摘要:
A device for monitoring heart rhythms. The device is provided with an amplifier for receiving electrogram signals, a memory for storing digitized electrogram segments including signals indicative of depolarizations of a chamber or chamber of a patient's heart and a microprocessor and associated software for transforming analyzing the digitized signals. The digitized signals are analyzed by first transforming the signals into signal wavelet coefficients using a wavelet transform. The higher amplitude ones of the signal wavelet coefficients are identified and the higher amplitude ones of the signal wavelet coefficients are compared with a corresponding set of template wavelet coefficients derived from signals indicative of a heart depolarization of known type. The digitized signals may be transformed using a Haar wavelet transform to obtain the signal wavelet coefficients, and the transformed signals may be filtered by deleting lower amplitude ones of the signal wavelet coefficients. The transformed signals may be compared by ordering the signal and template wavelet coefficients by absolute amplitude and comparing the orders of the signal and template wavelet coefficients. Alternatively, the transformed signals may be compared by calculating distances between the signal and wavelet coefficients. In preferred embodiments the Haar transform may be a simplified transform which also emphasizes the signal contribution of the wider wavelet coefficients.
摘要:
A method and apparatus are provided for improving the detection of certain cardiac rhythms by combining dual chamber interval-related detection methods with electrogram morphology analysis. A prioritized set of rules are defined wherein each rule is directed at identifying a particular arrhythmia or type of arrhythmia. Each rule includes clauses that may be related to sensed event intervals and interval patterns and at least one rule includes at least one clause relating to the EGM morphology.
摘要:
A method of generating a template in an implantable medical device for implantation within a patient, and a processor readable medium for performing the method, that includes generating a template corresponding to a supraventricular rhythm of the patient, determining whether the template is valid, and monitoring the template to determine whether the template is an accurate representation of the supraventricular rhythm. The template is created from non-paced R waves that are below a predetermined heart rate, and a statistical validation of the template is performed by evaluating the template based on matches against ongoing slow heart rhythm. The quality of the template is continuously monitored, similar to the statistical validation, with the exception that one thousand beats are evaluated and once more than thirty out of the last one hundred beats do not match the template within the threshold, an attempt is made to create a new template.
摘要:
An extra-systolic stimulation (ESS) therapy addresses cardiac dysfunction including heart failure. ESS therapy employs atrial and/or ventricular extra-systoles via pacing-level stimulation to a heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). The present invention relates to therapy delivery guidance and options for improved ESS therapy delivery. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要:
AV synchronous, dual chamber pacing systems are disclosed having improved sensing of ectopic ventricular depolarizations or PVCs coincidentally occurring at or shortly following delivery of an A-PACE pulse. A first ventricular sense amplifier that is blanked during and following delivery of an A-PACE pulse is coupled to active and indifferent ventricular pace/sense electrodes defining a ventricular sense vector for sensing natural ventricular depolarizations and declaring a V-EVENT. A far field PVC sense amplifier coupled to a far field PVC sense electrode pair defining a PVC sense vector detects such PVCs while the ventricular sense amplifier is blanked. A PVC declared during the ventricular blanking period by the far field PVC sense amplifier is employed to deliver a VSP pulse upon time-out of a VSP delay, if the VSP function is provided and programmed ON, and/or to halt time-out of an AV delay.
摘要:
A method and device for generating a template that includes identifying events of a plurality of sensed events having predetermined characteristics as first selected events and generating the template from the first selected events. Events of the plurality of events having the predetermined characteristics are identified as second selected events, and a determination is made as to whether the template is valid in response to the second selected events. The template is updated from the second selected events in response to the template not being valid.