Medical device and method for detecting arrhythmia

Patent metadata

Field	Value
Publication number	US-12569688-B2
Application number	US-202218054137-A
Country	US
Kind code	B2
Filing date	Nov 9, 2022
Priority date	Dec 6, 2021
Publication date	Mar 10, 2026
Grant date	Mar 10, 2026

Abstract

A medical device is configured to determine tachyarrhythmia evidence in a cardiac signal segment received from a cardiac electrical signal sensed during a pacing escape interval started to schedule a pending cardiac pacing pulse. The medical device may delay the pending cardiac pacing pulse in response to determining the tachyarrhythmia evidence during the pacing escape interval.

First claim

What is claimed is:

1 . A medical device comprising:
a sensing circuit configured to sense at least one cardiac electrical signal; a therapy delivery circuit configured to deliver cardiac pacing pulses; and a control circuit in communication with the sensing circuit and the therapy delivery circuit, the control circuit configured to:
schedule a pending pacing pulse of the cardiac pacing pulses by starting a first pacing escape interval;
receive a first cardiac signal segment from the at least one cardiac electrical signal sensed by the sensing circuit during the first pacing escape interval;
determine tachyarrhythmia evidence in the first cardiac signal segment by determining at least one tachyarrhythmia morphology metric from the first cardiac signal segment; and
delay the pending pacing pulse scheduled at an expiration of the first pacing escape interval in response to determining the tachyarrhythmia evidence in at least the first cardiac signal segment.

2 . The medical device of claim 1 , wherein:
the sensing circuit is further configured to sense cardiac event signals from the at least one cardiac electrical signal; the control circuit is further configured to schedule the pending pacing pulse by starting the first pacing escape interval in response to the sensing circuit sensing a cardiac event signal.

3 . The medical device of claim 1 , wherein the control circuit is further configured to schedule the pending pacing pulse by starting the first pacing escape interval in response to the therapy delivery circuit delivering a cardiac pacing pulse.

4 . The medical device of claim 1 , wherein the control circuit is further configured to delay the pending pacing pulse by restarting the first pacing escape interval.

5 . The medical device of claim 1 , wherein the control circuit is further configured to delay the pending pacing pulse by starting a pacing delay interval different than the first pacing escape interval.

6 . The medical device of claim 1 , wherein the control circuit is further configured to:
receive a plurality of cardiac signal segments including the first cardiac signal segment from the at least one cardiac electrical signal; determine tachyarrhythmia evidence in at least a threshold number of the plurality of cardiac signal segments; and delay the pending pacing pulse in response to determining the tachyarrhythmia evidence in at least the threshold number of the plurality of cardiac signal segments.

7 . The medical device of claim 1 , wherein the control circuit is further configured to determine the tachyarrhythmia evidence in the first cardiac signal segment by:
identifying signal pulse peaks from the first cardiac signal segment; determining peak intervals between the identified signal pulse peaks; and determining that the peak intervals meet a tachyarrhythmia rate threshold.

8 . The medical device of claim 1 , wherein the control circuit is further configured to determine the tachyarrhythmia evidence in the first cardiac signal segment by:
determining at least one of:
a low slope content from the first cardiac signal segment;
a spectral width from the first cardiac signal segment; and
a mean period from the first cardiac signal segment;
determining that at least one of the low slope content, the spectral width and the mean period meet tachyarrhythmia evidence criteria; and determining the tachyarrhythmia evidence in the first cardiac signal segment in response to the at least one of the low slope content, the spectral width and the mean period meeting the tachyarrhythmia evidence criteria.

9 . The medical device of claim 1 , wherein the control circuit is further configured to determine the tachyarrhythmia evidence in the first cardiac signal segment by:
determining a spectral width from the cardiac signal segment; determining a mean period from the cardiac signal segment; determining that the mean period meets a first threshold; determining that a ratio of the spectral width and the mean period meets a second threshold; and determining the tachyarrhythmia evidence in the first cardiac signal segment based on the mean period meeting the first threshold and the ratio of the spectral width and the mean period meeting the second threshold.

10 . The medical device of claim 1 , wherein:
the control circuit is further configured to:
receive a second cardiac signal segment from the at least one cardiac electrical signal sensed by the sensing circuit after delaying the pending pacing pulse; and
determine no tachyarrhythmia evidence in the second cardiac signal segment; and
the therapy delivery circuit is further configured to deliver the delayed pending pacing pulse in response to the control circuit determining no tachyarrhythmia evidence in at least the second cardiac signal segment.

11 . The medical device of claim 1 , wherein:
the control circuit is further configured to:
receive a second cardiac signal segment from the at least one cardiac electrical signal sensed by the sensing circuit;
determine an amplitude metric from the second cardiac signal segment;
determine that the amplitude metric is less than an amplitude threshold; and
determine no tachyarrhythmia evidence in the second cardiac signal segment in response to the amplitude metric being less than the amplitude threshold; and
the therapy delivery circuit is further configured to deliver the delayed pending pacing pulse in response to the control circuit determining no tachyarrhythmia evidence in at least the second cardiac signal segment.

12 . The medical device of claim 1 , wherein:
the control circuit is further configured to:
receive a second cardiac signal segment from the at least one cardiac electrical signal sensed by the sensing circuit;
determine at least one noise metric from the second cardiac signal segment; and
determine no tachyarrhythmia evidence in the second cardiac signal segment based on the at least one noise metric; and
the therapy delivery circuit is further configured to deliver the delayed pending pacing pulse in response to the control circuit determining no tachyarrhythmia evidence in at least the second cardiac signal segment.

13 . The medical device of claim 1 , wherein the control circuit is further configured to:
delay the pending pacing pulse by setting a first delay interval in response to determining tachyarrhythmia evidence in at least the first cardiac signal segment; receive a second cardiac signal segment from the at least one cardiac electrical signal sensed by the sensing circuit during the first delay interval; determine tachyarrhythmia evidence in the second cardiac signal segment; and delay the pending pacing pulse by setting a second delay interval in response to determining the tachyarrhythmia evidence in at least the second cardiac signal segment.

14 . The medical device of claim 1 , wherein:
the therapy delivery circuit is further configured to deliver a plurality of pacing pulses; and the control circuit is further configured to:
start a plurality of pacing escape intervals comprising the first pacing escape interval, wherein each pacing escape interval of the plurality of pacing escape intervals is started in response to the therapy delivery circuit delivering a pacing pulse of the plurality of pacing pulses;
receive a plurality of cardiac signal segments comprising the first cardiac signal segment from the at least one cardiac electrical signal, wherein the plurality of cardiac signal segments are sensed by the sensing circuit during the plurality of pacing escape intervals;
determine tachyarrhythmia evide

Assignees

• Medtronic Inc

Inventors

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

Classifications

• A61N1/36507

  controlled by gradient or slope of the heart potential · CPC title

• A61B5/363

  Detecting tachycardia or bradycardia · CPC title

• A61B5/4836

  Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence) · CPC title

• A61N1/3925

  Monitoring; Protecting · CPC title

• A61N1/362 Primary

  Heart stimulators (heart defibrillators A61N1/39) · CPC title