Patent EP0597459A2 successfully refreshed from Google Patents.
EP0597459A2
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Implantable antitachycardia cardioverter/defibrillator
Assignee: Individual
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Filing: 1993-11-10
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Granted: —
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Expires: 2013-11-10
Abstract
Abstract An algorithm for classifying cardiac arrhythmias comprising multiple stages and dual chamber sensing. A first stage includes the steps of comparing ventricular and atrial rates and declaring that the heart is in atrial tachycardia or atrial fibrillation on the one hand, or that the heart is in ventricular fibrillation on the other hand. The second stage is entered if no determination is made in the first stage and, in particular, when the atrial rate equals the ventricular rate. A third stage is entered in which the heart is paced (ventricular, atrial or both) at a predetermined rate for a set period of time. Cardiac rhythm classification is made based on heart responses during and after pacing.
Inventors
- 👤 Masood Akhtar
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-11-10 01:30
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/3621; A61N1/3622; A61N1/38; A61N1/39; A61N1/3956; A61N1/3962; A61N1/39622; A61N1/395
Claims Analysis
Total Claims: 14
Claim 1
Independent Claim
239 words
Implantable antitachycardia cardioverter/defibrillator comprising an arrhythmia analyzer (10), a ventricular and an atrial sensing electrode (12, 14), a pacer unit (20), a ventricular and atrial pacing electrode (22, 24) and a defibrillation/cardioversion unit (30) in which the arrhythmia analyzer (10) senses cardiac activity and classifies the condition of the heart whereby the sensing and classifying comprises the following steps: a first stage including the steps of: sensing atrial and ventricular depolarization rates of the heart; comparing the atrial depolarization rate with the ventricular depolarization rate; declaring the heart condition based on said step of comparing if the atrial depolarization rate does not equal the ventricular depolarization rate; a second stage implemented if the atrial depolarization rate equals the ventricular depolarization rate, said second stage including the steps of: computing an A-V time interval between consecutive atrial and ventricular depolarizations; comparing the A-V time interval with a baseline value; declaring the heart condition based on the difference between the A-V time interval and the baseline value; and a third stage implemented if no declaration is made in said second stage, said third stage including the steps of: pacing the heart at a predetermined rate for a predetermined period of time; monitoring the response to said step of pacing during and after said predetermined period of time; and declaring the specific arrhythmia based on the response of the heart during said step of pacing and after said predetermined period of time.
Claim 2
Dependent Claim
138 words
Implantable antitachycardia cardioverter/defibrillator according to claim 1, wherein said second stage further comprises the steps of: declaring that the heart is in sinus tachycardia if said A-V time interval differs from said baseline value by a predetermined amount; determining if said A-V time interval is within a predetermined threshold interval if said A-V time interval differs from said baseline value by more than said predetermined amount; declaring that the heart is in A-V nodal reentry if said A-V time interval is within said predetermined threshold interval; determining if atrial depolarization occurs before ventricular depolarization but before the end of the ventricular electrogram if said A-V time interval is outside of said predetermined threshold interval; declaring that the heart is in A-V nodal reentry if atrial depolarization occur before ventricular depolarization but before the end of the ventricular electrogram;
Claim 3
Dependent Claim
67 words
Implantable antitachycardia cardioverter/defibrillator according to claim 2, wherein said second stage further comprises the steps of: comparing a V-A time interval between ventricular depolarization and atrial depolarization with a predetermined threshold value if atrial depolarizations do not occur before ventricular depolarizations; and declaring that the heart is in atrial tachycardia, A-V nodal reentry or ventricular tachycardia if said V-A interval is less than said predetermined threshold value.
Claim 4
Dependent Claim
123 words
Implantable antitachycardia cardioverter/defibrillator according to claim 1, wherein said step of pacing of said third stage comprises the step of pacing an atrium of the heart at said predetermined rate for said predetermined period of time, and said step of monitoring comprises the steps of determining if the ventricular depolarization rate accelerates or does not change during said step of pacing, and said step of declaring of said third stage comprises the steps of declaring that the heart is in ventricular tachycardia if the ventricular depolarization rate does not change, declaring that the heart is in atrial tachycardia if the ventricular depolarization rate accelerates, or declaring that the heart is in A-V nodal reentry or ventricular tachycardia if the ventricular depolarization rate decelerates.
Claim 5
Dependent Claim
92 words
Implantable antitachycardia cardioverter/defibrillator according to claim 4, wherein said step of monitoring after pacing of said third stage comprises the step of comparing an A-V time interval after pacing with said baseline value, and said step of declaring comprises the step of declaring that the heart is in sinus tachycardia if said A-V time interval after pacing differs from said baseline value by said predetermined amount or declaring that the heart is in atrial tachycardia if said A-V time interval after pacing differs from said baseline value more than said predetermined amount.
Claim 6
Dependent Claim
129 words
Implantable antitachycardia cardioverter/defibrillator according to claim 4, wherein said step of monitoring after pacing further comprises the steps of: determining if said A-V time interval is within a predetermined threshold interval if said A-V time interval differs from said baseline value by more than said predetermined amount; comparing a V-A time interval between ventricular depolarization and atrial depolarization with a predetermined threshold value if atrial depolarizations do not occur before ventricular depolarizations; and wherein said step of declaring further comprises the steps of: declaring that the heart is in atrial tachycardia, A-V nodal reentry or ventricular tachycardia if said V-A interval is less than said predetermined threshold value; and declaring that the heart is in A-V nodal reentry if said A-V time interval is within said predetermined threshold interval.
Claim 7
Dependent Claim
123 words
Implantable antitachycardia cardioverter/defibrillator according to claim 1, wherein said step of pacing of said third stage comprises the step of pacing a ventricle of the heart at said predetermined rate for said predetermined period of time, and said step of monitoring comprises the steps of determining if the ventricular depolarization rate accelerates or does not change during said step of pacing, and said step of declaring of said third stage comprises the steps of declaring that the heart is in ventricular tachycardia if the ventricular depolarization rate does not change, declaring that the heart is in atrial tachycardia if the ventricular depolarization rate accelerates, or declaring that the depolarization is in A-V nodal reentry or ventricular tachycardia if the ventricular heart rate decelerates.
Claim 8
Dependent Claim
86 words
Implantable antitachycardia cardioverter/defibrillator according to claim 7, wherein said step of monitoring after pacing comprises the step of comparing an A-V time interval with said baseline value, and said step of declaring comprises the step of declaring that the heart is in sinus tachycardia if said A-V time interval after pacing differs from said baseline value by said predetermined amount or declaring that the heart is in atrial tachycardia if said A-V time interval after pacing differs from said baseline value more than said predetermined amount.
Claim 9
Dependent Claim
129 words
Implantable antitachycardia cardioverter/defibrillator according to claim 7, wherein said step of monitoring after pacing further comprises the steps of: determining if said A-V time interval is within a predetermined threshold interval if said A-V time interval differs from said baseline value by more than said predetermined amount; comparing a V-A time interval between ventricular depolarization and atrial depolarization with a predetermined threshold value if atrial depolarizations do not occur before ventricular depolarizations; and wherein said step of declaring further comprises the steps of: declaring that the heart is in atrial tachycardia, A-V nodal reentry or ventricular tachycardia if said V-A interval is less than said predetermined threshold value; and declaring that the heart is in A-V nodal reentry if said A-V time interval is within said predetermined threshold interval.
Claim 10
Dependent Claim
27 words
Implantable antitachycardia cardioverter/defibrillator according to claim 1, wherein said predetermined rate of said step of pacing is a predetermined amount above a tachycardia rate of the heart.
Claim 11
Dependent Claim
68 words
Implantable antitachycardia cardioverter/defibrillator which senses cardiac activity and classifies heart rhythm comrising the steps of: pacing the heart at a predetermined rate for a predetermined period of time; monitoring the response to said step of pacing during and after said predetermined period of time; and declaring the heart condition based on the response of the heart during said step of pacing and after said predetermined period of time.
Claim 12
Dependent Claim
88 words
Implantable antitachycardia cardioverter/defibrillator according to claim 11, wherein said step of monitoring after pacing comprises the step of comparing an A-V time interval after pacing with a baseline value, and said step of declaring comprises the step of declaring that the heart is in sinus tachycardia if said A-V time interval after pacing differs from said baseline value by said predetermined amount or declaring that the heart is in atrial tachycardia if said A-V time interval after pacing differs from said baseline value more than said predetermined amount.
Claim 13
Dependent Claim
129 words
Implantable antitachycardia cardioverter/defibrillator according to claim 11, wherein said step of monitoring after pacing further comprises the steps of: determining if said A-V time interval is within a predetermined threshold interval if said A-V time interval differs from a baseline value by more than said predetermined amount; comparing a V-A time interval between ventricular depolarization and atrial depolarization with a predetermined threshold value if atrial depolarizations do not occur before ventricular depolarizations; and wherein said step of declaring further comprises the steps of: declaring that the heart is in atrial tachycardia, A-V nodal reentry or ventricular tachycardia if said V-A interval is less than said predetermined threshold value; and declaring that the heart is in A-V nodal reentry if said A-V time interval is within said predetermined threshold interval.
Claim 14
Dependent Claim
115 words
Implantable antitachycardia cardioverter/defibrillator according to claim 11, wherein said step of pacing comprises the step of pacing a ventricle of the heart at said predetermined rate for said predetermined period of time, and said step of monitoring comprises the steps of determining if the ventricular depolarization rate accelerates or does not change during said step of pacing, and said step of declaring comprises the steps of declaring that the heart is in ventricular tachycardia if the ventricular depolarization rate does not change, declaring that the heart is in atrial tachycardia if the ventricular depolarization rate accelerates, or declaring that the heart is in A-V nodal reentry or ventricular tachycardia if the ventricular depolarization rate decelerates.
References Cited (Backward Citations)
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