Automatic Capture Verification using Electrocardiograms Sensed from Multiple Implanted Electrodes
First Claim
1. A method of classifying a cardiac response to a pacing pulse, comprising:
- delivering, from within a patient, a cardiac pacing pulse;
sensing one or more composite cardiac signals following delivery of the cardiac pacing pulse using at least three spatially distributed implantable electrodes;
performing source separation using the sensed one or more composite cardiac signals, the source separation algorithmically separating one or more components of the sensed composite cardiac signals according to correlation between components of cardiac origin;
producing one or more cardiac signal vectors representative of all or a portion of one or more cardiac activation sequences based on the separated one or more components of the sensed composite cardiac signals;
comparing an orientation of the one or more cardiac signal vectors with predetermined vector orientation criteria comprising at least a capture vector orientation criterion and a fusion vector orientation criterion; and
classifying the cardiac response to the pacing pulse as one of capture and fusion based on the comparison.
0 Assignments
0 Petitions
Accused Products
Abstract
Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed for automatic capture verification using cardiac activation sequence information. Devices and methods sense composite cardiac signals using implantable electrodes. A source separation is performed using the composite signals. One or more signal vectors are produced that are associated with all or a portion of one or more cardiac activation sequences based on the source separation. A cardiac response to the pacing pulses is classified using characteristics associated with cardiac signal vectors and the signals associated with the vectors. Further embodiments may involve classifying the cardiac response as capture or non-capture, fusion or intrinsic cardiac activity. The characteristics may include an angle or an angle change of the cardiac signal vectors, such as a predetermined range of angles of the one or more cardiac signal vectors.
-
Citations
26 Claims
-
1. A method of classifying a cardiac response to a pacing pulse, comprising:
-
delivering, from within a patient, a cardiac pacing pulse; sensing one or more composite cardiac signals following delivery of the cardiac pacing pulse using at least three spatially distributed implantable electrodes; performing source separation using the sensed one or more composite cardiac signals, the source separation algorithmically separating one or more components of the sensed composite cardiac signals according to correlation between components of cardiac origin; producing one or more cardiac signal vectors representative of all or a portion of one or more cardiac activation sequences based on the separated one or more components of the sensed composite cardiac signals; comparing an orientation of the one or more cardiac signal vectors with predetermined vector orientation criteria comprising at least a capture vector orientation criterion and a fusion vector orientation criterion; and classifying the cardiac response to the pacing pulse as one of capture and fusion based on the comparison. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
-
-
9. A method of classifying a cardiac response to a pacing pulse, comprising:
-
delivering, from within a patient, a cardiac pacing pulse; sensing one or more composite cardiac signals following delivery of the cardiac pacing pulse using at least three spatially distributed implantable electrodes; performing source separation using the sensed one or more composite cardiac signals, the source separation algorithmically separating one or more components of the sensed composite cardiac signals according to correlation between components of cardiac origin; producing one or more cardiac signal vectors representative of all or a portion of one or more cardiac activation sequences based on the separated one or more components of the sensed composite cardiac signal; comparing an orientation of the one or more cardiac signal vectors with predetermined vector orientation criteria comprising at least a criterion for bi-ventricular capture vector orientation and a criterion for single ventricular chamber capture vector orientation; and classifying a cardiac response to the pacing pulse as one of bi-ventricular capture and single ventricular chamber capture based on the comparison. - View Dependent Claims (10, 11, 12, 13, 14, 15)
-
-
16. An implantable cardiac electrical stimulation system, comprising:
-
a pulse generator configured to generate pacing pulses; at least three implantable electrodes coupled to the pulse generator; sensing circuitry coupled to the at least three electrodes and configured for sensing cardiac electrical activity following delivery of a pacing pulse by the pulse generator, thereby providing one or more composite cardiac signals; a control system coupled to the pulse generator and the sensing circuitry, the control system comprising a signal processor; and the signal processor configured to execute stored program instructions to cause the system to; perform source separation using the one or more composite cardiac signals, the source separation performed by the signal processor algorithmically separating one or more components of the composite cardiac signals according to correlation between components of cardiac origin; produce one or more cardiac signal vectors representative of all or a portion of one or more cardiac activation sequences based on the separated one or more components of the composite cardiac signals; compare an orientation of the one or more cardiac signal vectors with predetermined vector orientation criteria comprising at least a capture vector orientation criterion and a fusion vector orientation criterion; and classify the cardiac response to the pacing pulse as one of capture and fusion based on the comparison. - View Dependent Claims (17, 18, 19, 20, 21)
-
-
22. An implantable cardiac electrical stimulation system, comprising:
-
a pulse generator configured to generate pacing pulses; at least three implantable electrodes coupled to the pulse generator; sensing circuitry coupled to the at least three electrodes and configured for sensing cardiac electrical activity following delivery of a pacing pulse by the pulse generator, thereby providing one or more composite cardiac signals; a control system coupled to the pulse generator and the sensing circuitry, the control system comprising a signal processor; and the signal processor configured to execute stored program instructions to cause the system to; perform source separation using the one or more composite cardiac signals, the source separation performed by the signal processor algorithmically separating one or more components of the composite cardiac signals according to correlation between components of cardiac origin; produce one or more cardiac signal vectors representative of all or a portion of one or more cardiac activation sequences based on the separated one or more components of the composite cardiac signals; compare an orientation of the one or more cardiac signal vectors with predetermined vector orientation criteria comprising at least a criterion for bi-ventricular capture vector orientation and a criterion for single ventricular chamber capture vector orientation; and classify a cardiac response to the pacing pulse as one of bi-ventricular capture and single ventricular chamber capture based on the comparison. - View Dependent Claims (23, 24, 25, 26)
-
Specification