Selection of cardiac signal features detected in multiple classification intervals for cardiac pacing response classification

• US 7,337,000 B2
• Filed: 04/28/2005
• Issued: 02/26/2008
• Est. Priority Date: 04/28/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Meyer, Scott A., Dong, Yanting, Stalsberg, Kevin John
• Primary Examiner(s): Layno; Carl
• Assistant Examiner(s): Heller; Tammie K.
• Application Number:
  US11/116,525
• Publication Number:
  US 20060247691A1
• Time in Patent Office: 1,034 Days
• Field of Search: 607/27, 607/28, 600/510
• US Class Current: 607/27
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Cardiac devices and methods involve the detection of cardiac signals features in adjacent classification intervals. Portions of the cardiac signal features detected in adjacent classification intervals are associated and are used to classify the cardiac response to a pacing pulse. Associating the portions of the cardiac signal features may be based on expected signal morphology.

Claims

1. A method for classifying a cardiac response to a pacing pulse, comprising:

timing first and second adjacent classification intervals following delivery of a pacing pulse;

timing a boundary region overlapping said first and second classification intervals;

sensing a cardiac signal in said first and second classification intervals following delivery of the pacing pulse;

detecting one or more cardiac signal features in said boundary region; and

classifying the cardiac response to the pacing pulse based on the one or more cardiac signal features detected in the boundary region.

2. The method of claim 1, wherein classifying the cardiac response to the pacing pulse comprises:

associating portions of the one or more cardiac signal features that fall within the boundary region; and

classifying the cardiac response to the pacing pulse based on the associated portions of the one or more cardiac signal features.

3. The method of claim 2, wherein associating the portions of the one or more cardiac signal features comprises associating the portions of the one or more cardiac signal features based on expected signal morphology.

4. The method of claim 2, wherein associating the portions of the one or more cardiac signal features comprises evaluating the cardiac signal across the adjacent classification intervals to determine feature information associated with the one or more cardiac signal features.

5. The method of claim 4, wherein evaluating the cardiac signal comprises evaluating the cardiac signal based on an expected time variation associated with the one or more cardiac signal features.

6. The method of claim 1, wherein:

detecting the one or more cardiac signal features comprises detecting portions of a cardiac signal peak within the boundary region; and

classifying the cardiac response to the pacing pulse comprises;

associating the portions of the cardiac signal peak that fall within the boundary region; and

classifying the cardiac response to the pacing pulse based on the associated portions of the cardiac signal peak.

7. The method of claim 6, wherein detecting the portions of the cardiac signal peak comprises detecting portions of a positive cardiac signal peak or detecting portions of a negative cardiac signal peak.

8. The method of claim 6, wherein detecting the cardiac signal peak comprises:

detecting a first portion of the cardiac signal peak in a first classification interval and in the boundary region;

detecting a second portion of the cardiac signal peak in a second classification interval, adjacent to the first classification interval, and in the boundary region; and

associating the first and the second portions of the cardiac signal peak.

9. The method of claim 8, wherein associating the first and the second portions of the cardiac signal peak comprises associating the first and the second portions of the cardiac signal peak if the first portion and the second portion satisfy an expected signal morphology.

10. The method of claim 1, wherein:

detecting the one or more cardiac signal features in the boundary region comprises;

detecting a first portion of a negative cardiac signal peak including a first minimum value of the cardiac signal in a first classification interval;

detecting a second portion of the negative cardiac signal peak including a second minimum value of the cardiac signal in a second classification interval; and

associating the first and the second portions of the negative cardiac signal peak if the second minimum value has a magnitude greater than a magnitude of the first minimum value; and

classifying the cardiac response to the pacing pulse based on the detected one or more cardiac signal features comprises classifying the cardiac response to the pacing pulse based on the associated portions of the negative cardiac signal peak.

11. The method of claim 10, further comprising associating the first and the second portions of the negative cardiac signal peak if the negative cardiac signal peak occurs before a positive cardiac signal peak.

12. The method of claim 1, wherein:

detecting the one or more cardiac signal features in the boundary region comprises;

detecting a first portion of a positive cardiac signal peak including a first maximum value of the cardiac signal in a first classification interval;

detecting a second portion of the positive cardiac signal peak including a second maximum value of the cardiac signal in a second classification interval; and

associating the first and the second portions of the positive cardiac signal peak if the second maximum value is greater than the first maximum value; and

classifying the cardiac response to the pacing pulse comprises classifying the cardiac response to the pacing pulse based on the associated portions of the positive cardiac signal peak.

13. The method of claim 12, further comprising associating the first and the second portions of the positive cardiac signal peak if the positive cardiac signal peak occurs after a negative cardiac signal peak.

14. A system for characterizing a cardiac response to pacing, comprising:

a sensing system configured to sense cardiac signals following pacing pulses delivered to a heart; and

a processor coupled to the sensing system, the processor configured to time first and second adjacent classification intervals following delivery of a pacing pulse, time a boundary region overlapping said first and second classification intervals, sense a cardiac signal in said first and second classification intervals, detect one or more cardiac signal features in said boundary region, and classify the cardiac response to the pacing pulse based on the one or more cardiac signal features detected in the boundary region.

15. The system of claim 14, wherein the processor is further configured to associate portions of the one or more cardiac signal features detected in the boundary region.

16. The system of claim 14, wherein the processor is configured to associate portions of a negative signal peak or portions of a positive signal peak that fall within the boundary region.

17. The system of claim 14, wherein the processor is configured to evaluate the cardiac signal across the adjacent classification intervals to determine feature information associated with the one or more cardiac signal features.

18. The system of claim 14, wherein the processor is further configured to detect a first portion of the cardiac signal peak in a first classification interval, detect a second portion of the cardiac signal peak in a second classification interval, adjacent to the first classification interval, and associate the first and the second portions of the cardiac signal peak if the timing of peaks satisfies an expected signal morphology.

19. A system for characterizing a cardiac response to pacing, comprising:

means for timing first and second adjacent classification intervals following delivery of a pacing pulse;

means for timing a boundary region overlapping said first and second classification intervals;

means for sensing a cardiac signal in said first and second adjacent classification intervals following delivery of the pacing pulse;

means for detecting one or more cardiac signal features in said boundary region of the adjacent classification intervals; and

means for classifying the cardiac response to the pacing pulse based on the detected one or more cardiac signal features.

20. The device of claim 19, further comprising means for associating portions of the cardiac signal peaks that fall within the boundary region based on expected signal morphology.