Dynamic capture management safety margin
First Claim
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1. A method of providing capture management, the method comprising:
- (a) employing a cardiac pacemaker to determine capture thresholds of a chamber of a patient'"'"'s heart;
(b) storing into memory the determined capture thresholds;
(c) determining a historical variability of the determined capture thresholds;
(d) setting a safety margin using the historical variability of the determined capture thresholds; and
(e) using the set safety margin to determine a pacing pulse level and subsequently employing the cardiac pacemaker to pace the chamber of the patient'"'"'s heart at the pacing pulse level;
wherein determining the historical variability of the determined capture thresholds comprises determining a rolling maximum and rolling minimum of the determined capture thresholds over a time period and determining a difference in amplitude between the rolling maximum and the rolling minimum; and
wherein using the set safety margin to determine a pacing pulse level comprises selecting the safety margin in response to the difference in amplitude; and
wherein the safety margin is set to a first value if the difference in amplitude between the rolling maximum and the rolling minimum is less than a second value.
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Abstract
A cardiac stimulation system and associated capture management method are provided in which capture and device longevity are improved. The device determines a series of capture thresholds. Capture threshold is the minimum pulse level (pulse energy or pulse amplitude or pulse width) that captures the heart. Each determination requires delivery of pacing pulses at several (at least two) known levels (pulse energy, pulse amplitude and/or pulse width) over time. The individual determined capture thresholds are combined into a set and the variability of the set is used to set the safety margin. The greater the variability in the capture thresholds, the bigger the safety margin.
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Citations
10 Claims
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1. A method of providing capture management, the method comprising:
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(a) employing a cardiac pacemaker to determine capture thresholds of a chamber of a patient'"'"'s heart; (b) storing into memory the determined capture thresholds; (c) determining a historical variability of the determined capture thresholds; (d) setting a safety margin using the historical variability of the determined capture thresholds; and (e) using the set safety margin to determine a pacing pulse level and subsequently employing the cardiac pacemaker to pace the chamber of the patient'"'"'s heart at the pacing pulse level; wherein determining the historical variability of the determined capture thresholds comprises determining a rolling maximum and rolling minimum of the determined capture thresholds over a time period and determining a difference in amplitude between the rolling maximum and the rolling minimum; and wherein using the set safety margin to determine a pacing pulse level comprises selecting the safety margin in response to the difference in amplitude; and wherein the safety margin is set to a first value if the difference in amplitude between the rolling maximum and the rolling minimum is less than a second value. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A method of providing capture management, the method comprising:
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(a) employing a cardiac pacemaker to determine capture thresholds of a chamber of a patient'"'"'s heart; (b) storing into memory the determined capture thresholds; (c) determining a historical variability of the determined capture thresholds; (d) setting a safety margin using the historical variability of the determined capture thresholds; and (e) using the set safety margin to determine a pacing pulse level and subsequently employing the cardiac pacemaker to pace the chamber of the patient'"'"'s heart at the pacing pulse level; wherein determining the historical variability of the determined capture thresholds comprises determining a rolling maximum and rolling minimum of the determined capture thresholds over a time period and determining a difference in amplitude between the rolling maximum and the rolling minimum; and wherein using the set safety margin to determine a pacing pulse level comprises selecting the safety margin in response to the difference in amplitude; and wherein the safety margin is set to 0.5V if the difference in amplitude between the rolling maximum and the rolling minimum is less than 0.5V. - View Dependent Claims (8, 9, 10)
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Specification
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Current AssigneeMedtronic Incorporated (Medtronic Plc)
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Original AssigneeMedtronic Incorporated (Medtronic Plc)
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InventorsShilling, Eric A, Kleckner, Karen J
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Primary Examiner(s)Marlen, Tammie K
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Application NumberUS15/419,212Publication NumberTime in Patent Office960 DaysField of SearchUS Class CurrentCPC Class CodesA61N 1/3684 for stimulating the heart a...A61N 1/3712 Auto-capture, i.e. automati...
