Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias

• US 5,545,186 A
• Filed: 03/30/1995
• Issued: 08/13/1996
• Est. Priority Date: 03/30/1995
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Kaemmerer, William F., Olson, Walter H.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US08/413,570
• Time in Patent Office: 502 Days
• Field of Search: 607/4, 607/5, 607/6, 607/13, 607/14, 607/15, 607/9, 607/25, 607/26, 128/703, 128/705, 123/708
• US Class Current: 607/14
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

An implantable antiarrhythmia device which detects and classifies arrhythmias of the human heart, and delivers appropriate therapy. The device employs a method of arrhythmia classification based on a set of prioritized rules, each of the rules defining a plurality of criteria based upon characteristics of sensed depolarizations of heart tissue, each role being met when the criteria associated with the role are met. Some rules, when met, trigger delivery of antiarrhythmia therapy. Other rules, when met, inhibit delivery of antiarrhythmia therapy. The rules may be met simultaneously, and if so, the highest priority rule governs the behavior of the device.

Claims

1. An antiarrhythmia device comprising:

means for sensing depolarizations of heart tissue;

means for defining a plurality of prioritized rules capable of being simultaneously met, each of said rules defining at least one criterion based upon characteristics of sensed depolarizations of heart tissue, each said rule being met when the said at least one criterion of said rule is met, at least a first one of said rules when met indicating need for delivery of an antiarrhythmia therapy, at least a second one or said rules when met indicating that antiarrhythmia therapy should not be delivered;

means for analyzing said characteristics of said sensed polarizations to determine which of said rules are met;

means for determining the highest priority one of said rules which are met;

means responsive to at least said first one of said rules being the highest priority rule met, for delivering an antiarrhythmia therapy; and

means responsive to at least said second one of said rules being the highest priority rule met, for preventing delivery of an antiarrhythmia therapy.

2. An anti-arrhythmia device, comprising:

means for sensing atrial and ventricular depolarizations of heart tissue;

means for measuring R-R intervals separating sensed ventricular depolarizations;

means for measuring R-P intervals separating sensed atrial depolarizations from preceding ventricular depolarizations;

means for measuring co-variance of said measured R-R and P-R intervals;

means for detecting occurrence of an arrhythmia responsive to said measured co-variance of R-R and P-R intervals meeting a defined threshold;

means responsive to detection of an occurrence of said arrhythmia for delivering an anti-arrhythmia therapy.

3. An anti-arrhythmia device, comprising:

means for sensing depolarizations of two heart chambers;

means for assigning beat codes to intervals between successive depolarizations of one of said heart chambers based on occurrences of depolarizations the other of said heart chambers therebetween;

means for defining a set of sequences of said beat codes, indicative of an arrhythmia;

means for detecting occurrence of said arrhythmia in response to a series of said assigned beat codes falling within said defined set of sequences;

means responsive to detection of an occurrence of said arrhythmia for delivering an anti-arrhythmia therapy.

4. An anti-arrhythmia device, comprising:

means for sensing depolarizations of heart tissue in a patient'"'"'s atrium;

means for sensing depolarizations of heart tissue in said patient'"'"'s ventricle;

means for determining whether sensing of a depolarization in said patient'"'"'s atrium is likely due to a ventricular depolarization;

means for determining relative numbers of depolarizations sensed in said patient'"'"'s atrium and ventricle, over a preceding series of depolarizations sensed in said patient'"'"'s ventricle;

means for determining numbers of said depolarizations sensed in said patient'"'"'s atrium which are likely due to ventricular depolarizations, over a preceding series of depolarizations sensed in said patient'"'"'s ventricle,

means for classifying tachyarrhythmias as being of ventricular or supraventricular origin as a function of said relative numbers of depolarizations sensed in said patient'"'"'s atrium and ventricle and said numbers of said depolarizations sensed in said patient'"'"'s atrium which are likely due to ventricular depolarizations;

means responsive to classification of a tachyarrhythmia as being of ventricular origin for delivering an anti-arrhythmia therapy.