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US 9,433,791 B2Granted
AV nodal stimulation during atrial tachyarrhythmia to prevent inappropriate therapy delivery
AssigneeMedtronic, Inc.
InventorsEduardo N. Warman, John E. Burnes, Koen J. Michels, Paul D. Ziegler, Lilian Kornet
Life of this patent
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Abstract
The disclosure describes techniques for delivering electrical stimulation to decrease the ventricular rate response during an atrial tachyarrhythmia, such as atrial fibrillation. AV nodal stimulation is employed during an atrial tachyarrhythmia episode with rapid ventricular conduction to distinguish ventricular tachyarrhythmia from supraventricular tachycardia and thereby prevent delivering inappropriate therapy to a patient.
Claims50
A method comprising:
- incrementing a counter upon detection of a ventricular tachyarrhythmia event;
- detecting an atrial tachyarrhythmia;
- during the detected atrial tachyarrhythmia, anticipating detection of a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count;
- in response to anticipating detection of the ventricular tachyarrhythmia, delivering electrical stimulation to block the atrioventricular node of the heart;
- and
- terminating the delivery of electrical stimulation based on one or more stimulation termination criteria.
3 more elements
A method comprising:
- incrementing a counter upon detection of a ventricular tachyarrhythmia event;
- anticipating detection of a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count;
- determining a sense time period;
- and
- in response to anticipating detection of the ventricular tachyarrhythmia, delivering electrical stimulation to block the atrioventricular node of the heart over an electrical stimulation delivery time period, wherein the electrical stimulation delivery time period is based on the sense time period over which ventricular depolarizations can be sensed during the electrical stimulation delivery time period, the stimulation time period being bounded by limits that prevent an accumulation of blanking periods applied to a sensing amplifier that would exceed the sense time period.
2 more elements
A system comprising:
- a stimulation generator configured to deliver electrical stimulation to a patient;
- and
- a processor configured to increment a counter upon detection of a ventricular tachyarrhythmia event, anticipate detection of a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count, and in response to anticipating detection of the ventricular tachyarrhythmia, control the stimulation generator to deliver electrical stimulation to block the atrioventricular node of the heart over an electrical stimulation delivery time period,
- wherein the processor determines a sense time period and establishes a stimulation time period based on the sense time period over which ventricular depolarizations can be sensed during the electrical stimulation delivery time period and controls the stimulation generator to deliver the electrical stimulation during the stimulation time period, the established stimulation time period being bounded by limits that prevent an accumulation of blanking periods applied to a sensing amplifier that would exceed the sense time period.
1 more element
A non-transitory computer-readable storage medium comprising instructions for causing a programmable processor to:
- increment a counter upon detection of a ventricular tachyarrhythmia event;
- anticipate detection of a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count;
- determine a sense time period;
- and
- in response to anticipating detection of the ventricular tachyarrhythmia, deliver electrical stimulation to block the atrioventricular node of the heart over an electrical stimulation delivery time period, wherein the electrical stimulation is delivered during a stimulation time period established based on the sense time period over which ventricular depolarizations can be sensed during the electrical stimulation delivery time period, the stimulation time period being bounded by limits that prevent an accumulation of blanking periods applied to a sensing amplifier that would exceed the sense time period.
2 more elements
A system comprising:
- means for anticipating detection of a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count;
- means for determining a sense time period;
- and
- means for, in response to anticipating detection of the ventricular tachyarrhythmia, delivering electrical stimulation to block the atrioventricular node of the heart over an electrical stimulation delivery time period, wherein the electrical stimulation is delivered based on the sense time period over which ventricular depolarizations can be sensed during the electrical stimulation delivery time period,
- the electrical stimulation delivery time period being bounded by limits that prevent an accumulation of blanking periods applied to a sensing amplifier that would exceed the sense time period.
2 more elements
A method comprising:
- anticipating a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count;
- determining a sense time period;
- and
- in response to anticipating the ventricular tachyarrhythmia, delivering electrical stimulation to block the atrioventricular node of the heart over an electrical stimulation delivery time period, wherein the electrical stimulation delivery time period is based on the sense time period over which ventricular depolarizations can be sensed during the electrical stimulation delivery time period, the electrical stimulation delivery time period being bounded by limits that prevent an accumulation of blanking periods applied to a sensing amplifier that would exceed the sense time period.
1 more element
A method comprising:
- incrementing a counter upon detection of a ventricular tachyarrhythmia event;
- anticipating detection of a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count;
- measuring an RR interval;
- determining, using the RR interval, a sense time period over which ventricular depolarizations need to be sensed in order to detect development of a ventricular tachyarrhythmia;
- determining a stimulation time period based on the sense time period;
- in response to anticipating detection of the ventricular tachyarrhythmia, delivering electrical stimulation to block the atrioventricular node of the heart over a first time period regardless of the sense time period;
- and
- delivering the electrical stimulation during the stimulation time period over a second time period after the first time period, the stimulation time period being bounded by limits that prevent an accumulation of blanking periods applied to a sensing amplifier that would exceed the sense time period.
5 more elements
A system comprising:
- a stimulation generator configured to deliver electrical stimulation to a patient;
- and
- a processor configured to increment a counter upon detection of a ventricular tachyarrhythmia event;
- detect an atrial tachyarrhythmia;
- during the detected atrial tachyarrhythmia, anticipate detection of a ventricular tachyarrhythmia in a heart of a patient based on a ventricular tachyarrhythmia not yet being detected but the counter reaching a threshold value of a ventricular tachyarrhythmia event count;
- in response to anticipating detection of the ventricular tachyarrhythmia, control delivery of electrical stimulation to block the atrioventricular node of the heart;
- and terminate the delivery of electrical stimulation based on one or more stimulation termination criteria.
4 more elements
Dependencies are inferred from the claim text.