EP1615692A2 - Multi-parameter arrhythmia discrimination - Google Patents
Multi-parameter arrhythmia discriminationInfo
- Publication number
- EP1615692A2 EP1615692A2 EP04759318A EP04759318A EP1615692A2 EP 1615692 A2 EP1615692 A2 EP 1615692A2 EP 04759318 A EP04759318 A EP 04759318A EP 04759318 A EP04759318 A EP 04759318A EP 1615692 A2 EP1615692 A2 EP 1615692A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- signal
- cardiac
- arrhythmia
- signals
- electrocardiogram
- Prior art date
- Legal status (The legal status 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 status listed.)
- Withdrawn
Links
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Classifications
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Definitions
- the energy delivery circuitry may include one or both of defibrillation therapy circuitry and pacing therapy circuitry.
- the sensor may be provided in or on the housing, and/or in or on a lead coupled to the housing.
- sensing circuitry 204 and noise reduction circuitry 203 may be useful to minimize the necessary componentry and lower the power requirements of the system.
- FIGS 1 A- 1E The components, functionality, and structural configurations depicted in Figures 1 A- 1E are intended to provide an understanding of various features and combination of features that may be incorporated in an ITCS device. It is understood that a wide variety of ITCS and other implantable cardiac monitoring and/or stimulation device configurations are contemplated, ranging from relatively sophisticated to relatively simple designs. As such, particular ITCS or cardiac monitoring and/or stimulation device configurations may include particular features as described herein, while other such device configurations may exclude particular features described herein.
- an ITCS device may use . an alternate signal to identify cardiac signals within a group of separated signals, such as those obtained. from a blind source separation (BSS) technique.
- BSS blind source separation
- the patient activity signal 1420 is, in this case, derived from a cardiac electrode arrangement preferentially located to provide a signal indicative of skeletal muscle activity. Note that the patient activity signal 1420 includes a significant ECG component, but that muscle movement is clearly identifiable witliin at least a muscle noise detect window 1440.
- a blood sensor is used to provide an alternate signal for arrhythmia discrimination and verification.
- Electrocardiogram signals often contain noise signals and artifacts that mimic true cardiac signals and various aiThythmias.
- Using a blood sensor as an alternate sensor in accordance with the present invention provides the ability to discriminate true arrhythmia conditions from various noisy conditions.
- using a blood sensor as an alternate sensor in accordance with the present invention provides the ability to confirm that the signals upon which arrhythmia detection and therapy delivery decisions are made contain a cardiac signal (e.g., a QRS complex), rather than a spurious signal that may have features similar to those of a true cardiac signal.
- a cardiac signal e.g., a QRS complex
- a subcutaneous photoplethysmogram is used to confirm or verify that the cardiac signal used for cardiac rhythm analysis is indeed a cardiac signal, rather than a spurious signal, such as a skeletal noise signal.
- the subcutaneous photoplethysmogram may be used to verify that the cardiac signal used to make tachyarrythmia therapy delivery decisions is an electrocardiogram indicative of the patient's actual heart rhythm.
- the subcutaneous photoplethysmogram is used primarily for verifying that the signal used for arrhythmia analysis and therapy delivery decisions is indeed the cardiac signal, which is distinct from using this signal to separately verify the presence or absence of an arrhythmia. It is understood, however, that the subcutaneous photoplethysmogram may be used as a signal to separately verify the presence or absence of an arrhythmia, exclusively or in addition to using tins signal for cardiac signal confirmation.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Physiology (AREA)
- Chemical & Material Sciences (AREA)
- Vascular Medicine (AREA)
- Medicinal Chemistry (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Spectroscopy & Molecular Physics (AREA)
- Optics & Photonics (AREA)
- Electrotherapy Devices (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
- Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US46227203P | 2003-04-11 | 2003-04-11 | |
| US10/804,471 US7218966B2 (en) | 2003-04-11 | 2004-03-19 | Multi-parameter arrhythmia discrimination |
| US10/816,464 US7117035B2 (en) | 2003-04-11 | 2004-04-01 | Subcutaneous cardiac stimulation system with patient activity sensing |
| US10/817,749 US7302294B2 (en) | 2003-04-11 | 2004-04-02 | Subcutaneous cardiac sensing and stimulation system employing blood sensor |
| PCT/US2004/010917 WO2004091719A2 (en) | 2003-04-11 | 2004-04-09 | Multi-parameter arrhythmia discrimination |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| EP1615692A2 true EP1615692A2 (en) | 2006-01-18 |
Family
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP04759318A Withdrawn EP1615692A2 (en) | 2003-04-11 | 2004-04-09 | Multi-parameter arrhythmia discrimination |
Country Status (3)
| Country | Link |
|---|---|
| EP (1) | EP1615692A2 (enExample) |
| JP (1) | JP4521396B2 (enExample) |
| WO (1) | WO2004091719A2 (enExample) |
Families Citing this family (53)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7174203B2 (en) * | 2004-11-18 | 2007-02-06 | Inovise Medical, Inc. | Method and system relating to monitoring and characterizing heart condition |
| ATE556648T1 (de) | 2004-11-24 | 2012-05-15 | Remon Medical Technologies Ltd | Implantierbares medizinprodukt mit integriertem akustischem wandler |
| US7333855B2 (en) * | 2004-12-01 | 2008-02-19 | Medtronic, Inc. | Method and apparatus for determining oversensing in a medical device |
| US7522962B1 (en) | 2004-12-03 | 2009-04-21 | Remon Medical Technologies, Ltd | Implantable medical device with integrated acoustic transducer |
| 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 |
| US7570998B2 (en) | 2005-08-26 | 2009-08-04 | Cardiac Pacemakers, Inc. | Acoustic communication transducer in implantable medical device header |
| 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 |
| WO2007069963A1 (en) * | 2005-12-16 | 2007-06-21 | St. Jude Medical Ab | Implantable medical device with condition detection |
| US7844331B2 (en) * | 2005-12-20 | 2010-11-30 | Cardiac Pacemakers, Inc. | Method and apparatus for controlling anti-tachyarrhythmia pacing using hemodynamic sensor |
| JP2009544366A (ja) | 2006-07-21 | 2009-12-17 | 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 | 金属製キャビティが植え込まれた医療器具に用いる超音波トランスデューサ |
| US7912548B2 (en) | 2006-07-21 | 2011-03-22 | Cardiac Pacemakers, Inc. | Resonant structures for implantable devices |
| ATE493064T1 (de) | 2007-02-28 | 2011-01-15 | Medtronic Inc | Implantierbares gewebeperfusions-messsystem |
| US8755892B2 (en) | 2007-05-16 | 2014-06-17 | Cardiac Pacemakers, Inc. | Systems for stimulating neural targets |
| EP2162185B1 (en) | 2007-06-14 | 2015-07-01 | 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 |
| EP2303401B1 (en) | 2008-06-19 | 2016-11-23 | 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 |
| US8391944B2 (en) | 2009-01-15 | 2013-03-05 | Medtronic, Inc. | Implantable medical device with adaptive signal processing and artifact cancellation |
| US8706202B2 (en) | 2009-01-15 | 2014-04-22 | Medtronic, Inc. | Implantable medical device with adaptive signal processing and artifact cancellation |
| US8200329B2 (en) | 2009-03-23 | 2012-06-12 | Medtronic, Inc. | Combined hemodynamic and EGM-based arrhythmia detection |
| WO2010144667A1 (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 |
| WO2010144662A1 (en) | 2009-06-10 | 2010-12-16 | Medtronic, Inc. | Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction |
| US8352008B2 (en) | 2009-06-10 | 2013-01-08 | Medtronic, Inc. | Active noise cancellation in an optical sensor signal |
| US9126049B2 (en) | 2009-06-10 | 2015-09-08 | Medtronic, Inc. | Shock reduction using absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction |
| CA2766866A1 (en) | 2009-06-29 | 2011-01-20 | 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 |
| AU2015301633B2 (en) | 2014-08-14 | 2018-05-17 | Cardiac Pacemakers, Inc. | Atrial fibrillation detection using ventricular rate variability |
| WO2016160674A1 (en) | 2015-04-02 | 2016-10-06 | Cardiac Pacemakers, Inc. | Atrial fibrillation detection |
| 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 |
| WO2017079245A1 (en) | 2015-11-06 | 2017-05-11 | Cardiac Pacemakers, Inc. | System for enhanced atrial fibrillation detection |
| KR101777583B1 (ko) | 2015-12-02 | 2017-09-13 | 한양대학교 에리카산학협력단 | 심전도 신호 처리 방법 및 그 장치 |
| US10149981B2 (en) * | 2016-05-03 | 2018-12-11 | Cardiac Pacemakers, Inc. | Authentication of shock therapy deferral |
| US10470681B2 (en) * | 2016-07-27 | 2019-11-12 | Medtronic, Inc. | Cardiac electrical signal noise detection for tachyarrhythmia episode rejection |
| WO2018164840A1 (en) | 2017-03-07 | 2018-09-13 | Cardiac Pacemakers, Inc. | Post-hoc atrial fibrillation detection |
| CN108968976B (zh) | 2017-05-31 | 2022-09-13 | 心脏起搏器股份公司 | 具有化学传感器的植入式医疗设备 |
| US12004853B2 (en) | 2017-07-26 | 2024-06-11 | Cardiac Pacemakers, Inc. | Systems and methods for disambiguation of posture |
| CN109381195B (zh) | 2017-08-10 | 2023-01-10 | 心脏起搏器股份公司 | 包括电解质传感器融合的系统和方法 |
| CN109419515B (zh) | 2017-08-23 | 2023-03-24 | 心脏起搏器股份公司 | 具有分级激活的可植入化学传感器 |
| CN109864746B (zh) | 2017-12-01 | 2023-09-29 | 心脏起搏器股份公司 | 用于医学装置的多模式分析物传感器 |
| CN109864747B (zh) | 2017-12-05 | 2023-08-25 | 心脏起搏器股份公司 | 多模式分析物传感器光电子接口 |
| EP3530180A1 (en) * | 2018-02-23 | 2019-08-28 | BIOTRONIK SE & Co. KG | Method and device for arrhythmia detection |
| CN113301849B (zh) | 2019-01-09 | 2024-11-15 | 心脏起搏器股份公司 | 用于增强心房纤颤检测的系统 |
| US11324954B2 (en) | 2019-06-28 | 2022-05-10 | Covidien Lp | Achieving smooth breathing by modified bilateral phrenic nerve pacing |
| US12076574B2 (en) | 2020-10-08 | 2024-09-03 | Cardiac Pacemakers, Inc. | Cardiac beat classification to avoid delivering shock during ventricular repolarization |
| JP7334991B2 (ja) * | 2021-04-22 | 2023-08-29 | 株式会社エイティセンス | 心電図データに係わる心音データを利用し、心電図データの異常信号区間を検出する生体信号測定装置及び生体信号測定方法 |
Family Cites Families (18)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5203348A (en) | 1990-06-06 | 1993-04-20 | Cardiac Pacemakers, Inc. | Subcutaneous defibrillation electrodes |
| US5184614A (en) * | 1990-10-19 | 1993-02-09 | Telectronics Pacing Systems, Inc. | Implantable haemodynamically responsive cardioverting/defibrillating pacemaker |
| US6144879A (en) * | 1991-05-17 | 2000-11-07 | Gray; Noel Desmond | Heart pacemaker |
| US5313953A (en) | 1992-01-14 | 1994-05-24 | Incontrol, Inc. | Implantable cardiac patient monitor |
| US5417714A (en) * | 1992-03-05 | 1995-05-23 | Pacesetter, Inc. | DDI pacing with PVC-protected hysteresis and automatic AV interval adjustment |
| US5342404A (en) * | 1992-04-03 | 1994-08-30 | Intermedics, Inc. | Implantable medical interventional device |
| US5496362A (en) | 1992-11-24 | 1996-03-05 | Cardiac Pacemakers, Inc. | Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillation |
| US5411031A (en) | 1993-11-24 | 1995-05-02 | Incontrol, Inc. | Implantable cardiac patient monitor |
| US5556421A (en) * | 1995-02-22 | 1996-09-17 | Intermedics, Inc. | Implantable medical device with enclosed physiological parameter sensors or telemetry link |
| US5995860A (en) * | 1995-07-06 | 1999-11-30 | Thomas Jefferson University | Implantable sensor and system for measurement and control of blood constituent levels |
| US5620466A (en) | 1995-08-14 | 1997-04-15 | Cardiac Pacemakers, Inc. | Digital AGC using separate gain control and threshold templating |
| US5662688A (en) | 1995-08-14 | 1997-09-02 | Cardiac Pacemakers, Inc. | Slow gain control |
| US5978707A (en) * | 1997-04-30 | 1999-11-02 | Cardiac Pacemakers, Inc. | Apparatus and method for treating ventricular tachyarrhythmias |
| US6198952B1 (en) * | 1998-10-30 | 2001-03-06 | Medtronic, Inc. | Multiple lens oxygen sensor for medical electrical lead |
| US6055454A (en) | 1998-07-27 | 2000-04-25 | Cardiac Pacemakers, Inc. | Cardiac pacemaker with automatic response optimization of a physiologic sensor based on a second sensor |
| US6044298A (en) | 1998-10-13 | 2000-03-28 | Cardiac Pacemakers, Inc. | Optimization of pacing parameters based on measurement of integrated acoustic noise |
| US6904319B2 (en) * | 2001-04-06 | 2005-06-07 | Cardiac Pacemakers, Inc. | Method and apparatus for inhibiting atrial tachyarrhythmia therapy |
| EP1423163B1 (en) * | 2001-08-30 | 2012-04-25 | Medtronic, Inc. | System for detecting myocardial ischemia |
-
2004
- 2004-04-09 WO PCT/US2004/010917 patent/WO2004091719A2/en not_active Ceased
- 2004-04-09 JP JP2006509836A patent/JP4521396B2/ja not_active Expired - Fee Related
- 2004-04-09 EP EP04759318A patent/EP1615692A2/en not_active Withdrawn
Non-Patent Citations (1)
| Title |
|---|
| See references of WO2004091719A2 * |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2004091719A2 (en) | 2004-10-28 |
| JP2006524106A (ja) | 2006-10-26 |
| JP4521396B2 (ja) | 2010-08-11 |
| WO2004091719A3 (en) | 2004-12-29 |
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