JPH11503038A - 優先順位付けルール・ベース方式を採用した不整脈の診断及び治療のための方法及び装置 - Google Patents
優先順位付けルール・ベース方式を採用した不整脈の診断及び治療のための方法及び装置Info
- Publication number
- JPH11503038A JPH11503038A JP8529569A JP52956996A JPH11503038A JP H11503038 A JPH11503038 A JP H11503038A JP 8529569 A JP8529569 A JP 8529569A JP 52956996 A JP52956996 A JP 52956996A JP H11503038 A JPH11503038 A JP H11503038A
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Classifications
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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
- A61N1/3621—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
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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
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
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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
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/29—Invasive for permanent or long-term implantation
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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]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/361—Detecting fibrillation
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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]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/363—Detecting tachycardia or bradycardia
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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
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
Abstract
Description
Claims (1)
- 【特許請求の範囲】 1.心臓組織の脱分極を検出する脱分極検出手段と、 優先順位付けした複数のルールから成る優先順位付けルール集合を規定するル ール集合規定手段であって、前記複数のルールの各々は、検出された心臓組織の 脱分極の特性に基づいた1つまたは複数の判定基準を規定したものであり、前記 複数のルールの各々は、当該ルールの判定基準が満足されたときに該当状態とな るものであり、前記複数のルールは、それらのうちの2つ以上が同時に該当状態 になることがあり得るように規定されている、前記ルール集合規定手段と、 前記検出された脱分極の特性を解析して前記複数のルールのうちのどのルール が該当状態にあるかを判定する解析手段と、 該当状態にある前記ルールのうちで最も優先順位の高いルールを判定する最高 優先順位ルール判定手段と、 前記複数のルールのうちの少なくとも1つのルールが、該当状態にあるルール のうちで最も優先順位の高いルールであることに応答して、抗不整脈治療用出力 を送出する手段と、 前記複数のルールのうちの少なくとも1つのルールが、該当状態にあるルール のうちで最も優先順位の高いルールであることに応答して、抗不整脈治療用出力 の送出を抑止する手段と、 を備えたことを特徴とする抗不整脈装置。 2.前記解析手段が、連続した所定個数の脱分極が検出される間に亙って、検 出されたそれら脱分極が前記判定基準のうちの1つまたは幾つかを満足している 状態が継続したか否かを判定する手段と、その判定結果に応答して前記複数のル ールのうちの1つのルールが該当状態にあると判定する手段とを含んでいること を特徴とする請求項1記載の抗不整脈装置。 3.前記解析手段が判定手段を含んでおり、該判定手段は、前記複数のルール のうちの1つのルールが該当状態になったことに応答して、それ以後、検出され た複数個の脱分極が前記判定基準のうちの1つを満足しなかった場合にのみ、前 記1つのルールが該当状態にないと判定する手段であることを特徴とする請求項 2記載の抗不整脈装置。 4.前記複数のルールのうちのある1つのルールが該当状態になるための判定 基準の1つが、前記複数のルールのうちの別の1つのルールが該当状態になるた めの判定基準の1つでもあることを特徴とする請求項1、2、または3記載の抗 不整脈装置。 5.前記複数のルールのうちのある1つのルールが該当状態になるための判定 基準の1つが、前記複数のルールのうちの別の1つのルールの判定基準の1つが どの程度に該当しているかというその該当の程度であることを特徴とする請求項 1、2、または3記載の抗不整脈装置。 6.前記複数のルールのうちのある1つのルールが該当状態になるための判定 基準の1つが、前記検出された脱分極が前記複数のルールのうちの別の1つのル ールに該当しないことであることを特徴とする請求項1、2、または3記載の抗 不整脈装置。 7.心臓組織の心房脱分極と心室脱分極とを検出する手段と、 1つの心室脱分極の検出時点から次の心室脱分極の検出時点までの期間である R−R期間の長さを測定する手段と、 1つの心室脱分極の検出時点から次の心房脱分極の検出時点までの期間である R−P期間の長さを測定する手段と、 前記R−R期間の長さの測定値と前記P−R期間の長さの測定値との共分散の 値を算出する手段と、 前記R−R期間の長さの測定値と前記P−R期間の長さの測定値との共分散の 前記算出値が所定のスレショルド値条件を満足することに応答して、不整脈の発 生を検出する手段と、 前記不整脈の検出に応答して抗不整脈治療用出力を送出する手段と、 を備えたことを特徴とする抗不整脈装置。 8.心房と心室の夫々の脱分極を検出する手段と、 心房と心室のうちの一方において連続して発生した2個の脱分極の発生時点間 の期間に対して、それら2つの脱分極の発生時点間に心房と心室のうちの他方に おいて発生した脱分極の発生の仕方に基づいて、ビート・コードを付与する手段 と、 複数個の前記ビート・コードの連鎖から成る様々なビート・コード・シーケン スのうち、不整脈が発生していることを示すビート・コード・シーケンスの集合 を規定する手段と、 複数個の前記付与されたビート・コードの連鎖から成るビート・コード・シー ケンスが、前記規定されたビート・コード・シーケンス集合に含まれるときに、 それに応答して前記不整脈の発生を検出する検出手段と、 前記不整脈の発生の検出に応答して抗不整脈治療用出力を送出する手段と、 を備えたことを特徴とする抗不整脈装置。 9.前記検出手段が、所定個数の前記ビート・コードから成るビート・コード ・シーケンスが、前記規定されたビート・コード・シーケンス集合に含まれるこ とを判定する手段を含んでいることを特徴とする請求項8記載の抗不整脈装置。 10.前記検出手段がカウント手段を含んでおり、該カウント手段は、前記規 定されたビート・コード・シーケンス集合に含まれるビート・コード・シーケン スの発生個数をカウントし、そのカウント値が所定値を超えることに応答して前 記不整脈の発生を検出する手段であることを特徴とする請求項8または9記載の 抗不整脈装置。 11.前記カウント手段が、前記規定されたビート・コード・シーケンス集合 に含まれないビート・コード・シーケンスの発生に応答して前記カウント値をデ クリメントするデクリメント手段を含んでいることを特徴とする請求項10記載 の抗不整脈装置。 12.前記デクリメント手段が、前記規定されたビート・コード・シーケンス 集合に含まれないビート・コード・シーケンスの発生に応答して前記カウント値 を所定値にリセットするリセット手段を含んでいることを特徴とする請求項11 記載の抗不整脈装置。 13.前記デクリメント手段が、前記規定されたビート・コード・シーケンス 集合に含まれないビート・コード・シーケンスの発生に応答して前記カウント値 を所定のデクリメント量だけデクリメントする手段を含んでいることを特徴とす る請求項11記載の抗不整脈装置。 14.前記検出手段が、前記カウント値が所定値までデクリメントされたこと に応答して前記不整脈がもはや発生していないと判定する手段を含んでいること を特徴とする請求項11、12、または13記載の抗不整脈装置。 15.患者の心房において心臓組織の脱分極を検出する手段と、 患者の心室において心臓組織の脱分極を検出する手段と、 患者の心房において検出された脱分極が、心室脱分極によるものである可能性 が高いか否かを判定する手段と、 患者の心室において最新の一連の所定回数の脱分極が検出されている間に患者 の心房と心室において夫々に検出された脱分極の夫々の検出回数の間の相対回数 関係を判定する手段と、 患者の心室において最新の一連の所定個数の脱分極が検出されている間に患者 の心房において検出された脱分極のうち、心室脱分極によるものである可能性が 高い脱分極の検出回数を判定する手段と、 頻脈性不整脈を、患者の心房と心室において夫々に検出された脱分極の夫々の 検出回数の間の前記相対回数関係と、患者の心房において検出された心室脱分極 によるものである可能性が高い前記脱分極の前記検出回数との関数として、心室 起原または上室起原の頻脈性不整脈に分類する手段と、 頻脈性不整脈が心室起原のものとして分類されたことに応答して抗不整脈治療 用出力を送出する手段と、 を備えたことを特徴とする抗不整脈装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US08/413,570 | 1995-03-30 | ||
US08/413,570 US5545186A (en) | 1995-03-30 | 1995-03-30 | Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias |
PCT/US1996/004048 WO1996030081A1 (en) | 1995-03-30 | 1996-03-26 | Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2005325780A Division JP2006068549A (ja) | 1995-03-30 | 2005-11-10 | 抗不整脈装置 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH11503038A true JPH11503038A (ja) | 1999-03-23 |
JP3768535B2 JP3768535B2 (ja) | 2006-04-19 |
Family
ID=23637748
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP52956996A Expired - Fee Related JP3768535B2 (ja) | 1995-03-30 | 1996-03-26 | 抗不整脈装置 |
JP2005325780A Pending JP2006068549A (ja) | 1995-03-30 | 2005-11-10 | 抗不整脈装置 |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2005325780A Pending JP2006068549A (ja) | 1995-03-30 | 2005-11-10 | 抗不整脈装置 |
Country Status (7)
Country | Link |
---|---|
US (7) | US5545186A (ja) |
EP (2) | EP0939660B1 (ja) |
JP (2) | JP3768535B2 (ja) |
AU (1) | AU695634B2 (ja) |
CA (1) | CA2215899C (ja) |
DE (2) | DE69626227T2 (ja) |
WO (1) | WO1996030081A1 (ja) |
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JP2018523518A (ja) * | 2015-07-30 | 2018-08-23 | 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 | 植込み可能なデバイスにおける心房細動電気記録図のトリガ |
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- 2001-03-28 US US09/819,433 patent/US6487443B2/en not_active Expired - Fee Related
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2002
- 2002-10-30 US US10/283,634 patent/US6731978B2/en not_active Expired - Fee Related
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2005
- 2005-11-10 JP JP2005325780A patent/JP2006068549A/ja active Pending
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2007501067A (ja) * | 2003-08-01 | 2007-01-25 | ノーススター ニューロサイエンス インコーポレイテッド | 患者に神経刺激を印加する装置およびその方法 |
JP2018523518A (ja) * | 2015-07-30 | 2018-08-23 | 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 | 植込み可能なデバイスにおける心房細動電気記録図のトリガ |
US10617320B2 (en) | 2015-07-30 | 2020-04-14 | Cardiac Pacemakers, Inc. | Method to trigger an atrial fibrillation electrogram in an implantable device that detects R-waves |
US10881317B2 (en) | 2017-03-07 | 2021-01-05 | Cardiac Pacemakers, Inc. | Post-hoc atrial fibrillation detection |
Also Published As
Publication number | Publication date |
---|---|
US6141581A (en) | 2000-10-31 |
AU5429996A (en) | 1996-10-16 |
EP1179355A1 (en) | 2002-02-13 |
US20030125772A1 (en) | 2003-07-03 |
CA2215899A1 (en) | 1996-10-03 |
AU695634B2 (en) | 1998-08-20 |
US5991656A (en) | 1999-11-23 |
CA2215899C (en) | 2001-10-30 |
DE69632601T2 (de) | 2005-06-23 |
US5545186A (en) | 1996-08-13 |
DE69626227D1 (de) | 2003-03-20 |
US6731978B2 (en) | 2004-05-04 |
US6487443B2 (en) | 2002-11-26 |
EP0939660A1 (en) | 1999-09-08 |
DE69626227T2 (de) | 2003-11-13 |
US6259947B1 (en) | 2001-07-10 |
WO1996030081A1 (en) | 1996-10-03 |
JP3768535B2 (ja) | 2006-04-19 |
US5855593A (en) | 1999-01-05 |
EP0939660B1 (en) | 2003-02-12 |
US20010034538A1 (en) | 2001-10-25 |
EP1179355B1 (en) | 2004-05-26 |
DE69632601D1 (de) | 2004-07-01 |
JP2006068549A (ja) | 2006-03-16 |
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