Medical monitoring and treatment device with external pacing

A non-invasive external ambulatory medical monitoring and treatment device comprising:

• a garment configured to be removably attached about a body of a patient;
• at least one therapy electrode disposed in the garment and configured to be in electrical contact with the patient's skin;
• a plurality of ECG sensing electrodes disposed in the garment at a plurality of locations on the patient's body;
• a memory storing ECG information indicative of the patient's cardiac activity, the ECG information obtained from the plurality of ECG sensing electrodes;
• a therapy delivery interface and associated circuitry configured to implement a plurality of pacing routines corresponding to a plurality of paceable cardiac arrhythmia conditions comprising at least a bradycardia condition and an asystole condition;
• and
• at least one processor coupled to the memory and the therapy delivery interface and associated circuitry, the at least one processor configured to:
• identify, within the ECG information, at least one cardiac arrhythmia condition in the patient;
• detect whether the at least one cardiac arrhythmia condition is one of the bradycardia condition and the asystole condition;
• determine, from among the plurality of pacing routines, at least one pacing routine corresponding to the detected cardiac arrhythmia condition;
• cause the therapy delivery interface and associated circuitry to execute the at least one pacing routine of the plurality of pacing routines by delivering a first pacing pulse to the body of the patient;
• determine, subsequent to the delivery of the first pacing pulse to the body of the patient, that a first interval has passed without detection of an intrinsic heartbeat;
• responsive to determining that the first interval has passed without detection of the intrinsic heartbeat, to cause the therapy delivery interface and associated circuitry to continue execution of the at least one pacing routine by delivering a second pacing pulse to the body of the patient;
• and
• responsive to determining that the intrinsic heartbeat is detected within the first interval, determine a second interval based on the detected intrinsic heartbeat, and monitor the plurality of ECG electrodes to detect whether a second intrinsic heartbeat is detected in the second interval.

A method of treating a cardiac dysfunction using a non-invasive external ambulatory medical monitoring and treatment device, the method comprising:

• monitoring ECG information indicative of cardiac activity of a patient, the ECG information obtained from a plurality of ECG sensing electrodes of the non-invasive external ambulatory medical monitoring and treatment device;
• identifying, within the ECG information, at least one cardiac arrhythmia condition in the patient;
• detecting whether the at least one cardiac arrhythmia condition is one of a bradycardia condition and an asystole condition;
• identifying, from among a plurality of pacing routines, at least one pacing routine corresponding to the detected cardiac arrhythmia condition;
• executing the at least one pacing routine by delivering a first pacing pulse to the body of the patient via at least one therapy electrode of the non-invasive external ambulatory medical monitoring and treatment device;
• determining, subsequent to the delivery of the first pacing pulse to the body of the patient, that a first interval has passed without detection of an intrinsic heartbeat;
• responsive to determining that the first interval has passed without detection of the intrinsic heartbeat, continuing to execute the at least one pacing routine by delivering a second pacing pulse to the body of the patient;
• and
• responsive to determining that the intrinsic heartbeat is detected within the first interval, suspending execution of the at least one pacing routine.