Method and apparatus for detecting arrhythmias in a medical device

• US 8,306,618 B2
• Filed: 04/20/2010
• Issued: 11/06/2012
• Est. Priority Date: 03/29/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ghanem, Raja N., Stadler, Robert W., Zhang, Xusheng
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Porter, Jr., Allen
• Application Number:
  US12/763,499
• Publication Number:
  US 20100204597A1
• Time in Patent Office: 931 Days
• Field of Search: 600508-513, 600515-519, 600/521, 607/2, 607/4, 607/5, 607/9, 607/26
• US Class Current: 607/9
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock
• CPC Class Codes: Y10S 128/901 Suppression of noise in electric signal
• CPC Class Codes: Y10S 128/902 Biological signal amplifier

Abstract

A method of detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes, determining rates of change of the sensed cardiac signals, and determining a range of the sensed cardiac signals. The sensed cardiac signals are detected as being associated with the cardiac event in response to the determined rates of change and the determined range.

Claims

1. A method of detecting a cardiac event in a medical device, comprising:

sensing cardiac signals from a plurality of electrodes coupled to the medical device;

determining a low slope content metric of the sensed cardiac signals by the medical device;

determining a spectral width metric of the sensed cardiac signals by the medical device;

detecting the sensed cardiac signals as being associated with the cardiac event in response to the determined low slope content metric and spectral width metric of the sensed cardiac signals by the medical device; and

delivering a therapy via the device in response to the detecting.

2. The method of claim 1, wherein determining a low slope content metric of the sensed cardiac signals comprises:

determining a slope threshold in response to the sensed cardiac signals; and

determining a number of the slopes being less than the slope threshold.

3. The method of claim 2, wherein detecting the sensed cardiac signals comprises:

determining whether the number of the slopes that are less than the slope threshold is less than a first boundary; and

determining whether the spectral width metric is less than a second boundary different from the first boundary.

4. The method of claim 3, wherein detecting the sensed cardiac signals as being associated with the cardiac event comprises determining the sensed cardiac signal is not associated with the cardiac event in response to determining that at least one of the number of the slopes that are less than the slope threshold is not less than the first boundary or the spectral width metric is not less than the second boundary.

5. The method of claim 4, wherein the cardiac event comprises ventricular fibrillation.

6. A method of detecting a cardiac event in a medical device, comprising:

sensing cardiac signals from a plurality of electrodes coupled to the medical device, the plurality of electrodes forming a first sensing vector and a second sensing vector;

determining a first low slope content metric of the cardiac signals sensed by the first sensing vector over a predetermined sensing window by the medical device;

determining a second low slope content metric of the cardiac signals sensed by the second sensing vector over the predetermined sensing window by the medical device;

determining a first spectral width metric of the cardiac signals sensed by the first sensing vector over the predetermined sensing window by the medical device;

determining a second spectral width metric of the cardiac signals sensed by the second sensing vector over the predetermined sensing window by the medical device;

detecting the sensed cardiac signals as being associated with the cardiac event in response to the first low slope content, the second low slope content, the first spectral width metric and the second spectral width metric by the medical device; and

delivering a therapy via the medical device in response to the detecting.

7. The method of claim 6, wherein detecting the sensed cardiac signals comprises:

determining whether a number of slopes of the first low slope content and the second low slope content that are less than a slope threshold are also less than a first boundary; and

determining whether the first spectral width metric or the second spectral width metric is less than a second boundary different from the first boundary.

8. The method of claim 7, wherein detecting the sensed cardiac signals as being associated with the cardiac event comprises determining the sensed cardiac signal is not associated with the cardiac event in response to determining that at least one of the number of the slopes that are less than the slope threshold is not less than the first boundary or one of the first spectral width metric and the second spectral width metric is not less than the second boundary.

9. The method of claim 8, wherein the cardiac event comprises ventricular fibrillation.

10. A non-transitory computer readable medium having computer executable instructions for performing a method comprising:

sensing cardiac signals from a plurality of electrodes;

determining a low slope content metric of the sensed cardiac signals;

determining a spectral width metric of the sensed cardiac signals;

detecting the sensed cardiac signals as being associated with the event in response to the determined low slope content metric and the determined spectral width metric.

11. A medical device for detecting a cardiac event, comprising:

a plurality of electrodes sensing cardiac signals;

a processor configured to determine a low slope content metric of the sensed cardiac signals, determine a spectral width metric of the sensed cardiac signals, and detect the sensed cardiac signals as being associated with the cardiac event in response to the determined low slope content metric and spectral width metric of the sensed cardiac signals by the medical device; and

a pulse generator to deliver a therapy via an electrode of the plurality of electrodes.