Autocapture determination for an implantable cardioverter defibrillator
First Claim
1. A cardiac pacing/defibrillation system having an automatic determination of whether a pacing stimulus evokes a response, said cardiac pacing/defibrillation system including:
- (a) an atrial lead having atrial electrodes electrically coupled to a cardiac pacer/defibrillator;
(b) a ventricular lead having ventricular coil electrodes electrically coupled to said cardiac pacer/defibrillator;
(c) pulse generator means for providing a pacing stimulus to at least one of an atrium and a ventricle of a heart, said pulse generator means electrically coupled to the atrial lead and ventricular lead;
(d) defibrillation means for providing an electrical stimulus to the ventricle of the heart electrically coupled to the ventricular lead;
(e) sensing means for sensing a response evoked by the pacing stimulus, said sensing means electrically coupled to at least one of said atrial lead and said ventricular lead, wherein a signal associated with the evoked response is sensed between at least one of said atrial electrodes and said ventricular coil electrodes; and
(f) afterpotential attenuation means for attenuating afterpotentials which result due to the application of the pacing stimulus to the heart, said afterpotential attenuation means being electrically coupled to said pulse generator means.
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Abstract
A cardiac pacing/defibrillation system that enhances the ability of a cardiac pacer to automatically detect whether a pacing stimulus results in heart capture or contraction. The cardiac pacing/defibrillation system includes a pacing circuit that attenuates polarization voltages or “afterpotential” which develop at the heart tissue/electrode interface following the delivery of a stimulus to the heart tissue, which thereby allows the pacing electrodes to be utilized to sense an evoked response to the pacing stimulus. The cardiac pacing/defibrillation system may utilize the ventricular coil electrode and superior vena cava coil electrode to sense an evoked response, thereby eliminating the necessity for an additional ventricular lead for sensing an evoked response. The present invention allows accurate detection of an evoked response of the heart, to thereby determine whether each pacing stimulus results in capture.
220 Citations
31 Claims
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1. A cardiac pacing/defibrillation system having an automatic determination of whether a pacing stimulus evokes a response, said cardiac pacing/defibrillation system including:
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(a) an atrial lead having atrial electrodes electrically coupled to a cardiac pacer/defibrillator;
(b) a ventricular lead having ventricular coil electrodes electrically coupled to said cardiac pacer/defibrillator;
(c) pulse generator means for providing a pacing stimulus to at least one of an atrium and a ventricle of a heart, said pulse generator means electrically coupled to the atrial lead and ventricular lead;
(d) defibrillation means for providing an electrical stimulus to the ventricle of the heart electrically coupled to the ventricular lead;
(e) sensing means for sensing a response evoked by the pacing stimulus, said sensing means electrically coupled to at least one of said atrial lead and said ventricular lead, wherein a signal associated with the evoked response is sensed between at least one of said atrial electrodes and said ventricular coil electrodes; and
(f) afterpotential attenuation means for attenuating afterpotentials which result due to the application of the pacing stimulus to the heart, said afterpotential attenuation means being electrically coupled to said pulse generator means. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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Specification