Method and device for multi-chamber cardiac pacing in response to a tachycardia

Abstract

An apparatus and method for performing multi-chamber anti-tachycardia pacing (ATP) in response to a tachycardia that is of particular use in an implantable cardiac stimulation device. The expected benefits of such a multi-chamber ATP include improved hemodynamic performance and the ability to terminate the tachycardia sooner. Embodiments of the present invention use an intrinsic chamber activation sequence and associated interchamber time delays, preferably automatically detected during a period of time when a pathologic tachycardia is not present, to treat a pathologic tachycardia should it occur. Such a device monitors two or more chambers of the patient's heart, i.e., the controlled chambers, and in the event a tachycardia is detected, the device determines the chamber which originated the tachycardia. The device then calculates anti-tachycardia pacing (ATP) cycle lengths, typically as percentages of the detected tachycardia cycle length of the chamber where the tachycardia originated, and begins pacing the controlled chambers according to the intrinsic chamber activation sequence and interchamber delays (initially synchronized relative to a cardiac signal from the chamber which originated the tachycardia) at the ATP cycle lengths for a predefined period or until the tachycardia ends. Optionally, embodiments of the present invention may additionally include a hemodynamic sensor and may adaptively alter the activation sequence and/or interchamber time delays in response to feedback from the hemodynamic sensor.