US 5,620,471 A · System and method for discriminating between atrial and ventricular arrhythmias and for applying cardiac therapy therefor

Abstract

Improved methods and apparatus are provided for applying atrial and ventricular therapies to the heart of a patient using an implanted cardiac stimulating device. Atrial and ventricular heart rates are monitored and analyzed to determine whether the patient is suffering from an atrial or ventricular arrhythmia and to determine what type of therapy is appropriate to apply to the heart. Atrial and ventricular heart rates are compared to determine if the ventricular heart rate exceeds the atrial heart rate and to determine whether the ventricular heart Fate is stable. An early atrial stimulation pulse can also be applied to determine whether the ventricular heart rate follows the atrial heart rate. Atrial and ventricular therapies are applied to the heart based on these determinations.

Claims26

Dependent claims

An implantable cardiac stimulating device for monitoring and stimulating the heart of a patient, the cardiac stimulating device comprising:

means for measuring intrinsic atrial and ventricular heart rates;
rate determining means for determining whether the ventricular heart rate is less than, equal to or exceeds the atrial heart rate;
ventricular stimulation means for applying ventricular stimulation therapy to the heart when the rate determining means determines that the ventricular heart rate exceeds the atrial heart rate;
stability determining means for determining whether the ventricular heart rate is stable, wherein a stable ventricular heart rate provides an indication that the rhythm is a tachycardia and an unstable ventricular heart rate provides an indication that the rhythm requires further testing to determine if it is of natural origin;
atrial pulse generating means for applying an atrial stimulation pulse to the heart at a rate slightly faster than the measured intrinsic atrial heart rate;
reset determining means for determining whether the ventricular heart rate is reset by the atrial stimulation pulse, whereby the resetting of the ventricular heart rate provides an indication that the ventricle is tracking the atrium;
and
atrial stimulation means for applying atrial stimulation therapy to the heart when:
the stability determining means determines that the ventricular heart rate is stable;
the rate determining means determines that the atrial heart rate is equal to the ventricular heart rate;
and
the reset determining means determines that the ventricular heart rate is reset by the atrial stimulation pulse, thereby indicating that the ventricle is tracking the atrium and an atrial arrhythmia is present.

9 more elements

An implantable cardiac stimulating device for monitoring and stimulating the heart of a patient, the cardiac stimulating device comprising:

means for measuring intrinsic atrial and ventricular heart rates;
rate determining means for determining whether the ventricular heart rate is less than, equal to or exceeds the atrial heart rate;
ventricular stimulation means for applying ventricular stimulation therapy to the heart when the rate determining means determines that the ventricular heart rate exceeds the atrial heart rate;
stability determining means for determining whether the ventricular heart rate is stable, wherein a stable ventricular heart rate provides an indication that the rhythm is a tachycardia and an unstable ventricular heart rate provides an indication that the rhythm requires further testing to determine if it is of natural origin;
and
atrial stimulation means for applying atrial stimulation therapy to the heart when:
the stability determining means determines that the ventricular heart rate is not stable;
and
the rate determining means determines that the atrial heart rate exceeds the ventricular heart rate, thereby indicating an atrial arrhythmia is present.

6 more elements

An implantable cardiac stimulating device for monitoring and stimulating the heart of a patient, the cardiac stimulating device comprising:

means for measuring intrinsic atrial and ventricular heart rate;
rate determining means for determining whether the atrial heart rate exceeds the ventricular heart rate;
and
stability determining means for determining whether the ventricular heart rate is stable;
means for applying ventricular stimulation therapy to the heart when:
the stability determining means determines that the ventricular heart rate is stable;
and
the rate determining means determines that the atrial heart rate exceeds the ventricular heart rate;
atrial pulse generating means for applying an atrial pacing pulse to the heart at a rate slightly faster than the measured intrinsic atrial heart rate;
reset determining means for determining whether the ventricular heart rate is reset by the atrial stimulation pulse, whereby the resetting of the ventricular heart rate provides an indication that the ventricle is tracking the atrium;
and
means for applying atrial stimulation therapy to the heart when:
the stability determining means determines that the ventricular heart rate is stable;
the rate determining means determines that the atrial heart rate does not exceed the ventricular heart rate;
and
the reset determining means determines that the ventricular heart rate is reset by the atrial stimulation pulse, thereby indicating that the ventricle is tracking the atrium and an atrial arrhythmia is present.

13 more elements

An implantable cardiac stimulating device for monitoring and stimulating the heart of a patient, the cardiac stimulating device comprising

means for measuring intrinsic atrial and ventricular heart rate;
rate determining means for determining whether the atrial heart rate exceeds the ventricular heart rate;
and
stability determining means for determining whether the ventricular heart rate is stable;
means for applying ventricular stimulation therapy to the heart when:
the stability determining means determines that the ventricular heart rate is stable;
and
the rate determining means determines that the atrial heart rate exceeds the ventricular heart rate;
and
atrial stimulation means for applying atrial stimulation therapy to the heart when:
the stability determining means determines that the ventricular heart rate is not stable;
and
the rate determining means determines that the atrial heart rate exceeds the ventricular heart rate, thereby providing an indication that an atrial arrhythmia is present.

10 more elements

Dependencies are inferred from the claim text.

System and method for discriminating between atrial and ventricular arrhythmias and for applying cardiac therapy therefor

Life of this patent

System and method for discriminating between atrial and ventricular arrhythmias and for applying cardiac therapy therefor

Life of this patent

Abstract

Claims26