Discrimination of noxious and non noxious ventricular extrasystoles in an active implantable medical device such as a cardiac pacemaker, defibrillator, cardiovertor and/or multisite device

摘要

An active implantable medical device, such as a cardiac pacemaker, defibrillator, cardiovertor and/or multisite device, able to discriminate noxious and non noxious ventricular extrasystoles. The device is able to detect a heartbeat rate and detect in the rate an occurrence of a ventricular extrasystole (VES). It also is able to measure an intracardiac impedance (Z), correlated with the instantaneous blood flow, and determine, in response to variations of the impedance signal, the presence or the absence of a significant mechanical activity of the myocardium consecutive to the ventricular extrasystole. In response to such variations, the device provides an indicator of the noxious or non noxious character of the ventricular extrasystole. This indicator allows, inter alia, on the following cycle, to adapt in a differentiated way an operating parameter such as the ventricular escape interval, according to the determined noxious or non noxious character of the ventricular extrasystole.