US5191884A — Reconfirmation prior to shock for implantable def…

Claim 1

Independent Claim 147 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said reconfirmation means confirming the presence of said tachyarrhythmia at a first predetermined time after detection of said tachyarrhythmia by said detection means, and reconfirming the presence of said tachyarrhythmia at a second time after detection by said detection means, said second time being no greater than a second predetermined time after said first time.

Claim 2

Independent Claim 147 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said reconfirmation means confirming the presence of said tachyarrhythmia at a first predetermined time after detection of said tachyarrhythmia by said detection means, and reconfirming the presence of said tachyarrhythmia at a second time after detection by said detection means, said second time being no greater than a second predetermined time after said first time.

Claim 3

Dependent Claim 86 words

The apparatus of claim 1, wherein said shock means includes at least one capacitor, a discharge means for discharging to the heart energy stored in said at least one capacitor, and means for supplying over time, a predetermined quantity of energy to said at least one capacitor, and wherein said second predetermined time coincides with termination of the earlier of a fixed interval after detection by said detection means or an interval required to supply said predetermined quantity of energy to said at least one capacitor.

Claim 4

Independent Claim 147 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said detection means comprising: means for defining a tachycardia detection window for sensed events; means for determining whether at least a predetermined portion of said sensed events fall within said window; and means for providing an output signal to said reconfirmation means when at least said predetermined portion of sensed events fall within said window.

Claim 5

Independent Claim 147 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said detection means comprising: means for defining a tachycardia detection window for sensed events; means for determining whether at least a predetermined portion of said sensed events fall within said window; and means for providing an output signal to said reconfirmation means when at least said predetermined portion of sensed events fall within said window.

Claim 6

Dependent Claim 22 words

The apparatus of claim 3, wherein said predetermined portion is equal to six out of a last seven of said sensed events.

Claim 7

Independent Claim 198 words

A method for treating tachyarrhythmias of the heart comprising the steps of: a) detecting a tachyarrhythmia; b) reconfirming whether said tachyarrhythmia exists at at least one time after detecting said tachyarrhythmia; and c) delivering a shock to the heart only if at said step of reconfirming whether said tachyarrhythmia exists, a presence of said tachyarrhythmia is reconfirmed, one of said at least one times being immediately prior to delivering said shock, said method further comprising the steps of: commencing charging of a capacitor when said tachyarrhythmia is detected; reconfirming the presence of said tachyarrhythmia at a first predetermined time; and discharging the charge on said capacitor to a load other than the heart if said presence of said tachyarrhythmia is not confirmed at said first time, said method still further comprising the steps of: again reconfirming the presence of said tachyarrhythmia at a second time, said second time being a shorter of a second predetermined time or the time required for said capacitor to charge to a predetermined energy level, and supplying a shock to the patient by discharging said capacitor into the heart if said tachyarrhythmia is present at said first time and at said second time.

Claim 8

Independent Claim 198 words

A method for treating tachyarrhythmias of the heart comprising the steps of: a) detecting a tachyarrhythmia; b) reconfirming whether said tachyarrhythmia exists at at least one time after detecting said tachyarrhythmia; and c) delivering a shock to the heart only if at said step of reconfirming whether said tachyarrhythmia exists, a presence of said tachyarrhythmia is reconfirmed, one of said at least one times being immediately prior to delivering said shock, said method further comprising the steps of: commencing charging of a capacitor when said tachyarrhythmia is detected; reconfirming the presence of said tachyarrhythmia at a first predetermined time; and discharging the charge on said capacitor to a load other than the heart if said presence of said tachyarrhythmia is not confirmed at said first time, said method still further comprising the steps of: again reconfirming the presence of said tachyarrhythmia at a second time, said second time being a shorter of a second predetermined time or the time required for said capacitor to charge to a predetermined energy level, and supplying a shock to the patient by discharging said capacitor into the heart if said tachyarrhythmia is present at said first time and at said second time.

Claim 9

Dependent Claim 30 words

The method of claim 5, further comprising the step of discharging the capacitor to a load other than the heart if said tachyarrhythmia is not present at said second time.

Claim 10

Dependent Claim 43 words

The method of claim 5, further comprising the steps of: again charging said capacitor after said defibrillation shock is delivered to the heart, said charging being to a higher energy level than that of said first shock, and repeating steps a) to c).

Claim 11

Dependent Claim 39 words

The method of claim 7, further comprising repeating recharging said capacitor to a higher energy level and steps a) to c) until the earlier of when said tachyarrhythmia has reverted or a predetermined number of shocks have been delivered.

Claim 12

Dependent Claim 20 words

The method of claim 8, wherein said predetermined number of shocks is selected to be between four and seven shocks.

Claim 13

Dependent Claim 39 words

The method of claim 7, further comprising, subsequent to delivering said shocks and prior to again charging said capacitor, the step of: again determining whether said tachyarrhythmia exists, and if said tachyarrhythmia is not present, again detecting subsequent tachyarrhythmias.

Claim 14

Independent Claim 123 words

A method for treating tachyarrhythmias of the heart comprising the steps of: a) detecting a tachyarrhythmia; b) reconfirming whether said tachyarrhythmia exists at at least one time after detecting said tachyarrhythmia; and c) delivering a shock to the heart only if at said step of reconfirming whether said tachyarrhythmia exists, a presence of said tachyarrhythmia is confirmed, one of said at least one times being immediately prior to delivering said shock, said step of confirming whether a tachyarrhythmia exists comprising: sensing a series of events of the heart; defining a tachycardia window during which a number of sensed events of the heart occurs; and recognizing the presence of a tachyarrhythmia if a predetermined portion of said sensed evens occur within said tachycardia window.

Claim 15

Independent Claim 123 words

A method for treating tachyarrhythmias of the heart comprising the steps of: a) detecting a tachyarrhythmia; b) reconfirming whether said tachyarrhythmia exists at at least one time after detecting said tachyarrhythmia; and c) delivering a shock to the heart only if at said step of reconfirming whether said tachyarrhythmia exists, a presence of said tachyarrhythmia is confirmed, one of said at least one times being immediately prior to delivering said shock, said step of confirming whether a tachyarrhythmia exists comprising: sensing a series of events of the heart; defining a tachycardia window during which a number of sensed events of the heart occurs; and recognizing the presence of a tachyarrhythmia if a predetermined portion of said sensed evens occur within said tachycardia window.

Claim 16

Dependent Claim 18 words

The method of claim 11, wherein said predetermined portion is six out of a seven last sensed events.

Claim 17

Independent Claim 180 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said shock means including: an energy storage means; a discharge means for discharging to the heart energy stored in said storage means; and means for supplying energy to said energy storage means; said apparatus further comprising: monitoring means for monitoring a value of energy supplied to said energy storage means; and comparison means for comparing said value to a predetermined value, said comparison means being for controlling said reconfirmation means to reconfirm the presence of the tachyarrhythmia when said value of energy supplied to said energy storage means reaches said predetermined value.

Claim 18

Independent Claim 180 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of said shock means, said reconfirmation means controlling said shock means so that only if the presence of said tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said shock means including: an energy storage means; a discharge means for discharging to the heart energy stored in said storage means; and means for supplying energy to said energy storage means; said apparatus further comprising: monitoring means for monitoring a value of energy supplied to said energy storage means; and comparison means for comparing said value to a predetermined value, said comparison means being for controlling said reconfirmation means to reconfirm the presence of the tachyarrhythmia when said value of energy supplied to said energy storage means reaches said predetermined value.

Claim 19

Independent Claim 128 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of the tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said detection means continuously detecting for said tachyarrhythmia and continuously providing an output indicative of detection thereof, and said reconfirmation means being responsive to said continuously provided output to determine whether a tachyarrhythmia is still present.

Claim 20

Independent Claim 128 words

An apparatus for treating a tachyarrhythmia of the heart comprising: detection means for detecting a tachyarrhythmia; shock means for delivering a shock to the heart; and reconfirmation means for confirming a presence of the tachyarrhythmia subsequent to detection by said detection means and for reconfirming the presence of the tachyarrhythmia immediately prior to delivery of a shock by said shock means, said reconfirmation means controlling said shock means so that only if the presence of the tachyarrhythmia is both confirmed and reconfirmed does said shock means deliver said shock to the heart, said detection means continuously detecting for said tachyarrhythmia and continuously providing an output indicative of detection thereof, and said reconfirmation means being responsive to said continuously provided output to determine whether a tachyarrhythmia is still present.

Annuity Stage	Window Opens	Payment Deadline	Surcharge Period Until	Estimated Fee	Status
3.5 Years (Year 4)	1996-03-08	1996-09-07	1997-03-09	$2000.00	Window Closed / Lapsed
7.5 Years (Year 8)	2000-03-08	2000-09-07	2001-03-09	$3760.00	Window Closed / Lapsed
11.5 Years (Year 12)	2004-03-08	2004-09-07	2005-03-09	$7700.00	Window Closed / Lapsed

Reconfirmation prior to shock for implantable defibrillation

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