Cardiac rhythm pacing rate selection for automatic capture threshold testing

• US 20060212084A1
• Filed: 03/17/2005
• Published: 09/21/2006
• Est. Priority Date: 03/17/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Foster, Clayton Scott, Yost, David William
• Granted Patent: US 7,761,159 B2
• Time in Patent Office: Days
• US Class Current: 607/28
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold

Abstract

Cardiac devices and methods that select pacing rates for automatic threshold tests based on a patient'"'"'s hemodynamic need. A sensor-indicated pacing rate corresponding to a patient'"'"'s hemodynamic need is determined. A test pacing rate is selected from either the sensor-indicated rate or another rate. Capture threshold testing is performed using the selected pacing rate.

Claims

1. A method for performing a capture threshold test, comprising:

determining a sensor-indicated pacing rate corresponding to a patient'"'"'s sensed hemodynamic need;

selecting a test pacing rate from one of the sensor-indicated pacing rate and a non-sensor-indicated pacing rate; and

performing the capture threshold test using the test pacing rate.

2. The method of claim 1, wherein selecting the test pacing rate comprises:

selecting the sensor-indicated pacing rate if the sensor-indicated pacing rate is greater than the non-sensor-indicated pacing rate; and

selecting the non-sensor-indicated pacing rate if the non-sensor-indicated pacing rate is greater than the sensor-indicated pacing rate.

3. The method of claim 1, wherein selecting the test pacing rate comprises selecting one of the sensor-indicated pacing rate and a predetermined pacing rate.

4. The method of claim 1, wherein selecting the test pacing rate comprises selecting one of the sensor-indicated pacing rate and a pacing rate determined based on a heart rate before the capture threshold test.

5. The method of claim 1, wherein selecting the test pacing rate comprises:

selecting one of the sensor-indicated pacing rate and a predetermined pacing rate if a current pacing mode comprises a tracking mode; and

selecting one of the sensor-indicated pacing rate and a pacing rate determined based on a heart rate before the capture threshold test if the current pacing mode comprises a non-tracking mode.

6. The method of claim 1, wherein selecting one of the sensor-indicated pacing rate and the predetermined pacing rate comprises using a shortened AV-delay if the current pacing mode comprises a tracking mode.

7. The method of claim 1, wherein selecting the test pacing rate comprises selecting the test pacing rate to reduce fusion beats during the capture threshold test.

8. The method of claim 1, wherein the selecting test pacing rate comprises selecting the test pacing rate to increase a likelihood of captured beats during the capture threshold test.

9. The method of claim 1, wherein selecting the test pacing rate comprises selecting the test pacing rate to reduce a pacing rate change when the capture threshold test is initiated.

10. The method of claim 1, wherein selecting the test pacing rate comprises selecting the test pacing rate to reduce a pacing rate change when the capture threshold test is terminated.

11. The method of claim 1, wherein performing the capture threshold test using the test pacing rate comprises adapting the test pacing rate to meet the patient'"'"'s hemodynamic need.

12. The method of claim 1, wherein performing the capture threshold test using the test pacing rate comprises:

delivering pacing pulses at the test pacing rate;

sensing cardiac signals respectively following the pacing pulses; and

determining a capture threshold based on the sensed cardiac signals.

13. A cardiac rhythm management system, comprising:

a sensing system configured to sense cardiac signals; and

a processor coupled to the sensing system, the processor configured to determine a sensor-indicated pacing rate corresponding to a patient'"'"'s sensed hemodynamic need, select a test pacing rate from one of the sensor-indicated pacing rate and a non-sensor-indicated pacing rate, and perform a capture threshold test using the test pacing rate.

14. The system of claim 13, wherein the processor is further configured to select the sensor-indicated pacing rate if the sensor-indicated pacing rate is greater than the non-sensor-indicated pacing rate, and select the non-sensor-indicated pacing rate if the non-sensor-indicated pacing rate is greater than the sensor-indicated pacing rate.

15. The system of claim 13, wherein the processor is further configured to select one of the sensor-indicated pacing rate and a predetermined pacing rate if a current pacing mode comprises a tracking mode, and select one of the sensor-indicated pacing rate and a pacing rate determined based on the heart rate before the capture threshold test if the current pacing mode comprises a non-tracking mode.

16. The system of claim 13, wherein the processor is further configured to use a shortened AV-delay if the current pacing mode comprises a tracking mode.

17. The system of claim 13, wherein the processor is further configured to select the test pacing rate to reduce a pacing rate change when the capture threshold test is initiated.

18. The system of claim 13, wherein the processor is further configured to select the test pacing rate to reduce a pacing rate change when the capture threshold test is terminated.

19. A cardiac rhythm management system, comprising:

means for determining a sensor-indicated pacing rate corresponding to a patient'"'"'s sensed hemodynamic need;

means for selecting a test pacing rate from one of the sensor-indicated pacing rate and a non-sensor-indicated pacing rate; and

means for performing a capture threshold test using the test pacing rate.

20. The device of claim 19, wherein the selecting means comprises means for selecting the test pacing rate to reduce a pacing rate change when the capture threshold test is initiated or terminated.