Patent US987178A successfully refreshed from Google Patents.
EP0340045A2
Expired / Lapsed
EP
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Apparatus and method for controlling multiple sensitivities in arrhythmia control system including post therapy pacing delay
Assignee: Telectronics NV
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Filing: 1989-04-28
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Granted: —
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Expires: 2009-04-28
Abstract
Abstract An apparatus and method for tachyarrhythmia reversion uses multiple sensitivities programmed for automatic operation. A first (medium) sensitivity is used normally for the detection of sinus rhythm and ventricular tachycardia. A second (higher) sensitivity is designed for differentiating ventricular fibrillation from asystole. A third (lower) sensitivity can also be programmed into the device to differentiate between R-waves and high amplitude current of injury T-waves which may occur post shock. Following the delivery of antitachycardia therapy in the form of either antitachycardia pacing therapy or cardioversion shock therapy, there is a pause, or post therapy pacing delay for a period of time prior to the commencement of bradycardia support pacing. The magnitude of the delay period is substantially greater than the normal bradycardia support pacing standby interval.
Inventors
- 👤 Richard Grevis
- 👤 Norma Louise Gilli
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-30 12:53
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/3621; A61N1/37; A61N1/3702; A61N1/3704; A61N1/38; A61N1/39; A61N1/3956; A61N1/3962; A61N1/39622
Claims Analysis
Total Claims: 38
Claim 1
Independent Claim
204 words
An apparatus for administering electrotherapy to the heart comprising: a detector responsive to an electrical signal from the heart, said detector being for providing an output signal in response to said electrical signal; sensitivity control means for controlling the sensitivity of said detector to said electrical signal, said sensitivity control means controlling said sensitivity to a first sensitivity level at a first time; tachyarrhythmia detection means for receiving said output signal from said detector set at said first sensitivity level to determine if a tachyarrhythmia is sensed at said first time; tachyarrhythmia confirmation means for receiving said output signal from said detector set at said first sensitivity level to confirm the presence of said tachyarrhythmia at a second time after said first time; tachyarrhythmia therapy means for delivering tachyarrhythmia therapy to the heart if said tachyarrhythmia confirmation means confirms the presence of tachyarrhythmia at said second time; said sensitivity control means controlling said sensitivity of said detector to a second sensitivity level if a tachyarrhythmia is not sensed by said detector at said second time, said second sensitivity level being higher than said first sensitivity level; and said tachyarrhythmia therapy means delivering tachyarrhythmia therapy if said detector, at said second sensitivity level, detects tachyarrhythmia.
Claim 2
Independent Claim
204 words
An apparatus for administering electrotherapy to the heart comprising: a detector responsive to an electrical signal from the heart, said detector being for providing an output signal in response to said electrical signal; sensitivity control means for controlling the sensitivity of said detector to said electrical signal, said sensitivity control means controlling said sensitivity to a first sensitivity level at a first time; tachyarrhythmia detection means for receiving said output signal from said detector set at said first sensitivity level to determine if a tachyarrhythmia is sensed at said first time; tachyarrhythmia confirmation means for receiving said output signal from said detector set at said first sensitivity level to confirm the presence of said tachyarrhythmia at a second time after said first time; tachyarrhythmia therapy means for delivering tachyarrhythmia therapy to the heart if said tachyarrhythmia confirmation means confirms the presence of tachyarrhythmia at said second time; said sensitivity control means controlling said sensitivity of said detector to a second sensitivity level if a tachyarrhythmia is not sensed by said detector at said second time, said second sensitivity level being higher than said first sensitivity level; and said tachyarrhythmia therapy means delivering tachyarrhythmia therapy if said detector, at said second sensitivity level, detects tachyarrhythmia.
Claim 3
Dependent Claim
30 words
The apparatus of claim 1, wherein said second sensitivity level is sufficient so that said detector provides an output if tachyarrhythmia is present, but pro vides no output during asystole.
Claim 4
Dependent Claim
32 words
The apparatus of claim 1, further comprising: bradycardia detection means responsive to the output of said detector; and bradycardia pacing means for supplying bradycardia pacing when said bradycardia detecting means detects bradycardia.
Claim 5
Dependent Claim
29 words
The apparatus of claim 3, further comprising delay means for delaying delivery of bradycardia pacing pulses by said bradycardia pacing means, after said tachyarrhythmia therapy means delivers tachyarrhythmia therapy.
Claim 6
Dependent Claim
57 words
The apparatus of claim 4, wherein said tachyarrhythmia therapy means delivers a first type of tachyarrhythmia therapy and a second type of tachyarrythmia therapy, said delay means having a first delay interval generation means for delay after said first type of therapy, and a second delay interval generation means for delay after said second type of therapy.
Claim 7
Dependent Claim
25 words
The apparatus of claim 5, wherein delay of said first delay interval generation means and of said second delay interval generation means are independently programmable.
Claim 8
Dependent Claim
44 words
The apparatus of claim 1, wherein said sensitivity control means controls said sensitivity to change from said second sensitivity level to said first sensitivity level when said tachyarrhythmia detection means fails to detect a tachyarrhythmia when said detector is at said second sensitivity level.
Claim 9
Dependent Claim
49 words
The apparatus of claim 7, further comprising: bradycardia detection means responsive to the output of said detector, when said sensitivity control means controls said detector sensitivity to return to said first sensitivity level; and bradycardia pacing means for supplying brady cardia pacing when said bradycardia detection means detects bradycardia.
Claim 10
Dependent Claim
23 words
The apparatus of claim 1, wherein said tachyarrhythmia therapy means includes at least one of: a tachyarrhythmia pacing means, and a cardioversion means.
Claim 11
Dependent Claim
46 words
The apparatus of claim 1, wherein after tachyarrhythmia therapy has been delivered to the heart by said tachyarrhythmia therapy means, said sensitivity control means controls the sensitivity of said detector to a third level, said third sensitivity level being of lower sensitivity than said first level.
Claim 12
Dependent Claim
36 words
The apparatus of claim 10, wherein said third sensitivity level is sufficiently high so that said detector detects sinus rhythm, but is sufficiently low so that said detector does not detect a current of injury T-wave.
Claim 13
Dependent Claim
32 words
The apparatus of claim 10, wherein said sensitivity control means controls said sensitivity to said third level for at least a period of time sufficient to detect the presence of sinus rhythm.
Claim 14
Dependent Claim
39 words
The apparatus of claim 12, wherein if sinus rhythm is not detected at said third sensitivity level, said sensitivity control means controls the sensitivity of said detector to change from said third sensitivity level to said second sensitivity level.
Claim 15
Independent Claim
110 words
An apparatus for reversion of tachycardia comprising: bradycardia support pacing means for providing bradycardia support pacing; detection means for detecting the presence of a tachycardia; therapy means for delivering antitachyarrhythmia therapy; confirmation means for providing confirmation of reversion of tachycardia following delivery of said antitachyarrhythmia therapy; and delay means for delaying, for a post therapy delay period, the providing of bradycardia support pacing by said bradycardia support pacing means after said therapy means delivers said antitachyarrhythmia therapy and when said confirmation means has provided said confirmation of reversion of said tachycardia, wherein said delay period is a period of time substantially longer than a normal bradycardia support pacing standby interval.
Claim 16
Independent Claim
110 words
An apparatus for reversion of tachycardia comprising: bradycardia support pacing means for providing bradycardia support pacing; detection means for detecting the presence of a tachycardia; therapy means for delivering antitachyarrhythmia therapy; confirmation means for providing confirmation of reversion of tachycardia following delivery of said antitachyarrhythmia therapy; and delay means for delaying, for a post therapy delay period, the providing of bradycardia support pacing by said bradycardia support pacing means after said therapy means delivers said antitachyarrhythmia therapy and when said confirmation means has provided said confirmation of reversion of said tachycardia, wherein said delay period is a period of time substantially longer than a normal bradycardia support pacing standby interval.
Claim 17
Dependent Claim
29 words
The apparatus of claim 14, wherein said delay means delays providing of bradycardia support pacing for a post therapy delay period of between substantially two and substantially five seconds.
Claim 18
Dependent Claim
32 words
The apparatus of claim 14, wherein said antitachyarrhythmia therapy means comprises at least one of an antitachycardia pacing pulse generation means and cardioversion shock means for delivering at least one cardioversion shock.
Claim 19
Dependent Claim
57 words
The apparatus of claim 16, wherein said delay means includes a first delay interval generation means for providing a first delay after antitachycardia pacing by said antitachycardia pacing pulse generation means, and a second delay interval generation means for providing a second delay after delivery of said at least one cardioversion shock by said cardioversion shock means.
Claim 20
Dependent Claim
38 words
The apparatus of claim 17, further comprising means for independently setting said first delay interval generation means and said second delay interval generation means to provide said first delay interval of different duration than said second delay interval.
Claim 21
Dependent Claim
18 words
The apparatus of claim 17, wherein said first delay interval is of a duration of substantially three seconds.
Claim 22
Dependent Claim
18 words
The apparatus of claim 17, wherein said second delay interval is of a duration of substantially four seconds.
Claim 23
Dependent Claim
57 words
The apparatus of claim 14, wherein said antitachycardia therapy means delivers a first type of antitachyarrhythmia therapy and a second type of antitachyarrhythmia therapy, said delay means having a first delay interval generation means for delay after said first type of therapy and a second delay interval generation means for delay after said second type of therapy.
Claim 24
Independent Claim
155 words
A method for operating a medical apparatus to administer electrotherapy to the heart comprising the steps of: setting the sensitivity of a detector, in said apparatus, to an electrical signal from the heart to a first sensitivity level; detecting the presence of a tachyarrhythmia with said detector, at a first time; determining whether said tachyarrhythmia is detected by said detector at a second time, at said first sensitivity level, said second time being after said first time; delivering tachyarrhythmia therapy if said tachyarrhythmia is detected at said second time; changing said sensitivity to a second sensitivity level if said tachyarrhythmia is not detected at said second time, said second sensitivity level being higher than said first sensitivity level; determining whether said tachyarrhythmia is detected at said second sensitivity level at a third time, said third time being later than said second time; and delivering tachyarrhythmia therapy if said tachyarrhythmia is detected at said third time.
Claim 25
Independent Claim
155 words
A method for operating a medical apparatus to administer electrotherapy to the heart comprising the steps of: setting the sensitivity of a detector, in said apparatus, to an electrical signal from the heart to a first sensitivity level; detecting the presence of a tachyarrhythmia with said detector, at a first time; determining whether said tachyarrhythmia is detected by said detector at a second time, at said first sensitivity level, said second time being after said first time; delivering tachyarrhythmia therapy if said tachyarrhythmia is detected at said second time; changing said sensitivity to a second sensitivity level if said tachyarrhythmia is not detected at said second time, said second sensitivity level being higher than said first sensitivity level; determining whether said tachyarrhythmia is detected at said second sensitivity level at a third time, said third time being later than said second time; and delivering tachyarrhythmia therapy if said tachyarrhythmia is detected at said third time.
Claim 26
Dependent Claim
29 words
The method of claim 22, further comprising the step of: changing said sensitivity back to said first sensitivity level if said tachyarrhythmia is not detected at said third time.
Claim 27
Dependent Claim
35 words
The method of claim 26, further comprising the steps of: detecting the presence of bradycardia after said step of changing said sensitivity back to said second level, and delivering bradycardia pacing when bradycardia is detected.
Claim 28
Dependent Claim
28 words
The method of claim 24, further comprising the step of delaying the delivering of bradycardia pacing by a predetermined period of time after delivery of said tachyarrhythmia therapy.
Claim 29
Dependent Claim
47 words
The method of claim 25, wherein said tachyarrythmia therapy is of a first type of therapy and a second type of therapy, said first type of therapy being delayed for a first delay interval and said second type of therapy being delayed for a second delay interval.
Claim 30
Dependent Claim
94 words
The method of claim 22, further comprising the steps of: setting said sensitivity of said detector to a third level after the delivery of tachyarrhythmia therapy, for a period of time sufficient to detect the presence of sinus rhythm, said third level being lower than said first level; determining whether sinus rhythm is detected by said detector at said third sensitivity level; maintaining said sensitivity at said third level for a predetermined period of time if sinus rhythm is detected; and changing said sensitivity to said second level if sinus rhythm is not detected.
Claim 31
Dependent Claim
27 words
The method of claim 27, wherein said third sensitivity level is sufficiently high to detect sinus rhythm and insufficiently high to detect a current of injury T-wave.
Claim 32
Independent Claim
77 words
A method of operation of a medical device for tachyarrhythmia reversion and bradycardia pacing comprising the steps of: detecting the presence of tachyarrhythmia; delivering antitachyarrhythmia therapy; confirming the absence of tachyarrhythmia following the delivery of said antitachyarrhythmia therapy; pausing for a period of time after the delivery of said antitachyarrhythmia therapy and confirming the absence of tachyarrhthmia, said period of time being substantially longer than a normal bradycardia support pacing standby interval; and commencing bradycardia support pacing.
Claim 33
Independent Claim
77 words
A method of operation of a medical device for tachyarrhythmia reversion and bradycardia pacing comprising the steps of: detecting the presence of tachyarrhythmia; delivering antitachyarrhythmia therapy; confirming the absence of tachyarrhythmia following the delivery of said antitachyarrhythmia therapy; pausing for a period of time after the delivery of said antitachyarrhythmia therapy and confirming the absence of tachyarrhthmia, said period of time being substantially longer than a normal bradycardia support pacing standby interval; and commencing bradycardia support pacing.
Claim 34
Dependent Claim
19 words
The method of claim 24, wherein said period of time is between substantially two seconds and substantially five seconds.
Claim 35
Dependent Claim
20 words
The method of claim 29, wherein said antitachyarrhythmia therapy comprises one of antitachycardia pacing and at least one cardioversion shock.
Claim 36
Dependent Claim
48 words
The method of claim 31, wherein said pausing is for a first period of time after delivery of antitachycardia pacing and a second period of time after delivery of said at least one cardioversion shock, said first period of time being different than said second period of time.
Claim 37
Dependent Claim
25 words
The method of claim 32, wherein said first period of time is substantially three seconds and said second period of time is substantially four seconds.
Claim 38
Dependent Claim
47 words
The method of claim 29, wherein said antitachyarrhythmia therapy is of a first type of therapy and a second type of therapy, said first type of therapy being delayed for a first delay interval and said second type of therapy being delayed for a second delay interval.
References Cited (Backward Citations)
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