System and method for atrial autocapture in single-chamber pacemaker modes using far-field detection
First Claim
1. A system for detecting capture in an atrial chamber of a patient'"'"'s heart and implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the system comprising:
- pulse generating means for generating a stimulation pulse for delivery to the atrial chamber through the lead to trigger a subsequent contraction in a ventricular chamber of the heart so as to produce a far-field signal;
first sampling means for generating a far-field signal sample by sampling the produced far-field signal during a far-field interval window;
window generating means for periodically determining the far-field interval window; and
first control means for comparing the far-field signal sample to a predetermined far-field signal recognition template, such that;
(i) when the far-field signal sample is approximately equal to the predetermined far-field signal recognition template, the first control means generates a first signal indicative of presence of atrial capture, and(ii) when the far-field signal sample is not approximately equal to the predetermined far-field signal recognition template, the first control means generates a second signal indicative of absence of atrial capture.
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Accused Products
Abstract
An implantable pacemaker automatically verifies atrial capture and performs atrial stimulation energy assessment when atrial capture is absent. The pacemaker delivers a stimulation pulse in the atrial chamber of the heart and samples the resulting far-field signal from the ventricular chamber during a predetermined far-field interval window. The pacemaker then compares the far-field signal sample to a predetermined far-field signal recognition template. If the far-field signal sample is approximately equal to the far-field signal recognition template, then atrial capture is deemed verified; otherwise, the pacemaker performs an atrial stimulation energy determination. Optionally, the pacemaker automatically determines the timing of the far-field interval window and defines the far-field signal recognition template.
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Citations
30 Claims
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1. A system for detecting capture in an atrial chamber of a patient'"'"'s heart and implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the system comprising:
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pulse generating means for generating a stimulation pulse for delivery to the atrial chamber through the lead to trigger a subsequent contraction in a ventricular chamber of the heart so as to produce a far-field signal; first sampling means for generating a far-field signal sample by sampling the produced far-field signal during a far-field interval window; window generating means for periodically determining the far-field interval window; and first control means for comparing the far-field signal sample to a predetermined far-field signal recognition template, such that; (i) when the far-field signal sample is approximately equal to the predetermined far-field signal recognition template, the first control means generates a first signal indicative of presence of atrial capture, and (ii) when the far-field signal sample is not approximately equal to the predetermined far-field signal recognition template, the first control means generates a second signal indicative of absence of atrial capture. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A system for determining a far-field signal recognition template for use in identification of a far-field signal originating from a ventricle of a patient'"'"'s heart, the system being implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the system comprising:
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pulse generating means for generating a stimulation pulse for delivery to the atrial chamber through the lead so as to; (i) produce a response signal in the atrial chamber, and (ii) produce a far-field signal caused by a subsequently triggered contraction in a ventricular chamber of the heart; sampling means for; (i) generating a response sample by sampling the produced response signal; and (ii) generating a far-field signal sample by sampling the produced far-field signal after a delay following the generation of the stimulation pulse, the delay being substantially equal to a predefined AV conduction time value; memory means for storing the produced response and far-field signal samples; and control means for; (i) repeatedly and sequentially triggering the pulse generating means, the sampling means, and the memory means to generate and store by the memory means a predetermined plurality of the response samples and a predetermined plurality of the far-field signal samples; (ii) determining an average response by averaging the plural response samples; (iii) determining an average far-field signal by averaging the plural far-field signal samples; and (iv) determining a far-field signal recognition template by comparing the average response from the average far-field signal. - View Dependent Claims (8)
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9. A system for detecting capture in an atrial chamber of a patient'"'"'s heart and implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the system comprising:
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a pulse generator that generates a stimulation pulse for delivery to the atrial chamber through the lead to trigger a subsequent contraction in a ventricular chamber of the heart so as to produce a far-field signal; a signal sampler operatively connected to the pulse generator, that generates a far-field signal sample by sampling the produced far-field signal during a far-field interval window; a window generator for periodically determining the far-field interval window; and a controller operatively connected to the pulse generator and the signal sampler that compares the far-field signal sample to a predetermined far-field signal recognition template, such that; (i) when the far-field signal sample is approximately equal to the predetermined far-field signal recognition template, the controller generates a first signal indicative of presence of atrial capture, and (ii) when the far-field signal sample is not approximately equal to the predetermined far-field signal recognition template, the controller generates a second signal indicative of absence of atrial capture. - View Dependent Claims (10, 11, 12, 13, 14)
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15. A system for determining a far-field signal recognition template for use in identification of a far-field signal originating from a ventricle of a patient'"'"'s heart, the system being implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the system comprising:
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a pulse generator that generates a stimulation pulse for delivery to the atrial chamber through the lead so as to; (i) produce a response signal in the atrial chamber, and (ii) produce a far-field signal caused by a subsequently triggered contraction in a ventricular chamber of the heart; a signal sampler that; (i) generates a response sample by sampling the produced response signal; and (ii) generates a far-field signal sample by sampling the produced far-field signal after a delay following the generation of the stimulation pulse, the delay being substantially equal to a predefined AV conduction time value; a memory that stores the response and far-field signal samples; and a controller that; (i) repeatedly and sequentially triggers the pulse generator, the signal sampler, and the memory to generate and store in the memory a predetermined plurality of the response samples and a predetermined plurality of the far-field signal samples; (ii) determines an average response by averaging the plural response samples; (iii) determines an average far-field signal by averaging the plural far-field signal samples; and (iv) determines the far-field signal recognition template by comparing the average response from the average far-field signal. - View Dependent Claims (16)
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17. A method for detecting capture in an atrial chamber of a patient'"'"'s heart and implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the method comprising the steps of:
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(a) generating, by a pulse generator, a stimulation pulse for delivery to the atrial chamber through the lead to trigger a subsequent contraction in a ventricular chamber of the heart so as to produce a far-field signal; (b) generating, by a signal sampler, a far-field signal sample by sampling the produced far-field signal during a far-field interval window, wherein the far-field interval window is periodically determined; and (c) comparing, by a controller, the far-field signal sample to a predetermined far-field signal recognition template, and (1) when the far-field signal sample is approximately equal to the predetermined far-field signal recognition template, generating a first signal indicative of presence of atrial capture, and (2) when the far-field signal sample is not approximately equal to the predetermined far-field signal recognition template, generating a second signal indicative of absence of atrial capture. - View Dependent Claims (18, 19, 20, 21, 22)
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23. A method for determining a far-field signal recognition template for use in identification of a far-field signal originating from a ventricle of a patient'"'"'s heart, the method being implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the method comprising the steps of:
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(a) generating, by a pulse generator, a stimulation pulse for delivery to the atrial chamber through the lead so as to; (1) produce a response signal in the atrial chamber, and (2) produce a far-field signal caused by a subsequently triggered contraction in a ventricular chamber of the heart; (b) generating, by a signal sampler, a response sample by sampling the produced response signal; (c) generating, by the signal sampler, a far-field signal sample by sampling the produced far-field signal after a delay following step (a), the delay being substantially equal to a predetermined AV conduction time value; (d) storing, in a memory, the response and far-field signal samples; (e) generating, a predetermined plurality of the stored response samples and a predetermined plurality of the stored far-field signal samples by repeating, by a controller, steps (a) through (d) for a predetermined number of repetitions; (f) determining, by the controller, an average response by averaging the plural response samples; (g) determining, by the controller, an average far-field signal by averaging the plural far-field signal samples; and (h) determining, by the controller, the far-field signal recognition template by subtracting the average response from the average far-field signal. - View Dependent Claims (24)
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25. A system for detecting capture in an atrial chamber of a patient'"'"'s heart and implemented in an implantable pacemaker implanted in the patient and connected to the atrial chamber via a lead, the system comprising:
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a pulse generator that generates a stimulation pulse for delivery to the atrial chamber through the lead to trigger a subsequent contraction in a ventricular chamber of the heart so as to produce a far-field signal; a signal sampler operatively connected to the pulse generator, that generates a far-field signal sample by sampling the produced far-field signal during a predetermined far-field interval window; a template generator for periodically determining a far-field signal recognition template; and a controller operatively connected to the pulse generator and the signal sampler that compares the far-field signal sample to the far-field signal recognition template, such that; (i) when the far-field signal sample is approximately equal to the far-field signal recognition template, the controller generates a first signal indicative of presence of atrial capture, and (ii) when the far-field signal sample is not approximately equal to the far-field signal recognition template, the controller generates a second signal indicative of absence of atrial capture. - View Dependent Claims (26, 27, 28, 29, 30)
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Specification