Apparatus and method for identifying atrial arrhythmia by far-field sensing
IPC분류정보
국가/구분
United States(US) Patent
등록
국제특허분류(IPC7판)
A61N-001/00
A61N-001/39
A61B-005/0452
A61B-005/0456
A61B-005/046
출원번호
US-0350574
(2016-11-14)
등록번호
US-9993653
(2018-06-12)
발명자
/ 주소
Bardy, Gust H.
Rissmann, William J.
Ostroff, Alan H.
Erlinger, Paul J.
Allavatam, Venugopal
출원인 / 주소
CAMERON HEALTH, INC.
대리인 / 주소
Seager, Tufte & Wickhem LLP
인용정보
피인용 횟수 :
0인용 특허 :
292
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. An implantable medical device (IMD) configured for monitoring a patient's cardiac rhythm to determine whether an arrhythmia is occurring, the IMD comprising: a housing containing a battery and operational circuitry for the IMD, the operational circuitry comprising an ECG input, an amplifier, one
1. An implantable medical device (IMD) configured for monitoring a patient's cardiac rhythm to determine whether an arrhythmia is occurring, the IMD comprising: a housing containing a battery and operational circuitry for the IMD, the operational circuitry comprising an ECG input, an amplifier, one or more filter circuits, and a detector configured to detect QRS events; andat least first and second electrodes on the housing and electrically coupled to the operational circuitry, the electrodes configured for sensing a cardiac signal of the patient;wherein the operational circuitry is configured to detect one or more QRS signals for the patient during a normal sinus rhythm;wherein the operational circuitry is further configured to detect atrial fibrillation (AF) by determining whether detected signals show an absence of P-waves between consecutive QRS signals by differentiating between a well-defined P-wave and a low-amplitude signal; andwherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a polarity relationship of the P-wave to the QRS. 2. The IMD of claim 1 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a rate of the P-wave. 3. The IMD of claim 1 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a morphology of the P-wave. 4. The IMD of claim 1 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including an amplitude of the P-wave. 5. The IMD of claim 1 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a frequency content of the P-wave. 6. The IMD of claim 1 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a timing relative to the QRS. 7. The IMD of claim 1 wherein the operational circuitry is further configured to detect AF by monitoring for stability of the coupling interval between R-waves in the QRS signal and finding irregularly spaced R-waves. 8. The IMD of claim 1 wherein the operational circuitry is further configured, in the event that AF is not identified, to determine whether a cardiac rate of the patient exceeds a threshold and, if so, to deliver defibrillation therapy to the patient. 9. The IMD of claim 1 wherein the operational circuitry is further configured, in the event that AF is identified, to deliver cardioversion therapy to the patient to terminate the detected AF, further wherein the operational circuitry is configured to deliver the cardioversion therapy by detecting the onset of the QRS signal and delivering the cardioversion shock during a synchronized time period. 10. An implantable medical device (IMD) configured for monitoring a patient's cardiac rhythm to determine whether an arrhythmia is occurring, the IMD comprising: a housing containing a battery and operational circuitry for the IMD, the operational circuitry comprising an ECG input, an amplifier, one or more filter circuits, and a detector configured to detect QRS events; andat least a first electrode on the housing and electrically coupled to the operational circuitry, the first electrode configured for sensing a cardiac signal of the patient;at least a second electrode disposed on an implantable lead configured for coupling to the housing to electrically couple the second electrode to the operational circuitry, the second electrode configured for sensing a cardiac signal of the patient;wherein the operational circuitry is configured to detect one or more QRS signals for the patient during a normal sinus rhythm;wherein the operational circuitry is further configured to detect atrial fibrillation (AF) by determining whether detected signals show an absence of P-waves between consecutive QRS signals by differentiating between a well-defined P-wave and a low-amplitude signal; andwherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a polarity relationship of the P-wave to the QRS. 11. The IMD of claim 10 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a rate of the P-wave. 12. The IMD of claim 10 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a morphology of the P-wave. 13. The IMD of claim 10 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including an amplitude of the P-wave. 14. The IMD of claim 10 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a frequency content of the P-wave. 15. The IMD of claim 10 wherein the operational circuitry is configured to establish one or more parameters for P-waves associated with QRS signals including a timing relative to the QRS. 16. The IMD claim 10 wherein the operational circuitry is further configured to detect AF by monitoring for stability of the coupling interval between R-waves in the QRS signal and finding irregularly spaced R-waves. 17. The IMD of claim 10 wherein the operational circuitry is further configured, in the event that AF is not identified, to determine whether a cardiac rate of the patient exceeds a threshold and, if so, to deliver defibrillation therapy to the patient. 18. The IMD of claim 10 wherein the operational circuitry is further configured, in the event that AF is identified, to deliver cardioversion therapy to the patient to terminate the detected AF, further wherein the operational circuitry is configured to deliver the cardioversion therapy by detecting the onset of the QRS signal and delivering the cardioversion shock during a synchronized time period.
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이 특허에 인용된 특허 (292)
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