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Method and device for low-energy termination of atrial tachyarrhythmias

A technology for arrhythmia and treatment devices, used in electrotherapy, therapy, internal electrodes, etc., to solve problems such as energy levels exceeding pain thresholds

Active Publication Date: 2011-01-05
WASHINGTON UNIV IN SAINT LOUIS
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

Although initial clinical trials have shown IADs to be highly specific and sensitive for AF and to deliver safe and effective shocks, successful cardioversion methods require energy levels that exceed pain thresholds

Method used

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  • Method and device for low-energy termination of atrial tachyarrhythmias
  • Method and device for low-energy termination of atrial tachyarrhythmias
  • Method and device for low-energy termination of atrial tachyarrhythmias

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Embodiment Construction

[0040] The defibrillation method of embodiments of the present invention is based on the delivery of virtual electrode polarization from an implantable device as a graded pull-out far-field therapy, and a method of disrupting and subsequently terminating anatomical reentry tachyarrhythmias. This method involves a low voltage shock that disrupts or terminates the core of the parent rotor that is anchored to heterogeneous myocardium, such as the vena cava region or areas of fibrosis. With this method, a defibrillation energy that is 20 times lower than traditional high-energy defibrillation can be obtained. In ventricular tachycardia, a reduction in energy from 6.1±1.0 Joules to 0.3±0.1 Joules was observed, p<0.001. Myocardial tissue anatomy is inherently heterogeneous. These averagely moderately proportioned syncytial inhomogeneities represent an important mechanism contributing to the far-field excitation process. Fishler, M.G., Vepa K. "Spatial and temporal effects of syncy...

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Abstract

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.

Description

technical field [0001] The present invention generally relates to the treatment of atrial arrhythmias, such as atrial fibrillation ("AF") and atrial flutter ("AF1"). In particular, the present invention relates to devices and methods for delivering low-energy electrical stimuli using implantable devices that deliver graded unplugging far-field therapy to disrupt and terminate the reentry mechanisms that maintain AF and AF1. Background technique [0002] Atrial tachyarrhythmia is the most common atrial arrhythmia, currently estimated to affect approximately 2.3 million Americans. There are two major forms of atrial tachyarrhythmia: AF and AF1, respectively, with the chronic forms found in approximately 10:1 ratio. Studies from several current projects suggest that by 2050, between 12 and 15 million Americans will be living with AF. The well-described clinical consequences of thromboembolic stroke, congestive heart failure (CHF), congestive dysfunction, and possibly increase...

Claims

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Application Information

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IPC IPC(8): A61N1/05A61N1/372
CPCA61N1/3956A61N1/395A61N1/3624
Inventor 伊格尔·叶菲莫夫克里斯特尔·M·利普林格尔瓦迪姆·V·费多洛夫凯西·V·弗伊尔克里斯缇娜·安布罗西
Owner WASHINGTON UNIV IN SAINT LOUIS
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