Atrial defibrillation system having patient selectable atrial fibrillation detection

Abstract

An atrial defibrillation system includes an implantable atrial defibrillator having an atrial defibrillation detector for detecting atrial fibrillation and a cardioverter for cardioverting the atria of a heart. The implantable atrial defibrillator further includes a receiver for receiving commands from an external nonimplanted transmitter. A nonimplantable communication device includes a transmitter for transmitting a command to the receiver. The command causes only the atrial fibrillation detector to be activated resulting only in the detection for atrial fibrillation without committing to atrial fibrillation cardioversion should atrial fibrillation be detected.

What is claimed is:  
     
       1. An atrial defibrillation system comprising: 
       an implantable atrial defibrillator including an atrial fibrillation detector for detecting atrial fibrillation and a cardioverter for cardioverting the atria of a heart, the implantable atrial defibrillator further including a receiver for receiving commands from an external nonimplanted transmitter; and  
       a nonimplantable communication device adapted for use by the patient including a transmitter for transmitting a first command to the receiver for activating only the atrial fibrillation detector to cause the atrial fibrillation detector to detect for atrial fibrillation and wherein the cardioverter is not activated in response to the detection of atrial fibrillation unless a further command is transmitted from the nonimplantable communication device to the receiver in the implantable atrial defibrillator.  
     
     
       2. A defibrillation system as defined in  claim 1  wherein the implantable atrial defibrillator liner includes a transmitter for transmitting an acknowledgment message upon receiving the first command and wherein the communication device includes a receiver for receiving the acknowledgment message transmitted by the atrial defibrillator transmitter. 
     
     
       3. A defibrillator system as defined in  claim 1  wherein the implantable atrial defibrillator includes a transmitter for transmitting a status message indicative of detected atrial fibrillation and wherein the communication device includes a receiver for receiving the status message and means for providing a perceptible indication responsive to receipt of the status message. 
     
     
       4. A defibrillation system as defined in  claim 3  wherein the communication device transmitter further includes means for transmitting a further command to the atrial defibrillator receiver and wherein the atrial defibrillator includes means responsive to receipt of the further command to cause the atrial fibrillation detector to redetect for atrial fibrillation and the cardioverter to cardiovert the atria responsive to redetection of atrial fibrillation. 
     
     
       5. An atrial defibrillation system comprising: 
       an implantable atrial defibrillator including an atrial fibrillation detector for detecting fibrillation of a patient's atria, an atrial cardioverter for applying cardioverting electrical energy to the patient's atria, a receiver for receiving operation commands transmitted from an external transmitter, and a mode selecting stage for causing the defibrillator to operate in a first mode of operation wherein only the atrial fibrillation detector is activated to detect for atrial fibrillation and wherein the cardioverter is not activated if atrial fibrillation is detected or in a second mode of operation wherein the atrial fibrillation detector is activated to detect for atrial fibrillation and the cardioverter is automatically activated for applying cardioverting electrical energy to the patient's atria if atrial fibrillation is detected; and  
       a nonimplantable communication device dimensioned to be hand-held and operable by the patient including a transmitter for selectively transmitting a first operation command to cause the mode selector stage to render the implantable atrial defibrillator in the first mode of operation and a second operation command to cause the mode selector stage to render the implantable atrial defibrillator in the second mode of operation.  
     
     
       6. A defibrillation system as defined in  claim 5  wherein the implantable atrial defibrillator further includes a transmitter for transmitting atrial fibrillation detection outcome status messages responsive to the atrial fibrillation detector and wherein the nonimplantable communication device includes a receiver for receiving the outcome status messages and an indicator for providing a perceptible indication of atrial fibrillation detection outcome status. 
     
     
       7. A method of operating an atrial defibrillation system including an implantable atrial defibrillator including an atrial fibrillation detector for detecting atrial fibrillation, a cardioverter for cardioverting the atria of a heart, and a receiver for receiving commands transmitted from an external nonimplanted transmitter in a nonimplantable communication device adapted for use by the patient, comprising the steps of: 
       transmitting a first command from the nonimplantable communication device to the implantable atrial defibrillator; and  
       activating only the atrial fibrillation detector to detect for atrial fibrillation in response to the first command and not automatically activating the cardioverter if atrial fibrillation is detected.  
     
     
       8. The method of  claim 7  comprising the additional steps of: 
       transmitting a further command from the nonimplantable communication device to the implantable atrial defibrillator; and  
       activating the atrial fibrillation detector to redetect for atrial fibrillation and automatically activating the cardioverter to cardiovert the atria in response to redetection of atrial fibrillation in response to the further command.  
     
     
       9. The method of  claim 7  wherein the nonimplantable communication device includes a receiver for receiving status messages transmitted from a transmitter in the implantable atrial defibrillator and comprising the additional steps of transmitting a status message indicative of detected atrial fibrillation from the implantable atrial defibrillator to the nonimplantable communication device and providing a perceptible indication in response to receipt of the status message by the nonimplantable communication device. 
     
     
       10. An atrial defibrillation system comprising: 
       
         an implantable atrial defibrillator including an atrial fibrillation detector for detecting the presence of atrial fibrillation, a cardioverter for cardioverting the atria of a heart, a receiver for receiving commands from an external device, and a transmitter for transmitting information to an external device; and  
       
         a hand - held patient - activated communication device including a transmitter for transmitting a detect only command to the atrial defibrillator to determine the presence of atrial fibrillation without activating the cardioverter if atrial fibrillation is determined to be present in response to the detect only command, a receiver for receiving information from the atrial defibrillator indicating the presence of atrial fibrillation, and an indicator to indicate to the patient the presence of atrial fibrillation.    
     
     
       11. An atrial defibrillation system comprising: 
       
         an implantable atrial defibrillator including an atrial fibrillation detector for detecting the presence of atrial fibrillation, a cardioverter including at least one capacitor that is charged and discharged to cardiovert the atria of a heart, a receiver for receiving commands from an external device, and a transmitter for transmitting information to an external device; and  
       
         a hand - held patient activated - communication device including a transmitter for transmitting a detect only command to the atrial defibrillator to determine the presence of atrial fibrillation without charging the capacitor if atrial fibrillation is determined to be present in response to the detect only command, a receiver for receiving information from the atrial defibrillator indicating the presence of atrial fibrillation, and an indicator to indicate to the patient the presence of atrial fibrillation.    
     
     
       12. An atrial defibrillation system comprising: 
       
         an implantable atrial defibrillator including an atrial fibrillation detector for detecting the presence of atrial fibrillation, a cardioverter including at least one capacitor that is charged and discharged to cardiovert the atria of a heart, a receiver for receiving commands from an external device, and a transmitter for transmitting information to an external device; and  
       
         a hand - held patient - activated communication device including a transmitter for transmitting a detect only command to the atrial defibrillator to determine the presence of atrial fibrillation without charging the capacitor if atrial fibrillation is determined to be present in response to the detect only command and for transmitting a further command to the atrial defibrillator to again determine the presence of atrial fibrillation and charging the capacitor if atrial fibrillation is determined to be present in response to the further command, the patient - activated communication device further including a receiver for receiving information from the atrial defibrillator indicating the presence of atrial fibrillation and an indicator to indicate to the patient the presence of atrial fibrillation.    
     
     
       13. An atrial defibrillation system comprising: 
       
         an implantable atrial defibrillator including an atrial fibrillation detector providing a detection result representative of the presence or absence of atrial fibrillation, a cardioverter including at least one capacitor that is charged and discharged to cardiovert the atria of a heart, a receiver for receiving commands from an external device, and a transmitter for transmitting information to an external device;  
       
         a hand - held patient - activated communication device including a transmitter for transmitting a status request to the implantable atrial defibrillator, the defibrillator being responsive to the status request to transmit a status message representing a detection result indicating the presence or absence of atrial fibrillation and wherein the capacitor of the cardioverter is not charged if the detection result indicates the presence of atrial fibrillation, the patient - activated communication device including a receiver for receiving the transmitted status message and an indicator to provide a perceptible indication to the patient indicating the detection result.    
     
     
       14. An atrial defibrillation system as recited in  claim 13  wherein the indicator includes a light emitting diode that is lit to indicate the presence of atrial fibrillation.  
     
     
       15. An atrial defibrillation system as recited in  claim 13  wherein the indicator provides an audible indication of the presence of atrial fibrillation.  
     
     
       16. An atrial defibrillation system as recited in  claim 13  wherein the cardioverter is activated by charging the capacitor in response to the receipt of a therapy command from the patient- activated communication device and a detection result indicating the presence of atrial fibrillation.    
     
     
       17. An atrial defibrillation system as recited in  claim 16  wherein the atrial defibrillator is responsive to the receipt of a therapy sequence command to cause the detector to determine the presence or absence of atrial fibrillation.  
     
     
       18. An atrial defibrillation system as recited in  claim 13  operable in a combined automatic and patient- activated mode wherein the cardioverter is automatically activated by charging the capacitor in response to automatic detection of atrial fibrillation by the detector and the cardioverter is patient activated in response to the receipt of a therapy command from the patient - activated communication device and a detection result indicating the presence of atrial fibrillation.    
     
     
       19. An atrial defibrillation system as recited in  claim 13  operable in a combined automatic and patient- activated mode wherein the cardioverter is automatically activated by charging the capacitor in response to automatic detection of atrial fibrillation by the detector and the cardioverter is patient activated in response to the receipt of a therapy command from the patient - activated communication device.    
     
     
       20. An atrial defibrillation system comprising: 
       
         an implantable atrial defibrillator including an atrial fibrillation detector providing a result detection representative of the presence or absence of atrial fibrillation, a cardioverter including at least one capacitor that is charged and discharged to cardiovert the atria of a heart, a receiver for receiving commands from an external device, and a transmitter for transmitting information to an external device;  
       
         a hand - held patient - activated communication device including at least a status - request switch and a therapy - sequence switch, a transmitter, a receiver, and an indicator,    
         the patient - activated communication device being responsive to actuation of the status - request switch for transmitting a status request to the implantable atrial defibrillator;    
       
         the implantable atrial defibrillator being responsive to the status request to transmit a status message representing a detection result indicating the presence or absence of atrial fibrillation and wherein the capacitor of the cardioverter is not charged if the detection result indicates the presence of atrial fibrillation;  
       
         the patient - activated communication device being responsive to actuation of the therapy - sequence switch to transmit a therapy command to the implantable atrial defibrillator; and    
       
         the defibrillator being responsive to the therapy command to determine the presence of atrial fibrillation and to activate the cardioverter by charging the capacitor if atrial fibrillation is present.  
       
     
     
       21. An atrial defibrillation system as recited in  claim 20  wherein the indicator includes a light emitting diode that is lit in response to receipt of a status message indicating the presence of atrial defibrillation.  
     
     
       22. An atrial defibrillation system as recited in  claim 20  wherein the indicator provides an audible indication of the presence of the atrial fibrillation in response to receipt of a status message indicative thereof.  
     
     
       23. An atrial defibrillation system as recited in  claim 20  operable in a combined automatic and patient- activated mode wherein the cardioverter is automatically activated by charging the capacitor in response to automatic detection of atrial fibrillation by the detector and the cardioverter is patient activated in response to the receipt of a therapy command from the patient - activated communication device and a detection result indicating the presence of atrial fibrillation.    
     
     
       24. An atrial defibrillation system comprising: 
       
         an implantable atrial defibrillator including an atrial fibrillation detector for detecting the presence of atrial fibrillation, a cardioverter including at least one capacitor that is charged and discharged to cardiovert the atria of a heart, a receiver for receiving commands from an external device and a transmitter for transmitting information to an external device; and  
       
         a hand - held patient activated - communication device including a transmitter for transmitting a detect only command to the atrial defibrillator to determine the presence of atrial fibrillation without charging the capacitor if atrial fibrillation is determined to be present in response to the detect only command.