Template based AV/VA interval comparison for the discrimination of cardiac arrhythmias
원문보기
IPC분류정보
국가/구분
United States(US) Patent
등록
국제특허분류(IPC7판)
A61B-005/0452
A61B-005/0464
A61B-005/0468
출원번호
UP-0844475
(2004-05-12)
등록번호
US-7515956
(2009-07-01)
발명자
/ 주소
Thompson, Julie
출원인 / 주소
Cardiac Pacemakers, Inc.
대리인 / 주소
Schwegman, Lundberg & Woessner, P.A.
인용정보
피인용 횟수 :
22인용 특허 :
158
초록▼
An implantable cardioverter/defibrillator includes a tachycardia detection system that detects one-to-one (1:1) tachycardia, which is a tachycardia with a one-to-one relationship between atrial and ventricular contractions. When the 1:1 tachycardia is detected, the system discriminates ventricular t
An implantable cardioverter/defibrillator includes a tachycardia detection system that detects one-to-one (1:1) tachycardia, which is a tachycardia with a one-to-one relationship between atrial and ventricular contractions. When the 1:1 tachycardia is detected, the system discriminates ventricular tachycardia (VT) from supraventricular tachycardia (SVT) based on analysis of a cardiac time interval. Examples of the cardiac time interval include an atrioventricular interval (AVI) and a ventriculoatrial interval (VAI). A template time interval is created during a known normal sinus rhythm. The system measures a tachycardia time interval after detecting the 1:1 tachycardia, and indicates a VT detection if the tachycardia time interval differs from the template time interval by at least a predetermined percentage of the template time interval.
대표청구항▼
What is claimed is: 1. A system for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT), the system comprising: a sensing circuit that senses an atrial electrogram indicative of atrial depolarizations and a ventricular electrogram indicative of ventricular depolariza
What is claimed is: 1. A system for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT), the system comprising: a sensing circuit that senses an atrial electrogram indicative of atrial depolarizations and a ventricular electrogram indicative of ventricular depolarizations; a rate detector circuit, coupled to the sensing circuit, that detects an atrial rate based on the atrial electrogram and a ventricular rate based on the ventricular electrogram; a tachycardia detector circuit, coupled to the rate detector circuit, that detects a tachycardia based on at least one of the atrial rate and the ventricular rate; a rhythm classifier circuit, coupled to the rate detector circuit and the tachycardia detector circuit, that classifies the detected tachycardia as a 1:1 tachycardia in response to the atrial rate and the ventricular rate being substantially equal; and a tachycardia discriminator circuit coupled to the rhythm classifier circuit, the tachycardia discriminator circuit including: a time interval measurement circuit, coupled to the sensing circuit, that measures a tachycardia time interval between an atrial depolarization and an adjacent ventricular depolarization during the 1:1 tachycardia; and a VT comparator circuit coupled to the time interval measurement circuit, the VT comparator circuit having an output that indicates a VT detection in response to the VT comparator circuit determining that the tachycardia time interval differs from a template time interval by at least a predetermined percentage of the template time interval and that indicates a detection of SVT in response to the VT comparator circuit determining that the tachycardia time interval does not differ from the template time interval by at least the predetermined percentage of the template time interval, wherein the template time interval is a time interval between an atrial depolarization and an adjacent ventricular depolarization measured during a normal sinus rhythm. 2. The system of claim 1, wherein the time interval measurement circuit comprises an atrioventricular interval (AVI) measurement module that measures a tachycardia AVI in response to the detection of the tachycardia and the classification of the 1:1tachycardia. 3. The system of claim 2, wherein the AVI measurement module measures the template time interval as an AVI during a normal sinus rhythm. 4. The system of claim 1, wherein the time interval measurement circuit comprises a ventriculoatrial interval (VAI) measurement module that measures a tachycardia VAI in response to the detection of the tachycardia and the classification of the 1:1tachycardia. 5. The system of claim 4, wherein the VAI measurement module measures the template time interval as a VAI during a normal sinus rhythm. 6. The system of claim 1, wherein the output of the VT comparator circuit indicates an SVT detection in response to the tachycardia time interval not differing from the template time interval by at least the predetermined percentage of the template time interval. 7. The system of claim 1, wherein the tachycardia detector circuit comprises a tachycardia comparator circuit having a tachycardia output indicative a detected tachycardia in response to the ventricular rate exceeding a predetermined tachycardia threshold rate. 8. The system of claim 7, wherein the rhythm classifier circuit comprises a rhythm comparator circuit that compares the atrial rate to the ventricular rate after the tachycardia is detected, the rhythm comparator circuit having an atrial rate input to receive the atrial rate, a ventricular rate input to receive a ventricular rate, and a classification output indicative of VT if the ventricular rate is substantially higher than the atrial rate, SVT or dual arrhythmia if the atrial rate is substantially higher than the ventricular rate, and the 1:1 tachycardia if the atrial rate and the ventricular rate are substantially equal, wherein the dual arrhythmia includes a combination of SVT and VT. 9. The system of claim 8, further comprising an atrial fibrillation (AF) detector circuit, coupled to the rhythm classifier, to detect AF. 10. The system of claim 9, further comprising an atrial defibrillation circuit, coupled to the AF detector circuit, that delivers one or more atrial defibrillation shocks in response to the detection of AF. 11. The system of claim 8, further comprising a ventricular fibrillation (VF) detector circuit, coupled to the rhythm classifier circuit, to detect VF. 12. The system of claim 11, further comprising a ventricular defibrillation circuit, coupled to the VF detector circuit, that delivers one or more ventricular defibrillation shocks in response to the detection of VF. 13. The system of claim 1, wherein the tachycardia discriminator circuit further comprises a VT verifier circuit, coupled to the VT comparator circuit that verifies the VT detection. 14. The system of claim 13, wherein the VT verifier circuit comprises a further tachycardia discriminator circuit. 15. The system of claim 1, comprising an implantable cardiovertor/defibrillator including a hermetically sealed implantable can to house a cardiovertor/defibrillator circuit including at least the sensing circuit, the rate detector circuit, the tachycardia detector circuit, the rhythm classifier circuit, and the tachycardia discriminator circuit. 16. A cardiac rhythm management (CRM) system, comprising: an implantable atrial lead allowing for sensing an atrial electrogram indicative of atrial depolarizations; an implantable ventricular lead allowing for sensing a ventricular electrogram indicative of ventricular depolarizations; and an implantable cardioverter/defibrillator (ICD) including: a sensing circuit, coupled to the implantable atrial lead and the implantable ventricular lead, to sense the atrial electrogram and the ventricular electrogram; a rate detector circuit, coupled to the sensing circuit, that detects an atrial rate based on the atrial electrogram and a ventricular rate based on the ventricular electrogram; a tachycardia detector circuit, coupled to the rate detector circuit, that detects a tachycardia based on at least one of the atrial rate and the ventricular rate; a rhythm classifier circuit, coupled to the rate detector circuit and the tachycardia detector circuit, that classifies the detected tachycardia as a 1:1 tachycardia in response to the atrial rate and the ventricular rate being substantially equal; and a tachycardia discriminator circuit coupled to the rhythm classifier circuit, the tachycardia discriminator circuit including: a time interval measurement circuit, coupled to the sensing circuit, that measures a tachycardia time interval between an atrial depolarization and an adjacent ventricular depolarization during the 1:1 tachycardia; and a VT comparator circuit coupled to the time interval measurement circuit, the VT comparator circuit having an output that indicates a detection of VT in response to the VT comparator circuit determining that the tachycardia time interval differs from a template time interval by at least a predetermined percentage of the template time interval and that indicates an SVT detection in response to the VT comparator circuit determining that the tachycardia time interval does not differ from the template time interval by at least the predetermined percentage of the template time interval, wherein the template time interval is a time interval between an atrial depolarization and an adjacent ventricular depolarization measured during a normal sinus rhythm. 17. The CRM system of claim 16, wherein the time interval measurement circuit comprises an atrioventricular interval (AVI) measurement module that measures a tachycardia AVI in response to the detection of the tachycardia and the classification of the 1:1 tachycardia. 18. The CRM system of claim 16, wherein the time interval measurement circuit comprises a ventriculoatrial interval (VAI) measurement module that measures a tachycardia VAI in response to the detection of the tachycardia and the classification of the 1:1 tachycardia. 19. The CRM system of claim 16, wherein the tachycardia detector circuit comprises a tachycardia comparator circuit having a tachycardia output indicative a detected tachycardia in response to the ventricular rate exceeding a predetermined tachycardia threshold rate. 20. The CRM system of claim 19, wherein the rhythm classifier circuit comprises a rhythm comparator circuit that compares the atrial rate to the ventricular rate after the tachycardia is detected, the rhythm comparator circuit having an atrial rate input to receive the atrial rate, a ventricular rate input to receive a ventricular rate, and a classification output indicative of VT if the ventricular rate is substantially higher than the atrial rate, SVT or dual arrhythmia if the atrial rate is substantially higher than the ventricular rate, and the 1:1tachycardia if the atrial rate and the ventricular rate are substantially equal, wherein the dual arrhythmia includes a combination of SVT and VT. 21. The CRM system of claim 16, wherein the LCD further comprises an atrial fibrillation (AF) detector circuit, coupled to the rhythm classifier circuit, that detects AF if SVT is indicated. 22. The CRM system of claim 21, wherein the LCD further comprises an atrial defibrillation circuit, coupled to the AF detector circuit, that delivers one or more atrial defibrillation shocks in response to the detection of AF. 23. The CRM system of claim 16, wherein the LCD further comprises a ventricular fibrillation (VF) detector circuit, coupled to the rhythm classifier circuit and the VT discriminator circuit, that detects VF if VT is detected. 24. The CRM system of claim 23, wherein the ICD further comprises a ventricular defibrillation circuit, coupled to the VF detector circuit, that delivers one or more ventricular defibrillation shocks in response to the detection of VF. 25. The CRM system of claim 16, wherein the ICD further comprises a VT verifier circuit, coupled to the VT discriminator circuit, that verifies VT detections. 26. The CRM system of claim 25, wherein the VT verifier comprises a further tachycardia discriminator circuit. 27. The CRM system of claim 16, further comprising an external system including an external device communicatively coupled to the LCD via telemetry, a remote device providing for access to the LCD from a distant location, and a network communicatively coupling the external device and the remote device. 28. A method for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT), the method comprising: detecting a ventricular rate being a frequency of ventricular depolarizations; detecting an atrial rate being a frequency of atrial depolarizations; detecting a tachycardia based on at least one of the atrial and ventricular rates; classifying the tachycardia as a 1:1 tachycardia if the detected atrial rate is substantially the same as the detected ventricular rate; measuring a tachycardia time interval between adjacent atrial and ventricular depolarizations during the 1:1 tachycardia; determining whether the tachycardia time interval differs from a template time interval by at least a predetermined percentage of the template time interval; indicating a VT detection if the determining indicates that the tachycardia time interval differs from the template time interval by at least the predetermined percentage of the template time interval; and indicating a SVT detection if the determining indicates that the tachycardia time interval does not differ from the template time interval by the predetermined percentage of the template time interval, wherein the template time interval is a time interval between adjacent atrial and ventricular depolarizations measured during a normal sinus rhythm. 29. The method of claim 28, wherein measuring the tachycardia time interval comprises measuring a tachycardia atrioventricular interval (AVI) during the 1:1 tachycardia, and wherein indicating the VT detection comprises indicating the VT detection if the tachycardia AVI exceeds a template AVI by at least a predetermined percentage of the template AVI. 30. The method of claim 29, further comprising creating the template AVI by measuring an AVI during a normal sinus rhythm. 31. The method of claim 28, wherein measuring the tachycardia time interval comprises measuring a tachycardia ventriculoatrial interval (VAI) and a tachycardia heart rate during the 1:1 tachycardia, and wherein indicating the VT detection comprises adjusting the tachycardia VAI based on the tachycardia heart rate and a template heart rate, and indicating the VT detection if a template VAI exceeds the adjusted tachycardia VAL by a predetermined percentage of the template VAI. 32. The method of claim 31, further comprising: creating the template VAI by measuring a VAI during a normal sinus rhythm; and creating the template heart rate by measuring a heart rate during the normal sinus rhythm. 33. The method of claim 28, further comprising performing a statistical study based on a patient population to determine the predetermined percentage of the template time interval. 34. The method of claim 28, wherein detecting the ventricular rate comprises sensing a ventricular electrogram indicative of ventricular depolarizations, and detecting the atrial rate comprises sensing an atrial electrogram indicative of atrial depolarizations. 35. The method of claim 34, wherein detecting tachycardia comprises comparing the detected ventricular rate to a predetermined tachycardia threshold rate. 36. The method of claim 35, further comprising classifying the tachycardia as VT if the detected ventricular rate is substantially higher than the detected atrial rate. 37. The method of claim 36, further comprising detecting ventricular fibrillation (VF). 38. The method of claim 35, further comprising delivering at least one ventricular defibrillation shock if VF is detected. 39. The method of claim 35, further comprising classifying the tachycardia as SVT or dual arrhythmia if the detected atrial rate is substantially higher than the detected ventricular rate, wherein the dual arrhythmia includes a combination of SVT and VT. 40. The method of claim 39, further comprising detecting atrial fibrillation (AF). 41. The method of claim 40, further comprising delivering at least one atrial defibrillation shock if AF is detected. 42. The method of claim 28, further comprising confirming the VT detection after indicating the VT detection.
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이 특허에 인용된 특허 (158)
Long Ronald J. (Simi Valley CA), Adjustable template for pacemaker ECG analysis and method of use.
Shah Atul P. (Palm Bay FL) Reuss James L. (Melbourne Beach FL) Guckert Toni (W. Melbourne FL) Clesius Jeffrey J. (Palm Bay FL), Ambulatory ECG analyzer and recorder.
Reinhold ; Jr. Herbert E. (Rockville MD) Auerbach Albert A. (New York NY), Ambulatory monitoring system with real time analysis and telephone transmission.
Nappholz Tibor A. (Englewood CO) Dawson Albert K. (Denver CO) Lu Richard M. T. (Aurora CO) Steinhaus Bruce M. (Parker CO), Apparatus and method for detecting abnormal cardiac rhythms using evoked potential measurements in an arrhythmia control.
Mason David (Lane Cove AUX) Bassin David (Coogee AUX) Murphy Anthony (Leichhardt AUX) Stephens Anthony C. (Willoughby AUX), Apparatus and method for discriminating between associated and dissociated cardiac rhythms.
Farrugia Steven (Bexley AUX) Yee Hansen (Wollstonecraft AUX) Nickolls Peter (Vaucluse AUX), Apparatus and method for discriminating between cardiac rhythms on the basis of their morphology using a neural network.
Mason David (Lane Cove AUX) Bassin David (Coogee AUX) Murphy Anthony (Leechardt AUX) Stephens Anthony C. (Willoughby AUX), Apparatus and method for discriminating between heart rhythms with similar atrial and ventricular rates.
Mika Yuval,ILX ; Prutchi David ; Belsky Ziv,ILX ; Routh Andre G., Apparatus and method for setting the parameters of an alert window used for timing the delivery of ETC signals to a heart under varying cardiac conditions.
Krig David B. ; Gilkerson James O. ; Dreher Robert D. ; Wald Jan D. ; Linder William J. ; Zimmer William L., Apparatus and method for treating ventricular tachyarrhythmias.
Krig David B. ; Gilkerson James O. ; Dreher Robert D. ; Wald Jan D. ; Linder William J. ; Zimmer William L., Apparatus and method for treating ventricular tachyarrhythmias.
Arai Makoto R. (Chicago IL) Gordon David (Chicago IL) McAlpine Laura E. (Chicago IL), Apparatus for monitoring cardiovascular regulation using heart rate power spectral analysis.
Schlager Kenneth J. ; Boehlen Bruce H. ; Gorski Stephen H., Automated seismic detection of myocardial ischemia and related measurement of cardiac output parameters.
Lu Richard M. T. (Highlands Ranch CO) Steinhaus Bruce M. (Parker CO) Crosby Peter A. (Greenwood Village CO), Automatic atrial pacing threshold determination utilizing an external programmer and a surface electrogram.
Arand Patricia A. (McMinnville OR) Post William L. (McMinnville OR) Forbes Alfred D. (Palo Alto CA), Calculating a heart rate from an ECG waveform by discarding a percentage of R-R intervals prior to averaging.
McClure Kelly H. (Simi Valley CA) Mouchawar Gabriel (Newhall CA) Causey ; III James D. (Simi Valley CA), Cardiac arrhythmia detection system for an implantable stimulation device.
Victor T. Chen ; Jay A. Warren ; Gary T. Seim ; David B. Krig ; Jesse W. Hartley ; Jeffrey E. Stahmann, Cardiac rhythm management system with atrial shock timing optimization.
Branham Barry H. (Ballwin MO) Cox James L. (Ladue MO) Boineau John P. (Ladue MO) Schuessler Richard B. (Ballwin MO), Computerized three-dimensional cardiac mapping with interactive visual displays.
Steinhaus Bruce M. (Parker CO) Wells Randy T. (Littleton CO), Data compression of cardiac electrical signals using scanning correlation and temporal data compression.
Steinhaus Bruce M. (Parker CO) Wells Randy T. (Littleton CO), Detection of cardiac arrhythmias using correlation of a cardiac electrical signals and temporal data compression.
Steinhaus Bruce M. (Parker CO) Vance Fred I. (Parker CO) Curtis Anne (Gansville FL) Koestner Ken (Englewood CO), Heart rejection monitoring apparatus and method.
Murphy Anthony J. (Annandale AUX) Bassin David (Coogee AUX) Mason David (Kilsyth AUX), Heart rhythm classification method, and implantable dual chamber cardioverter/defibrillator employing the same.
Nappholz Tibor A. (Englewood CO) Greenhut Saul E. (Aurora CO) Dawson Albert K. (Denver CO), Implantable cardiac stimulating apparatus and method employing detection of P-waves from signals sensed in the ventricle.
Saumarez Richard (Old Coulsdon GB2) Murphy Anthony (Leichhardt AUX), Implantable cardioverter/defibrillator and method employing cross-phase spectrum analysis for arrhythmia detection.
Buchanan Stuart W. (Saugus CA), Implantable pacemaker including means and method of terminating a pacemaker-mediated tachycardia during rate adaptive pa.
Mouchawar, Gabriel A.; Street, Anne M.; Badelt, Steven W., Implantable stimulation device and method for discrimination atrial and ventricular arrhythmias.
Albert David E. (McAlester OK) Lander Paul (Norman OK), Method and apparatus for analyzing and interpreting electrocardiograms using spectro-temporal mapping.
Anderson Donald L. (San Juan Capistrano CA) Cherry Isaac R. (Mission Viejo CA) Ripley John A. (Newport Beach CA) Tanaka David T. (San Juan Capistrano CA), Method and apparatus for arrhythmia analysis of ECG recordings.
Riff Kenneth M. (Plymouth MN) McDonald Ray S. (Roseville MN) German Michael J. (Mounds View MN), Method and apparatus for intracardiac electrogram morphologic analysis.
Snell Jeffery D. (Northridge CA) Schloss Harold C. (Los Angeles CA) Mann Brian M. (Beverly Hills CA) Poore John W. (South Pasadena CA) Medlin Roy B. (West Hills CA), Method and apparatus for reporting and displaying a sequential series of pacing events.
Caswell Stephanie A. ; Jenkins Janice M. ; DiCarlo Lorenzo A., Method and apparatus for separation of ventricular tachycardia from ventricular fibrillation for implantable cardioverte.
Nevo Erez,ILX, Method and apparatus for the assessment and display of variability in mechanical activity of the heart, and enhancement of ultrasound contrast imaging by variability analysis.
Spinelli Julio C. (Shoreview MN) Heemels Jan P. (Minneapolis MN), Method and apparatus to continuously optimize the A-V delay in a dual chamber pacemaker.
Throne Robert D. (Ann Arbor) Jenkins Janice M. (Ann Arbor) DiCarlo Lorenzo A. (Ann Arbor MI), Method and system for monitoring electrocardiographic signals and detecting a pathological cardiac arrhythmia such as ve.
Murphy Anthony J. (Annandale AUX) Wickham John (Fivedock AUX) Bassin David (Coogee AUX), Method of classifying heart rhythms by analyzing several morphology defining metrics derived for a patient\s QRS complex.
Bornzin Gene A. ; Vogel Alan B. ; Zadeh Ali Enayat ; Kleks Jonathan A. ; Wilson Raymond J., Methods and apparatus for classifying cardiac events with an implantable cardiac device.
Karlsson Per (Taby SEX) Lundahl Gunilla (Lidingo SEX) Oljemark Michael (Saltsjo-Boo SEX) Ubby Johan (Vaxholm SEX), Myocardial ischemia and infarction analysis and monitoring method and apparatus.
Epstein Andrew E. (Birmingham AL) Duncan James L. (Alpharetta GA) Levine Paul A. (Santa Clarita CA) Sholder Jason A. (Beverly Hills CA), Programming system having means for recording and analyzing a patient\s cardiac signal.
Steinhaus Bruce M. (Parker CO) Wells Randy T. (Littleton CO), Signal averaging of cardiac electrical signals using temporal data compression and scanning correlation.
Cho,Yong K.; Erickson,Mark K.; Markowitz,H. Toby, System and method for automatically monitoring and delivering therapy for sleep-related disordered breathing.
Mouchawar Gabriel (Newhall CA) McClure Kelly H. (Simi Valley CA) Moberg Sheldon B. (Kagel Canon CA), System and method for deriving hemodynamic signals from a cardiac wall motion sensor.
Florio, Joseph J., System and method for distinguishing electrical events originating in the atria from far-field electrical events originating in the ventricles as detected by an implantable medical device.
Bocek Joseph M. ; Finch David P. ; Foshee ; Jr. Phillip D. ; Kim Jaeho, System for detecting atrial fibrillation notwithstanding high and variable ventricular rates.
Andrew P. Kramer ; Jeffrey E. Stahmann ; Rene H. Wentkowski ; Kenneth L. Baker ; Jesse W. Hartley ; David B. Krig, System providing ventricular pacing and biventricular coordination.
Lehmann Michael H. (West Bloomfield MI), Tachycardia detection for automatic implantable cardioverter/defibrillator with atrial and ventricular sensing capabilit.
Sarkar, Shantanu; Hansen, Daniel L; Neitzell, Grant A; Reiland, Jerry D; Wyszynski, Ryan, Method and apparatus for adjusting a threshold during atrial arrhythmia episode detection in an implantable medical device.
Sarkar, Shantanu; Hansen, Daniel L; Neitzell, Grant A; Reiland, Jerry D; Wyszynski, Ryan, Method and apparatus for atrial arrhythmia episode detection.
Zhang, Xusheng; Cao, Jian; Greenhut, Saul E.; Stadler, Robert W., System and method for sensing and detection in an extra-cardiovascular implantable cardioverter defibrillator.
Stahmann, Jeffrey E.; Simms, Jr., Howard D.; Maile, Keith R.; Kane, Michael J.; Linder, William J., Systems and methods for detecting cardiac arrhythmias.
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