TREA

Supraventricular tachy sensing vector

Follow

Information

  • Patent Grant
  • 10350419
  • Patent Number
    10,350,419
  • Date Filed
    Wednesday, September 14, 2016
    8 years ago
  • Date Issued
    Tuesday, July 16, 2019
    5 years ago
Information
Abstract
A system includes a pulse generator including a can electrode and a lead couplable to the pulse generator, the lead including a distal coil electrode and a proximal coil electrode, wherein both of the coil electrodes are electrically uncoupled from the can electrode such that a unipolar sensing vector is provided between at least one of the coil electrodes and the can electrode.
Description
TECHNICAL FIELD

This relates to the field of medical devices, and more specifically to a sensing vector for an implantable device.


BACKGROUND

Pulse generators and leads having electrodes implanted in or about the heart have been used to reverse certain life threatening arrhythmia, or to stimulate contraction of the heart. Electrical energy is applied to the heart via an electrode to return the heart to normal rhythm. Leads are usually positioned on, in, or near the ventricle or the atrium and the lead terminal pins are attached to a pacemaker or defibrillator which is implanted subcutaneously. The pulse generator is configured to utilize the electrodes to receive signals from the heart which can indicate certain cardiac events.


SUMMARY

A system includes a pulse generator including a can electrode and a lead couplable to the pulse generator, the lead including a distal coil electrode and a proximal coil electrode, wherein both of the coil electrodes are electrically uncoupled from the can electrode such that a unipolar sensing vector is provided between at least one of the coil electrodes and the can electrode.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 shows a lead and pulse generator in accordance with one embodiment.



FIG. 2 shows a schematic representation of a lead and pulse generator in accordance with one embodiment.





DETAILED DESCRIPTION

In the following detailed description, reference is made to the accompanying drawings which form a part hereof, and in which is shown by way of illustration specific embodiments in which the invention may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that other embodiments may be utilized and that structural changes may be made without departing from the scope of the present invention. Therefore, the following detailed description is not to be taken in a limiting sense, and the scope of the present invention is defined by the appended claims and their equivalents.



FIG. 1 shows a view of a lead 100 coupled to a pulse generator 150. In one embodiment, lead 100 is adapted to deliver defibrillation shock energy to a heart. Certain embodiments deliver pacing pulses to a heart. Pulse generator 150 can be implanted in a surgically-formed pocket in a patient's chest or other desired location. Pulse generator 150 generally includes electronic components to perform signal analysis, processing, and control. Pulse generator 150 can include a power supply such as a battery, a capacitor, and other components housed in a case or can 151. The device can include microprocessors to provide processing and evaluation to determine and deliver electrical shocks and pulses of different energy levels and timing for ventricular defibrillation, cardioversion, and pacing to a heart in response to cardiac arrhythmia including fibrillation, tachycardia, and bradycardia.


In one embodiment, lead 100 includes a lead body 105 extending from a proximal end 107 to a distal end 109 and having an intermediate portion 111. Lead 100 includes one or more conductors, such as coiled conductors or other conductors, to conduct energy from pulse generator 150 to one or more electrodes, such as a distal defibrillation coil electrode 120 configured to be implanted in right ventricle 20, and a proximal defibrillation coil electrode 122 configured to be implanted in right atrium 22 or superior vena cava 24. The superior vena cava and the right atrium are called the supraventricular portion of the heart. In one embodiment, the lead 100 can include a tip electrode 130 and a distal ring electrode 132 for ventricular sensing and pacing. Some embodiments include one or more proximal ring electrodes for atrial sensing and pacing.


Lead 100 can include lead terminal pins which are attached to pulse generator 150 at a header. The system can include a unipolar system with the housing can 151 acting as an electrode or a bipolar system with a pulse between two electrodes 120, 122, or electrodes 130, 132.


The present system is directed to providing a supraventricular tachycardia sensing vector. The present system provides a technique to better distinguish supraventricular tachycardia (SVT) from ventricular tachycardia (VT). For example, in a past approach, the proximal coil 122 was electrically coupled to can electrode 151 and tachycardia sensing was performed using the distal coil 120 to both the can 151 plus the proximal coil 122. However, this configuration results in difficulties in distinguishing between SVT and VT.


In one embodiment, the present system electrically isolates the can electrode 151 from proximal coil electrode 122 and from the distal coil electrode 120 to provide a supraventricular tachy sensing vector. For example, coil electrode 122 can be electrically isolated from the can electrode 151 and a unipolar sensing vector can be from the proximal coil electrode 122 to the can electrode 151. In one embodiment, a unipolar sensing vector can be from the distal coil 120 to the can electrode 151. In one embodiment, a sensing vector can be from distal coil 120 to proximal electrode 122. These configurations are useful for distinguishing between SVT and VT.


In other embodiments, the present system uncouples the proximal electrode 122 from the can 151 and provides sensing utilizing one or more of electrodes 130, 132.


The term sensing vector is described herein by the location of the two electrodes used by a sensing channel within the pulse generator. The sensing channel uses the electrical signal that exists between the two electrodes to sense cardiac activity. Different sense vectors will present different aspects of the cardiac signal to the sensing channel. In the present embodiments, the sense vectors have improved performance for sensing SVT because these vectors produce a larger SVT to VT signal ratio than in the past.


Thus in various examples, both of the coil electrodes 120, 122 are electrically uncoupled from the can electrode 151 such that a unipolar sensing vector is provided between at least one of the coil electrodes and the can electrode 151. For example, the sensing vector can be provided between the distal electrode 120 and the can electrode 151, or the sensing vector can be provided between the proximal electrode 122 and the can electrode 151. In another example a second sensing vector can be provided between the distal coil electrode 120 and the proximal coil electrode 122.


In another example, the pulse generator can be configured such that the unipolar sensing vector can alternate between the distal coil electrode 120 and the can electrode 151 and the proximal electrode 122 and the can electrode 151. In one embodiment, the pulse generator is configured such that a first unipolar sensing vector between the distal coil electrode 120 and the can electrode 151 and a second unipolar sensing vector between the proximal electrode 122 and the can electrode 151 occur simultaneously.


The pulse generator can be configured to distinguish between VT and SVT using the unipolar sensing vectors discussed above. For example, one technique to distinguish between VT and SVT is to use a template of the correlation between shock vector electrograms and RV rate vector electrograms during normal sinus rhythm. When an arrhythmia is detected, the template is compared to the on-going rhythm; if the rhythm matches the existing template, then it is believed that the origin of the rhythm is supraventricular and the device withholds therapy—the assumption being that a supraventricular rhythm follows the same conduction pathway as normal sinus rhythm, and thus the correlation of the two vectors during SVT would match the normal sinus rhythm template, and therapy can be delivered.


However, if the correlation of the vectors during the rhythm does not match the template, then it is assumed that the rhythm is VT (i.e. the rhythm is not using the normal conduction pathway).


Further embodiments can use a different template created from the new vectors described herein. This new template would provide more power to discriminate problem cases using the template described above—and thus more information from the combination of more vectors would yield more discrimination power.


In one embodiment, electrode 122 is disposed along the lead such that the electrode 122 is configured to be located in the right atrium 22 or superior vena cava 24 after implantation.



FIG. 2 shows a schematic representation of portions of the system described above, in accordance with one embodiment. The lead includes a first conductor 202 coupled between the proximal coil electrode 122 and electronics 201 within the pulse generator 150. The lead also includes a second conductor 203 coupled between distal coil electrode 120 and electronics 201. The can electrode 151 is also coupled to the electronics 201. Electronics 201 includes electrically pathways which provide that the electrodes 122, and 120 are electrically insulated from the can electrode 151. As discussed, the electronics 201 can be configured to allow the various connections to be uncoupled or coupled as desired.


It is understood that the above description is intended to be illustrative, and not restrictive. Many other embodiments will be apparent to those of skill in the art upon reviewing the above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

Claims
  • 1. A method comprising: providing a lead and an associated pulse generator, the pulse generator including a can electrode, the lead including a proximal coil electrode which is electrically isolated from the can electrode, and the lead including a distal coil electrode which is electrically isolated from the can electrode;sensing heart signals using a first unipolar sensing vector between the distal coil electrode and the can electrode and a second unipolar sensing vector between the proximal coil electrode and the can electrode.
  • 2. The method of claim 1, wherein sensing heart signals includes the pulse generator differentiating between SVT signals and VT signals.
  • 3. The method of claim 2, wherein differentiating between SVT signals and VT signals includes using a template of a correlation between shock vector electrograms and RV rate vector electrograms during normal sinus rhythm.
  • 4. The method of claim 3, including detecting an arrhythmia from a heart signal, wherein when the arrhythmia is detected, the template is compared to an on-going rhythm, and when the on-going rhythm matches the existing template, then the pulse generator withholds therapy.
  • 5. The method of claim 1, wherein the lead further includes one or more distal pacing and/or sensing electrodes.
  • 6. The method of claim 1, wherein a third sensing vector is provided between the distal coil electrode and the proximal coil electrode.
  • 7. The method of claim 1, wherein the pulse generator is configured such that a sensed unipolar sensing vector can alternate between the first unipolar sensing vector between the distal coil electrode and the can electrode and the second unipolar sensing vector between the proximal electrode and the can electrode.
  • 8. The method of claim 1, wherein the pulse generator is configured such that a first unipolar sensing vector between the distal coil electrode and the can electrode and a second unipolar sensing vector between the proximal electrode and the can electrode occur simultaneously.
CLAIM OF PRIORITY

This application is a continuation of U.S. application Ser. No. 12/277,101, filed Nov. 24, 2008, which claims the benefit under 35 U.S.C. 119(e) of U.S. Provisional Application No. 61/007,635, filed on Dec. 13, 2007, each of which is hereby incorporated by reference in its entirety.

US Referenced Citations (304)
Number Name Date Kind
3857399 Zacouto Dec 1974 A
4030510 Bowers Jun 1977 A
4059116 Adams Nov 1977 A
4163451 Lesnick et al. Aug 1979 A
4208008 Smith Jun 1980 A
RE30387 Denniston, III et al. Aug 1980 E
4432360 Mumford et al. Feb 1984 A
4485818 Leckrone et al. Dec 1984 A
4503857 Boute et al. Mar 1985 A
4556063 Thompson et al. Dec 1985 A
4562841 Brockway et al. Jan 1986 A
4596255 Snell et al. Jun 1986 A
4791936 Snell et al. Dec 1988 A
4809697 Causey, III et al. Mar 1989 A
4830006 Haluska et al. May 1989 A
4856523 Sholder et al. Aug 1989 A
4860749 Lehmann Aug 1989 A
4869252 Gilli Sep 1989 A
4890617 Markowitz et al. Jan 1990 A
4905697 Heggs et al. Mar 1990 A
4917115 Flammang et al. Apr 1990 A
4920965 Funke et al. May 1990 A
4928688 Mower May 1990 A
4932406 Berkovits Jun 1990 A
4940054 Grevis et al. Jul 1990 A
4941471 Mehra Jul 1990 A
4944298 Sholder Jul 1990 A
4944928 Grill et al. Jul 1990 A
4945909 Fearnot et al. Aug 1990 A
4972834 Begemann et al. Nov 1990 A
4998974 Aker Mar 1991 A
5012814 Mills et al. May 1991 A
5042480 Hedin et al. Aug 1991 A
5077667 Brown et al. Dec 1991 A
5085215 Nappholz et al. Feb 1992 A
5101824 Lekholm Apr 1992 A
5107850 Olive Apr 1992 A
5127404 Wyborny et al. Jul 1992 A
5129394 Mehra Jul 1992 A
5133350 Duffin Jul 1992 A
5139020 Koestner et al. Aug 1992 A
5144949 Olson Sep 1992 A
5156147 Warren et al. Oct 1992 A
5156154 Valenta, Jr. et al. Oct 1992 A
5176136 Giele Jan 1993 A
5179949 Chirife Jan 1993 A
5183040 Nappholz et al. Feb 1993 A
5184614 Collins et al. Feb 1993 A
5188106 Nappholz et al. Feb 1993 A
5193535 Bardy et al. Mar 1993 A
5193550 Duffin Mar 1993 A
5197467 Steinhaus et al. Mar 1993 A
5207219 Adams et al. May 1993 A
5226415 Girodo et al. Jul 1993 A
5282836 Kreyenhagen et al. Feb 1994 A
5284491 Sutton et al. Feb 1994 A
5292339 Stephens et al. Mar 1994 A
5292341 Snell Mar 1994 A
5311874 Baumann et al. May 1994 A
5312452 Salo May 1994 A
5331966 Bennett et al. Jul 1994 A
5334220 Sholder Aug 1994 A
5340361 Sholder Aug 1994 A
5350409 Stoop et al. Sep 1994 A
5356425 Bardy et al. Oct 1994 A
5360437 Thompson Nov 1994 A
5365932 Greenhut Nov 1994 A
5372607 Stone et al. Dec 1994 A
5379776 Murphy et al. Jan 1995 A
5383910 den Dulk Jan 1995 A
5387229 Poore Feb 1995 A
5391189 van Krieken et al. Feb 1995 A
5395373 Ayers Mar 1995 A
5395397 Lindgren et al. Mar 1995 A
5400796 Wecke Mar 1995 A
5411524 Rahul May 1995 A
5411531 Hill et al. May 1995 A
5417714 Levine et al. May 1995 A
5423869 Poore et al. Jun 1995 A
5431691 Snell et al. Jul 1995 A
5437285 Verrier et al. Aug 1995 A
5462060 Jacobson et al. Oct 1995 A
5474574 Payne et al. Dec 1995 A
5480413 Greenhut et al. Jan 1996 A
5486198 Ayers et al. Jan 1996 A
5487752 Salo et al. Jan 1996 A
5507782 Kieval et al. Apr 1996 A
5507784 Hill et al. Apr 1996 A
5514163 Markowitz et al. May 1996 A
5522850 Yomtov et al. Jun 1996 A
5522859 Stroebel et al. Jun 1996 A
5523942 Tyler et al. Jun 1996 A
5527347 Shelton et al. Jun 1996 A
5534016 Boute Jul 1996 A
5540232 Laney et al. Jul 1996 A
5540727 Tockman et al. Jul 1996 A
5545182 Stotts et al. Aug 1996 A
5545186 Olson et al. Aug 1996 A
5549649 Florio et al. Aug 1996 A
5549654 Powell Aug 1996 A
5554174 Causey, III Sep 1996 A
5560369 McClure et al. Oct 1996 A
5560370 Verrier et al. Oct 1996 A
5584864 White Dec 1996 A
5584867 Limousin et al. Dec 1996 A
5591215 Greenhut et al. Jan 1997 A
5605159 Smith et al. Feb 1997 A
5607460 Kroll et al. Mar 1997 A
5613495 Mills et al. Mar 1997 A
5620471 Duncan Apr 1997 A
5620473 Poore Apr 1997 A
5622178 Gilham Apr 1997 A
5626620 Kieval et al. May 1997 A
5626622 Cooper May 1997 A
5626623 Kieval et al. May 1997 A
5632267 Hognelid et al. May 1997 A
5674250 de Coriolis et al. Oct 1997 A
5674251 Combs et al. Oct 1997 A
5674255 Walmsley et al. Oct 1997 A
5676153 Smith et al. Oct 1997 A
5683429 Mehra Nov 1997 A
5690686 Min et al. Nov 1997 A
5690689 Sholder Nov 1997 A
5700283 Salo Dec 1997 A
5702424 Legay et al. Dec 1997 A
5713928 Bonnet et al. Feb 1998 A
5713929 Hess et al. Feb 1998 A
5713930 van der Veen et al. Feb 1998 A
5713932 Gillberg et al. Feb 1998 A
5716382 Snell Feb 1998 A
5716383 Kieval et al. Feb 1998 A
5716384 Snell Feb 1998 A
5718235 Golosarsky et al. Feb 1998 A
5724985 Snell et al. Mar 1998 A
5725559 Alt et al. Mar 1998 A
5725561 Stroebel et al. Mar 1998 A
5730141 Fain et al. Mar 1998 A
5730142 Sun et al. Mar 1998 A
5738096 Ben-Haim Apr 1998 A
5741304 Patwardhan et al. Apr 1998 A
5741308 Sholder Apr 1998 A
5749901 Bush et al. May 1998 A
5749906 Kieval et al. May 1998 A
5755736 Gillberg et al. May 1998 A
5755737 Prieve et al. May 1998 A
5755739 Sun et al. May 1998 A
5755740 Nappholz May 1998 A
5759196 Hess et al. Jun 1998 A
5776164 Ripart Jul 1998 A
5776167 Levine et al. Jul 1998 A
5782887 van Krieken et al. Jul 1998 A
5782888 Sun et al. Jul 1998 A
5788717 Mann et al. Aug 1998 A
5792193 Stoop Aug 1998 A
5792200 Brewer Aug 1998 A
5800464 Kieval Sep 1998 A
5800471 Baumann Sep 1998 A
5814077 Sholder et al. Sep 1998 A
5814081 Ayers et al. Sep 1998 A
5814085 Hill Sep 1998 A
5836975 DeGroot Nov 1998 A
5836987 Baumann et al. Nov 1998 A
5840079 Warman et al. Nov 1998 A
5842997 Verrier et al. Dec 1998 A
5846263 Peterson et al. Dec 1998 A
5853426 Shieh Dec 1998 A
5855593 Olson et al. Jan 1999 A
5861007 Hess et al. Jan 1999 A
5865838 Obel et al. Feb 1999 A
5871507 Obel et al. Feb 1999 A
5873895 Sholder et al. Feb 1999 A
5873897 Armstrong et al. Feb 1999 A
5876422 Van Groeningen Mar 1999 A
5891178 Mann et al. Apr 1999 A
5893882 Peterson et al. Apr 1999 A
5897575 Wickham Apr 1999 A
5902324 Thompson et al. May 1999 A
5928271 Hess et al. Jul 1999 A
5931856 Bouhour et al. Aug 1999 A
5931857 Prieve et al. Aug 1999 A
5935081 Kadhiresan Aug 1999 A
5944744 Paul et al. Aug 1999 A
5951592 Murphy Sep 1999 A
5968079 Warman et al. Oct 1999 A
5968081 Levine Oct 1999 A
5974341 Er et al. Oct 1999 A
5978707 Krig et al. Nov 1999 A
5978710 Prutchi et al. Nov 1999 A
5983138 Kramer Nov 1999 A
5987354 Cooper et al. Nov 1999 A
5987356 DeGroot Nov 1999 A
5991656 Olson et al. Nov 1999 A
5991657 Kim Nov 1999 A
5991662 Kim et al. Nov 1999 A
5999850 Dawson et al. Dec 1999 A
5999854 Deno et al. Dec 1999 A
6026320 Carlson et al. Feb 2000 A
6041251 Kim et al. Mar 2000 A
6044298 Salo et al. Mar 2000 A
6047210 Kim et al. Apr 2000 A
6049735 Hartley et al. Apr 2000 A
6052617 Kim Apr 2000 A
6052620 Gillberg et al. Apr 2000 A
6058328 Levine et al. May 2000 A
6070101 Struble et al. May 2000 A
6081745 Mehra Jun 2000 A
6081746 Pendekanti et al. Jun 2000 A
6081747 Levine et al. Jun 2000 A
6081748 Struble et al. Jun 2000 A
RE36765 Mehra Jul 2000 E
6085116 Pendekanti et al. Jul 2000 A
6088618 Kerver Jul 2000 A
6091988 Warman et al. Jul 2000 A
6096064 Routh Aug 2000 A
6122545 Struble et al. Sep 2000 A
6128529 Elser Oct 2000 A
6129745 Sun et al. Oct 2000 A
6134469 Wietholt Oct 2000 A
6151524 Krig et al. Nov 2000 A
6219579 Bakels et al. Apr 2001 B1
6223072 Mika et al. Apr 2001 B1
6223079 Bakels et al. Apr 2001 B1
6223082 Bakels et al. Apr 2001 B1
6238420 Bakels et al. May 2001 B1
6246909 Ekwall Jun 2001 B1
6249699 Kim Jun 2001 B1
6256534 Dahl Jul 2001 B1
6263242 Mika et al. Jul 2001 B1
6266554 Hsu et al. Jul 2001 B1
6272380 Warman et al. Aug 2001 B1
6275734 McClure et al. Aug 2001 B1
6280391 Olson et al. Aug 2001 B1
6285907 Kramer et al. Sep 2001 B1
6292693 Darvish et al. Sep 2001 B1
6317632 Krig et al. Nov 2001 B1
6324425 Blow Nov 2001 B1
6351669 Hartley et al. Feb 2002 B1
6353759 Hartley et al. Mar 2002 B1
6353761 Conley et al. May 2002 B1
6408209 Bouhour et al. Jun 2002 B1
6411847 Mower Jun 2002 B1
6411848 Kramer et al. Jun 2002 B2
6421564 Yerich et al. Jul 2002 B1
6424865 Ding Jul 2002 B1
6430438 Chen et al. Aug 2002 B1
6430439 Wentkowski et al. Aug 2002 B1
6434424 Igel et al. Aug 2002 B1
6438410 Hsu et al. Aug 2002 B2
6438421 Stahmann et al. Aug 2002 B1
6501987 Lovett et al. Dec 2002 B1
6501988 Kramer et al. Dec 2002 B2
6512951 Marcovecchio et al. Jan 2003 B1
6522925 Gilkerson et al. Feb 2003 B1
RE38119 Mower May 2003 E
6687541 Marcovecchio et al. Feb 2004 B2
6760615 Ferek-Petric Jul 2004 B2
6763267 Ding Jul 2004 B2
6847842 Rodenhiser et al. Jan 2005 B1
6957100 Vanderlinde et al. Oct 2005 B2
7013176 Ding et al. Mar 2006 B2
7069077 Lovett et al. Jun 2006 B2
7120490 Chen et al. Oct 2006 B2
7123960 Ding et al. Oct 2006 B2
7142915 Kramer et al. Nov 2006 B2
7142918 Stahmann et al. Nov 2006 B2
7184834 Levine Feb 2007 B1
7203540 Ding et al. Apr 2007 B2
7266411 Paris et al. Sep 2007 B1
7283872 Boute et al. Oct 2007 B2
7308310 Levine et al. Dec 2007 B1
7460908 Krig et al. Dec 2008 B2
20020062139 Ding May 2002 A1
20020082509 Vanderlinde et al. Jun 2002 A1
20020082660 Stahmann et al. Jun 2002 A1
20020087198 Kramer et al. Jul 2002 A1
20020091415 Lovett et al. Jul 2002 A1
20020120298 Kramer et al. Aug 2002 A1
20030004551 Chen et al. Jan 2003 A1
20030069610 Kramer et al. Apr 2003 A1
20030078630 Lovett et al. Apr 2003 A1
20030083587 Ferek-Petric May 2003 A1
20030105491 Gilkerson et al. Jun 2003 A1
20030204214 Ferek-Patric Oct 2003 A1
20030233131 Kramer et al. Dec 2003 A1
20040010295 Kramer et al. Jan 2004 A1
20040077963 Perschbacher et al. Apr 2004 A1
20040172076 Stahmann et al. Sep 2004 A1
20040215249 Corbucci Oct 2004 A1
20040215259 Krig et al. Oct 2004 A1
20040243188 Vanderlinde et al. Dec 2004 A1
20040254613 Ostroff Dec 2004 A1
20050038480 Ding Feb 2005 A1
20050192506 Kim Sep 2005 A1
20050283196 Bocek et al. Dec 2005 A1
20050288719 Zhang et al. Dec 2005 A1
20060111747 Cazares et al. May 2006 A1
20060116594 Zhang et al. Jun 2006 A1
20060219252 Bardy et al. Jun 2006 A1
20060167508 Boute et al. Jul 2006 A1
20060195150 Lovett Aug 2006 A1
20060195151 Vanderlinde et al. Aug 2006 A1
20090149904 Perschbacher et al. Jun 2009 A1
20090149907 Perschbacher et al. Jun 2009 A1
20090157133 Perschbacher et al. Jun 2009 A1
Foreign Referenced Citations (24)
Number Date Country
0033418 Aug 1981 EP
0360412 Mar 1990 EP
0401962 Dec 1990 EP
0597459 May 1994 EP
0617980 Oct 1994 EP
0674917 Oct 1995 EP
0748638 Dec 1996 EP
2007513708 May 2007 JP
2007517549 Jul 2007 JP
WO-9302746 Feb 1993 WO
WO-9509029 Apr 1995 WO
WO-9711745 Apr 1997 WO
WO-9739798 Oct 1997 WO
WO-9848891 Nov 1998 WO
WO-0004950 Feb 2000 WO
WO-0038782 Jul 2000 WO
WO-0047277 Aug 2000 WO
WO-0071200 Nov 2000 WO
WO-0071202 Nov 2000 WO
WO-0071203 Nov 2000 WO
WO-02045797 Jun 2002 WO
WO-2005058412 Jun 2005 WO
WO-09075725 Jun 2009 WO
WO-09075749 Jun 2009 WO
Non-Patent Literature Citations (76)
Entry
“”, Metrix Model 3020 Implantable Atrial Defibrillator, Physician's Manual, InControl, Inc., Redmond, WA, (1998), pp. 4-24-4-27.
“U.S. Appl. No. 09/316,588, Non Final Office Action dated Nov. 21, 2000”, 4 pgs.
“U.S. Appl. No. 09/316,588, Notice of Allowance dated Mar. 19, 2001”, 6 pgs.
“U.S. Appl. No. 09/316,588, Response filed Feb. 21, 2001 to Non Final Office Action dated Nov. 21, 2000”, 10 pgs.
“U.S. Appl. No. 09/837,019, Non Final Office Action dated Aug. 1, 2001”, 5 pgs.
“U.S. Appl. No. 09/837,019, Notice of Allowance dated Feb. 8, 2002”, 3 pgs.
“U.S. Appl. No. 10/852,602, Corrected Notice of Allowance dated Aug. 4, 2008”, 4 pgs.
“U.S. Appl. No. 10/852,602, Notice Of Allowance dated Jul. 11, 2007”, 9 pgs.
“U.S. Appl. No. 11/380,148, Restriction Requirement dated Oct. 29, 2008”, 7 pgs.
“U.S. Appl. No. 12/277,101, Appeal Brief filed Mar. 26, 2014”, 11 pgs.
“U.S. Appl. No. 12/277,101, Appeal Decision mailed Jul. 15, 2016”, 6 pgs.
“U.S. Appl. No. 12/277,101, Final Office Action dated Aug. 15, 2013”, 8 pgs.
“U.S. Appl. No. 12/277,101, Final Office Action dated Oct. 1, 2012”, 7 pgs.
“U.S. Appl. No. 12/277,101, Final Office Action dated Nov. 8, 2011”, 10 pgs.
“U.S. Appl. No. 12/277,101, Non Final Office Action dated Mar. 7, 2013”, 8 pgs.
“U.S. Appl. No. 12/277,101, Non Final Office Action dated Mar. 28, 2012”, 7 pgs.
“U.S. Appl. No. 12/277,101, Non Final Office Action dated Jun. 29, 2011”, 9 pgs.
“U.S. Appl. No. 12/277,101, Response filed Feb. 8, 2012 to Final Office Action dated Nov. 8, 2011”, 8 pgs.
“U.S. Appl. No. 12/277,101, Response filed Mar. 1, 2013 to Final Office Action dated Oct. 1, 2012”, 8 pgs.
“U.S. Appl. No. 12/277,101, Response filed Jun. 7, 2013 to Non Final Office Action dated Mar. 7, 2013”, 7 pgs.
“U.S. Appl. No. 12/277,101, Response filed Aug. 8, 2012 to Non Final Office Action dated Mar. 28, 2012”, 11 pgs.
“U.S. Appl. No. 12/277,101, Response filed Oct. 27, 2011 to Non Final Office Action dated Jun. 29, 2011”, 8 pgs.
“U.S. Appl. No. 12/327,567, Non-Final Office Action dated Sep. 22, 2010”, 8 pgs.
“French CNH Equipment Approvals”, Clinica, 417, p. 9, (Sep. 5, 1990), 3 pgs.
“International Application Serial No. PCT/US2008/013069, International Search Report dated Mar. 27, 2009”, 5 pgs.
“International Application Serial No. PCT/US2008/013305, Search Report dated Mar. 18, 2009”, 8 pgs.
“International Application Serial No. PCT/US2008/013305, Written Opinion dated Mar. 18, 2009”, 8 pgs.
“International Application Serial No. PCT/US2008/013960, Written Opinion dated Mar. 27, 2009”, 8 pgs.
“Japanease Application Serial No. 2010-537922, Office Action dated Jul. 3, 2012”, With English Translation, 7 pgs.
“Japanese Application Serial No. 2010-537922, Office Action dated Dec. 18, 2012”, With English Translation, 7 pgs.
“Japanese Application Serial No. 2010-537922, Response filed Sep. 26, 2012 to Office Action dated Jul. 3, 2012”, With English Claims, 7 pgs.
“Pacemaker System Guide”, (c) 2001 Guidant Corporation, 240 pgs.
“Pacemaker System Guide for Pulsar Max II; Mulitprogrammable Pacemakers”, Product brochure published by Guidant Corporation, (Apr. 18, 1999), pp. 6-48 and 6-49.
“Pacemaker System Guide for Pulsar Max II; Multiprogrammable Pacemakers”, Product brochure published by Guidant Corporation, (Apr. 18, 1999), p. 6-39-6-51.
“Rate-Adaptive Devices Impact Pacemaker Market”, Clinica, 467, p. 16, (Sep. 11, 1991), 6 pgs.
“Vitatron Medical Harmony Automatic Dual Chamber Pacemaker Product Information and Programming Guide”, Viatron Medical, 22 p., (Date Unknown), Harmony Dual Chamber mentioned in publication Clinica, 467, p. 16, Sep. 11, 1991, “Rate Devices Impact Pacemaker Market”, also mentioned in Clinica, 417, p. 9, Sep. 5, 1990 “French CNH Equipment Approvals”., Product Brochure published by Vitatron Medical, 22 pgs.
Ayers, Gregory M., et al., “Ventricular Proarrhythmic Effects of Ventricular Cycle Length and Shock Strength in a Sheep Model of Transvenous Atrial Defibrillation”, Circulation, 89 (1), (Jan. 1994), 413-422.
Blommaert, D., et al., “Effective Prevention of Atrial Fibrillation by Continuous Atrial Overdrive Pacing After Coronary Artery Bypass Surgery”, JACC, vol. 35, No. 6, (May 2000), 1411-1415 pgs.
Buhr, T. A., et al., “Novel Pacemaker Algorithm Diminishes Short-Coupled Ventricular Beats In Atrial Fibrillation”, Pacing and Clinical Electrophysiology, vol. 24, Part II, (Abstract Only), (Apr. 2001), 729 pgs.
Campbell, R. M., et al., “Atrial Overdrive Pacing for Conversion of Atrial Flutter in Children”, Pediatrics, 75(4), (Apr. 1985), 730-736.
Clark, David M., et al., “Hemodynamic Effects of an Irregular Sequence of Ventricular Cycle Lengths During Atrial Fibrillation”, JACC, vol. 30, No. 4, (Oct. 1997), 1039-1045.
Cohen, R. J., et al., “Quantitative Model for Ventricular Response During Atrial Fibrillation”, IEEE Transactions on Biomedical Engineering, 30, (1983), 769-782.
Duckers, H. J., et al., “Effective use of a novel rate-smoothing algorithm in atrial fibrillation by ventricular pacing”, European Heart Journal, 18, (1997), 1951-1955 pgs.
Fahy, G. J., et al., “Pacing Strategies to Prevent Atrial Fibrillation”, Atrial Fibrillation, 14(4), (Nov. 1996), 591-596.
Fromer, M., et al., “Algorithm for the Prevention of Ventricular Tachycardia Onset: The Prevent Study”, The American Journal of Cardiology, 83 (5B), (Mar. 11, 1999), 450-470 pgs.
Garrigue, S., et al., “Prevention of Atrial Arrhythmias during DDD Pacing by Atrial Overdrive”, Pacing and Clinical Electrophysiology, 21(9), (Sep. 1998), 1751-1759.
Greenhut, S., et al., “Effectiveness of a Ventricular Rate Stabilization Algorithm During Atrial Fibrillation in Dogs”, Pace Abstract, Abstract No. 60, (1996), 1 pg.
Guidant, “CONTAK TR CHFD Model 1241”, System Guide, Congestive Heart Failure Device, (1999), 1-191.
Heuer, H., et al., “Dynamic Dual-Chamber Overdrive Pacing with an Implantable Pacemaker System: A New Method for Terminating Slow Ventricular Tachycardia”, Zeitschrift fur Kardiologie, 75, German Translation by the Ralph McElroy Translation Company, Austin, TX, (1986), 6 pages.
Heuer, H., et al., “Dynamische Zweikammer-Overdrive-Stimulation mit einem implantierbaren Schrittmachersystem als neue Methode zur Beendigung Langsamer ventrikularer Tachykardien”, Z Kardiol; 75, Includes English translation (5 pgs.), (1986), 673-675 pgs.
Jenkins, J., et al., “Diagnosis of Atrial Fibrillation Using Electrogram from Chronic Leads: Evaluation of Computer Algorithm”, Pacing and Clinical Electrophysiology, 11(5), (1988), 622-631.
Jung, J., et al., “Discrimination of Sinus Rhythm, Atrial Flutter, and Atrial Fibrillation Using Bipolar Endocardial Signals”, Journal of Cardiovascular Electrophysiology, 9 (7), (Jul. 1998), 689-695 pgs.
Krig, D. B, et al., “Method and Apparatus for Treating Irregular Ventricular Contractions Such as During Atrial Arrhythmia”, U.S. Appl. No. 09/316,515, filed May 21, 1999, 57 pgs.
Lau, C. P., et al., “A new pacing method for rapid regularization and rate control in atrial fibrillation”, Am J Cardiol., 65(18), (May 15, 1990), 1198-203.
Lau, Chu-Pak, et al., “Efficacy of Ventricular Rate Stabilization by Right Ventricular Pacing During Atrial Fibrillation”, Pacing and Clinical Electrophysiology, 21(3), (Mar. 1998), 542-548.
Lovett, E. G., “Cardiac Pacing System for Prevention of Ventricular Fibrillation and Ventricular Tachycardia Episodes”, U.S. Appl. No. 09/569,295, filed May 13, 2000, 30 pgs.
Medtronic, “Insync III Device Model 8042”, Device Programming Guide, Insync III Device Model 8042, Vision Programmer Software Model 9981, (2000), 1-260.
Medtronic, “Insync III Device Model 8042”, Device Reference Guide, Insync III Device Model 8042, Vision Programmer Software Model 9981, (2002), 1-252.
Mehra, R., et al., “Prevention of Atrial Fibrillation/Flutter by Pacing Techniques”, Interventional Electrophysiology, Second Edition, Chapter 34, Futura Publishing Company, Inc., (1996), 521-540 pgs.
Morris, M. M., et al., “Intracardiac Electrogram Transformation: Morphometric Implications for Implantable Devices”, Journal of Electrocardiology, 29 Supplement, (1996), 124-129.
Mower, Morton, “Method and Apparatus for Treating Hemodynamic Disfunction”, U.S. Patent Office Patent Application Information Retrieval (PAIR) search results for U.S. Appl. No. 10/214,474, filed Aug. 8, 2002, entitled, 3 pgs.
Murgatroyd, F. D., et al., “A New Pacing Algorithm for Overdrive Suppression of Atrial Fibrillation”, Pacing and Clinical Electrophysiology, 17(11 Pt. 2), (Nov. 1994, Part), 1966-1973.
Schuller, H., et al., “Far Field R-Wave Sensing—An Old Problem Repeating”, Pacing and Clinical Electrophysiology, 19, Part II, NASPE Abstract No. 264, (1996), p. 631.
Seim, G., et al., “Classification of Atrial Flutter and Atrial Fibrillation Using an Atrial Dispersion Index (ADI)”, Guidant CRM Therapy Research Peer Review Report Revision 2.0, (Jan. 6, 1999), 27 pgs.
St. Jude Medical, “Atlas + HF Models V-343, V-341”, User's Manual, Implantable Cardioverter-Defibrillator, (Sep. 2003), 1-30.
St. Jude Medical, “Epic HF Model V-339”, User's Manual, Implantable Cardioverter-Defibrillator, (Jul. 2002), 1-26.
St. Jude Medical, “Model 3510 Programmer with Model 3307 Software”, Reference Manual, For Atlas, Atlas+, Epic, Epic+, Photon u and Photon Implantable Cardioverter/Defibrillators, (Sep. 2003), 1-314.
Stephany, G. R., et al., “Real-Time Estimation of Magnitude-Square Coherence for Use in Implantable Devices”, IEEE Computers in Cardiology, (1992), 375-378 pgs.
Sutton, R., “Pacing in Atrial Arrhythmias”, Pacing and Clinical Electrophysiology, 13(12), (Dec. 1990, Part), 1823-1827.
Sweeney, M. O., et al., “Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction”, Circulation, 107(23), (Jun. 17, 2003), 2932-2937.
Swiryn, S., et al., “Detection of Atrial Fibrillation by Pacemakers and Antiarrhythmic Devices”, Nonpharmacological Management of Atrial Fibrillation, Chapter 21, Futura Publishing Co, Inc. Armonk, NY, (1997), 309-318 pgs.
Tse, H. F., et al., “Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (Atrial fibrillation symptoms mediated by pacing to mean rates [AF Symptoms study])”, Am J Cardiol., 94(7), (Oct. 2004), 938-41.
Wittkampf, F. H.M ., et al., “Rate Stabilization by Right Ventricular Patching in Patients with Atrial Fibrillation”, Pace, 9(6)(Part 2), (Nov.-Dec. 1986), 1147-1153.
Wittkampf, Fred H.M., et al., “Effect of Right Ventricular Pacing on Ventricular Rhythm During Atrial Fibrillation”, JACC, vol. 11, No. 3, (Mar. 1988), 539-545.
Zhu, D. W, “Electrophysiology, Pacing and Arrhythmia: Pacing Therapy for Atrial Tachyarrhythmias”, Clinical Cardiology, 19(9), (1996), 737-742.
“Japanese Application Serial No. 2010-537922, Response filed Jun. 14, 2013 to Non Final Office Action dated Dec. 18, 2012”, With English Claims, 7 pgs.
Related Publications (1)
Number Date Country
20170001020 A1 Jan 2017 US
Provisional Applications (1)
Number Date Country
61007635 Dec 2007 US
Continuations (1)
Number Date Country
Parent 12277101 Nov 2008 US
Child 15265674 US