Devices, systems and methods to perform arrhythmia discrimination based on R-R interval stability corresponding to a plurality of ventricular regions

摘要

Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination. A plurality of different sensing vectors are used to obtain a plurality of different IEGMs, each of which is indicative of cardiac electrical activity at a different ventricular region. The plurality of different IEGMs can include, e.g., an IEGM indicative of cardiac electrical activity at a first region of the patient's left ventricular (LV) chamber and an IEGM indicative of cardiac electrical activity at a second region of the patient's LV chamber. Additionally, the plurality of different IEGMs can further include an IEGM indicative of cardiac electrical activity at a region of a patient's right ventricular (RV) chamber. For each of the IEGMs, there is a determination of a corresponding localized R-R interval stability metric indicative of the R-R interval stability at the corresponding ventricular region. This can include, e.g., determining, for each of the IEGMs, a plurality of R-R intervals corresponding to a plurality of consecutive cardiac cycles of the IEGM. For each IEGM, a measure of variation (e.g., standard deviation, range or variance, but not limited thereto) can then be determined for the plurality of R-R intervals to thereby determine the localized R-R interval stability metric for the IEGM. Arrhythmia discrimination is then performed using the plurality of determined localized R-R interval stability metrics.

主权项

1. A method for use in arrhythmia discrimination, the method comprising:
(a) using a plurality of different sensing vectors to obtain a plurality of different intracardiac electrograms (IEGMs), each of which is indicative of cardiac electrical activity at a different ventricular region, wherein step (a) includes
(a.1) using a first sensing vector to obtain a first IEGM indicative of cardiac electrical activity at a first region of the left ventricular (LV) chamber, and(a.2) using a second sensing vector, that is different than the first sensing vector, to obtain a second IEGM indicative of cardiac electrical activity at a second region of the LV chamber, the second region of the LV chamber being different than the first region of the LV chamber; (b) for each of the IEGMs, determining a corresponding localized R-R interval stability metric indicative of the R-R interval stability at the corresponding ventricular region, wherein step (b) includes
(b.1) determining, based on the first IEGM, a first localized R-R interval stability metric indicative of the R-R interval stability at the first region of the LV chamber, and(b.2) determining, based on the second IEGM, a second localized R-R interval stability metric indicative of the R-R interval stability at the second region of the LV chamber; and (c) performing arrhythmia discrimination using the first and second localized R-R interval stability metrics determined at step (b).