Apparatus and method for reliably detecting a depolarization activation wave of the heart and atrial defibrillator utilizing same

An atrial defibrillator for reliably detecting a depolarization activation wave of the heart and delivering cardioverting electrical energy to the atria of the heart in synchronism with said detected depolarization activation wave, said atrial defibrillator comprising:

• first sensing means for electrical contact with the heart between a first pair of spaced apart locations for sensing said depolarization activation wave;
• first output means coupled to said first sensing means for producing a first electrical output having a first predetermined characteristic corresponding to said depolarization activation wave sensed by said first sensing means;
• second sensing means for electrical contact with the heart between a second pair of spaced apart locations for sensing said depolarization activation wave;
• second output means coupled to said second sensing means for producing a second electrical output having a second predetermined characteristic corresponding to said depolarization activation wave sensed by said second sensing means;
• discriminating means coupled to said first and second output means and being responsive to said first and second electrical outputs for discriminating between said first and second predetermined characteristics and including indicating means for providing an indication signal indicating the occurrence of said depolarization activation wave when said first and second predetermined characteristics are different;
• and
• delivery means coupled to said discriminating means and responsive to said indication signal for applying electrical cardioverting energy to the atria of the heart.

A method of reliably detecting a depolarization activation wave of the heart, said method including the steps of:

• sensing said depolarization activation wave of the heart between a first pair of spaced apart locations;
• producing a first electrical output having a first predetermined characteristic corresponding to said depolarization activation wave sensed between said first pair of locations;
• sensing said depolarization activation wave of the heart between a second pair of spaced apart locations;
• producing a second electrical output having a second predetermined characteristic corresponding to the said depolarization activation wave sensed between said second pair of locations;
• comparing said first and second predetermined characteristics;
• and
• indicating the occurrence of said depolarization activation wave when said first and second predetermined characteristics are different.

A method of reliably detecting a depolarization activation wave of the heart and delivering cardioverting electrical energy to the atria of the heart in synchronism with said detected depolarization activation wave, said method including the steps of:

• sensing said depolarization activation wave of the heart between a first pair of spaced apart locations;
• producing a first electrical output having a first predetermined characteristic corresponding to said depolarization activation wave sensed between said first pair of locations;
• sensing said depolarization activation wave of the heart between a second pair of spaced apart locations;
• producing a second electrical output having a second predetermined characteristic corresponding to said depolarization activation wave sensed between said second pair of locations;
• comparing said first and second predetermined characteristics;
• providing an indication signal indicating the occurrence of said depolarization activation wave when said first and second predetermined characteristics are different;
• and
• applying electrical cardioverting energy to the atria of the heart responsive to said indication signal.

An apparatus for reliably detecting a depolarization activation wave of the heart, said apparatus comprising:

• first sensing means for electrical contact with the heart for producing a first electrocardiographic signal of the heart;
• first output means coupled to said first sensing means and responsive to said first electrocardiographic signal for isolating a predetermined feature of said first electrocardiographic signal and producing a first output characteristic of said feature of said first electrocardiographic signal;
• second sensing means for electrical contact with the heart for producing a second electrocardiographic signal of the heart;
• second output means coupled to said second sensing means and responsive to said second electrocardiographic signal for isolating said predetermined feature of said second electrocardiographic signal and producing a second output characteristic of said feature of said second electrocardiographic signal;
• and
• discriminating means coupled to said first and second output means and being responsive to said first and second electrical outputs for discriminating between said predetermined features of said first and second electrocardiographic signals and including indicating means for indicating the occurrence of said depolarization activation wave when said predetermined features of said first and second electrocardiographic signals are different.

A method of reliably detecting a depolarization activation wave of the heart, said method comprising the steps of:

• sensing electrical activity of the heart at a first location of the heart and producing a first electrocardiographic signal;
• isolating a predetermined feature of said first electrocardiographic signal and producing a first output characteristic of said feature of said first electrocardiographic signal;
• sensing said electrical activity of the heart at a second location of the heart and producing a second electrocardiographic signal;
• isolating said predetermined feature of said second electrocardiographic signal and producing a second output characteristic of said feature of said second electrocardiographic signal
• discriminating between said predetermined features of said first and second electrocardiographic signals;
• and
• indicating the occurrence of said depolarization activation wave when said predetermined features of said first and second electrocardiographic signals are different.