System and method for eliminating cross-talk due to far-field signals

• US 6,522,921 B2
• Filed: 12/26/2000
• Issued: 02/18/2003
• Est. Priority Date: 12/26/2000
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Kramer, Andrew P., Wentkowski, Rene H.
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US09/748,722
• Publication Number:
  US 20020082650A1
• Time in Patent Office: 784 Days
• Field of Search: 607/4-28
• US Class Current: 607/9
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence

Abstract

A method and system for reducing the effects of far-field signals in a cardiac rhythm management device. Such far-field signals can be produced by contralateral ventricular depolarization and can cause cross-talk between ventricular sensing channels.

Claims

1. A method for operating a cardiac rhythm management device, comprising:

sensing right and left ventricles through separate channels and generating ventricular sense signals upon detection of depolarization occurring in a ventricle;

pacing a ventricle upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from the right ventricle sensing channel;

rendering the left ventricular sensing channel refractory for a specified time interval in order to avoid sensing both a far-field right ventricular signal and a left ventricular depolarization during the same cardiac cycle.

2. The method of claim 1 wherein the left ventricular sensing channel is rendered refractory after a first ventricular sense for a specified time period.

3. The method of claim 2 wherein the left ventricle is paced upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from the right ventricle sensing channel, unless the pace would occur within a left ventricular protection period beginning after receipt of a left ventricular sense signal in which case no left ventricular pace is delivered;

and,

wherein the left ventricular protection period is triggered by a depolarization detected in the left ventricular sensing channel during both refractory and non-refractory periods.

4. The method of claim 1 wherein a right ventricular sense triggers a left ventricular refractory period.

5. The method of claim 1 wherein a left ventricular sense triggers a left ventricular refractory period.

6. The method of claim 4 wherein the left ventricle is paced upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from the right ventricle sensing channel, unless the pace would occur within a left ventricular protection period beginning after receipt of a left ventricular sense signal in which case no left ventricular pace is delivered;

and,

wherein the left ventricular protection period is triggered by a depolarization detected in the left ventricular sensing channel during both refractory and non-refractory periods.

7. The method of claim 4 wherein the left ventricle is paced upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from the right ventricle sensing channel, unless the pace would occur within a left ventricular protection period in which case no left ventricular pace is delivered;

and,

wherein the left ventricular protection period is triggered by either a left ventricular or a right ventricular sense.

8. A method for operating a cardiac rhythm management device, comprising:

sensing a first heart chamber and a second heart chamber contralateral to the first chamber through separate channels and generating separate sense signals upon detection of depolarization occurring in a chamber;

rendering a sensing channel refractory for a specified time interval in order to avoid sensing depolarizations from both chambers during the same cardiac cycle; and

,

wherein the first chamber is sensed with a bipolar lead in order to reduce the sensing of far-field signals due to depolarizations in the second chamber.

9. The method of claim 8 wherein the first and second chambers are the paired ventricles.

10. The method of claim 8 wherein the first and second chambers are the paired atria.

11. A method for operating a cardiac rhythm management device, comprising:

sensing a first heart chamber and a second heart chamber contralateral to the first chamber through separate channels and generating separate sense signals upon detection of depolarization occurring in a chamber;

rendering a sensing channel refractory for a specified time interval in order to avoid sensing depolarizations from both chambers during the same cardiac cycle; and

,

wherein the first chamber is sensed with a unipolar lead in which an electrode of the lead is referenced to a housing structure in order to reduce the sensing of far-field signals due to depolarizations in the second chamber.

12. The method of claim 11 wherein the first and second chambers are the paired ventricles.

13. The method of claim 11 wherein the first and second chambers are the paired atria.

14. The method of claim 11 wherein the housing structure is an electrode attached to a non-conductive part of a device housing.

15. A cardiac rhythm management device, comprising:

right and left ventricular sensing channels for sensing right and left ventricular depolarizations and generating ventricular sense signals in accordance therewith;

a pacing channel for delivering pacing pulses to a ventricle;

a controller for controlling the delivery of paces in accordance with a programmed pacing mode;

wherein the controller is programmed to render the left ventricular sensing channel refractory for a specified time interval in order to avoid sensing both a far-field right ventricular signal and a left ventricular depolarization during the same cardiac cycle.

16. The device of claim 15 wherein the left ventricular sensing channel is rendered refractory after a first ventricular sense for a specified time period.

17. The device of claim 16 wherein the controller is programmed to pace left ventricle upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from the right ventricle sensing channel, unless the pace would occur within a left ventricular protection period beginning after receipt of a left ventricular sense signal in which case no left ventricular pace is delivered;

and,

wherein the left ventricular protection period is triggered by a depolarization detected in the left ventricular sensing channel during both refractory and non-refractory periods.

18. The device of claim 15 wherein a right ventricular sense triggers a left ventricular refractory period.

19. The device of claim 18 wherein a left ventricular sense triggers a left ventricular refractory period.

20. The device of claim 18 wherein the controller is programmed to pace the left ventricle upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from the right ventricle sensing channel, unless the pace would occur within a left ventricular protection period beginning after receipt of a left ventricular sense signal in which case no left ventricular pace is delivered;

and,

wherein the left ventricular protection period is triggered by a depolarization detected in the left ventricular sensing channel during both refractory and non-refractory periods.

21. The device of claim 18 wherein the controller is programmed to pace the left ventricle upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from the right ventricle sensing channel, unless the pace would occur within a left ventricular protection period in which case no left ventricular pace is delivered;

and,

wherein the left ventricular protection period is triggered by either a left ventricular or a right ventricular sense.

22. A method for operating a cardiac rhythm management device, comprising:

sensing a first heart chamber and a contralateral second heart chamber through separate sensing channels; and

,

rendering a sensing channel refractory for a specified time interval in order to avoid sensing depolarizations from both chambers during the same cardiac cycle.

23. The method of claim 22 wherein the first and second heart chambers are the paired ventricles.

24. The method of claim 22 wherein the first and second heart chambers are the paired atria.

25. The method of claim 22 further comprising pacing a ventricle upon expiration of a ventricular escape interval without receipt of a right ventricular sense signal from a right ventricle sensing channel.