Method for discriminating between ventricular and supraventricular arrhythmias
First Claim
1. A method of determining whether to deliver therapy in a cardiac defibrillation system, the system comprising operational circuitry for analyzing cardiac signals coupled to a plurality of electrodes for sensing cardiac signals for analysis by the operational circuitry, the method comprising:
- detecting cardiac events and calculating an elevated cardiac rate above a first rate threshold and below a second rate threshold;
when an elevated cardiac rate is present, discriminating supraventricular, monomorphic, and polymorphic rhythms using first and second factors wherein;
the first factor comprises a correlation between detected cardiac events and a template of supraventricular rhythm, the first factor being analyzed relative to a first factor threshold to yield high correlation or low correlation;
the second factor comprises variability in correlation between sensed cardiac complexes and a dynamic template, the second factor being analyzed relative to a second factor threshold to yield high variability or low variability;
when the first factor indicates high correlation and the second factor indicates low variability, the rhythm is found to be supraventricular;
when the first factor indicates low correlation and the second vector indicates low variability, the rhythm is found to be monomorphic; and
when the first factor indicates low correlation and the second factor indicates high variability, the rhythm is found to be polymorphic; and
determining whether to withhold or deliver electrical therapy as follows;
when the rhythm is found to be supraventricular, withholding electrical therapy;
when the rhythm is found to be a monomorphic ventricular rhythm, determining to deliver electrical therapy; and
when the rhythm is found to be a polymorphic ventricular rhythm, determining to deliver electrical therapy.
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Abstract
The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.
208 Citations
20 Claims
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1. A method of determining whether to deliver therapy in a cardiac defibrillation system, the system comprising operational circuitry for analyzing cardiac signals coupled to a plurality of electrodes for sensing cardiac signals for analysis by the operational circuitry, the method comprising:
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detecting cardiac events and calculating an elevated cardiac rate above a first rate threshold and below a second rate threshold; when an elevated cardiac rate is present, discriminating supraventricular, monomorphic, and polymorphic rhythms using first and second factors wherein; the first factor comprises a correlation between detected cardiac events and a template of supraventricular rhythm, the first factor being analyzed relative to a first factor threshold to yield high correlation or low correlation; the second factor comprises variability in correlation between sensed cardiac complexes and a dynamic template, the second factor being analyzed relative to a second factor threshold to yield high variability or low variability; when the first factor indicates high correlation and the second factor indicates low variability, the rhythm is found to be supraventricular; when the first factor indicates low correlation and the second vector indicates low variability, the rhythm is found to be monomorphic; and when the first factor indicates low correlation and the second factor indicates high variability, the rhythm is found to be polymorphic; and determining whether to withhold or deliver electrical therapy as follows; when the rhythm is found to be supraventricular, withholding electrical therapy; when the rhythm is found to be a monomorphic ventricular rhythm, determining to deliver electrical therapy; and when the rhythm is found to be a polymorphic ventricular rhythm, determining to deliver electrical therapy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A medical device configured to deliver cardiac electrical therapy to a patient, the device comprising:
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a plurality of electrodes for capturing cardiac signal data; and operational circuitry for receiving the captured cardiac signal data and analyzing the captured cardiac signal data to determine whether a treatable cardiac arrhythmia is occurring; wherein the operational circuitry is configured to perform the following; detecting cardiac events and calculating an elevated cardiac rate above a first rate threshold and below a second rate threshold; in response to the elevated cardiac rate, discriminating supraventricular, monomorphic, and polymorphic rhythms using first and second factors wherein; the first factor comprises a correlation between detected cardiac events and a template of supraventricular rhythm, the first factor being analyzed relative to a first factor threshold to yield high correlation or low correlation; the second factor comprises variability in correlation between sensed cardiac complexes and a dynamic template, the second factor being analyzed relative to a second factor threshold to yield high variability or low variability; if the first factor indicates high correlation and the second factor indicates low variability, the rhythm is found to be supraventricular; if the first factor indicates low correlation and the second vector indicates low variability, the rhythm is found to be monomorphic; and if the first factor indicates low correlation and the second factor indicates high variability, the rhythm is found to be polymorphic; and determining whether to withhold or deliver electrical therapy as follows; if the rhythm is found to be supraventricular, withholding electrical therapy; if the rhythm is found to be a monomorphic ventricular rhythm, determining to deliver electrical therapy; and if the rhythm is found to be a polymorphic ventricular rhythm, determining to deliver electrical therapy. - View Dependent Claims (11, 12, 13, 14, 15, 16)
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17. A medical device configured to deliver cardiac electrical therapy to a patient, the device comprising:
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a plurality of electrodes for capturing cardiac signal data; and operational circuitry for receiving the captured cardiac signal data and analyzing the captured cardiac signal data to determine whether a treatable cardiac arrhythmia is occurring; wherein the operational circuitry is configured to perform the following; detecting cardiac events and calculating an elevated cardiac rate above a first rate threshold and below a second rate threshold; in response to the elevated cardiac rate, discriminating supraventricular from ventricular rhythms using first, second and third factors wherein; the first factor comprises a correlation between detected cardiac events and a template of supraventricular rhythm, the first factor being analyzed relative to a first factor threshold to yield high correlation or low correlation; the second factor comprises variability in correlation between sensed cardiac complexes and a dynamic template, the second factor being analyzed relative to a second factor threshold to yield high variability or low variability; and the third factor comprises width of a sensed cardiac complexes; determining whether sensed cardiac complexes cluster into; a first grouping with a defined combination of high correlation using the first factor, low variability using the second factor, and narrow width using the third factor;
ora second grouping not illustrating the defined combination; if the sensed cardiac complexes cluster into the first grouping, finding that a supraventricular rhythm is occurring or, if not, finding that a ventricular rhythm is occurring; and determining whether to withhold or deliver electrical therapy as follows; if the rhythm is found to be supraventricular, withholding electrical therapy; if the rhythm is found to be a ventricular rhythm, determining to deliver electrical therapy. - View Dependent Claims (18, 19, 20)
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Specification