69 results about "Atrial arrhythmias" patented technology

A system and method for detecting and discriminating atrial arrhythmias based on mechanical signals of cardiac wall motion and electrical signals of cardiac depolarizations. A mechanical event rate determined from sensed mechanical events is used to corroborate an electrical event rate determined from sensed EGM or ECG signals to classify the heart rhythm. If the event rates are not correlated, other parameterized data from the mechanical signal and electrical signal are evaluated to detect evidence of an arrhythmia. If electrical and mechanical event data do not corroborate a common arrhythmia condition, electrical and mechanical sensing parameters may be adjusted.

An electrophysiology (EP) device suitable for ablating tissue within a patient's body lumen. The EP device of the invention generally comprises an elongated shaft having a distal shaft section with a helical shape and at least one electrode on an exterior portion thereof. One aspect of the invention comprises a method of performing a medical procedure, such as treating a patient for atrial arrhythmia, by forming a lesion using an EP device embodying features of the invention.

An implantable cardiac stimulation device discriminates and treats accelerated atrial arrhythmias of a patient's heart. The device includes a sensing circuit that senses cardiac activity of one of the patient's atria to provide an atrial activity signal, a detector that detects an accelerated atrial arrhythmia of the patient's heart, and a classifying circuit that measures relative correspondence between successive P waves of the atrial activity signal to classify the detected accelerated atrial arrhythmia as either atrial tachycardia or atrial fibrillation. A therapy circuit provides anti-tachycardia pacing therapy responsive to a classified atrial tachycardia and defibrillation therapy responsive to a classified atrial fibrillation.

A multi-layer method for detecting atrial arrhythmias using ventricular cycle length information that includes performing a base layer algorithm for detecting the onset and offset of an atrial tachyarrhythmia. The multi-layer method further includes one or more higher layer algorithms executed in response to a base layer detection to confirm or reject the base layer detection. The base layer is designed to operate with high sensitivity to atrial fibrillation and / or organized atrial tachycardia and the higher layer is designed to operate with high sensitivity and high specificity to atrial fibrillation and / or organized atrial tachycardia.

A system and method which employs atrial discrimination algorithms to distinguish between different atrial arrhythmias occurring in a patient for selecting an optimal pacing therapy corresponding to the type of arrhythmia identified. The invention may be implemented in a bradycardia pacemaker or other implantable cardiac device. In response to the detection of an atrial rate above the atrial tracking rate, discrimination criteria are applied to a detected atrial activity signal to distinguish between different types of supraventricular tachycardia, such as fast atrial flutter and other atrial flutter at a relatively slower rate, which may be occurring in the patient. The discrimination criteria may be, for example, rate-based or morphology based. The pacer is controlled to provide pacing therapy to a heart in a manner corresponding to the type of supraventricular tachycardia identified. For example, antitachycardia pacing may be provided to the heart in response to the detection of a relatively lower rate supraventricular tachycardia / other atrial flutter, whereas another pacing control, e.g., ventricular pacing, such as ventricular rate regulation or Rate Smoothing, may be applied if a more rapid rate supraventricular tachycardia / fast atrial flutter is identified. The output of an atrial discrimination algorithm may be tracked and the trend thereof used to improve therapy timing.

A system and method are provided for developing a database of body surface ECG P-wave maps for classification and localization of left-sided atrial arrhythmias. The system and method include generating and receiving P-wave data in a subject by left atrial pacing or receiving P-wave data in a subject during spontaneously occurring or induced left atrial arrhythmias; computing (e.g. potential or integral) maps of the P-wave data; classifying the maps specific to a left atrial ectopic origin; verifying the classification procedure; averaging the classified maps into mean maps; and storing and accessing the mean maps in the database. The mean maps of the P-wave data in the database can be used to automatically classify and localize P-wave data from a patient obtained during a left atrial arrhythmia such as atrial tachycardia, focal atrial fibrillation, or orthodromic atrioventricular reentrant tachycardia.

This invention describes methods and algorithms for processing a plurality of relevant signals / data intrinsic to a patient and / or derived from external diagnostic equipment for management of atrial arrhythmias. The intrinsic signals are acquired from intracardiac leads / sensors and analogous extrinsic data obtained from imaging equipment and patient demographics. These data are input into software algorithms that use digital signal processing to output informational data of clinical and technical relevance after comparisons are made to patients with access to this technology whose outcome under varying treatments is known. These combined data are used to define prognosis, make treatment suggestions, direct programming of cardiac devices and digitally convert intrinsically and extrinsically derived indices into a common metric. In a preferred embodiment, the intrinsically and extrinsically acquired data is utilized in the design of catheters and software algorithms for performing intracardiac procedures such as ablation of atrial arrhythmias.

A multi-layer method for detecting atrial arrhythmias using ventricular cycle length information that includes performing a base layer algorithm for detecting the onset and offset of an atrial tachyarrhythmia. The multi-layer method further includes one or more higher layer algorithms executed in response to a base layer detection to confirm or reject the base layer detection. The base layer is designed to operate with high sensitivity to atrial fibrillation and / or organized atrial tachycardia and the higher layer is designed to operate with high sensitivity and high specificity to atrial fibrillation and / or organized atrial tachycardia.

A non-invasive vagal stimulation device and method. The device comprises a body having a vibration member. The stimulation is created by the vibration member which has a vibratory rate that can be adjusted from being off to a preferred operating range. The non-invasive stimulation method consists of placing the non-invasive stimulation device in the vicinity of the carotid artery bifrication where arises a carotid sinus and body which contain afferent sensory nerves that travel to medulla oblongata of brain, and either applying pressure in place, or moving the device along the target arm. The method can be accomplished either with the vibration feature of the device turned on or off.

A non-invasive vagal stimulation device and method. The device comprises a body having a vibration member. The stimulation is created by the vibration member which has a vibratory rate that can be adjusted from being off to a preferred operating range. The non-invasive stimulation method consists of placing the non-invasive stimulation device in the vicinity of the carotid artery bifrication where arises a carotid sinus and body which contain afferent sensory nerves that travel to medulla oblongata of brain, and either applying pressure in place, or moving the device along the target arm. The method can be accomplished either with the vibration feature of the device turned on or off.

A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V—V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable.

Methods and apparatus for a three-stage atrial cardioversion therapy that treats atrial arrhythmias within pain tolerance thresholds of a patient. An implantable therapy generator adapted to generate and selectively deliver a three-stage atrial cardioversion therapy and at least two leads operably each having at least one electrode adapted to be positioned proximate the atrium of the patient. The device is programmed with a set of therapy parameters for delivering a three-stage atrial cardioversion therapy to the patient via both a far-field configuration and a near-field configuration of the electrodes upon detection of an atrial arrhythmia. The three-stage atrial cardioversion therapy includes a first stage for unpinning of one or more singularities associated with an atrial arrhythmia, a second stage for anti-repinning of the one or more singularities associated with the atrial arrhythmia, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities associated with the atrial arrhythmia delivered via the near-field configuration of the electrodes.

Methods and apparatus for a three-stage atrial cardioversion therapy that treats atrial arrhythmias within pain tolerance thresholds of a patient. An implantable therapy generator adapted to generate and selectively deliver a three-stage atrial cardioversion therapy and at least two leads, each having at least one electrode adapted to be positioned proximate the atrium of the patient. The device is programmed for delivering a three-stage atrial cardioversion therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of an atrial arrhythmia. The three-stage atrial cardioversion therapy includes a first stage for unpinning of one or more singularities associated with an atrial arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities delivered via the near-field configuration of the electrodes.

A method and apparatus for detecting atrial arrhythmias and discriminating atrial fibrillation (AF) and organized atrial tachycardia (OAT) that includes defining a threshold detection criteria for a cluster signature evidence metric corresponding to a Lorenz distribution of ventricular cycle lengths representative of AF or OAT. Using a signal containing VCL information, a number of consecutive ventricular cycle lengths are determined during a selected time interval for generating a one-dimensional or a two-dimensional histogram as a numerical representation of a Lorenz plot of VCLs. A number of cluster signature metrics are computed using the stored ventricular cycle length information, and a cluster signature evidence metric is computed from the cluster signature metrics. AF or OAT is detected if a comparative analysis of a corresponding cluster signature evidence metric meets a respective threshold detection criteria.

Techniques are provided for detecting atrial events that might be hidden due to the operation of a post-ventricular atrial blanking (PVAB) interval or other atrial channel blanking interval. In one example, candidate atrial events are identified within signals occurring during the PVAB interval. Then, a determination is made as to whether the candidate atrial event is a true atrial event based on a comparison of characteristics of the candidate atrial event with characteristics of prior known atrial events within the patient. By comparing the characteristics of the “hidden” event with the characteristics of prior known atrial events within the patient, a quick and accurate determination can be made whether the event should be counted as a P-wave. In this manner, hidden atrial arrhythmias can be detected and mode switch oscillations can be reduced or eliminated.

Techniques are provided for detecting atrial events that might be hidden due to the operation of a post-ventricular atrial blanking (PVAB) interval or other atrial channel blanking interval. In one example, candidate atrial events are identified within signals occurring during the PVAB interval. Then, a determination is made as to whether the candidate atrial event is a true atrial event based on a comparison of characteristics of the candidate atrial event with characteristics of prior known atrial events within the patient. By comparing the characteristics of the “hidden” event with the characteristics of prior known atrial events within the patient, a quick and accurate determination can be made whether the event should be counted as a P-wave. In this manner, hidden atrial arrhythmias can be detected and mode switch oscillations can be reduced or eliminated.

The present invention concerns certain isoquinolinone compounds and their utility as inhibitors of voltage-dependent potassium channels or currents, such as Kv1.5 and IKur, that could serve as targets for the treatment of cardiac arrhythmias especially atrial arrhythmias. The present invention also provide a method for treating or preventing conditions which respond to the inhibition of potassium channels or currents, such as cardiac arrhythmias and more especially atrial arrhythmias. The present invention further includes pharmaceutical formulations and a process of making a pharmaceutical composition comprising a compound of certain isoquinolinone or its pharmaceutically acceptable salts, hydrates, solvates, crystal forms, and stereoisomers thereof, and a pharmaceutically acceptable carrier.

Apparatus for detecting atrial arrhythmias in the treatment of disorders of the heartbeat rate in active implantable medical devices of the pacemaker, cardioverter, defribillator and / or multisite type. This device includes conventional systems, circuits and control algorithm for detecting spontaneous and stimulated ventricular events (R, V) and atrial events (P, A), indicating the delivery of a ventricular and / or atrial event, and inhibiting the detection of atrial events after detection of a ventricular event throughout a post-ventricular atrial absolute refractory period (PVAARP). Detecting atrial events includes protecting against the detection of atrial signals that do not correspond to an atrial event that has actually occurred, in particular protecting against atrial detection of far-field signals caused by a ventricular event. The protection operates by a dynamic adjustment of the sensitivity of detection by temporarily raising (t1, t2) a detection threshold (ΔS1, ΔS2) after detection of a ventricular event without detection of a preceding (spontaneous or stimulated) atrial event during the same cardiac cycle.

Atrial arrhythmias, a major contributor to cardiovascular morbidity, are believed to be influenced by autonomic nervous system tone. The main purpose of this invention was to highlight new findings that have emerged in the study of effects of autonomic nervous system tone on atrial arrhythmias, and its interaction with class III antiarrhythmic drug effects. This invention evaluates the significance of sympathetic and parasympathetic activation by determining the effects of autonomic nervous system using a vagal and stellar ganglions stimulation, and by using autonomic nervous system neurotransmitters infusion (norepinephrine, acetylcholine). This invention evaluates the autonomic nervous system effects on the atrial effective refractory period duration and dispersion, atrial conduction velocity, atrial wavelength duration, excitable gap duration during a stable circuit (such atrial flutter circuit around an anatomical obstacle), and on the susceptibility of occurrence (initiation, maintenance and termination) of atrial re-entrant arrhythmias in canine. This invention also evaluates whether autonomic nervous system activation effects via a local neurotransimitters infusion into the right atria can alter those of class III antiarrhythmic drug, sotalol, during a sustained right atrial flutter. This invention represents an emergent need to set-up and develop a new class of anti-cholinergic drug therapy for the treatment of atrial arrhythmias and to combine this new anti-cholinergic class to antiarrhythmic drugs. Furthermore, this invention also highlights the importance of a local application of parasympathetic neurotransmitters / blockers and a catheter ablation of the area of right atrium with the highest density of parasympathetic fibers innervation. This may significantly reduce the occurrence of atrial arrhythmias and may preserve the antiarrhythmic effects of any drugs used for the treatment of atrial re-entrant arrhythmias.

A system and method which employs atrial discrimination algorithms to distinguish between different atrial arrhythmias occurring in a patient for selecting an optimal pacing therapy corresponding to the type of arrhythmia identified. In response to the detection of an atrial rate above the atrial tracking rate, discrimination criteria are applied to a detected atrial activity signal to distinguish between different types of supraventricular tachycardia, such as fast atrial flutter and other atrial flutter at a relatively slower rate, which may be occurring in the patient. The pacer is controlled to provide pacing therapy to a heart in a manner corresponding to the type of supraventricular tachycardia identified. The output of an atrial discrimination algorithm may be tracked and the trend thereof used to improve therapy timing. Various embodiments are disclosed herein.

A system and method for applying atrial therapy to a human heart using a defibrillator includes detecting an atrial arrhythmia and delivering electrical energy to at least one atrium in response to a detected atrial arrhythmia. A first atrial activation is detected after delivering the electrical energy, occurrence of a detected first atrial activation defining a first moment. Finally, a first pacing pulse is delivered to a number of locations within the atria when the first atrial activation is detected. The first pacing pulse is delivered at a second moment substantially synchronous with the first moment.

A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V-V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable.

The invention relates to the combination of one or more beta-blockers and of one or more Kv1.5 blockers, in particular phenylcarboxamides of the formula la and / or lb and / or physiologically tolerable salts thereof, and the use of the combination for the treatment or prophylaxis of atrial arrhythmias.

Methods for treating atrial arrhythmias can involve configuring an implantable arrhythmia treatment device. A device can be configured after implantation when the patient is fully conscious and after any pain suppression medication has worn off. The device is caused to apply a phased unpinning far field therapy to the patient in response to detection of an arrhythmia via a far field configuration of electrodes. An indication of a pain sensation of the patient and the effectiveness of the treatment in response to the therapy can then be received. In response, at least one of a set of therapy parameters is adjusted and the steps are repeated until it is determined that an effective treatment is provide at a pain sensation that is tolerable to the patient. The device is then programmed to automatically treat arrhythmias detected in the patient with the determined set of therapy parameters.

An implantable cardiac stimulation device includes a system that identifies and prevents the occurrence of impending atrial arrhythmias. A sensing circuit senses atrial activity of a patient's heart to provide an atrial activity signal. A processor compares the atrial activity signal to a predetermined standard indicative of an impending accelerated atrial arrhythmia to identify an impending accelerated atrial arrhythmia. A therapy circuit provides accelerated atrial arrhythmic preventive therapy to the patient when an impending accelerated atrial arrhythmia is identified. Data associated with the identification and therapy delivery is stored in a memory.