# US 8,788,027 B2 · Method and system for detecting and treating junctional rhythms

> Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt

- Number: US 8,788,027 B2
- Document ID: US8788027B2
- Status: Granted
- Kind: B2
- Application number: 14/186,317
- Filed: 2014-02-21
- Published: 2014-06-19
- Granted: 2014-07-22
- Earliest claimed: 2010-03-18
- Assignees: Pacesetter, Inc.
- Applicants: Pacesetter, Inc.
- Inventors: Xing Pei; Paul A. Levine
- Web page: https://patentgrep.com/patent/US8788027B2

## CPC

- A61N 1/3621: {for treating or preventing abnormally high heart rate}
- A61B 5/287: Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
- A61B 5/353: Detecting P-waves
- A61N 1/36507: {controlled by gradient or slope of the heart potential}
- A61N 1/36521: {the parameter being derived from measurement of an electrical impedance}
- A61N 1/37211: {Means for communicating with stimulators}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

An implantable medical device is provided for detecting transportless ventricular rhythm of a heart lacking atrial transport and comprises a housing, sensors configured to be located proximate to a heart, a sensing module to sense cardiac signals representative of a rhythm originating from the heart and a rhythm detection module. The rhythm detection module determines a change in AV association and identifies a potential ventricular complex with loss of atrial transport (VCLAT) based on the change in AV association.

## Claims

### Claim 1

An implantable cardiac stimulation device for treating a transportless ventricular rhythm, comprising:
a housing;
sensors configured to be located proximate to a heart;
a sensing module to sense cardiac signals representative of a rhythm originating from the heart;
a rhythm detection module to identify at least one of an accelerated junctional rhythm (AJR) and an accelerated idioventricular rhythm (AIVR); and
a therapy control module to deliver an AJR-based therapy when the rhythm detection module identifies an AJR and to deliver an AIVR-based therapy when the rhythm detection module identifies an AIVR, wherein the AJR-based therapy differs from the AIVR-based therapy.

### Claim 2 (depends on 1)

The device of claim 1, wherein the therapy control module calculates an overdrive pacing interval and an VS-AP interval, the therapy control module to delivery the AJR-based therapy as atrial pace events at the VS-AP interval beginning after a current R-wave event.

### Claim 3 (depends on 1)

The device of claim 1, wherein the rhythm detection module records a post-therapy AP-VS interval following delivery of the AJR-based therapy and obtains an AP-VS difference between the post-therapy AP-VS interval and an overdrive AP-VS interval.

### Claim 4 (depends on 3)

The device of claim 3, wherein the rhythm detection module compares the AP-VS difference to a predefined threshold to determine whether the rhythm has been converted and entered recovery pacing.

### Claim 5 (depends on 1)

The device of claim 1, wherein the AJR-based therapy includes a recovery pacing adjustment in which the therapy control module successively increases the VS-AP interval between atrial pace events until a pacing rate reaches a predetermined pacing rate.

### Claim 6

A method for treating a transportless ventricular rhythm, comprising:
sensing cardiac signals representative of a rhythm originating from the heart;
identifying at least one of an accelerated junctional rhythm (AJR) and an accelerated idioventricular rhythm (AIVR);
delivering an AJR-based therapy when the rhythm detection module identifies an AJR; and
delivering an AIVR-based therapy when the rhythm detection module identifies an AIVR, wherein the AJR-based therapy differs from the AIVR-based therapy.

### Claim 7 (depends on 6)

The method of claim 6, further comprising calculating an overdrive pacing interval and an VS-AP interval, the AJR-based therapy being delivered as atrial pace events at the VS-AP interval beginning after a current R-wave event.

### Claim 8 (depends on 6)

The method of claim 6, further comprising recording a post-therapy AP-VS interval following delivery of the AJR-based therapy and obtaining an AR difference between the post-therapy AP-VS interval and an overdrive AP-VS interval.

### Claim 9 (depends on 8)

The method of claim 8, further comprising comparing the AP-VS difference to a predefined threshold to determine whether the rhythm has been converted and entered recovery pacing.

### Claim 10 (depends on 6)

The method of claim 6, further comprising adjusting the AJR-based therapy by a recovery pacing adjustment that successively increases the VS-AP interval between atrial pace events until a pacing rate reaches a predetermined pacing rate.