Adjusting Cardiac Pacing Response Sensing Intervals
First Claim
1. A method of operating a cardiac device, comprising:
- delivering a pacing pulse to a heart chamber during a cardiac cycle;
sensing a cardiac pacing response signal of the heart chamber during the cardiac cycle and following the pacing pulse in one or both of a first classification interval and a second classification interval, each of the first and second classification intervals associated with one or more timing parameters including at least a start time;
adapting at least one timing parameter of one or more of the first classification interval, the second classification interval, and one or more blanking periods based on timing of at least one signal feature of the pacing response signal and a temporal relationship between the first classification interval and the second classification interval;
applying the first and second classification intervals having the adapted timing parameters to a subsequent pacing response signal sensed following a subsequent pacing pulse delivered to the heart chamber;
determining if the signal feature of the subsequent pacing response signal falls within the first or second classification intervals that have the adapted timing parameters;
classifying a pacing response of the heart chamber to the subsequent cardiac pacing pulse based on a determination that the signal feature falls within the first or second classification intervals having the adapted timing parameters; and
delivering cardiac therapy based on classification of the pacing response.
1 Assignment
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Accused Products
Abstract
Discrimination between different types of possible cardiac pacing responses may depend on the timing of expected features that are sensed within a temporal framework. The temporal framework may include classification intervals, blanking periods and appropriately timed back up paces. The classification intervals and blanking periods of the temporal framework are intervals of time that have time parameters that include start time, end time, and length. The relationships and timing parameters of the elements of the temporal framework, e.g., blanking periods, classification intervals, delay periods, and backup pacing, should support detection of features used to discriminate between different types of pacing responses. As the system learns the morphology of the particular patient by analyzing the waveform of the pacing response signal, the temporal framework for pacing response determination may be adjusted to accommodate the individual patient.
92 Citations
30 Claims
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1. A method of operating a cardiac device, comprising:
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delivering a pacing pulse to a heart chamber during a cardiac cycle; sensing a cardiac pacing response signal of the heart chamber during the cardiac cycle and following the pacing pulse in one or both of a first classification interval and a second classification interval, each of the first and second classification intervals associated with one or more timing parameters including at least a start time; adapting at least one timing parameter of one or more of the first classification interval, the second classification interval, and one or more blanking periods based on timing of at least one signal feature of the pacing response signal and a temporal relationship between the first classification interval and the second classification interval; applying the first and second classification intervals having the adapted timing parameters to a subsequent pacing response signal sensed following a subsequent pacing pulse delivered to the heart chamber; determining if the signal feature of the subsequent pacing response signal falls within the first or second classification intervals that have the adapted timing parameters; classifying a pacing response of the heart chamber to the subsequent cardiac pacing pulse based on a determination that the signal feature falls within the first or second classification intervals having the adapted timing parameters; and delivering cardiac therapy based on classification of the pacing response. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A cardiac device, comprising:
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pacing circuitry configured to deliver a pacing pulse to a heart chamber during a cardiac cycle; sensing circuitry configured to sense a cardiac pacing response signal of the heart chamber during the cardiac cycle and following the pacing pulse in one or both of a first classification interval and a second classification interval, each of the first and second classification intervals associated with one or more timing parameters including at least a start time; control circuitry configured to adapt at least one timing parameter of one or more of the first classification interval, the second classification interval, and one or more blanking periods based on timing of at least one signal feature of the pacing response signal and a temporal relationship between the first classification interval and the second classification interval; apply the first and second classification intervals having the adapted timing parameters to a subsequent pacing response signal sensed following a subsequent pacing pulse delivered to the heart chamber; determine if the signal feature of the subsequent pacing response signal falls within the first or second classification intervals that have the adapted timing parameters; classify a pacing response of the heart chamber to the subsequent cardiac pacing pulse based on a determination that the signal feature falls within the first or second classification intervals having the adapted timing parameters; and deliver cardiac therapy based on classification of the pacing response. - View Dependent Claims (10, 11, 12, 13)
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14. A method of operating a cardiac device, comprising:
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delivering at least one pacing pulse to a heart chamber; sensing a pacing response signal of the heart chamber following the pacing pulse; detecting a temporal event of the pacing response signal, the temporal event comprising a point in time that falls between a first feature and a second feature of the pacing response signal; and initializing timing parameters of one or more of pacing response classification intervals and one or more blanking periods based on the detected temporal event so that the first feature falls within a first classification interval and the second feature falls within a second classification interval. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21)
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22. A cardiac device, comprising:
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pacing circuitry configured to deliver at least one pacing pulse to a heart chamber; sensing circuitry configured to sense a pacing response signal of the heart chamber following the pacing pulse and detect a temporal event of the pacing response signal, the temporal event comprising a point in time that falls between a first feature and a second feature of the pacing response signal; and control circuitry configured to initialize timing parameters of one or more of pacing response classification intervals and one or more blanking periods based on the detected temporal event so that the first feature falls within a first classification interval and the second feature falls within a second classification interval. - View Dependent Claims (23, 24)
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25. A method, comprising:
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delivering a pacing pulse to a left ventricle of a heart; sensing a cardiac pacing response signal of the left ventricle; detecting a first peak in a first capture detection interval and detecting a second peak in one of a fusion detection interval and a second capture detection interval that follows the fusion detection interval; and discriminating between capture and fusion based on the first and second peaks. - View Dependent Claims (26, 27, 28)
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29. A device, comprising:
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pacing circuitry configured to deliver a pacing pulse to a left ventricle of a heart; sensing circuitry configured to sense a cardiac pacing response signal of the left ventricle and detect a first peak in a first capture detection interval and detecting a second peak in one of a fusion detection interval and a second capture detection interval that follows the fusion detection interval; and control circuitry configured to discriminate between capture and fusion based on the first and second peaks. - View Dependent Claims (30)
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Specification