Automatic sensing vector selection for morphology-based capture verification
First Claim
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1. A method for verifying capture by a cardiac pacemaker, comprising:
- delivering biventricular pacing during a paced cardiac cycle;
recording an evoked response electrogram during a paced cardiac cycle;
comparing the waveform of the evoked response electrogram with template waveforms representing biventricular, left ventricle-only, and right ventricle-only capture;
determining that either biventricular, left ventricle-only, or right ventricle-only capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and one of the biventricular, left ventricle-only, or right ventricle-only capture template waveforms is above a specified threshold; and
,selecting an optimum sensing vector for generating the evoked response and template waveforms by generating biventricular, left ventricle-only, and right ventricle-only capture templates using a plurality of different sensing vectors and selecting the optimum sensing vector as that sensing vector for which the biventricular capture template is least similar to one or both of the left ventricle-only and right ventricle-only capture templates.
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Abstract
A system and method for verifying capture of the heart by one or more pacing pulses using an electrogram morphology-based technique. Capture is determined by comparing an evoked response electrogram recorded during a paced cycle with a template waveform representing a paced cycle in which capture is achieved. The comparison is facilitated and made more accurate by selecting a sensing vector in which an evoked response electrogram in which no capture occurs is most dissimilar to the template.
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26 Claims
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1. A method for verifying capture by a cardiac pacemaker, comprising:
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delivering biventricular pacing during a paced cardiac cycle; recording an evoked response electrogram during a paced cardiac cycle; comparing the waveform of the evoked response electrogram with template waveforms representing biventricular, left ventricle-only, and right ventricle-only capture; determining that either biventricular, left ventricle-only, or right ventricle-only capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and one of the biventricular, left ventricle-only, or right ventricle-only capture template waveforms is above a specified threshold; and
,selecting an optimum sensing vector for generating the evoked response and template waveforms by generating biventricular, left ventricle-only, and right ventricle-only capture templates using a plurality of different sensing vectors and selecting the optimum sensing vector as that sensing vector for which the biventricular capture template is least similar to one or both of the left ventricle-only and right ventricle-only capture templates. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A system for verifying capture by an implantable cardiac pacemaker, comprising:
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an implantable cardiac pacemaker configured to deliver biventricular pacing; an external programmer in communication with the pacemaker via a wireless telemetry link; and
,wherein the external programmer is configured to; store an evoked response electrogram recorded during a paced cardiac cycle; compare the waveform of the evoked response electrogram with template waveforms representing biventricular, left ventricle-only, and right ventricle-only capture; determine that either biventricular, left ventricle-only, or right ventricle-only capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and one of the biventricular, left ventricle-only, or right ventricle-only capture template waveforms is above a specified threshold; and
,select an optimum sensing vector for generating the evoked response and template waveforms by generating biventricular, left ventricle-only, and right ventricle-only capture templates using a plurality of different sensing vectors and selecting the optimum sensing vector as that sensing vector for which the biventricular capture template is least similar to one or both of the left ventricle-only and right ventricle-only capture templates. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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19. An implantable cardiac pacemaker, comprising:
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a pacing channel for delivering pacing pulses; a sensing channel for generating electrogram signals; a controller for controlling the operation of the pacemaker, wherein the controller is configured to; store an evoked response electrogram recorded during a paced cardiac cycle; compare the waveform of the evoked response electrogram with template waveforms representing biventricular, left ventricle-only, and right ventricle-only capture; determine that either biventricular, left ventricle-only, or right ventricle-only capture has occurred during the paced cardiac cycle if the degree of similarity between the evoked response and one of the biventricular, left ventricle-only, or right ventricle-only capture template waveforms is above a specified threshold; and
,select an optimum sensing vector for generating the evoked response and template waveforms by generating biventricular, left ventricle-only, and right ventricle-only capture templates using a plurality of different sensing vectors and selecting the optimum sensing vector as that sensing vector for which the biventricular capture template is least similar to one or both of the left ventricle-only and right ventricle-only capture templates. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26)
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Specification