摘要:
A method and device for controlling delivery of therapy in an implantable device that includes sensing a plurality of events, detecting whether there is an increase in the frequency of first events of the plurality of events corresponding to onset of a second event of the plurality of sensed events, adjusting parameters associated with delivery of the therapy in response to the detected increased frequency of first sensed events, and delivering the therapy using the adjusted parameters.
摘要:
Control of defibrillation therapy delivered by implantable medical devices (IMDS) using hemodynamic sensor feedback is disclosed. The hemodynamic sensor feedback allows for increased control over application of atrial defibrillation therapy. Specifically, the therapy is delivered when a fibrillation episode results in a discrete loss of hemodynamic function. Defibrillation therapy is thus withheld for hemodynamically benign arrhythmias.
摘要:
A method and device for determining an optimal lower rate and adjusting the programmed lower pacing rate to the optimal rate that includes monitoring a parameter in response to therapy delivered at a first rate during a first time period to generate first parameter data, and determining whether the therapy was delivered for a predetermined portion of the first time period. The parameter is monitored in response to the therapy delivered at a next rate during a next time period to generate next parameter data, and a determination is made as to whether the therapy was delivered for a predetermined portion of the next time period. A metric corresponding to the first parameter data is determined to generate a first parameter metric, and corresponding to the next parameter data to generate a next parameter metric used for determining an optimal therapy delivery rate.
摘要:
A method of and a system for treatment of atrial tachyarrhythmias. The system includes a set of hemostats having elongated opposing jaws carrying mechanisms for applying ablation energy along the jaws. The jaws having straight and curved configurations selected to allow arrangement of the jaws of along opposite sides of walls of a patient's atrium. Treatment is accomplished by applying of ablation energy to the walls of a patient's artria to create lines of lesion corresponding generally to incisions employed in a Maze type procedure.
摘要:
An implantable medical device system and method are provided for synchronizing atrial cardioversion shocks to the ventricular rhythm using an adjustable atrial cardioversion/defibrillation ventricular refractory period. Upon determining a need for an atrial shock therapy, the method determines if the ventricular rate meets synchronization criteria based on an upper ventricular refractory period limit. If synchronization criteria are not met, the refractory period is automatically adjusted in stepwise decrements until the synchronization criteria are met, or until a lower refractory period limit is exceeded. If synchronization criteria are met, an atrial shock is synchronized to the next ventricular depolarization occurring outside the current refractory period. If the lower refractory period limit is exceeded, the atrial therapy is aborted.
摘要:
A device for ablating tissue is provided. The device comprises a conductive element with a channel for irrigating fluid formed therein, which is in contact with a non-conductive microporous interface. All or a portion of the interface may be removable. When the interface is removed, a portion of the conductive element is exposed for use in ablating tissue. Methods of using the device and of removing the interface are also provided.
摘要:
A method of and a system for treatment of atrial tachyarrhythmias. The system includes a set of hemostats having elongated opposing jaws carrying mechanisms for applying ablation energy along the jaws. The jaws having straight and curved configurations selected to allow arrangement of the jaws of along opposite sides of walls of a patient's atrium. Treatment is accomplished by applying of ablation energy to the walls of a patient's artria to create lines of lesion corresponding generally to incisions employed in a Maze type procedure.
摘要:
A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.
摘要:
A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.
摘要:
A method and apparatus for inducing fibrillation in a patient, for example to verify the efficacy of a defibrillator system. In the disclosed embodiment, an implantable cardioverter-defibrillator has an output stage coupled via a plurality of leads to the patient's heart. When it is desired to induce fibrillation in the patient, the device's control circuitry initiates an output capacitor charging cycle and subsequent delivery of a multi-phase fibrillation inducing stimulus to the heart. The multiple phases of the stimulus reflect an incremental discharging of the output capacitor. In one embodiment, the stimulus has three phases, with the first two separated by a time interval equal to or slightly less than the patient's "vulnerability window," which is defined as the time period following a paced cardiac event during which repolarization of the cardiac muscle is occurring, rendering the heart susceptible to induced fibrillation. The final phase of the multi-phase waveform reflects an untruncated discharge of the remaining energy on the output capacitor.