JP2011505961A - 単極検知ベクトルを提供するシステム - Google Patents
単極検知ベクトルを提供するシステム Download PDFInfo
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- 239000013598 vector Substances 0.000 title claims abstract description 45
- 238000001514 detection method Methods 0.000 title abstract description 8
- 230000000747 cardiac effect Effects 0.000 claims description 6
- 238000000034 method Methods 0.000 claims description 5
- 210000005245 right atrium Anatomy 0.000 claims description 5
- 210000005241 right ventricle Anatomy 0.000 claims description 3
- 208000003734 Supraventricular Tachycardia Diseases 0.000 description 11
- 206010047302 ventricular tachycardia Diseases 0.000 description 9
- 230000033764 rhythmic process Effects 0.000 description 8
- 239000004020 conductor Substances 0.000 description 5
- 206010003119 arrhythmia Diseases 0.000 description 3
- 230000035939 shock Effects 0.000 description 3
- 210000002620 vena cava superior Anatomy 0.000 description 3
- 230000006793 arrhythmia Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 210000002837 heart atrium Anatomy 0.000 description 2
- 230000006794 tachycardia Effects 0.000 description 2
- 230000002861 ventricular Effects 0.000 description 2
- 208000001871 Tachycardia Diseases 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000001746 atrial effect Effects 0.000 description 1
- 230000036471 bradycardia Effects 0.000 description 1
- 239000003990 capacitor Substances 0.000 description 1
- 238000013194 cardioversion Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000011156 evaluation Methods 0.000 description 1
- 230000010247 heart contraction Effects 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 208000021816 ventricular bradycardia Diseases 0.000 description 1
- 208000003663 ventricular fibrillation Diseases 0.000 description 1
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- 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
- A61N1/37—Monitoring; Protecting
- A61N1/3702—Physiological parameters
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- 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]
- A61B5/339—Displays specially adapted therefor
- A61B5/341—Vectorcardiography [VCG]
-
- 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
- A61N1/18—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
- A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
- A61N1/3622—Heart stimulators for treating or preventing abnormally high heart rate comprising two or more electrodes co-operating with different heart regions
-
- 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
- A61N1/36592—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by the heart rate variability
-
- 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
- A61N1/3925—Monitoring; Protecting
-
- 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
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Abstract
Description
本明細書において、検知ベクトルという用語は、パルス発生器内の検知チャネルによって使用される2つの電極の位置によって説明される。検知チャネルは2つの電極間に存在する電気信号を用いて心臓活動を検知する。それぞれの検知ベクトルが、心臓信号のそれぞれの態様を検知チャネルに提示する。これらのベクトルは従来よりも大きなSVT乃至VTの信号を生成するため、本実施形態において、検知ベクトルはSVTを検知するための改善された性能を有する。
さらなる実施形態は、本明細書において説明する新たなベクトルから作成された異なるテンプレートを用いてもよい。この新たなテンプレートは、上述したテンプレートを用いて問題の症状を識別する能力をさらに提供し得る。したがって、より多くのベクトルの組合せからのより多くの情報は、より高い識別能力を生み出すであろう。
図2は、一実施形態に基づく上述のシステムの一部の概略図を示す。リードはコイル電極122とパルス発生器150内の電子装置201との間に接続された第1の導体202を含む。リードは遠位コイル電極120と電子装置201との間に接続された第2の導体203をさらに含む。缶電極151もまた電子装置201に接続される。電子装置201は、電極122及び120が缶電極151から電気的に絶縁されるようにする電気経路を含む。既述したように、電子装置201は様々な接続を自由に取り外し、又は接続することが可能であるように構成され得る。
Claims (20)
- 缶電極を含むパルス発生器と、
パルス発生器に接続可能であるとともに、遠位コイル電極及び近位コイル電極を有するリードとを含むシステムであって、
少なくとも一方のコイル電極と缶電極との間に単極検知ベクトルが提供されるように、両方のコイル電極が缶電極から電気的に切り離されるシステム。 - 検知ベクトルが遠位電極と缶電極との間に提供される請求項1に記載のシステム。
- 検知ベクトルが近位電極と缶電極との間に提供される請求項1に記載のシステム。
- 遠位コイル電極と近位コイル電極との間に第2の検知ベクトルが提供される請求項1に記載のシステム。
- パルス発生器は、遠位コイル電極及び缶電極と、近位電極及び缶電極との間で単極検知ベクトルが交互に生じるように構成される請求項1に記載のシステム。
- パルス発生器は、遠位コイル電極と缶電極との間の第1の単極検知ベクトル及び近位電極と缶電極との間の第2の単極検知ベクトルが同時に発生するように構成される請求項1に記載のシステム。
- パルス発生器は、単極検知ベクトルを用いてVTとSVTとを識別するように構成される請求項1に記載のシステム。
- 缶電極を含むパルス発生器と、
パルス発生器に接続可能であるとともに、遠位コイル電極及び近位コイル電極を有し、かつ先端ペーシング/検知電極及びリング電極をさらに有するリードとを含むシステムであって、
遠位電極と缶電極との間に単極検知ベクトルが提供されるように、近位コイル電極及び遠位コイル電極が缶電極から電気的に切り離されるシステム。 - 近位電極と缶電極との間に第2の単極検知ベクトルが提供される請求項8に記載のシステム。
- 遠位コイル電極と近位コイル電極との間に第3の検知ベクトルが提供される請求項8に記載のシステム。
- リードは、近位コイル電極が右心房に埋め込み可能であり、かつ遠位コイル電極が右心室に埋め込み可能であるように構成される請求項8に記載のシステム。
- パルス発生器は、単極検知ベクトルを用いてVTとSVTとを識別するように構成される請求項8に記載のシステム。
- ハウジング缶電極を含むパルス発生器と、
パルス発生器内に配置された電子装置と、
ハウジング缶電極と電子装置との間の電気的接続とを含む装置であって、
電子装置及び電気的接続は、リードがパルス発生器に接続されるとき、少なくとも一方のコイル電極と缶電極との間に単極検知ベクトルが提供されるように、リード上の遠位コイル電極が電気経路によってハウジング缶電極から電気的に切り離され、かつリード上の近位コイル電極がハウジング缶電極から電気的に切り離されるように構成されるシステム。 - パルス発生器は、遠位コイル電極と缶電極との間に単極検知ベクトルを提供するように構成される請求項13に記載の装置。
- パルス発生器は、近位電極と缶電極との間に単極検知ベクトルを提供するように構成される請求項13に記載の装置。
- 遠位コイル電極と近位コイル電極との間に第2の検知ベクトルが提供される請求項13に記載の装置。
- パルス発生器は、単極検知ベクトルを用いてVTとSVTとを識別するように構成される請求項13に記載の装置。
- 缶電極を含むパルス発生器を提供する工程と、
パルス発生器にリードを接続する工程であって、リードは缶電極から電気的に絶縁された少なくとも1つの近位コイル電極を含み、かつリードは電気的に絶縁された1つの遠位コイル電極を含む工程と、
近位コイル電極が右心房に配置され、かつ遠位コイル電極が右心室に配置されるようにリードを埋め込む工程と、
少なくとも1つのコイル電極と缶電極との間の単極検知ベクトルを用いて心臓信号を検知する工程と
を含む方法。 - 心臓信号を検知する工程が、SVT信号とVT信号とを識別する工程を含む請求項18に記載の方法。
- リードが1つ以上のペーシング及び検知電極の少なくとも一方を含む請求項18に記載の方法。
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US763507P | 2007-12-13 | 2007-12-13 | |
US61/007,635 | 2007-12-13 | ||
PCT/US2008/013069 WO2009075725A1 (en) | 2007-12-13 | 2008-11-24 | Supraventricular tachy sensing vector |
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JP2011505961A true JP2011505961A (ja) | 2011-03-03 |
JP5438687B2 JP5438687B2 (ja) | 2014-03-12 |
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US (3) | US20090157133A1 (ja) |
EP (1) | EP2231004B1 (ja) |
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WO2009075725A1 (en) | 2007-12-13 | 2009-06-18 | Cardiac Pacemakers, Inc. | Supraventricular tachy sensing vector |
US8903490B2 (en) * | 2010-03-03 | 2014-12-02 | Cardiac Pacemakers, Inc. | Methods and systems for recognizing arrhythmias using neural stimulation |
Citations (3)
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2008
- 2008-11-24 WO PCT/US2008/013069 patent/WO2009075725A1/en active Application Filing
- 2008-11-24 JP JP2010537922A patent/JP5438687B2/ja active Active
- 2008-11-24 EP EP08859089.8A patent/EP2231004B1/en active Active
- 2008-11-24 US US12/277,101 patent/US20090157133A1/en not_active Abandoned
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2016
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WO2009075725A1 (en) | 2009-06-18 |
EP2231004A1 (en) | 2010-09-29 |
EP2231004B1 (en) | 2018-01-03 |
US20170001020A1 (en) | 2017-01-05 |
US11504538B2 (en) | 2022-11-22 |
US20090157133A1 (en) | 2009-06-18 |
JP5438687B2 (ja) | 2014-03-12 |
US10350419B2 (en) | 2019-07-16 |
US20190290916A1 (en) | 2019-09-26 |
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