Atrial Capture Verification
First Claim
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1. An implantable cardiac device, comprising:
- a plurality of implantable cardiac electrodes electrically coupled to a heart;
sensing circuitry configured to sense cardiac signals;
a processor configured tocontrol delivery of a first pacing pulse to an atrium during a first cardiac cycle,sense for an atrial evoked response following delivery of and associated with the first atrial pacing pulse,sense for an intrinsic activation of a ventricle during the first cardiac cycle,deliver a pacing pulse to the ventricle if the intrinsic ventricular activation is not sensed during the first cardiac cycle,sense in the atrium for a retrograde P-wave, the retrograde P-wave responsive to the ventricular pacing pulse or the intrinsic ventricular activation,classify the cardiac response to the first atrial pacing pulse as a non-captured response if the retrograde P-wave is detected and the atrial evoked response is not detected, andclassify the cardiac response to the first atrial pacing pulse as a captured response if the atrial evoked response is detected.
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Abstract
Methods and systems for classifying cardiac responses to pacing stimulation and/or preventing retrograde cardiac conduction are described. Following delivery of a pacing pulse to an atrium of the patient'"'"'s heart during a cardiac cycle, the system senses in the atrium for a retrograde P-wave. The system classifies the atrial response to the pacing pulse based on detection of the retrograde P-wave. The system may also sense for an atrial evoked response and utilize the atrial evoked response in classifying the cardiac pacing response.
91 Citations
20 Claims
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1. An implantable cardiac device, comprising:
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a plurality of implantable cardiac electrodes electrically coupled to a heart; sensing circuitry configured to sense cardiac signals; a processor configured to control delivery of a first pacing pulse to an atrium during a first cardiac cycle, sense for an atrial evoked response following delivery of and associated with the first atrial pacing pulse, sense for an intrinsic activation of a ventricle during the first cardiac cycle, deliver a pacing pulse to the ventricle if the intrinsic ventricular activation is not sensed during the first cardiac cycle, sense in the atrium for a retrograde P-wave, the retrograde P-wave responsive to the ventricular pacing pulse or the intrinsic ventricular activation, classify the cardiac response to the first atrial pacing pulse as a non-captured response if the retrograde P-wave is detected and the atrial evoked response is not detected, and classify the cardiac response to the first atrial pacing pulse as a captured response if the atrial evoked response is detected. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. An implantable cardiac device, comprising:
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a plurality of implantable cardiac electrodes electrically coupled to a heart; sensing circuitry configured to sense cardiac signals; circuitry configured to control delivery of a first pacing pulse to an atrium during a first cardiac cycle. sense for an atrial evoked response following delivery of and associated with the first atrial pacing pulse. sense for an intrinsic activation of a ventricle during the first cardiac cycle, deliver a pacing pulse to the ventricle if the intrinsic ventricular activation is not sensed during the first cardiac cycle, sense in the atrium for a retrograde P-wave, the retrograde P-wave responsive to the ventricular pacing pulse or the intrinsic ventricular activation, classify the cardiac response to the first atrial pacing pulse as a non-captured response if the retrograde P-wave is detected and the atrial evoked response is not detected, classify the cardiac response to the first atrial pacing pulse as a captured response if the atrial evoked response is detected, and delay a next atrial pacing pulse if the retrograde P-wave is detected and the next atrial pacing pulse is scheduled to occur before an atrial effective refractory period. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification