Cardiac wall motion-based automatic capture verification system and method
First Claim
1. An implantable cardiac stimulating device for administering pacing pulses to cardiac tissue through an implantable stimulation lead, the device comprising:
- a pacing pulse generator for generating the pacing pulses;
input circuitry for receiving a signal representative of cardiac wall motion; and
control circuitry, coupled to the pacing pulse generator and the input circuitry, for regulating the pacing pulse generator and for evaluating the signal representative of cardiac wall motion to determine when the pacing pulses evoke cardiac contractions.
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Accused Products
Abstract
An improved implantable cardiac stimulating device that performs cardiac wall motion-based automatic capture verification system is provided. Pacing pulses of varying energy content are administered to a patient'"'"'s heart, and the response of the patient'"'"'s heart is sensed by a cardiac wall motion sensor. The cardiac wall motion sensor provides a signal which is analyzed to determine the patient'"'"'s capture threshold, defined as the minimum amount of electrical stimulation required to evoke a cardiac contraction. The device then sets the amount of electrical stimulation at a level safely above the measured capture threshold. Capture verification may be performed at predetermined time intervals, on demand, or upon the occurrence of a significant cardiac event. Capture verification can also be performed on every pacing pulse delivered by the implantable cardiac stimulating device.
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Citations
48 Claims
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1. An implantable cardiac stimulating device for administering pacing pulses to cardiac tissue through an implantable stimulation lead, the device comprising:
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a pacing pulse generator for generating the pacing pulses; input circuitry for receiving a signal representative of cardiac wall motion; and control circuitry, coupled to the pacing pulse generator and the input circuitry, for regulating the pacing pulse generator and for evaluating the signal representative of cardiac wall motion to determine when the pacing pulses evoke cardiac contractions. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. An implantable system for administering pacing therapy to cardiac tissue in accordance with a patient'"'"'s capture threshold, the system comprising:
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a cardiac wall motion sensor for providing a signal representative of cardiac wall motion; a pacing pulse generator; pacing electrodes for delivering pacing pulses generated by the pacing pulse generator to cardiac tissue; and control circuitry for evaluating the signal representative of cardiac wall motion to determine the patient'"'"'s capture threshold and for causing the pacing pulse generator to generate pacing pulses that provide an amount of electrical stimulation determined in accordance with the patient'"'"'s capture threshold. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34)
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35. A method of regulating an amount of electrical stimulation provided by pacing pulses delivered to cardiac tissue from an implantable cardiac stimulating device in accordance with a patient'"'"'s capture threshold, comprising the steps of:
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generating a signal representative of cardiac wall motion; evaluating the signal representative of cardiac wall to determine the patient'"'"'s capture threshold; and adjusting the amount of electrical stimulation provided by the pacing pulses in accordance with the patient'"'"'s capture threshold. - View Dependent Claims (36, 37, 38, 39, 40, 41, 42)
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43. An implantable cardiac stimulating system for distinguishing cardiac asystole from ventricular fibrillation, comprising:
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means for generating a signal representative of cardiac wall motion; means for delivering electrical stimulation to cardiac tissue during a period when the signal representative of cardiac wall motion indicates an undetermined one of cardiac asystole and ventricular fibrillation, the electrical stimulation being sufficient to evoke a cardiac contraction during cardiac asystole; and means for monitoring the signal representative of cardiac wall motion for a predetermined period of time following delivery of the electrical stimulation to detect an excursion representing a cardiac contraction, the excursion being indicative of cardiac asystole and an absence of the excursion being indicative of ventricular fibrillation. - View Dependent Claims (44)
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45. A method of distinguishing cardiac asystole from ventricular fibrillation, comprising the steps of:
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generating a signal representative of cardiac wall motion; delivering electrical stimulation to cardiac tissue during a period when the signal representative of cardiac wall motion indicates an undetermined one of cardiac asystole and ventricular fibrillation, the electrical stimulation being sufficient to evoke a cardiac contraction during cardiac asystole; and monitoring the signal representative of cardiac wall motion for a predetermined period of time following delivery of the electrical stimulation to detect an excursion representing a cardiac contraction, the excursion being indicative of cardiac asystole and an absence of the excursion being indicative of ventricular fibrillation.
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46. An implantable cardiac stimulating device for administering pacing pulses to cardiac tissue through an implantable stimulation lead, the device comprising:
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a pacing pulse generator for generating the pacing pulses; a cardiac wall acceleration sensor for producing a cardiac wall acceleration signal corresponding to a mechanical cardiac contraction; detecting means for detecting the absence of a cardiac wall acceleration signal corresponding to loss of capture; control circuitry, coupled to the pacing pulse generator and the detecting means, for controlling the pacing pulse generator and for automatically increasing an amount of electrical stimulation energy provided by the pacing pulses whenever the cardiac wall acceleration signal indicates loss of capture. - View Dependent Claims (47, 48)
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Specification