Method and system for removing pacing artifacts from subcutaneous electrocardiograms
First Claim
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1. A cardiac rhythm management device, comprising:
- one or more sensing channels for sensing intrinsic cardiac activity;
a subcutaneous ECG channel incorporating a subcutaneous electrode for generating an electrogram referred to as a subcutaneous ECG signal;
a pacing channel for pacing a cardiac chamber;
a controller for controlling the delivery of pacing pulses in accordance with a programmed mode and recording electrograms from a sensing channel;
wherein the controller is programmed to remove the pacing artifact from an electrogram generated by the subcutaneous ECG channel and recorded during a paced cardiac cycle by subtracting a pacing pulse template from the recorded electrogram, wherein the pacing pulse template is an electrogram recorded when a pace is delivered to a cardiac chamber while the chamber is refractory.
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Abstract
An implantable cardiac rhythm management device is configured to remove pacing artifacts from recorded electrograms by a subtraction method. A template waveform representing a recorded pace without accompanying cardiac electrical activity is generated. Such a pacing pulse template is then aligned with the instant at which a pace is delivered and subtracted from the recorded electrogram in order to remove the pacing artifact.
125 Citations
18 Claims
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1. A cardiac rhythm management device, comprising:
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one or more sensing channels for sensing intrinsic cardiac activity; a subcutaneous ECG channel incorporating a subcutaneous electrode for generating an electrogram referred to as a subcutaneous ECG signal; a pacing channel for pacing a cardiac chamber; a controller for controlling the delivery of pacing pulses in accordance with a programmed mode and recording electrograms from a sensing channel; wherein the controller is programmed to remove the pacing artifact from an electrogram generated by the subcutaneous ECG channel and recorded during a paced cardiac cycle by subtracting a pacing pulse template from the recorded electrogram, wherein the pacing pulse template is an electrogram recorded when a pace is delivered to a cardiac chamber while the chamber is refractory. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A system for removing pacing artifacts from electrograms, comprising:
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an implantable device having a sensing channel for sensing intrinsic cardiac activity and a pacing channel for delivering pacing pulses to a cardiac chamber in accordance with a programmed mode; an external device in communication with the implantable device; wherein the implantable device is programmed to record an electrogram from a sensing channel and transmit the electrogram to the external device; and
,wherein the external device is programmed to remove pacing artifacts from the electrogram by subtracting a pacing pulse template from the recorded electrogram during each paced cardiac cycle, wherein the pacing pulse template is an electrogram recorded when a pace is delivered to a cardiac chamber while the chamber is refractory. - View Dependent Claims (12, 13, 14, 15)
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16. A system for removing pacing artifacts from electrograms, comprising:
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an implantable device having a sensing channel for sensing intrinsic cardiac activity and a pacing channel for delivering pacing pulses to a cardiac chamber in accordance with a programmed mode; an external device in communication with the implantable device; wherein the implantable device is programmed to record an electrogram from a sensing channel and transmit the electrogram to the external device; and
,wherein the external device is programmed to remove pacing artifacts from the electrogram by subtracting a pacing pulse template from the recorded electrogram during each paced cardiac cycle, wherein the pacing pulse template is generated by the implantable device and transmitted to the external device. - View Dependent Claims (17, 18)
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Specification