Methods for detecting atrial tachyarrhythmia in implantable devices without dedicated atrial sensing

Patent metadata

Field	Value
Publication number	US-2016135707-A1
Application number	US-201615007637-A
Country	US
Kind code	A1
Filing date	Jan 27, 2016
Priority date	Apr 22, 2009
Publication date	May 19, 2016
Grant date	—

Abstract

An apparatus comprises an implantable cardiac signal sensing circuit configured to provide a sensed depolarization signal from a ventricle and a processor. The processor includes a signal analyzer module and a tachyarrhythmia discrimination module. The signal analyzer module is configured to determine a measure of stability of ventricular (V−V) depolarization intervals using the depolarization signal, and determine a rate of change of the measure of stability. The tachyarrhythmia discrimination module is configured to detect an episode of tachyarrhythmia using the depolarization signal, determine whether the detected tachyarrhythmia is indicative of atrial tachyarrhythmia using the determined rate of change, and provide the determination to a user or process.

First claim

1 . (canceled)

2 . An apparatus comprising:
an implantable cardiac signal sensing circuit, configured to provide a sensed depolarization signal from a ventricle; a processor communicatively coupled to the cardiac signal sensing circuit, the processor including:
a signal analyzer module configured to measure V−V depolarization intervals; and
a tachyarrhythmia discrimination module configured to:
detect an episode of tachyarrhythmia using the measured V−V depolarization intervals;
detect a sudden presence of long and short V−V depolarization intervals;
classify the detected tachyarrhythmia as atrial tachyarrhythmia or ventricular tachyarrhythmia using a detected pattern of long and short V−V depolarization intervals; and
provide the tachyarrhythmia classification to a user or process.

3 . The apparatus of claim 2 , including:
a memory communicatively coupled to the processor and configured to a store a signal morphology template; and a far-field sensing channel configured to provide a far-field atrial and ventricular signal using an electrode location that is outside of an atrium or ventricle, and wherein the tachyarrhythmia discrimination module is configured to:
upon classifying the detected tachyarrhythmia as atrial tachyarrhythmia, initiate sensing of the far-field signal; and
initiate a comparison a morphology of the far-field signal to a stored morphology template by the signal analyzer module; and
confirm the classification as atrial tachyarrhythmia using the morphology comparison.

4 . The apparatus of claim 3 , wherein the signal analyzer module is configured to:
calculate a measure of similarity between a segment of the far-field signal and the morphology template, wherein the stored morphology template is representative of normal sinus rhythm; calculate a central tendency of the measure of similarity and a variance of the measure of similarity, and wherein the tachyarrhythmia discrimination module is configured to confirm the classification as atrial tachyarrhythmia when the central tendency of the measure of similarity is above a central tendency threshold, the variance of the measure of similarity is within a variance range, and the depolarization rate or interval satisfies a rate or interval detection threshold.

5 . The apparatus of claim 2 , including:
a memory communicatively coupled to the processor; and a communication circuit, communicatively coupled to the processor, configured to communicate information wirelessly with a second separate device, and wherein the tachyarrhythmia discrimination module is configured to:
upon classifying the detected tachyarrhythmia as atrial tachyarrhythmia, initiate storage of a segment of the depolarization signal when a duration of the detected arrhythmia exceeds a duration threshold;
initiate storage of a histogram of V−V depolarization intervals, wherein the histogram indicates regular and irregular V−V depolarization intervals; and
communicate the stored segment and histogram from an implantable medical device to a second device.

6 . A method comprising:
detecting an episode of tachyarrhythmia using a depolarization signal sensed from a ventricle in an absence of a dedicated atrial chamber sensing circuit; detecting a sudden presence of long and short V−V depolarization intervals using the depolarization signal; classifying the detected tachyarrhythmia as atrial tachyarrhythmia or ventricular tachyarrhythmia using a detected pattern of long and short V−V depolarization intervals; and providing the tachyarrhythmia classification to a user or process.

7 . The method of claim 6 , including:
upon classifying the detected tachyarrhythmia as atrial tachyarrhythmia, sensing a second signal using a far-field sensing channel; and comparing a morphology of the second sensed signal to a morphology template, and wherein classifying the tachyarrhythmia includes confirming the classification as atrial tachyarrhythmia using the morphology comparison.

8 . The method of claim 6 , including
upon classifying the detected tachyarrhythmia as atrial tachyarrhythmia, storing a segment of the depolarization signal when a duration of the detected arrhythmia exceeds a duration threshold; storing a histogram of V−V depolarization intervals, wherein the histogram indicates regular and irregular V−V depolarization intervals; and communicating the stored segment and histogram from an implantable medical device to a second device.

Assignees

• Cardiac Pacemakers Inc

Inventors

• Li Dan
• Perschbacher David L
• Dong Yanting
• Stephenson Julie

Classifications

• A61B5/0464 Primary

  Human Necessities · mapped topic

• A61B5/04012

  Human Necessities · mapped topic

• A61B5/686

  Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence) · CPC title

• A61B5/0006 Primary

  ECG or EEG signals · CPC title

• A61B5/363 Primary

  Detecting tachycardia or bradycardia · CPC title