System and method for rhythm identification and therapy discrimination using hemodynamic status information

A method for controlling cardiac ventricular tachyarrhythmias using an implanted medical device, the method comprising the implanted medical device:

• acquiring a pressure signal representative of CVP from a pressure sensor implanted within a coronary vein of the patient, and deriving a CVP index based on the pressure signal;
• acquiring a rate signal indicative of the patient's cardiac rate from an implanted rate sensor;
• detecting an onset of a VT episode based on the rate signal;
• monitoring the rate signal and the CVP index for an episode monitoring period;
• classifying the VT episode according to a degree of hemodynamic stability or hemodynamic instability based on the CVP index;
• delivering an anti-tachycardia therapy if the episode is classified as hemodynamically unstable;
• and
• withholding anti-tachycardia therapy and extending the episode monitoring period if the episode is classified as hemodynamically stable.

An implantable cardiac rhythm management system comprising:

• a plurality of implantable medical electrical leads configured to sense cardiac electrical activity and to deliver an electrical therapeutic stimulus to cardiac tissue, at least one of the leads being configured for chronic implantation within a coronary vein of the patient's heart and including a pressure sensor configured to generate a pressure signal indicative of fluid pressure within the coronary vein;
• an implantable pulse generator operatively coupled to the leads configured to generate the electrical therapeutic stimulus, the pulse generator including a control system configured to:
• acquire the pressure signal and derive a CVP index based on the pressure signal;
• acquire a rate signal indicative of the patient's cardiac rate from at least one of the implantable leads;
• detect an onset of a VT episode based on the rate signal;
• monitor the rate signal and the CVP index for an episode monitoring period;
• and
• classify the VT episode as hemodynamically stable or hemodynamically unstable based on the CVP index;
• deliver an anti-tachycardia therapy if the episode is determined to be hemodynamically unstable;
• and
• withhold anti-tachycardia therapy and extending the episode monitoring period if the episode is determined to be hemodynamically stable.