Method for reducing phrenic nerve stimulation
First Claim
1. A method, comprising:
- delivering pacing pulses to a ventricle of a heart using one of a plurality of pacing vectors;
sensing a transthoracic impedance signal;
detecting a breathing event based on a temporal association between pacing pulse delivery during a non-refractory period of the heart and a perturbation in the transthoracic impedance signal; and
verifying that the detected breathing event is representative of phrenic nerve stimulation resulting from pacing pulse delivery based on detection of an additional perturbation in the transthoracic impedance signal that is temporally associated with an additional pacing pulse delivered during a cardiac refractory period of the heart.
0 Assignments
0 Petitions
Accused Products
Abstract
Methods and devices for reducing phrenic nerve stimulation of cardiac pacing systems involve delivering a pacing pulse to a ventricle of a heart. A transthoracic impedance signal is sensed, and a deviation in the signal resulting from the pacing pulse may be used to determine phrenic nerve stimulation. Methods may further involve detecting the phrenic nerve stimulation from the pacing pulse by delivering two or more pacing pulse to the ventricle of the heart, and determining a temporal relationship. A pacing vector may be selected from the two or more vectors that effects cardiac capture and reduces the phrenic nerve stimulation. A pacing voltage and/or pulse width may be selected that provides cardiac capture and reduces the phrenic nerve stimulation. In other embodiments, a pacing pulse width and a pacing voltage may be selected from a patient'"'"'s strength-duration curve that effects cardiac capture and reduces the phrenic nerve stimulation.
-
Citations
25 Claims
-
1. A method, comprising:
-
delivering pacing pulses to a ventricle of a heart using one of a plurality of pacing vectors; sensing a transthoracic impedance signal; detecting a breathing event based on a temporal association between pacing pulse delivery during a non-refractory period of the heart and a perturbation in the transthoracic impedance signal; and verifying that the detected breathing event is representative of phrenic nerve stimulation resulting from pacing pulse delivery based on detection of an additional perturbation in the transthoracic impedance signal that is temporally associated with an additional pacing pulse delivered during a cardiac refractory period of the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
-
-
13. A method, comprising:
-
delivering pacing pulses to a ventricle of a heart using one of a plurality of pacing vectors; sensing a transthoracic impedance signal; detecting a breathing event based on a temporal association between pacing pulse delivery during a non-refractory period of the heart and a perturbation in the transthoracic impedance signal; and verifying that the detected breathing event is representative of phrenic nerve stimulation resulting from pacing pulse delivery based on detection of an additional perturbation in the transthoracic impedance signal that is temporally associated with an additional delivered pacing pulse. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
-
Specification