Capture detection with cross chamber backup pacing

• US 20080071319A1
• Filed: 09/14/2006
• Published: 03/20/2008
• Est. Priority Date: 09/14/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Brooke, M. Jason, Sathaye, Alok
• Granted Patent: US 8,948,867 B2
• Time in Patent Office: Days
• US Class Current: 607/28
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation

Abstract

Approaches for performing capture detection for a heart chamber with backup pacing in a contralateral heart chamber are described. A cardiac signal of the first heart chamber is sensed following delivery of a pacing pulse. The cardiac response of the first heart chamber to the pacing pulse is classified based on one or more features of the sensed cardiac signal. A backup pacing pulse is delivered to a second heart chamber contralateral to the first heart chamber. For example, the timing of the delivery of the backup pacing pulse may be based on the expected or detected timing of the features used to classify the cardiac pacing response. The backup pace may be delivered within a detection window used for sensing the features indicative of the cardiac pacing response.

Claims

1. A method of performing capture detection with backup pacing, comprising:

delivering a pacing pulse to a first heart chamber;

sensing a cardiac signal of the first heart chamber following delivery of the pacing pulse;

classifying a cardiac response to the pacing pulse based on one or more features of the sense cardiac signal; and

delivering a backup pacing pulse to a second heart chamber contralateral to the first heart chamber, wherein the timing of the backup pacing pulse is based on the timing of the one or more features used to classify the cardiac pacing response.

2. The method of claim 1, wherein the backup pacing pulse is delivered relative to an expected timing of the features used to classify the cardiac pacing response.

3. The method of claim 1, wherein the backup pacing pulse is delivered relative to a detected timing of the features used to classify the cardiac pacing response.

4. The method of claim 1, wherein sensing the cardiac signal of the first heart chamber following delivery of the pacing pulse comprises sensing the cardiac signal during a detection interval.

5. The method of claim 4, wherein the backup pacing pulse is delivered before or during the detection interval.

6. The method of claim 4, wherein the backup pacing pulse is delivered after the detection interval.

7. The method of claim 1, wherein the backup pacing pulse is delivered at an energy previously used for pacing the contralateral heart chamber.

8. The method of claim 1, wherein an energy of the backup pacing pulse is not increased from a previously used level.

9. A cardiac rhythm management system, comprising:

pacing circuitry configured to deliver a pacing pulse to a first cardiac chamber and to deliver a backup pacing pulse to a cardiac chamber contralateral to the first cardiac chamber;

sensing circuitry configured to sense a cardiac signal of the first chamber following the pacing pulse delivered to the first chamber;

capture detection circuitry configured to classify the cardiac response of the first chamber based on one or more features of the cardiac signal; and

backup pacing timing circuitry configured to time delivery of the backup pacing pulse based on the timing of the one or more features.

10. The system of claim 9, wherein the timing circuitry is configured to time delivery of the backup pacing pulse relative to an expected timing of the features used to classify the cardiac pacing response.

11. The system of claim 9, wherein the timing circuitry is configured to time delivery of the backup pacing pulse relative to a detected timing of the features used to classify the cardiac pacing response.

12. The system of claim 9, wherein:

the capture detection circuitry is configured to sense for the one or more features used for capture detection during a detection interval; and

the backup pacing pulse is delivered before or during the detection interval.

13. The system of claim 9, wherein:

the capture detection circuitry is configured to sense for the one or more features used for capture detection during a detection interval; and

the backup pacing pulse is delivered before or after the detection interval.

14. The system of claim 9, wherein the backup pacing pulse is delivered at an energy previously determined for pacing the contralateral heart chamber.

15. The system of claim 9, wherein the first chamber comprises a first ventricle and the contralateral chamber comprises a ventricle contralateral to the first ventricle.

16. The system of claim 9, wherein the first chamber comprises a first atrium and the contralateral chamber comprises an atrium contralateral to the first atrium.

17. A method of performing capture detection with backup pacing, comprising:

delivering a pacing pulse to a first heart chamber;

sensing a cardiac signal of the first heart chamber within a detection interval following delivery of the pacing pulse;

classifying the cardiac response as a captured response based on one or more features of the sensed cardiac signal; and

delivering a backup pacing pulse to a second heart chamber contralateral to the first heart chamber within the detection interval.

18. The method of claim 17, wherein the backup pacing pulse is delivered within 0 to 500 ms following delivery of the test pacing pulse.

19. The method of claim 17, wherein the backup pacing pulse is delivered after a predetermined delay following delivery of the test pacing pulse.

20. The method of claim 17, wherein the backup pacing pulse is delivered after initiation of the detection interval but prior to the occurrence of the one or more features of the cardiac signal upon which the cardiac response classification is based.

21. The method of claim 17, wherein the backup pacing pulse is delivered after initiation of the detection window but after the occurrence of the one or more features of the cardiac response upon which cardiac response classification is based.

22. A method of performing capture detection with backup pacing, comprising:

delivering a pacing pulse to a first heart chamber;

sensing a cardiac signal of the first heart chamber following delivery of the pacing pulse;

classifying the cardiac response to the pacing pulse based on one or more features of the sensed cardiac signal; and

delivering a backup pacing pulse to a heart chamber contralateral to the first heart chamber, the backup pacing pulse having an energy previously determined for pacing the contralateral chamber.

23. The method of claim 22, wherein the energy of the backup pacing pulse is not increased over the energy previously used for pacing the contralateral chamber.

24. The method of claim 22, wherein delivering the backup pacing pulse comprises delivering the backup pacing pulse relative to the expected timing of the one or more features.

25. The method of claim 22, wherein delivering the backup pacing pulse comprises delivering the backup pacing pulse relative to the detected timing of the one or more features.