Method and device for enhanced capture tracking by discrimination of fusion beats
First Claim
1. A method for identifying a fusion beat following delivery of a stimulating pulse in myocardial tissue, comprising:
- (a) sensing a post-pulse electrical response;
(b) assessing a detection feature of the post-pulse electrical response with at least one capture detection function to determine whether the post-pulse electrical response corresponds with capture;
(c) assessing the detection feature of the post-pulse electrical response with at least one loss-of-capture detection function to determine whether the post-pulse electrical response corresponds with loss-of-capture; and
(d) classifying the post-pulse electrical response as a fusion beat if the post-pulse electrical response does not correspond with either capture or loss-of-capture.
1 Assignment
0 Petitions
Accused Products
Abstract
An apparatus and a method for identifying fusion beats as part of an automatic capture routine in a cardiac stimulation device are disclosed. By requiring each post-pulse electrical response to be closely correlated with an expected morphology for either a capture condition or a loss-of-capture condition before classification of the post-pulse electrical response as either capture or loss-of-capture respectively, the present invention is able to identify fusion beats. In various embodiments, this fusion identification is performed using both template matching and assessment of particular detection features. Moreover, in one embodiment, a moving average and a standard deviation are maintained for each detection feature, thereby creating an automatically adjusting evoked response detection threshold.
135 Citations
50 Claims
-
1. A method for identifying a fusion beat following delivery of a stimulating pulse in myocardial tissue, comprising:
-
(a) sensing a post-pulse electrical response; (b) assessing a detection feature of the post-pulse electrical response with at least one capture detection function to determine whether the post-pulse electrical response corresponds with capture; (c) assessing the detection feature of the post-pulse electrical response with at least one loss-of-capture detection function to determine whether the post-pulse electrical response corresponds with loss-of-capture; and (d) classifying the post-pulse electrical response as a fusion beat if the post-pulse electrical response does not correspond with either capture or loss-of-capture. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
-
-
14. A method for detecting a fusion beat following delivery of a stimulating pulse in myocardial tissue, comprising:
-
(a) sensing a post-pulse electrical response; (b) computing a value for a detection feature for the post-pulse electrical response; (c) classifying the post-pulse electrical response as a fusion beat if the value falls outside a prescribed deviation and not within a loss-of-capture range specified by an evoked response sense level threshold, wherein the prescribed deviation is determined using a moving average and measure of variance for the detection feature; and (d) recalculating the moving average and the measure of variance using the value of the detection feature for the post-pulse electrical response if the value falls within the prescribed deviation. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
-
-
27. A system for detecting fusion beats comprising:
-
post-pulse electrical response sensing circuitry; and a control unit coupled with the sensing circuitry, the control unit being configured to; assess a detection feature of a post-pulse electrical response with at least one capture detection function to determine whether the post-pulse electrical response corresponds with capture; assess the detection feature of the post-pulse electrical response with at least one loss-of-capture detection function to determine whether the post-pulse electrical response corresponds with loss-of-capture; and classify the post-pulse electrical response as a fusion beat if the post-pulse electrical response does not correspond with either capture or loss-of-capture. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34, 35, 36, 37)
-
-
38. A stimulation device comprising:
-
a pulse generator; post-pulse electrical response sensing circuitry; and a control unit coupled with the pulse generator and the sensing circuitry, the control unit being configured to; compute a value for a detection feature for a post-pulse electrical response; classify the post-pulse electrical response as a fusion beat if the value falls outside a prescribed deviation and not within a loss-of-capture range specified by an evoked response sense level threshold, wherein the prescribed deviation is determined using a moving average and a measure of variance around the moving average for the detection feature; and recalculate the moving average and the measure of variance using the value of the detection feature for the post-pulse electrical response if the value falls within the prescribed deviation. - View Dependent Claims (39, 40, 41, 42, 43, 44, 45, 46, 47, 48)
-
-
49. A stimulation device comprising:
-
sensing means for sensing a post-pulse electrical response; and control means coupled with the sensing means, the control means comprising means for comparing a value of a detection feature of the post-pulse electrical response to a first threshold to identify capture, means for comparing the value of the detection feature of the post-pulse electrical response to a second threshold to identity loss-of-capture and means for identifying a fusion beat, wherein the fusion beat identification is the default identification resulting from a failure to confirm capture or loss-of-capture.
-
-
50. A stimulation device comprising:
-
sensing means for sensing a post-pulse electrical response; and control means coupled with the sensing means, the control means comprising; means for computing a value for a detection feature for a post-pulse electrical response; means for classifying the post-pulse electrical response as a fusion beat if the value falls outside a prescribed deviation and not within a loss-of-capture range specified by an evoked response sense level threshold, wherein the prescribed deviation is determined using a moving average and a measure of variance around the moving average for the detection feature; and means for recalculating the moving average and the measure of variance using the value of the detection feature for the post-pulse electrical response if the value falls within the prescribed deviation.
-
Specification