Medical device and method for detecting tachy arrhythmia

Patent metadata

Field	Value
Publication number	US-12543993-B2
Application number	US-202217823055-A
Country	US
Kind code	B2
Filing date	Aug 29, 2022
Priority date	Sep 30, 2021
Publication date	Feb 10, 2026
Grant date	Feb 10, 2026

Abstract

A medical device is configured to sense first ventricular event signals from a first cardiac electrical signal and sense second ventricular event signals from a second cardiac electrical signal. The medical device is configured to determine sensed event data in response to the first ventricular event signals and the second ventricular event signals. The medical device may select one of the first cardiac electrical signal or the second cardiac electrical signal for providing input for tachyarrhythmia detection based on the sensed event data.

First claim

What is claimed is:

1 . A medical device comprising:
a sensing circuit configured to:
receive a plurality of cardiac electrical signals;
sense first ventricular event signals from a first cardiac electrical signal of the plurality of cardiac electrical signals; and
sense second ventricular event signals from a second cardiac electrical signal of the plurality of cardiac electrical signals;
a control circuit configured to:
determine sensed event data in response to each one of the first ventricular event signals and the second ventricular event signals sensed by the sensing circuit;
detect a first threshold number of tachyarrhythmia intervals from one of the first cardiac electrical signal or the second cardiac electrical signal;
in response to detecting the first threshold number of tachyarrhythmia intervals, select based on the sensed event data one of the first cardiac electrical signal or the second cardiac electrical signal for providing input for tachyarrhythmia detection by:
identifying a candidate signal as one of the first cardiac electrical signal and the second cardiac electrical signal;
identifying a non-candidate signal as a second one of the first cardiac electrical signal and the second cardiac electrical signal;
determining when reliability criteria are met based on the sensed event data; and
selecting one of the first cardiac electrical signal or the second cardiac electrical signal for providing the input for the tachyarrhythmia detection by one of:
selecting the candidate signal for providing the input for the tachyarrhythmia detection in response to the reliability criteria being met; or
selecting the non-candidate signal for providing the input for the tachyarrhythmia detection in response to the reliability criteria not being met; and

detect a tachyarrhythmia based on the selected one of the first cardiac electrical signal or the second cardiac electrical signal; and

a therapy delivery circuit configured to deliver an electrical stimulation therapy in response to the control circuit detecting the tachyarrhythmia.

2 . The medical device of claim 1 , wherein the control circuit is further configured to determine the sensed event data by:
setting a first match window in response to each of the first ventricular event signals; determining whether one of the second ventricular event signals is sensed from the second cardiac electrical signal within the first match window; classifying each of the first ventricular event signals as one of:
a time-based matched event signal in response to one of the second ventricular event signals being sensed from the second cardiac electrical signal within the first match window; or
a time-based unmatched event signal in response to none of the second ventricular event signals being sensed from the second cardiac electrical signal within the first match window;
setting a second match window in response to each of the second ventricular event signals; determining whether one of the first ventricular event signals is sensed from the first cardiac electrical signal within the second match window; classifying each of the second ventricular event signals as one of:
a time-based matched event signal in response to one of the first ventricular event signals being sensed from the first cardiac electrical signal within the second match window; or
a time-based unmatched event signal in response to none of the first ventricular event signals being sensed from the first cardiac electrical signal within the second match window.

3 . The medical device of claim 2 , wherein the control circuit is further configured to:
determine, for the candidate signal, that the classified time-based matched event signals are at least a predetermined percentage of the respective first ventricular event signals or the second ventricular event signals sensed from the candidate signal; and select the candidate signal for providing the input for the tachyarrhythmia detection at least in response to the classified time-based matched event signals being at least the predetermined percentage of the respective first ventricular event signals or the second ventricular event signals sensed from the candidate signal.

4 . The medical device of claim 3 , wherein the control circuit is further configured to:
determine the sensed event data by:
determining first peak amplitudes from the candidate signal, the first peak amplitudes associated with the time-based matched event signals; and
determining second peak amplitudes from the candidate signal, the second peak amplitudes associated with the time-based unmatched event signals;
determine a ratio from the first peak amplitudes and the second peak amplitudes; determine that the ratio meets a threshold ratio; and select one of the first cardiac electrical signal or the second cardiac electrical signal for providing the input for the tachyarrhythmia detection by selecting the candidate signal in response to the ratio meeting the threshold ratio.

5 . The medical device of claim 1 , wherein the control circuit is further configured to determine the sensed event data by:
determining first peak amplitudes from the first ventricular event signals; and determining second peak amplitudes from the second ventricular event signals.

6 . The medical device of claim 5 , wherein:
the sensing circuit is further configured to: sense each of the first ventricular event signals from the first cardiac electrical signal by determining a crossing of a first auto-adjusting sensing threshold by the first cardiac electrical signal; sense each of the second ventricular event signals from the second cardiac electrical signal by determining a crossing of a second auto-adjusting sensing threshold by the second cardiac electrical signal; and the control circuit is further configured to: determine the sensed event data by:
determining a first sensing threshold amplitude for each of the first sensed event signals by determining an amplitude of the first auto-adjusting sensing threshold at the crossing of the first auto-adjusting sensing threshold; and
determining second sensing threshold amplitudes by determining, for each of the second sensed event signals, an amplitude of the second auto-adjusting sensing threshold at the crossing of the second auto-adjusting sensing threshold;
determine from the first peak amplitudes and the first sensing threshold amplitudes a first amplitude-to-sense threshold ratio associated with the first ventricular event signals; determine from the second peak amplitudes and the second sensing threshold amplitudes a second amplitude-to-sense threshold ratio associated with the second ventricular event signals; and select one of the first cardiac electrical signal or the second cardiac electrical signal for providing the input for the tachyarrhythmia detection based on at least the first amplitude-to-sense threshold ratio and the second amplitude-to-sense threshold ratio.

7 . The medical device of claim 5 , wherein the control circuit is further configured to:
determine an amplitude metric from the peak amplitudes determined from the non-candidate signal; determine that the amplitude metric is less than a threshold amplitude; and select one of the first cardiac electrical signal or the second cardiac electrical signal for providing the input for the tachyarrhythmia detection by selecting the candidate signal at least in response to the amplitude metric being less than the threshold amplitude.

8 . The medical device of claim 1 , wherein the control circuit is further configured to:
determine the sensed event data by:
applying a noise analysis time interval to the candidate signal in response to each of the first sen

Assignees

• Medtronic Inc

Inventors

• Liu Yuanzhen
• Aranda Hernandez Alfonso
• Ebeling Timothy A
• Greenhut Saul E
• Heinks Michael W
• Hudson Jean E
• Jackson Troy E
• Sanchez Irving J
• Vander Heyden James A
• Zhang Xusheng

Classifications

• A61B5/35

  by template matching · CPC title

• A61N1/3956

  Implantable devices for applying electric shocks to the heart, e.g. for cardioversion · CPC title

• A61B5/29

  for permanent or long-term implantation · CPC title

• A61B5/308

  for electrocardiography [ECG] · CPC title

• A61N1/3987

  characterised by the timing or triggering of the shock · CPC title