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US 8,527,047 B2Granted
Artificial conduction pathways in tachyarrhythmia
AssigneeCardiac Pacemakers, Inc.
InventorRobert J. Sweeney
Life of this patent
Estimating the term…
Abstract
An implantable medical device can establish one or more artificial conduction pathways during tachyarrhythmia. Withdrawal of the artificial conduction pathway may help self-terminate the tachyarrhythmia, or may pre-condition the tachyarrhythmia to be more favorable for receiving an anti-tachyarrhythmia therapy, such as anti-tachyarrhythmia pacing, defibrillation shock therapy, or cardioversion. This can help provide enhanced anti-tachyarrhythmia therapy.
Claims19
An implantable medical device comprising:
- a tachyarrhythmia detection circuit configured to detect a presence of a tachyarrhythmia in a subject;
- a sensing circuit, coupled to the tachyarrhythmia detection circuit, and further coupled to a first electrode and a second electrode, wherein the first electrode is configured to be located at a first location in association with a heart of the subject and the second electrode is configured to be located at a second location in association with the heart, and wherein the sensing circuit is configured to sense, in response to and during the tachyarrhythmia, an intrinsic electrical heart depolarization at the first electrode and an intrinsic electrical heart depolarization at the second electrode;
- a processor circuit, coupled to the sensing circuit and the tachyarrhythmia detection circuit, configured to:
- determine an intrinsic first time delay between the sensing of the intrinsic electrical heart depolarization at the first electrode and the sensing of the intrinsic electrical heart depolarization at the second electrode;
- determine a specified second timing delay, the specified second timing delay being at least one of fixed and determined, adjustable over time, within fifty percent of the determined intrinsic first time delay, or shorter than a central tendency of a plurality of measurements of the determined intrinsic first time delay;
- and
- an electrostimulation generator circuit, coupled to the processor circuit, configured to:
- deliver a plurality of electrostimulations using the first electrode;
- and
- trigger delivery of each individual electrostimulation in the plurality of electrostimulations, on a beat-by-beat basis, according to the specified second timing delay timed from a respective sensed intrinsic electrical heart depolarization at the second electrode, wherein the delivery of the plurality of electrostimulations is configured to produce an artificial conduction pathway in the heart during tachyarrhythmia;
- and
- an anti-tachyarrhythmia therapy circuit, coupled to the processor circuit, configured to provide anti-tachyarrhythmia pacing within a specified number of cardiac cycles after and in response to termination of the delivery of the plurality of electrostimulations and discontinuation of the artificial conduction pathway.
9 more elements
An apparatus comprising:
- means for determining that a tachyarrhythmia is present in a subject;
- means for sensing, in response to and during the tachyarrhythmia, an intrinsic electrical heart depolarization at a first electrode that is located at a first location in association with a heart of the subject;
- means for sensing, in response to and during the tachyarrhythmia, an intrinsic electrical heart depolarization at a second electrode that is located at a different second location in association with the heart;
- means for determining an intrinsic first time delay between the sensing of the intrinsic electrical heart depolarization at the first electrode and the sensing of the intrinsic electrical heart depolarization at the second electrode;
- means for determining a specified second timing delay, the specified second timing delay being at least one of fixed and determined, adjustable over time, within fifty percent of the determined intrinsic first time delay, or shorter than a central tendency of a plurality of measurements of the determined intrinsic first time delay;
- means for delivering a plurality of electrostimulations using the first electrode, including triggering delivery of each individual electrostimulation in the plurality of electrostimulations, on a beat-by-beat basis, according to the specified second timing delay timed from a respective sensed intrinsic electrical heart depolarization at the second electrode, wherein the delivery of the plurality of electrostimulations is configured to produce an artificial conduction pathway in the heart during tachyarrhythmia;
- and
- means for providing anti-tachyarrhythmia pacing within a specified time after and in response to terminating the delivery of the plurality of electrostimulations and discontinuation of the artificial conduction pathway.
5 more elements
A method comprising:
- determining that a tachyarrhythmia is present in a subject;
- and
- in response to and during the tachyarrhythmia:
- sensing an intrinsic electrical heart depolarization at a first electrode that is located at a first location in association with a heart of the subject;
- sensing an intrinsic electrical heart depolarization at a second electrode that is located at a different second location in association with the heart;
- determining an intrinsic first time delay between the sensing of the intrinsic electrical heart depolarization at the first electrode and the sensing of the intrinsic electrical heart depolarization at the second electrode;
- determining a specified second timing delay, the specified second timing delay being at least one of fixed and determined, adjustable over time, within fifty percent of the determined intrinsic first time delay, or shorter than a central tendency of a plurality of measurements of the determined intrinsic first time delay;
- delivering a plurality of electrostimulations using the first electrode, including triggering delivery of each individual electrostimulation in the plurality of electrostimulations, on a beat-by-beat basis, according to the specified second timing delay timed from a respective sensed intrinsic electrical heart depolarization at the second electrode, wherein the delivery of the plurality of electrostimulations is configured to produce an artificial conduction pathway in the heart during tachyarrhythmia;
- and
- within a specified time after and in response to terminating the delivery of the plurality of electrostimulations and discontinuing of the artificial conduction pathway, providing anti-tachyarrhythmia pacing.
7 more elements
Dependencies are inferred from the claim text.