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US 5,411,524 AGranted
Method and apparatus for synchronization of atrial defibrillation pulses
AssigneeMedtronic, Inc.
InventorMehra Rahul
Life of this patent
Estimating the term…
Abstract
A method and apparatus for detecting and treating atrial fibrillation. In response to detecting atrial fibrillation, the device derives an escape interval based on one or more preceding intervals between ventricular depolarizations. The escape interval is initiated in response to a ventricular depolarization, and in response to the expiration of the escape interval, an atrial cardioversion pulse is delivered. In one embodiment of the invention, the cardioverting pulse is delivered immediately upon expiration of the derived escape interval. In a second embodiment of the invention, a ventricular pacing pulse is delivered on expiration of the escape interval, with an atrial cardioversion pulse following after a short delay.
Claims12
An atrial cardioverter or defibrillator, comprising:
- means for detecting a tachyarrhythmia in a patient's atrium;
- means for delivering a cardioversion or defibrillation pulse to said patient's atrium;
- and
- synchronization means for triggering delivery of said cardioversion or defibrillation pulse, said synchronization means comprising:
- means for sensing depolarizations of said patient's ventricle;
- means for measuring intervals between sensed ventricular depolarizations to derive an interval indicative of intrinsic heart rate;
- means for deriving an escape interval less than said interval indicative of intrinsic heart rate, initiated on a sensed ventricular depolarization;
- and
- means for triggering delivery of said cardioversion or defibrillation pulse in response to expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval.
6 more elements
An atrial cardioverter or defibrillator, comprising:
- means for detecting a tachyarrhythmia in a patient's atrium;
- means for delivering a cardioversion or defibrillation pulse to said patient's atrium;
- and
- synchronization means for triggering delivery of said cardioversion or defibrillation pulse, said synchronization means comprising:
- means for sensing depolarizations of said patient's ventricle;
- means for measuring intervals between sensed ventricular depolarizations to determine an interval indicative of intrinsic heart rate;
- means for defining a single escape interval less than said interval indicative of intrinsic heart rate, initiated on a said sensed ventricular depolarization;
- and
- means for triggering delivery of said cardioversion or defibrillation pulse in response to expiration of said single escape interval, in the absence of sensed ventricular depolarizations during said single escape interval.
6 more elements
An atrial cardioverter or defibrillator comprising:
- means for detecting a tachyarrhythmia in a patient's atrium;
- means for delivering a cardioversion or defibrillation pulse to said patient's atrium;
- and
- synchronization means for triggering delivery of said cardioversion or defibrillation pulse, said synchronization means comprising:
- means for sensing depolarizations of said patient's ventricle;
- means for measuring intervals between sensed ventricular depolarizations;
- means for deriving an escape interval initiated on a sensed ventricular depolarization, based upon measured intervals between sensed ventricular depolarizations;
- means for triggering delivery of said cardioversion or defibrillation pulse in response to expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval;
- and
- means for delivering a pacing pulse to said patient's ventricle on expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval, and wherein said triggering means comprises means for triggering delivery of said cardioversion or defibrillation pulse on expiration of a delay interval following expiration of said escape interval.
7 more elements
An atrial cardioverter or defibrillator, comprising:
- means for detecting a tachyarrhythmia in a patient's atrium;
- means for delivering a cardioversion or defibrillation pulse to said patient's atrium;
- and
- synchronization means for triggering delivery of said cardioversion or defibrillation pulse, said synchronization means comprising:
- means for sensing depolarizations of said patient's ventricle;
- means for measuring intervals between sensed ventricular depolarizations;
- means for deriving an escape interval initiated on a sensed ventricular depolarization, based upon measured intervals between sensed ventricular depolarizations;
- and
- means for triggering delivery of said cardioversion or defibrillation pulse in response to expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval;
- and
- wherein said deriving means comprises means for determining whether said derived escape interval is less than a minimum interval, and means for preventing delivery of said cardioversion or defibrillation pulse if said derived interval is less than said minimum interval.
8 more elements
A method of atrial cardioversion or defibrillation, comprising:
- detecting a tachyarrhythmia in a patient's atrium;
- sensing depolarizations of said patient's ventricle;
- measuring intervals between sensed ventricular depolarizations to derive an interval indicative of intrinsic heart rate;
- deriving an escape interval less than said interval indicative of intrinsic heart rate, initiated on a sensed ventricular depolarization;
- and
- delivering a cardioversion or defibrillation pulse to said patient's atrium in response to expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval.
3 more elements
A method of atrial cardioversion or defibrillation, comprising:
- detecting a tachyarrhythmia in a patient's atrium;
- sensing depolarizations of said patient's ventricle;
- measuring intervals between sensed ventricular depolarizations to derive an interval indicative of intrinsic heart rate;
- deriving an escape interval less than said interval indicative of intrinsic heart rate, initiated on a sensed ventricular depolarization;
- and
- delivering a cardioversion or defibrillation pulse to said patient's atrium in response to expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval.
3 more elements
A method of atrial cardioversion or defibrillation, comprising:
- detecting a tachyarrhythmia in a patient's atrium;
- sensing depolarizations of said patient's ventricle;
- measuring intervals between sensed ventricular depolarizations;
- deriving an escape interval initiated on a sensed ventricular depolarization, based upon measured intervals between sensed ventricular depolarizations;
- and
- delivering a cardioversion or defibrillation pulse to said patient's atrium in response to expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval;
- and
- delivering a pacing pulse to said patient's ventricle on expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval, and wherein said step of delivering said cardioversion or defibrillation pulse comprises delivering said cardioversion or defibrillation pulse on expiration of a delay interval following expiration of said escape interval.
5 more elements
A method of atrial cardioversion or defibrillation, comprising:
- detecting a tachyarrhythmia in a patient's atrium;
- sensing depolarizations of said patient's ventricle;
- measuring intervals between sensed ventricular depolarizations;
- deriving an escape interval initiated on a sensed ventricular depolarization, based upon measured intervals between sensed ventricular depolarizations;
- and
- delivering a cardioversion or defibrillation pulse to said patient's atrium in response to expiration of said escape interval, in the absence of sensed ventricular depolarizations during said escape interval;
- and
- wherein said deriving step comprises determining whether said derived escape interval is less than a minimum interval, and further comprising the step of preventing delivery of said cardioversion or defibrillation pulse if said derived interval is less than said minimum interval.
5 more elements
Dependencies are inferred from the claim text.