WO2004091719A3 - Multi-parameter arrhythmia discrimination - Google Patents

Multi-parameter arrhythmia discrimination Download PDF

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Publication number
WO2004091719A3
WO2004091719A3 PCT/US2004/010917 US2004010917W WO2004091719A3 WO 2004091719 A3 WO2004091719 A3 WO 2004091719A3 US 2004010917 W US2004010917 W US 2004010917W WO 2004091719 A3 WO2004091719 A3 WO 2004091719A3
Authority
WO
WIPO (PCT)
Prior art keywords
signals
arrhythmia
alternate
electrocardiogram
discriminate
Prior art date
Application number
PCT/US2004/010917
Other languages
French (fr)
Other versions
WO2004091719A2 (en
Inventor
Paul Haefner
Darrell Orvin Wagner
Apurv Kamath
Marina Brockway
Original Assignee
Cardiac Pacemakers Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US10/804,471 external-priority patent/US7218966B2/en
Priority claimed from US10/816,464 external-priority patent/US7117035B2/en
Priority claimed from US10/817,749 external-priority patent/US7302294B2/en
Application filed by Cardiac Pacemakers Inc filed Critical Cardiac Pacemakers Inc
Priority to EP04759318A priority Critical patent/EP1615692A2/en
Priority to JP2006509836A priority patent/JP4521396B2/en
Publication of WO2004091719A2 publication Critical patent/WO2004091719A2/en
Publication of WO2004091719A3 publication Critical patent/WO2004091719A3/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A61B5/0086—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters using infrared radiation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02028—Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/1459—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters invasive, e.g. introduced into the body by a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N1/0565—Electrode heads
    • A61N1/0568—Electrode heads with drug delivery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/36585—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by two or more physical parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
    • A61N1/39622—Pacing therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14552—Details of sensors specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/361—Detecting fibrillation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/363—Detecting tachycardia or bradycardia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0587—Epicardial electrode systems; Endocardial electrodes piercing the pericardium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
    • A61N1/36542—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by body motion, e.g. acceleration

Abstract

An arrhythmia discrimination device and method involves receiving electrocardiogram signals and alternate signals at subcutaneous locations. Both the electrocardiogram signals and alternate signals are used to discriminate between normal sinus rhythm an arrhythmia. An arrhythmia may be detected using electrocardiogram signals, and verified using the alternate signals. A detection window may be initiated in response to receiving the electrocardiogram signal, and used to determine whether the alternate signal is received at a time falling with the detection window. Heart rates may be computed based on both the electrocardiogram signals and alternate signals. The rates may be used to discriminate between normal sinus rhythm and arrhythmia, and used to determining absence of an arrhythmia.
PCT/US2004/010917 2003-04-11 2004-04-09 Multi-parameter arrhythmia discrimination WO2004091719A2 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP04759318A EP1615692A2 (en) 2003-04-11 2004-04-09 Multi-parameter arrhythmia discrimination
JP2006509836A JP4521396B2 (en) 2003-04-11 2004-04-09 Implantable subcutaneous device and cardiac stimulation device

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US46227203P 2003-04-11 2003-04-11
US60/462,272 2003-04-11
US10/804,471 US7218966B2 (en) 2003-04-11 2004-03-19 Multi-parameter arrhythmia discrimination
US10/804,471 2004-03-19
US10/816,464 2004-04-01
US10/816,464 US7117035B2 (en) 2003-04-11 2004-04-01 Subcutaneous cardiac stimulation system with patient activity sensing
US10/817,749 2004-04-02
US10/817,749 US7302294B2 (en) 2003-04-11 2004-04-02 Subcutaneous cardiac sensing and stimulation system employing blood sensor

Publications (2)

Publication Number Publication Date
WO2004091719A2 WO2004091719A2 (en) 2004-10-28
WO2004091719A3 true WO2004091719A3 (en) 2004-12-29

Family

ID=33304108

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2004/010917 WO2004091719A2 (en) 2003-04-11 2004-04-09 Multi-parameter arrhythmia discrimination

Country Status (3)

Country Link
EP (1) EP1615692A2 (en)
JP (1) JP4521396B2 (en)
WO (1) WO2004091719A2 (en)

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US8346332B2 (en) 2009-06-10 2013-01-01 Medtronic, Inc. Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction
US8391979B2 (en) 2009-06-10 2013-03-05 Medtronic, Inc. Shock reduction using absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction

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US7174203B2 (en) * 2004-11-18 2007-02-06 Inovise Medical, Inc. Method and system relating to monitoring and characterizing heart condition
US7333855B2 (en) * 2004-12-01 2008-02-19 Medtronic, Inc. Method and apparatus for determining oversensing in a medical device
US9089691B2 (en) 2004-12-07 2015-07-28 Cardiac Pacemakers, Inc. Stimulator for auricular branch of vagus nerve
US7805191B2 (en) 2005-01-31 2010-09-28 Physio-Control, Inc. CPR time indicator for a defibrillator data management system
US7615012B2 (en) * 2005-08-26 2009-11-10 Cardiac Pacemakers, Inc. Broadband acoustic sensor for an implantable medical device
US7742815B2 (en) * 2005-09-09 2010-06-22 Cardiac Pacemakers, Inc. Using implanted sensors for feedback control of implanted medical devices
WO2007053820A1 (en) * 2005-10-31 2007-05-10 Medtronic, Emergency Response Systems, Inc. Motion detection system for an external defibrillator
US20080306565A1 (en) * 2005-12-16 2008-12-11 Nils Holmstrom Medical Device
US7844331B2 (en) * 2005-12-20 2010-11-30 Cardiac Pacemakers, Inc. Method and apparatus for controlling anti-tachyarrhythmia pacing using hemodynamic sensor
US7912548B2 (en) 2006-07-21 2011-03-22 Cardiac Pacemakers, Inc. Resonant structures for implantable devices
EP2043740A2 (en) 2006-07-21 2009-04-08 Cardiac Pacemakers, Inc. Ultrasonic transducer for a metallic cavity implanted medical device
WO2008106608A1 (en) 2007-02-28 2008-09-04 Medtronic, Inc. Implantable tissue perfusion sensing system and method
US8755892B2 (en) 2007-05-16 2014-06-17 Cardiac Pacemakers, Inc. Systems for stimulating neural targets
AU2008266678B2 (en) 2007-06-14 2013-06-20 Cardiac Pacemakers, Inc. Multi-element acoustic recharging system
US8165676B2 (en) 2007-12-21 2012-04-24 Medtronic, Inc. Optical sensor and method for detecting a patient condition
US8260415B2 (en) * 2007-12-21 2012-09-04 Medtronic, Inc. Optical sensor and method for detecting a patient condition
US8452402B2 (en) 2008-04-23 2013-05-28 Medtronic, Inc. Optical sensing device for use in a medical device
WO2009154758A2 (en) 2008-06-19 2009-12-23 Cardiac Pacemakers, Inc. Cardiac rhythm management system with hemodynamic tolerability analyzer
US8273032B2 (en) * 2008-07-30 2012-09-25 Medtronic, Inc. Physiological parameter monitoring with minimization of motion artifacts
WO2010083366A1 (en) 2009-01-15 2010-07-22 Medtronic, Inc. Implantable medical device with adaptive signal processing and artifact cancellation
US8391944B2 (en) 2009-01-15 2013-03-05 Medtronic, Inc. Implantable medical device with adaptive signal processing and artifact cancellation
EP2411092B1 (en) 2009-03-23 2017-03-08 Medtronic, Inc Combined hemodynamic and egm-based arrhythmia detection
US8352008B2 (en) 2009-06-10 2013-01-08 Medtronic, Inc. Active noise cancellation in an optical sensor signal
WO2010144652A1 (en) 2009-06-10 2010-12-16 Medtronic, Inc. Tissue oxygenation monitoring in heart failure
WO2010144670A1 (en) 2009-06-10 2010-12-16 Medtronic, Inc. Device and method for monitoring of absolute oxygen saturation and tissue hemoglobin concentration
AU2010273710B2 (en) 2009-06-29 2016-05-26 Cameron Health, Inc. Adaptive confirmation of treatable arrhythmia in implantable cardiac stimulus devices
US20110066017A1 (en) 2009-09-11 2011-03-17 Medtronic, Inc. Method and apparatus for post-shock evaluation using tissue oxygenation measurements
US8781547B2 (en) 2011-10-28 2014-07-15 Medtronic, Inc. Method and apparatus for calibrating an absolute oxygen saturation sensor
US11051746B2 (en) 2014-08-14 2021-07-06 Cardiac Pacemakers, Inc. Atrial fibrillation detection using ventricular rate variability
JP6525461B2 (en) 2015-04-02 2019-06-05 カーディアック ペースメイカーズ， インコーポレイテッド Device and computer readable medium for detecting atrial fibrillation
US9901741B2 (en) 2015-05-11 2018-02-27 Physio-Control, Inc. Wearable cardioverter defibrillator (WCD) system using sensor modules with reassurance code for confirmation before shock
US10716500B2 (en) 2015-06-29 2020-07-21 Cardiac Pacemakers, Inc. Systems and methods for normalization of chemical sensor data based on fluid state changes
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US10470681B2 (en) * 2016-07-27 2019-11-12 Medtronic, Inc. Cardiac electrical signal noise detection for tachyarrhythmia episode rejection
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Publication number Priority date Publication date Assignee Title
US8346332B2 (en) 2009-06-10 2013-01-01 Medtronic, Inc. Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction
US8391979B2 (en) 2009-06-10 2013-03-05 Medtronic, Inc. Shock reduction using absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction

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Publication number Publication date
JP2006524106A (en) 2006-10-26
EP1615692A2 (en) 2006-01-18
JP4521396B2 (en) 2010-08-11
WO2004091719A2 (en) 2004-10-28

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