The computer readable medium of claim 19, the method further comprising detecting a tachycardia and delivering an anti-tachycardia pacing therapy in response to the delayed cardioversion/defibrillation shock therapy.

21. The computer readable medium of claim 19, the method further comprising detecting a tachycardia and discriminating the detected tachycardia in response to determining the patient is in a substantially horizontal position.

22. The computer readable medium of claim 19, wherein delaying the programmed cardioversion/defibrillation includes adjusting a tachycardia detection criterion.