Apparatus and method for identifying atrial arrhythmia by far-field sensing
IPC분류정보
국가/구분
United States(US) Patent
등록
국제특허분류(IPC7판)
A61N-001/00
출원번호
US-0231613
(2011-09-13)
등록번호
US-8457737
(2013-06-04)
발명자
/ 주소
Bardy, Gust H.
Rissmann, William J.
Ostroff, Alan H.
Erlinger, Paul J.
Allavatam, Venugopal
출원인 / 주소
Cameron Health, Inc.
대리인 / 주소
Schwegman Lundberg & Woessner, P.A.
인용정보
피인용 횟수 :
16인용 특허 :
1
초록▼
In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameter
In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameters such as rate, QRS pulse width, cardiac QRS slew rate, amplitude and stability measures of these parameters from the filtered cardiac signal information are measured, processed and integrated to determine if the cardioverter/defibrillator needs to initiate therapeutic action.
대표청구항▼
1. A method of treating a patient with an implanted cardioverter-defibrillator comprising: the implanted cardioverter-defibrillator capturing far-field cardiac signals from electrodes disposed beneath the skin and outside of a patient's ribcage;the implanted cardioverter-defibrillator identifying th
1. A method of treating a patient with an implanted cardioverter-defibrillator comprising: the implanted cardioverter-defibrillator capturing far-field cardiac signals from electrodes disposed beneath the skin and outside of a patient's ribcage;the implanted cardioverter-defibrillator identifying the patient's P-wave in the far-field cardiac signals;the implanted cardioverter-defibrillator monitoring the patient's P-wave to determine whether the patient's P-wave abruptly changes; andthe implanted cardioverter-defibrillator if the patient's P-wave abruptly changes, determining that the patient is experiencing atrial fibrillation and withholding cardiac stimulus that would otherwise be delivered to the patient. 2. The method of claim 1, wherein the implanted cardioverter-defibrillator comprises a lead assembly coupled to a canister that houses operational circuitry for the implanted cardioverter-defibrillator wherein the canister and the lead assembly are implanted in the patient beneath the skin and outside of the patient's ribcage without accessing the vasculature or heart of the patient. 3. The method of claim 1, further comprising withholding cardiac stimulus that would otherwise be delivered to the patient if it is determined that the patient is experiencing atrial fibrillation. 4. The method of claim 1, wherein the step of monitoring the patient's P-wave includes determining whether the patient's P-wave disappears and, if so, concluding that the P-wave has abruptly changed. 5. The method of claim 1, further comprising identifying at least one characteristic of the patient's P-wave during normal sinus rhythm. 6. The method of claim 5, wherein the at least one characteristics of the patient's P-wave includes the morphology of the patient's P-wave during normal sinus rhythm, and further wherein an abrupt change is determined by observation of whether a change occurs in the morphology of the patient's P-wave. 7. The method of claim 5, wherein the at least one characteristic of the patient's P-wave includes the amplitude and timing relationship of the patient's P-wave to the patient's QRS during normal sinus rhythm, and further wherein an abrupt change is determined by observation of whether a change occurs in the amplitude and timing relationship of the patient's P-wave to the patient's QRS during an unknown rhythm. 8. The method of claim 5, wherein the at least one characteristic of the patient's P-wave includes the frequency content of the patient's P-wave during normal sinus rhythm, and further wherein an abrupt change is determined by observation of whether a change occurs in the frequency content of the patient's P-wave. 9. The method of claim 5, wherein the at least one characteristic of the patient's P-wave includes the timing of the patient's P-wave in relation to the patient's QRS during normal sinus rhythm, and further wherein an abrupt change is determined by observation of whether a change occurs in the timing of the patient's P-wave in relation to the patient's QRS. 10. The method of claim 5, wherein the at least one characteristic of the patient's P-wave includes polarity of the patient's P-wave in relation to the patient's QRS during normal sinus rhythm, and further wherein an abrupt change is determined by observation of whether a change occurs in the polarity of the patient's P-wave in relation to the patient's QRS. 11. An implantable cardioverter defibrillator (ICD) comprising a housing containing operational circuitry that is coupled to a plurality of electrodes for implantation in a patient, wherein the operational circuitry is configured to perform the following method of cardiac signal analysis while implanted in a patient: capturing far-field cardiac signals from electrodes disposed beneath the skin and outside of a patient's ribcage;identifying the patient's P-wave in the far-field cardiac signals;monitoring the patient's P-wave to determine whether the patient's P-wave abruptly changes; andif the patient's P-wave abruptly changes, determining that the patient is experiencing atrial fibrillation and withholding cardiac stimulus that would otherwise be delivered to the patient. 12. The ICD of claim 11, wherein the operational circuitry is further configured to withhold cardiac stimulus that would otherwise be delivered to the patient if it is determined that the patient is experiencing atrial fibrillation. 13. The ICD of claim 11, wherein the operational circuitry is further configured such that the step of monitoring the patient's P-wave includes determining whether the patient's P-wave disappears and, if so, concluding that the P-wave has abruptly changed. 14. The ICD of claim 11, wherein the operational circuitry is further configured such that the method also includes identifying at least one characteristic of the patient's P-wave during normal sinus rhythm. 15. The ICD of claim 14, wherein the operational circuitry is further configured such that: the at least one characteristic of the patient's P-wave includes the morphology of the patient's P-wave during normal sinus rhythm; andan abrupt change is determined by observation of whether a change occurs in the morphology of the patient's P-wave. 16. The ICD of claim 14, wherein the operational circuitry is further configured such that: the at least one characteristic of the patient's P-wave includes the amplitude and timing relationship of the patient's P-wave to the patient's QRS during normal sinus rhythm; andwherein an abrupt change is determined by observation of whether a change occurs in the amplitude and timing relationship of the patient's P-wave to the patient's QRS. 17. The ICD of claim 14, wherein the operational circuitry is further configured such that: the at least one characteristic of the patient's P-wave includes the frequency content of the patient's P-wave during normal sinus rhythm; andan abrupt change is determined by observation of whether a change occurs in the frequency content of the patient's P-wave. 18. The ICD of claim 14, wherein the operational circuitry is further configured such that: the at least one characteristic of the patient's P-wave includes the timing of the patient's P-wave in relation to the patient's QRS during normal sinus rhythm; andan abrupt change is determined by observation of whether a change occurs in the timing of the patient's P-wave in relation to the patient's QRS. 19. The ICD of claim 14, wherein the operational circuitry is further configured such that: the at least one characteristic of the patient's P-wave includes polarity of the patient's P-wave in relation to the patient's QRS during normal sinus rhythm; andan abrupt change is determined by observation of whether a change occurs in the polarity of the patient's P-wave in relation to the patient's QRS. 20. A method of treating a patient with a defibrillator comprising a housing containing operational circuitry and a lead having electrodes thereon coupled to the housing comprising implanting the housing beneath the skin and outside of the patients ribcage and implanting the lead beneath the skin and outside of the patients ribcage such without accessing the vasculature or heart of the patient; wherein the defibrillator's operational circuitry is configured, once implanted, to perform a method of cardiac signal analysis comprising: capturing far-field cardiac signals from at least one electrode of the lead;identifying the patient's P-wave in the far-field cardiac signals;monitoring the patient's P-wave to determine whether the patient's P-wave abruptly changes; andif the patient's P-wave abruptly changes, determining that the patient is experiencing atrial fibrillation and withholding cardiac stimulus that would otherwise be delivered to the patient.
Bardy, Gust H.; Rissmann, William J.; Ostroff, Alan H.; Erlinger, Paul J.; Allavatam, Venugopal, Apparatus and method for identifying atrial arrhythmia by far-field sensing.
Bardy, Gust H.; Rissmann, William J.; Ostroff, Alan H.; Erlinger, Paul J.; Allavatam, Venugopal, Apparatus and method for identifying atrial arrhythmia by far-field sensing.
Bardy, Gust H.; Rissmann, William J.; Ostroff, Alan H.; Erlinger, Paul J.; Allavatam, Venugopal, Apparatus and method for identifying atrial arrhythmia by far-field sensing.
Bardy, Gust H.; Rissmann, William J.; Ostroff, Alan H.; Erlinger, Paul J.; Allavatam, Venugopal, Apparatus and method for identifying atrial arrhythmia by far-field sensing.
Greenhut, Saul E; Stadler, Robert W; Zhang, Xusheng, Method and apparatus for adjusting a blanking period during transitioning between operating states in a medical device.
Greenhut, Saul E; Stadler, Robert W; Zhang, Xusheng, Method and apparatus for adjusting a blanking period for selecting a sensing vector configuration in a medical device.
Reinke, James D.; Zhang, Xusheng; Sharma, Vinod; Nikolski, Vladimir P.; Terry, Michael B.; Hareland, Scott A.; Hansen, Daniel L.; Salmi, Donna M., Pace pulse detector for an implantable medical device.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.