Arrhythmia discrimination using ECG's sensed from multiple implanted electrodes
First Claim
1. A processor-implemented method, comprising:
- sensing a plurality of composite cardiac signals at a plurality of patient-internal locations for a multiplicity of cardiac cycles;
performing a plurality of source separations using the sensed composite cardiac signals;
producing a cardiac signal vector indicative of a cardiac activation sequence of an area of the patient'"'"'s heart based on each of the plurality of source separations;
measuring an orientation of the cardiac signal vectors relative to a baseline established for the patient;
detecting ventricular tachycardia (VT) based on the cardiac signal vector orientation measurements; and
in response to detecting VT;
determining variation of the cardiac signal vector orientation measurements, wherein determining the variation of the cardiac signal vector orientation measurements comprises;
performing a subsequent source separation using sensed composite cardiac signals for each of a plurality of consecutive cardiac cycles after VT is detected;
producing a subsequent cardiac signal vector based on each of the subsequent source separations;
measuring an orientation of each subsequent cardiac signal vector relative to the baseline; and
determining the variation of the subsequent cardiac signal vector orientation measurements; and
discriminating between polymorphic ventricular tachycardia (PVT) and monomorphic ventricular tachycardia (MVT) based on the variation of the cardiac signal vector orientation measurements, wherein at least some of the method is implemented by a processor.
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Abstract
Cardiac monitoring and/or stimulation methods and systems provide for monitoring, diagnosing, defibrillation and pacing therapies, or a combination of these capabilities, including cardiac systems incorporating or cooperating with neuro-stimulating devices, drug pumps, or other therapies. Embodiments of the present invention relate generally to implantable medical devices employing automated cardiac activation sequence monitoring and/or tracking for arrhythmia discrimination. Embodiments of the invention are directed to devices and methods involving sensing a plurality of composite cardiac signals using a plurality of implantable electrodes. A source separation is performed using the sensed plurality of composite cardiac signals and the separation produces one or more cardiac signal vectors associated with one or more cardiac activation sequences that is indicative of ischemia. A change of the one or more cardiac signal vectors is detected using the one or more cardiac signal vectors. Cardiac arrhythmias are discriminated using the one or more cardiac signal vectors.
240 Citations
18 Claims
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1. A processor-implemented method, comprising:
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sensing a plurality of composite cardiac signals at a plurality of patient-internal locations for a multiplicity of cardiac cycles; performing a plurality of source separations using the sensed composite cardiac signals; producing a cardiac signal vector indicative of a cardiac activation sequence of an area of the patient'"'"'s heart based on each of the plurality of source separations; measuring an orientation of the cardiac signal vectors relative to a baseline established for the patient; detecting ventricular tachycardia (VT) based on the cardiac signal vector orientation measurements; and in response to detecting VT; determining variation of the cardiac signal vector orientation measurements, wherein determining the variation of the cardiac signal vector orientation measurements comprises; performing a subsequent source separation using sensed composite cardiac signals for each of a plurality of consecutive cardiac cycles after VT is detected; producing a subsequent cardiac signal vector based on each of the subsequent source separations; measuring an orientation of each subsequent cardiac signal vector relative to the baseline; and determining the variation of the subsequent cardiac signal vector orientation measurements; and discriminating between polymorphic ventricular tachycardia (PVT) and monomorphic ventricular tachycardia (MVT) based on the variation of the cardiac signal vector orientation measurements, wherein at least some of the method is implemented by a processor. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. An apparatus, comprising:
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a plurality of implantable electrodes configured for sensing composite cardiac signals over a multiplicity of cardiac cycles; a housing configured for implantation in a patient; and a processor provided in the housing and coupled to the plurality of implantable electrodes, the processor configured to perform a plurality of source separations using the sensed composite cardiac signals, produce a cardiac signal vector indicative of a cardiac activation sequence of an area of the patient'"'"'s heart based on each of the plurality of source separations, measure an orientation of the cardiac signal vectors relative to a baseline established for the patient, detect ventricular tachycardia (VT) based on the cardiac signal vector orientation measurements, and, if VT is detected, discriminate between polymorphic ventricular tachycardia (PVT) and monomorphic ventricular tachycardia (MVT) based on the cardiac signal vector orientation measurements; wherein the processor is configured to perform a subsequent source separation using sensed composite cardiac signals for each of a plurality of consecutive cardiac cycles after VT is detected, produce a subsequent cardiac signal vector based on each of the subsequent source separations, measure an orientation of each subsequent cardiac signal vector relative to the baseline, and determine the variation of the subsequent cardiac signal vector orientation measurements. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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Specification