Method and apparatus for concurrent atrio-ventricular anti-tachycardia pacing

An implantable cardiac rhythm management device, comprising:

• a pacing circuit configured to deliver atrial pacing pulses and ventricular pacing pulses;
• a tachyarrhythmia detection and classification circuit configured to detect a tachyarrhythmia and classify the detected tachyarrhythmia;
• and
• an anti-tachycardia pacing (ATP) control circuit coupled to the pacing circuit and the tachyarrhythmia detection and classification circuit, the ATP control circuit configured to control delivery of the atrial pacing pulses and the ventricular pacing pulses according to a plurality of ATP modes including a synchronized atrio-ventricular ATP (synchronized AV-ATP) mode during which the atrial pacing pulses and the ventricular pacing pulses are delivered synchronously, the ATP control circuit including an ATP mode selector and an atrio-ventricular ATP (AV-ATP) enabler, the ATP mode selector configured to select an ATP mode from the plurality of ATP modes using one or more specified ATP mode selection criteria and the classification of the detected tachyarrhythmia, the AV-ATP enabler configured to disallow selection of the synchronized AV-ATP mode according to one or more specified proarrhythmia prevention criteria.

A method for operating an implantable cardiac rhythm management device, the method comprising:

• providing the implantable cardiac rhythm management device with a plurality of anti-tachycardia pacing (ATP) modes for controlling delivery of atrial pacing pulses and ventricular pacing pulses, the plurality ATP modes including a synchronized atrio-ventricular ATP (synchronized AV-ATP) mode during which the atrial pacing pulses and the ventricular pacing pulses are delivered synchronously;
• detecting a tachyarrhythmia;
• classifying the detected tachyarrhythmia;
• producing a correlation coefficient representative of a correlation between a tachyarrhythmic waveform sensed during the detected tachyarrhythmia and a template waveform;
• selecting an ATP mode from the plurality of ATP modes using one or more specified ATP mode selection criteria and the classification of the detected tachyarrhythmia, including selecting the synchronized AV-ATP mode in response to the correlation coefficient exceeding a specified correlation threshold;
• and
• controlling the delivery of the atrial pacing pulses and the ventricular pacing pulses from the implantable cardiac rhythm management device according to the selected ATP mode.