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US 11,998,344 B2Granted
Method and apparatus for atrial tachyarrhythmia detection
AssigneeMedtronic, Inc.
InventorsShantanu Sarkar, Wade M. Demmer, Todd J. Sheldon, Vincent E. Splett
Life of this patent
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Abstract
An implantable medical device is configured to determine a first atrial arrhythmia score from ventricular events sensed by a sensing circuit of an implantable medical device and determine a second atrial arrhythmia score from an intraventricular signal comprising atrial mechanical event signals attendant to atrial systole and produced by a sensor of the implantable medical device. An atrial arrhythmia is detected based on the first atrial arrhythmia score and the second atrial arrhythmia score.
Claims21
A medical device, comprising:
- a sensor configured to sense a cardiac mechanical signal;
- a cardiac electrical signal sensing circuit configured to sense ventricular events;
- a pulse generator configured to generate ventricular pacing pulses;
- and
- a control circuit coupled to the sensor, the sensing circuit, and the pulse generator, the control circuit configured to:
- identify a plurality of ventricular events comprising the ventricular pacing pulses delivered by the pulse generator and ventricular events sensed by the cardiac electrical signal sensing circuit;
- determine a first atrial arrhythmia score from the identified plurality of ventricular events;
- determine a second atrial arrhythmia score from the cardiac mechanical signal by:
- determining ventricular cycle lengths between the identified plurality of ventricular events;
- sensing atrial events from the cardiac mechanical signal;
- determining a count of the ventricular cycle lengths that include exactly one sensed atrial event during the respective ventricular cycle length;
- and
- determining the second atrial arrhythmia score based on the determined count;
- determine a percentage of the identified plurality of ventricular events that are ventricular pacing pulses;
- determine that the percentage of the identified plurality of ventricular events that are ventricular pacing pulses is greater than a threshold percentage;
- determine that atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score;
- and
- in response to the percentage of the identified plurality of ventricular events that are ventricular pacing pulses being greater than the threshold percentage, withhold a detection of atrial arrhythmia when the atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score.
15 more elements
A medical device, comprising:
- a sensor configured to sense a cardiac mechanical signal;
- a cardiac electrical signal sensing circuit configured to sense ventricular events;
- a pulse generator configured to generate ventricular pacing pulses;
- and
- a control circuit coupled to the sensor, the sensing circuit, and the pulse generator, the control circuit configured to:
- identify a plurality of ventricular events comprising the ventricular pacing pulses delivered by the pulse generator and ventricular events sensed by the cardiac electrical signal sensing circuit;
- determine a first atrial arrhythmia score from the identified plurality of ventricular events;
- determine a second atrial arrhythmia score from the cardiac mechanical signal by:
- determining ventricular cycle lengths between the identified plurality of ventricular events;
- sensing atrial events from the cardiac mechanical signal;
- determining a count of the ventricular cycle lengths that include exactly one sensed atrial event during the respective ventricular cycle length;
- and
- determining the second atrial arrhythmia score based on the determined count;
- determine that atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score;
- and
- detect an atrial arrhythmia in response to the atrial arrhythmia criteria being met based on the first atrial arrhythmia score and the second atrial arrhythmia score.
13 more elements
A method, comprising:
- sensing a cardiac mechanical signal;
- sensing a cardiac electrical signal;
- sensing ventricular events from the cardiac electrical signal;
- generating ventricular pacing pulses;
- identifying a plurality of ventricular events comprising the ventricular pacing pulses and ventricular events sensed from the cardiac electrical signal;
- determining a first atrial arrhythmia score from the identified plurality of ventricular events;
- determining a second atrial arrhythmia score from the cardiac mechanical signal by:
- determining ventricular cycle lengths between the identified plurality of ventricular events;
- sensing atrial events from the cardiac mechanical signal;
- determining a count of the ventricular cycle lengths that include exactly one sensed atrial event during the respective ventricular cycle length;
- and
- determining the second atrial arrhythmia score based on the determined count;
- determining a percentage of the identified plurality of ventricular events that are ventricular pacing pulses;
- determining that the percentage of the identified plurality of ventricular events that are ventricular pacing pulses is greater than a threshold percentage;
- determining when atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score;
- and
- in response to the percentage of the identified plurality of ventricular events that are ventricular pacing pulses being greater than the threshold percentage, withholding a detection of atrial arrhythmia when the atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score.
14 more elements
A method, comprising:
- sensing a cardiac mechanical signal;
- sensing a cardiac electrical signal;
- sensing ventricular events from the cardiac electrical signal;
- generating one or more ventricular pacing pulse;
- identifying a plurality of ventricular events comprising the one or more ventricular pacing pulses and ventricular events sensed from the cardiac electrical signal;
- determining a first atrial arrhythmia score from the identified plurality of ventricular events;
- determining a second atrial arrhythmia score from the cardiac mechanical signal by:
- determining ventricular cycle lengths between the identified plurality of ventricular events;
- sensing atrial events from the cardiac mechanical signal;
- determining a count of the ventricular cycle lengths that include exactly one sensed atrial event during the respective ventricular cycle length;
- and
- determining the second atrial arrhythmia score based on the determined count;
- determining that atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score;
- and
- detect an atrial arrhythmia in response to the atrial arrhythmia criteria being met based on the first atrial arrhythmia score and the second atrial arrhythmia score.
12 more elements
A non-transitory, computer-readable storage medium comprising a set of instructions which, when executed by a control circuit of a medical device, cause the medical device to:
- sense a cardiac mechanical signal;
- sense a cardiac electrical signal;
- sense ventricular events from the cardiac electrical signal;
- generate ventricular pacing pulses;
- identify a plurality of ventricular events comprising the ventricular pacing pulses and ventricular events sensed from the cardiac electrical signal;
- determine a first atrial arrhythmia score from the identified plurality of ventricular events;
- determine a second atrial arrhythmia score from the cardiac mechanical signal by:
- determining ventricular cycle lengths between the identified plurality of ventricular events;
- sensing atrial events from the cardiac mechanical signal;
- determining a count of the ventricular cycle lengths that include exactly one sensed atrial event during the respective ventricular cycle length;
- and
- determining the second atrial arrhythmia score based on the determined count;
- determine a percentage of the identified plurality of ventricular events that are ventricular pacing pulses;
- determine that the percentage of the identified plurality of ventricular events that are ventricular pacing pulses is greater than a threshold percentage;
- determine when atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score;
- and
- in response to the percentage of the identified plurality of ventricular events that are ventricular pacing pulses being greater than the threshold percentage, withhold a detection of atrial arrhythmia when the atrial arrhythmia criteria are met based on the first atrial arrhythmia score and the second atrial arrhythmia score.
14 more elements
Dependencies are inferred from the claim text.