Biotronik Crm Patent Ag

Biotronik Mess-und Therapiegeraete Gmbh & Co Ingenieurbuero Berlin

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Biotronik Mess-und Therapiegeraete Gmbh & Co.

Biotronik Mess-und Therapiegeraete Gmbh & Co. Ingenierbuero Berlin

Indra B Nigam

Dirk Muessig

Max Schaldach

Mrigank Shekhar

Hannes Kraetschmer

Tran Thong

Paul Wyborny

Garth Garner

Max Schaldach, Jr

Andreas Kucher

Andreas Hahn

The present disclosure generally relates to a method, a device, and a computer-readable storage medium for detecting heart beats from cardiac signals whose quality, expressed in terms of signal amplitude and signal-to-noise ratio, varies dynamically in time. Hence, a method, a device, and a computer-readable storage medium for detecting electrical signals originating from a human or animal heart is proposed. The method includes the following steps:

Device, method, and computer-readable storage medium for detecting events in cardiac signals

Method for detecting cardiac events, e.g., Atrial Fibrillation (AF) or termination of AF. Based on analysis of the instability observed in heart rate, caused by irregular conduction from the atrium during AF. Change in heart interval is monitored on beat-to-beat basis to recognize instability that indicates presence of AF or Atrial Flutter. A packet of a number of consecutive intervals is evaluated, whether the length of an interval is stable compared with the length of the preceding interval, or whether the length of the subsequent interval has changed. After detection of an instability, instability counter is incremented. The result of the stability test for a packet of intervals is represented by the value of the instability counter. Depending upon whether or not an AF already declared, (indicated by AF status flag), different 'X-out-of-Y' criterion are applied. AF status flag set/cleared when declaring AF/termination of AF.

Device, method and computer-readable storage medium for detecting and classifying of cardiac events

Device for classifying tachyarrhythmia that obtains pre-defined values, monitors atrial intervals and compares lengths of each interval with pre-defined value IL, stores length of atrial interval if length is shorter than IL, in case X of most recent Y number of atrial intervals have length shorter than IL, evaluates most recent &#x3c;=N atrial intervals with length &#x3c;IL and performs test for stored lengths via criteria, classifies atrial tachyarrhythmia as stable if all tested lengths pass &#x3e;=1 criteria, and controls a cardiac device depending on the classification. Atrial intervals are first evaluated by using the 'X-out-of-Y' criterion and subsequently checked for stability after an atrial tachyarrhythmia is detected using 'X-out-of-Y' criterion. For stability check, only intervals found shorter than the interval limit are used. Check is based on interval-to-interval comparison rather than as generally practiced, comparisons of individual intervals with the minimum or average of all intervals.

Device, method and computer-readable storage medium for classifying atrial tachyarrhythmia

An implantable medical device provides for improved storage of recorded IEGMs. A sensing stage is connected to an electrode for picking up electric potentials from inside a heart, the time course of said electric potentials representing a heart signal, a control unit connected to said sensing stage is adapted to process a sequence of data points that each represent an amplitude or magnitude A of a time-varying signal at equidistant points of time t, wherein end points of data segments are determined by processing of the sequence of data points. The control unit is adapted to identify end points of data segments by processing of the sequence of data points.

Implantable medical device for improved storage of intracardiac electrograms

A heart stimulator provides a reliable automatic capture threshold search feature. A stimulation pulse generator is connected to at least a ventricular stimulation electrode for delivering electric stimulation pulses to at least the ventricle of the heart. The stimulation pulses generated have a strength depending on a control signal. A sensing stage is connected to an electrode for picking up electric potentials inside at least said ventricle of a heart and a control unit connected to the sensing stage and to the stimulation pulse generator determines points of time for scheduling stimulation pulses, to trigger the stimulation pulse generator so as to deliver a stimulation pulse when scheduled and to put out control signals for controlling the strength of the stimulation pulse. The control unit is further adapted to perform a capture analysis which may take into account extraordinary events.

Heart stimulator

Apparatus for treating fibrillation of at least one chamber of a heart comprising a fibrillation detector for detecting a fibrillation, a defibrillator for defibrillating the chamber of the heart, wherein the defibrillator is connected to the fibrillation detector and is adapted to effect defibrillation subsequently to a time interval after detection of the fibrillation, a warning device which is connected to the fibrillation detector and which is adapted to delivery a warning signal when a fibrillation has been detected, and a control circuit having a control input actuable by a patient, wherein the control circuit is connected to the defibrillator and is adapted to delay the time of a defibrillation if the control circuit receives a corresponding signal by way of the control input, wherein the apparatus includes a condition detector which is adapted to detect a hemodynamic condition of the heart, and the control circuit is connected to the condition detector and is adapted to prevent a delay in the time of defibrillation when the condition detector detects a predetermined hemodynamic condition.

Apparatus for treating fibrillation of at least one chamber of a heart

A method of storing signals having a course over time in an implantable medical device, and/or transmitting the signals out of the device and out of the patient's body, with the course over time being detected in the device, particularly at predetermined time intervals with a constant sampling interval, and a sequence of signal samples being obtained therefrom, of which a partial quantity is stored and/or transmitted as the result of a selection made with a predetermined selection criterion, with the selection criterion being the first derivation of the course over time of the signals according to time, and with the selection being made such that the first derivation of the straight-line connection between an nth and the (n&#x2212;1)th signal sample is determined and compared to the first derivation of the straight-line connection between the(n&#x2212;1)thnthsignal sample and the last-stored and/or last-transmitted signal sample, and thenth(n&#x2212;1)thsignal sample is then stored and/or transmitted as the new last signal sample exactly when these first derivations differ by more than a predetermined value.

Method and apparatus for storing signals in an implantable medical device

A heart therapy device includes a heart rate detector unit for detecting a heart rate, an evaluation and control unit adaptable to evaluate a measured heart rate and output a therapy control signal, and a therapy unit coupled to the output of the evaluation and control means for realizing at least one therapy having a predetermined therapy. The evaluation and control unit includes a three-area memory for storing heart rate value ranges, a heart rate discriminator for allocating a measured heart rate and outputting a first, second or third discriminator output signal, a stability evaluation unit for outputting a stability output signal and evaluating heart rate stability over a predetermined period of time in response to the output of the second heart rate discriminator output signal, and a logical processing unit for processing the second discriminator output.

Heart therapy device

Method for avoiding the detection of a far-field QRS by the atrial detector of a heart pacemaker or ICD while allowing the detection of a true atrial signal to a maximum possible extent; the method comprising generating a Short Atrial Refractory Period (SARP) following an atrial sensed or paced event by means of a SARP timer, blanking of the atrial detector following a ventricular paced event, generating a Post Ventricular Short Atrial Refractory Period (PVSARP) following a ventricular sensed or paced event by means of a PVSARP timer, generating a temporary decrease in the sensivity of an amplifier for the atrial signal for a time period following the elapse of the mentioned PVSARP, and gradually increasing the sensitivity of the amplifier for the atrial signal after said time period.

Avoiding far-field QRS in a tachy detections device

A heart therapy apparatus (,) with detection means (,) for detecting a physiological parameter that characterizes the state of the heart/circulatory system, with comparison value storage means (,), comparator means (,) for comparing the detected values to the stored values, therapy storage means (,) for storing a plurality of potential therapies, therapy means (,) for selectively realizing one of the potential therapies, with therapy registration means (,) for registering a realized therapy, and therapy selection means (,) for selecting one of the stored therapies and activating the therapy means in dependence on the classification signal and the memory content of the therapy registration means. In addition therapy correction means (,) are provided for delaying or inhibiting the realization of a therapy associated with the classification signal, or any therapy at all, or for changing the therapy coordinated with the classification signal in dependence on the classification signal and the memory content of the therapy registration means.

Heart therapy apparatus with therapy correction means

A device for detecting pathological tachycardia, in particular for use with an implantable device for terminating tachycardias, having a classifican device, responding to at least one electrical signal derived from the heart, which if the classification criterion is met outputs an output signal indicating pathological tachycardia, having a plurality of classification devices for checking various classification criteria within one heart interval or on the basis of the evaluation of preceding heart intervals; a controllable counter that is connected to the outputs of the classification devices via first logic means; means for incrementing the counter state of the counter by a predetermined counting amount each time, if during a heart interval at least one of the primary classification signals appears; means for keeping the counter state constant or decrementing it by a predetermined counting amount, if no primary classification signal appears within the heart interval; and discriminator means, which output the output signal indicating the occurrence of pathological tachycardia if the counter state of the counter exceeds a predetermined value.

Device for detecting tachycardia using a counter

An apparatus for detecting ventricular tachycardia includes a first and snd calculation unit, each having an input side connected to a ventricle sensor and an atrium sensor, respectively, and to a timer, for calculating the R--R and P--P intervals between respective successive electrical activities in the atrium and in the ventricle. A threshold value memory stores at least one threshold value for the R--R intervals in memory. A first comparator unit compares the R--R intervals with the at least one threshold value. A first and second interval memory store a predetermined number of calculated R--R and P--P intervals, respectively, or mean R--R and mean P--P interval values. A second comparator unit compares the P--P intervals with the R--R intervals. A third and fourth calculation unit, connected to the output of the first and second calculation unit and/or of the first and second interval memory unit, respectively, calculate the change over time between successive P--P and R--R intervals. First and second criterion memories stores predetermined stability criterion for the change over time between successive P--P and R--R intervals, respectively. A third and fourth comparator unit compare the calculated change over time in the P--P and R--R intervals with the associated stability criterion stored in memory.

Recognizing ventricular tachycardia condition using dual chamber sense

A signal detector for detecting a biosignal with approximately known morpogy in a complex input signal (ECG), in particular for the detection of QRS complexes in an electrocardiogram. The detector has circuitry for detecting the maximum amplitude (PEAK) of the detected signal complex within a predetermined time window, with a threshold value discriminator, a detector parameter preselection circuit for determining an initial value for the detector parameter characterizing the detector sensitivity, which parameter determines the detector threshold value when responding to a detection signal in dependence on the maximum amplitude and a detector parameter timing circuit for adjusting a predetermined time dependence of the detector parameter and thus the detection threshold value. The predetermined time dependence has at least in a first time domain a step-by-step reduction of the detection threshold value up to a lower limit value that is determined in dependence on the maximum amplitude and/or in a second time domain a step-by-step increase with preset steps (STEPS) up to an upper limit value determined in dependence on the maximum amplitude.

Signal detector

A method of storing signals having a course over time in an implantable medical device, and/or transmitting the signals out of the device and out of the patient's body, with the course over time being detected in the device, particularly at predetermined time intervals with a constant sampling interval, and a sequence of signal samples being obtained therefrom, of which a partial quantity is stored and/or transmitted as the result of a selection made with a predetermined selection criterion, with the selection criterion being the first derivation of the course over time of the signals according to time, and with the selection being made such that the first derivation of the straight-line connection between an nth and the (n-1)th signal sample is determined and compared to the first derivation of the straight-line connection between the (n-1)th signal sample and the last-stored and/or last-transmitted signal sample, and the nth signal sample is then stored and/or transmitted as the new last signal sample exactly when these first derivations differ by more than a predetermined value.

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Tigard, OR, United States of America

Indra B Nigam