Detection of dislodgement of a defibrillation lead
AssigneeLambda Nu Technology LLC
InventorCharles D. Swerdlow
Life of this patent
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Abstract
Dislodgement of a defibrillation lead from the right ventricle to the right atrium is a rare complication associated with implantable cardioverter-defibrillators. However, such dislodgement deserves attention out of proportion to its low incidence because of the possibility to cause fatal proarrhythmia. Various embodiments are directed to algorithms for detecting lead dislodgement, including a primary algorithm that operates during baseline rhythm and a secondary algorithm that operates during detection of ventricular tachycardia or ventricular fibrillation to identify lead dislodgement during atrial fibrillation.
Claims26
A method of identifying dislodgement of a defibrillation lead from a ventricle of a patient, the lead being operably coupled to an implanted cardioverter defibrillator, the method comprising:
- obtaining a far-field electrogram utilizing one or more electrodes of one or more of the defibrillation lead and the implanted cardioverter defibrillator, at least one of the one or more electrodes configured for delivering a shock therapy;
- using a processor within the implanted cardioverter defibrillator to determine, based on the far-field electrogram, dislodgement of the defibrillation lead from fixation in the ventricle;
- and
- generating an alert that the lead has dislodged in response to using the processor to determine dislodgement of the defibrillation lead.
An implantable cardioverter defibrillator, configured for coupling to a defibrillation lead the implantable cardioverter defibrillator comprising:
- a housing, including an electrode;
- and
- circuitry contained within the housing configured to, upon implant of the implantable cardioverter defibrillator in a patient:
- obtain a far-field electrogram utilizing a therapy electrode on the defibrillation lead and the housing electrode;
- determine, based on the far-field electrogram, dislodgement of the lead from fixation in a ventricle of the patient;
- and
- generate an alert that the lead has dislodged in response to using the processor to determine dislodgement of the lead.
A method, comprising:
- providing a cardioverter defibrillator to a user, the cardioverter defibrillator including a housing having an electrode;
- and
- providing instructions recorded on a tangible medium to the user, the instructions including:
- implanting the cardioverter defibrillator within a patient;
- coupling the cardioverter defibrillator to a defibrillation lead;
- and
- causing the cardioverter defibrillator to initiate operation, the defibrillator programmed to:
- obtain a far-field electrogram utilizing a therapy electrode on the defibrillation lead and the housing electrode;
- determine, based on the far-field electrogram, dislodgement of the lead from fixation in a ventricle of the patient;
- and
- generate an alert that the lead has dislodged in response to using the processor to determine dislodgement of the lead.
A method of identifying dislodgement of a defibrillation lead from a heart of a patient during atrial tachyarrhythmia, the lead being operably coupled to an implanted cardioverter defibrillator, the method comprising:
- obtaining a plurality of near-field electrograms utilizing one or more electrodes on one or more of the defibrillation lead and the implanted cardioverter defibrillator;
- using a processor within the implanted cardioverter defibrillator to classify a rhythm of the heart as ventricular fibrillation based on the near-field electrograms;
- obtaining a plurality of far-field electrograms utilizing one or more electrodes on one or more of the defibrillation lead and the implanted cardioverter defibrillator;
- using the processor to determine if a majority of amplitudes of the far-field electrograms are below a first predetermined threshold;
- using the processor to determine if the remainder of amplitudes of the far-field electrograms are below a second predetermined threshold, the second predetermined threshold being larger than the first predetermined threshold;
- determining, in response to identifying the rapid intervals on the near-field electrograms and determining a majority of amplitudes of the far-field electrograms are below a first predetermined threshold and the remainder of amplitudes of the far-field electrograms are below a second predetermined threshold, that the patient is experiencing an atrial tachyarrhythmia not ventricular fibrillation;
- and
- generating an alert that the lead has dislodged from fixation in a ventricle of the heart in response to determining the patient is experiencing atrial tachyarrhythmia.
Dependencies are inferred from the claim text.