WO2002009810B1 - Algorithm for synchronization of atrial cardioversion shock - Google Patents

Algorithm for synchronization of atrial cardioversion shock

Info

Publication number
WO2002009810B1
WO2002009810B1 PCT/US2001/022580 US0122580W WO0209810B1 WO 2002009810 B1 WO2002009810 B1 WO 2002009810B1 US 0122580 W US0122580 W US 0122580W WO 0209810 B1 WO0209810 B1 WO 0209810B1
Authority
WO
WIPO (PCT)
Prior art keywords
interval
sensed
wave
software system
ventricular
Prior art date
Application number
PCT/US2001/022580
Other languages
French (fr)
Other versions
WO2002009810A2 (en
WO2002009810A3 (en
Inventor
Luc R Mongeon
Thomas W Sinner
Original Assignee
Medtronic 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
Application filed by Medtronic Inc filed Critical Medtronic Inc
Priority to CA002416642A priority Critical patent/CA2416642A1/en
Priority to EP01952839A priority patent/EP1307259A2/en
Priority to JP2002515361A priority patent/JP2004504897A/en
Publication of WO2002009810A2 publication Critical patent/WO2002009810A2/en
Publication of WO2002009810A3 publication Critical patent/WO2002009810A3/en
Publication of WO2002009810B1 publication Critical patent/WO2002009810B1/en

Links

Classifications

    • 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

Abstract

Primarily, the invention relates to a safe delivery of atrial cardioversion pulses in complex cardiac therapy environments wherein cardiac events suggest, for example, rapid ventricular rates that would prevent a safe atrial cardioversion. The invention generally utilizes an algorithmic system in which a resultant R-R interval encountered subsequent to the delivery of a ventricular pacing pulse is decrementally scanned until an R-R interval is found that will yield a reliable sustained R-R interval. The sustenance of the R-R interval prolongation enables ventricular deceleration. Strategically selected timing windows are used to trigger a device response that is proper and tailored to the ventricular event detected during and within the timing windows. Further, the invention enables an atrial cardioversion synchronization method that allows for the safe delivery of atrial cardioversion pulses in the presence of very rapid ventricular rates.

Claims

22AMENDED CLAIMS[received by the International Bureau on 26 February 2002 (26.02.02); original claims 1-26 replaced by amended claims 1-4 (2 pages)]Wfrat is claimed is:
1. An implantable atrial deiϊbrillator device that provides safe delivery of atrial cardioversion pulses' in the presence of a rapid ventricular rate having a microprocessor (224) operating as an interrupt driven device under control of a software system comprising programming instructions stored in a read only memory (ROM) and being responsive to interrupts corresponding to the occurrences of sensed P- aves and R-waves to implement a cardioversion pulse ■ delivery synchronization mechanism, characterized in that: the software system monitors the' R-R intervals the presence of atrial
I fibrillation and calculates a mean R-R interval over a predetermined number of previous R-R intervals; the software system sets a decremented R-R interval based on the mean R-R interval to define a ventricular escape interval expected to expire before the next sensed R-wave; the software system directs delivery of an overdrive pacing output pulse closely timed to a sensed R-wave to cause prolongation of the next R-R interval; the software system decrementally scans the -R intervals to identify a sustained interval prolongation; the software system activates capacitor charging;' upon identification of a sustained interval prolongation; the software system confirms the presence of an atrial fibrillation episode upon completion of capacitor charging; and the software system directs delivery of an atrial cardioversion shock synchronized to a sensed R-wave.
2. The device of claim 1 further characterized in that the software system decrementally scans the R-R intervals to identify a sustained interval prolongation by deteπnming whether a sensed R-wave following the overdrive pacing output pulse has occurred during a shock synchronization period at a time that establishes a ventricular pace to sensed R-wave interval that is greater a predetermined time interval and, if an R-wave was sensed at a time that establishes a ventricular pace to sensed R-wave interval that is not greater than the predetermined time interval, the ventricular escape interval setting is further decremented prior/ tp the next overdrive pacing output pulse.
3. The device of claim 1 further characterized in that the software system decrementally scans the R-R intervals to identify a sustained interval prolongation by determining whether a sensed R-wave following the overdrive pacing output pulse has occurred during a shock synchronization period at a time that establishes a ventricular pace to sensed R-wave interval that is greater a predetermined time interval and, if an R-wave was sensed at a time that establishes a ventricular pace to sensed R-wave interval that is greater than the predetermined time interval, the decremented R-R interval setting is used to deliver the next overdrive pacing output pulse.
4. The device of claim 3 wherein a cardioversion shock is delivered synchronized to the delivery of the overdrive pacing pulse.
PCT/US2001/022580 2000-07-27 2001-07-18 Algorithm for synchronization of atrial cardioversion shock WO2002009810A2 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
CA002416642A CA2416642A1 (en) 2000-07-27 2001-07-18 Algorithm for synchronization of atrial cardioversion shock
EP01952839A EP1307259A2 (en) 2000-07-27 2001-07-18 Algorithm for synchronization of atrial cardioversion shock
JP2002515361A JP2004504897A (en) 2000-07-27 2001-07-18 Atrial cardioverter

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US62724300A 2000-07-27 2000-07-27
US09/627,243 2000-07-27

Publications (3)

Publication Number Publication Date
WO2002009810A2 WO2002009810A2 (en) 2002-02-07
WO2002009810A3 WO2002009810A3 (en) 2002-04-04
WO2002009810B1 true WO2002009810B1 (en) 2002-08-01

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2001/022580 WO2002009810A2 (en) 2000-07-27 2001-07-18 Algorithm for synchronization of atrial cardioversion shock

Country Status (5)

Country Link
US (1) US6988000B2 (en)
EP (1) EP1307259A2 (en)
JP (1) JP2004504897A (en)
CA (1) CA2416642A1 (en)
WO (1) WO2002009810A2 (en)

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Also Published As

Publication number Publication date
JP2004504897A (en) 2004-02-19
US20030135242A1 (en) 2003-07-17
WO2002009810A2 (en) 2002-02-07
CA2416642A1 (en) 2002-02-07
WO2002009810A3 (en) 2002-04-04
EP1307259A2 (en) 2003-05-07
US6988000B2 (en) 2006-01-17

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