Capture Detection for Multi-Chamber Pacing
First Claim
1. A method of operating a cardiac rhythm management device in a patient to classify a cardiac response to multi-chamber pacing, comprising:
- delivering a first pacing pulse to a left heart chamber during a cardiac cycle;
delivering a second pacing pulse to a right heart chamber during the cardiac cycle;
sensing a cardiac electrogram signal following the first and second pacing pulses;
determining at least whether (a) a first signal feature of the cardiac signal is disposed within a first detection window, and (b) a second signal feature of the cardiac signal is disposed within a second detection window, at least one of the first and second detection windows being finitely bounded in both time and amplitude; and
classifying the cardiac response to the first and second pacing pulses as one of bi-chamber capture and a single chamber capture based on the determination of (a) and (b).
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Abstract
Multi-chamber pacing may result in capture of one chamber, capture of multiple chambers, fusion, or non-capture. Approaches for detecting various capture conditions during multi-chamber pacing are described. Pacing pulses are delivered to left and right heart chambers during a cardiac cycle. A cardiac electrogram signal is sensed following the delivery of the pacing pulses. Left chamber capture only, right chamber capture only, and bi-chamber capture may be distinguished based on characteristics of the cardiac electrogram signal. Multi-chamber capture detection may be implemented using detection windows having dimensions of time and amplitude. The detection windows are associated with expected features, such as expected signal peaks, under a particular capture condition. The cardiac electrogram signal features are compared to detection windows to determine the capture condition.
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Citations
24 Claims
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1. A method of operating a cardiac rhythm management device in a patient to classify a cardiac response to multi-chamber pacing, comprising:
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delivering a first pacing pulse to a left heart chamber during a cardiac cycle; delivering a second pacing pulse to a right heart chamber during the cardiac cycle; sensing a cardiac electrogram signal following the first and second pacing pulses; determining at least whether (a) a first signal feature of the cardiac signal is disposed within a first detection window, and (b) a second signal feature of the cardiac signal is disposed within a second detection window, at least one of the first and second detection windows being finitely bounded in both time and amplitude; and classifying the cardiac response to the first and second pacing pulses as one of bi-chamber capture and a single chamber capture based on the determination of (a) and (b). - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An implantable system for classifying a cardiac response to multi-chamber pacing pulses, comprising:
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a pulse delivery system configured to deliver a first pacing pulse to a left heart chamber during a cardiac cycle and a second pacing pulse to a right heart chamber during the cardiac cycle; a sensor system configured to sense a cardiac electrogram signal following the first and second pacing pulses; and a processor coupled to the sensor system, the processor configured to determine whether (a) a first signal feature of the cardiac signal is disposed within a first detection window, and (b) a second signal feature of the cardiac signal is disposed within a second detection window, the processor further being configured to classify the cardiac response to the first and second pacing pulses as one of bi-chamber capture and a single chamber capture based on the determination of (a) and (b); wherein at least one of the first and second detection windows is finitely bounded in both time and amplitude. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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Specification