Cardiac response classification using multiple classification windows

• US 20080154324A1
• Filed: 01/15/2008
• Published: 06/26/2008
• Est. Priority Date: 12/11/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Bocek, Joseph, Kim, Jaeho, Meyer, Scott A., Sih, Haris J., Haefner, Paul A.
• Granted Patent: US 8,831,726 B2
• Time in Patent Office: Days
• US Class Current: 607/27
• 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 devices for classifying a cardiac response to pacing involve establishing a plurality of classification windows relative to and following a pacing pulse. One or more characteristics of a cardiac signal sensed following the pacing pulse are detected within one or more particular classification windows. The characteristics may be compared to one or more references. Classification of the cardiac response may be performed based on the comparison of the one or more characteristics to the one or more references and the particular classification windows in which the one or more characteristics are detected.

Claims

8-1. The method of claim 1, wherein:

the intrinsic template comprises a peak width; and

comparing the cardiac electrical signal to the intrinsic template comprises comparing a peak width of the cardiac electrical signal to the intrinsic template peak width.

11. A body implantable cardiac rhythm management system capable of determining a cardiac pacing response, the system comprising:

cardiac electrodes electrically coupled to one or more heart chambers;

a pulse generator configured to deliver pacing pulses to the one or more heart chambers;

sensing circuitry configured to provide a cardiac electrical activity signal corresponding to cardiac electrical activity associated with each pacing pulse;

a template processor configured to provide a signal template representing a non-captured, intrinsic beat;

a cardiac response classification processor configured to classify the cardiac pacing response by discriminating between capture or fusion and an intrinsic beat based on comparison of the cardiac electrical activity signal to the intrinsic template; and

a controller configured to control pacing therapy based at least in part on classification of the cardiac pacing response.

12. The system of claim 11, wherein the pacing pulses are delivered via a first electrode combination and the sensing circuitry is configured to sense the cardiac electrical activity via a second electrode combination which is different from the first electrode combination.

13. The system of claim 12, wherein the first electrode combination comprises at least one pacing electrode and the second electrode combination comprises at least two defibrillation electrodes.

14. The system of claim 11, further comprising a switch matrix configured to couple one of a plurality of first electrode combinations to the pulse generator and to couple one of a plurality of second electrode combinations to the sensing circuitry.

15. The system of claim 11, wherein:

the template processor is configured to provide a signal template indicative of a captured response; and

the cardiac response classification processor is configured to compare the cardiac electrical activity signal to the captured response template and to classify the cardiac pacing response based on comparison of the cardiac electrical activity signal to the captured response template.

16. The system of claim 15, wherein the cardiac response classification processor is configured to classify the cardiac pacing response as fusion if the cardiac electrical activity signal is not similar to either the captured response template or the intrinsic template.

17. The system of claim 11, wherein the cardiac response classification processor is configured to analyze the cardiac electrical activity signal relative to multiple classification time intervals and to classify the cardiac pacing response based on a classification time interval in which a peak of the cardiac activity signal is detected.

18. The system of claim 17, wherein the number of classification time intervals is greater than two.

19. A cardiac rhythm management system capable of classifying a cardiac response to a pacing pulse, the system comprising:

a sensing system configured to sense cardiac electrical activity following the pacing pulse and to provide a signal corresponding to the cardiac electrical activity;

means for comparing the cardiac electrical activity signal to a morphological template representative of a non-captured, intrinsic beat;

means for classifying the cardiac pacing response by discriminating between capture or fusion and an intrinsic beat based on the comparison; and

pulse generator circuitry configured to deliver pacing therapy based at least in part on classification of the cardiac pacing response.

20. The system of claim 19, wherein the means for classifying analyzes the cardiac electrical activity signal in a plurality of classification time intervals, determines a classification interval of the plurality of classification time intervals in which a peak of the cardiac electrical activity signal occurs, and classifies the cardiac pacing response based on the classification interval in which the signal peak occurs.