Automatic sensing vector selection for morphology-based capture verification
First Claim
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1. A method for verifying capture by a cardiac pacemaker, comprising:
- recording an evoked response electrogram during a paced cardiac cycle;
comparing the waveform of the evoked response electrogram with a template waveform representing capture;
determining that capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and template waveforms is above a specified threshold; and
, selecting a sensing vector for generating the evoked response and template waveforms by;
1) comparing electrograms generated by capturing and non-capturing pacing pulses for a plurality of different sensing vectors,
2) selecting the sensing vector which results in the greatest degree of dissimilarity between the electrograms generated by the capturing and non-capturing pacing pulses.
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Abstract
A system and method for verifying capture of the heart by one or more pacing pulses using an electrogram morphology-based technique. Capture is determined by comparing an evoked response electrogram recorded during a paced cycle with a template waveform representing a paced cycle in which capture is achieved. The comparison is facilitated and made more accurate by selecting a sensing vector in which an evoked response electrogram in which no capture occurs is most dissimilar to the template.
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Citations
29 Claims
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1. A method for verifying capture by a cardiac pacemaker, comprising:
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recording an evoked response electrogram during a paced cardiac cycle;
comparing the waveform of the evoked response electrogram with a template waveform representing capture;
determining that capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and template waveforms is above a specified threshold; and
,selecting a sensing vector for generating the evoked response and template waveforms by;
1) comparing electrograms generated by capturing and non-capturing pacing pulses for a plurality of different sensing vectors,
2) selecting the sensing vector which results in the greatest degree of dissimilarity between the electrograms generated by the capturing and non-capturing pacing pulses. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 27)
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10. A system for verifying capture by an implantable cardiac pacemaker, comprising:
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an implantable cardiac pacemaker;
an external programmer in communication with the pacemaker via a wireless telemetry link; and
,wherein the external programmer is configured to;
store an evoked response electrogram recorded during a paced cardiac cycle;
compare the waveform of the evoked response electrogram with a template waveform representing capture;
determine that capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and template waveforms is a above a specified threshold; and
,select a sensing vector for generating the evoked response and template waveforms by;
1) comparing electrograms generated by capturing and non-capturing pacing pulses for a plurality of different sensing vectors,
2) selecting the sensing vector which results in the greatest degree of dissimilarity between the electrograms generated by the capturing and non-capturing pacing pulses. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 28)
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19. An implantable cardiac pacemaker, comprising:
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a pacing channel for delivering pacing pulses;
a sensing channel for generating electrogram signals;
a controller for controlling the operation of the pacemaker, wherein the controller is configured to;
store an evoked response electrogram recorded during a paced cardiac cycle;
compare the waveform of the evoked response electrogram with a template waveform representing capture;
determine that capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and template waveforms is a above a specified threshold; and
,select a sensing vector for generating the evoked response and template waveforms by;
1) comparing electrograms generated by capturing and non-capturing pacing pulses for a plurality of different sensing vectors,
2) selecting the sensing vector which results in the greatest degree of dissimilarity between the electrograms generated by the capturing and non-capturing pacing pulses. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 29)
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Specification