Multi channel approach to capture verification

• US 20070016261A1
• Filed: 07/12/2005
• Published: 01/18/2007
• Est. Priority Date: 07/12/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Dong, Yanting, Zhu, Qingsheng, Meyer, Scott
• Granted Patent: US 7,529,578 B2
• Time in Patent Office: Days
• US Class Current: 607/28
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/7217 of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Methods and systems involve classifying the cardiac response to pacing using a multi-channel approach. Multiple cardiac response signals are sensed via multiple sense channels. Each sense channel comprises a distinct combination of electrodes and sensing circuitry. The cardiac response to the pacing pulse is classified based on the morphology of the cardiac response signals. Classifying the cardiac response involves discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity.

Claims

1. A method of classifying a cardiac response to a pacing pulse, comprising:

sensing a cardiac response to a pacing pulse via multiple sense channels, each sense channel comprising a distinct combination of sense electrodes and sensing circuitry;

classifying the cardiac response to the pacing pulse based on morphology of cardiac response signals sensed via the multiple sense channels, wherein classifying the cardiac response comprises discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity.

2. The method of claim 1, further comprising detecting non-capture without intrinsic activity if one or more of the cardiac response signals do not meet threshold criteria.

3. The method of claim 1, wherein classifying the cardiac response to the pacing pulse comprises:

discriminating between capture and non-capture with intrinsic activity using a first cardiac response signal sensed via a first sense channel of the multiple sense channels; and

detecting fusion using a second cardiac response signal sensed via a second sense channel of the multiple sense channels.

4. The method of claim 3, wherein discriminating between capture and non-capture with intrinsic activity comprises determining if an amplitude of the first cardiac response signal exceeds threshold value.

5. The method of claim 1, wherein classifying the cardiac response to the pacing pulse comprises:

detecting non-capture with intrinsic activity using a first cardiac response signal sensed via a first sense channel of the multiple sense channels; and

discriminating between capture and fusion using a second cardiac response signal sensed via a second sense channel of the multiple sense channels.

6. The method of claim 5, wherein discriminating between capture and fusion using the second cardiac response signal comprises discriminating between capture and fusion based on peaks of the second cardiac signal.

7. The method of claim 6, wherein:

discriminating between capture and fusion based on peaks of the second cardiac signal comprises;

sensing for the first peak of the second cardiac response signal in a first capture detection window; and

sensing for the second peak of the second cardiac response signal within a second capture detection window; and

classifying the cardiac response as capture if the first peak is detected in the first capture detection window and the second peak is detected in the second capture detection window.

8. The method of claim 7, wherein the first and the second capture detection windows have dimensions of time and amplitude.

9. The method of claim 7, further comprising classifying the cardiac response as fusion if the first peak is not detected in the first capture detection window or the second peak is not detected in the second capture detection window.

10. A capture detection system, comprising:

multiple sense channels configured to sense multiple cardiac response signals, each sense channel comprising a distinct combination of sense electrodes and sensing circuitry; and

cardiac response detection circuitry coupled to the multiple sense channels, the cardiac response circuitry configured to classify the cardiac response as one of non-capture, capture, fusion, and non-capture with intrinsic activation based on morphology of the multiple cardiac response signals.

11. The system of claim 10, wherein the cardiac response detection circuitry is configured to detect non-capture without intrinsic activity if none of the multiple cardiac response signals meet a threshold amplitude value.

12. The system of claim 11, wherein the threshold amplitude value comprises a positive amplitude value or a negative amplitude value.

13. The system of claim 10, wherein the cardiac response detection circuitry is configured to detect non-capture with intrinsic activity based on one or more features of a first cardiac response signal of the multiple cardiac response signals.

14. The system of claim 13, wherein the cardiac response detection circuitry is configured to detect non-capture with intrinsic activity if a peak value of a first cardiac response signal of the multiple cardiac response signals exceeds a threshold.

15. The system of claim 13, wherein the cardiac response detection circuitry is configured to detect first and second peaks of a second cardiac signal of the multiple cardiac response signals and discriminate between capture and fusion based on the first and second peaks.

16. The system of claim 15, wherein the cardiac response detection circuitry is configured to classify the cardiac response as capture if the first peak is detected in a first capture detection window and the second peak is detected in the second capture detection window.

17. The system of claim 15, wherein the cardiac response detection circuitry is configured to classify the cardiac response as fusion if the first peak is not detected in a first capture detection window or the second peak is not detected in a second capture detection window.

18. The system of claim 10, wherein a sense channel of the multiple sense channels comprises a tip electrode and a coil electrode.

19. The system of claim 18, wherein the sense channel of the multiple sense channels further comprises sense amplifier coupled to the tip electrode and the coil electrode.

20. The system of claim 18, wherein the cardiac response detection circuitry is configured to detect non-capture with intrinsic activity using a cardiac response signal sensed using the sense channel.

21. The system of claim 10, wherein a sense channel of the multiple sense channels comprises a coil electrode and a can electrode.

22. The system of claim 21, wherein the sense channel further comprises an evoked response amplifier coupled to the coil electrode and the can electrode.

23. The system of claim 21, wherein the cardiac response detection circuitry is configured to discriminate between capture and fusion using a cardiac response signal sensed using the sense channel.

24. A system for classifying a cardiac response to a pacing pulse, comprising:

means for sensing a cardiac response to a pacing pulse via multiple sense channels, each sense channel comprising a distinct combination of sense electrodes and sensing circuitry;

means for classifying the cardiac response to the pacing pulse based on morphology of cardiac response signals sensed via the multiple sense channels, wherein classifying the cardiac response comprises discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity.

25. The system of claim 24, further comprising:

means for detecting non-capture with intrinsic activity using a first cardiac response signal sensed via a first sense channel of the multiple sense channels; and

means for discriminating between capture and fusion using a second cardiac response signal sensed via a second sense channel of the multiple sense channels.