Multi channel approach to capture verification

• US 7,529,578 B2
• Filed: 07/12/2005
• Issued: 05/05/2009
• Est. Priority Date: 07/12/2005
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Meyer, Scott A., Dong, Yanting, Zhu, Qingsheng
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Gedeon; Brian T
• Application Number:
  US11/180,937
• Publication Number:
  US 20070016261A1
• Time in Patent Office: 1,393 Days
• Field of Search: 600/510, 607/27, 607/28
• US Class Current: 600/510
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/7217 of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
• 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

Methods and systems involve classifying the cardiac response to pacing using a multi-channel approach. Multiple cardiac response signals are sensed via multiple sense channels. Each sense channel comprises a distinct combination of electrodes and sensing circuitry. The cardiac response to the pacing pulse is classified based on the morphology of the cardiac response signals. Classifying the cardiac response involves discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity.

Claims

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

sensing a cardiac response to a pacing pulse via multiple sense channels, each sense channel comprising a distinct combination of sense electrodes and sensing circuitry; and

classifying the cardiac response to the pacing pulse based on morphology of cardiac response signals sensed via the multiple sense channels, wherein classifying the cardiac response comprises discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity;

wherein classifying the cardiac response to the pacing pulse comprises;

discriminating between capture and non-capture with intrinsic activity using a first cardiac response signal sensed via a first sense channel of the multiple sense channels; and

detecting fusion using a second cardiac response signal sensed via a second sense channel of the multiple sense channels.

2. The method of claim 1, wherein discriminating between capture and non-capture with intrinsic activity comprises determining if an amplitude of the first cardiac response signal exceeds a threshold value.

3. A method of classifying a cardiac response to a pacing pulse, comprising:

sensing a cardiac response to a pacing pulse via multiple sense channels, each sense channel comprising a distinct combination of sense electrodes and sensing circuitry; and

classifying the cardiac response to the pacing pulse based on morphology of cardiac response signals sensed via the multiple sense channels, wherein classifying the cardiac response comprises discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity;

wherein classifying the cardiac response to the pacing pulse comprises;

detecting non-capture with intrinsic activity using a first cardiac response signal sensed via a first sense channel of the multiple sense channels; and

discriminating between capture and fusion using a second cardiac response signal sensed via a second sense channel of the multiple sense channels.

4. The method of claim 3, wherein discriminating between capture and fusion using the second cardiac response signal comprises discriminating between capture and fusion based on peaks of the second cardiac signal.

5. The method of claim 4, wherein:

discriminating between capture and fusion based on peaks of the second cardiac signal comprises;

sensing for a first peak of the second cardiac response signal in a first capture detection window;

sensing for a second peak of the second cardiac response signal within a second capture detection window; and

classifying the cardiac response as capture if the first peak is detected in the first capture detection window and the second peak is detected in the second capture detection window.

6. The method of claim 5, wherein the first and the second capture detection windows have dimensions of time and amplitude.

7. The method of claim 5, further comprising classifying the cardiac response as fusion if the first peak is not detected in the first capture detection window or the second peak is not detected in the second capture detection window.

8. A system for classifying a cardiac response to a pacing pulse, comprising:

means for sensing a cardiac response to a pacing pulse via multiple sense channels, each sense channel comprising a distinct combination of sense electrodes and sensing circuitry;

means for classifying the cardiac response to the pacing pulse based on morphology of cardiac response signals sensed via the multiple sense channels, wherein classifying the cardiac response comprises discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity;

means for detecting non-capture with intrinsic activity using a first cardiac response signal sensed via a first sense channel of the multiple sense channels; and

means for discriminating between capture and fusion using a second cardiac response signal sensed via a second sense channel of the multiple sense channels.

9. The system of claim 8, wherein the means for discriminating between capture and fusion using the second cardiac response signal comprises means for discriminating between capture and fusion based on peaks of the second cardiac signal.

10. The system of claim 9, wherein:

the means for discriminating between capture and fusion based on peaks of the second cardiac signal comprises;

means for sensing a first peak of the second cardiac response signal in a first capture detection window;

means for sensing for a second peak of the second cardiac response signal within a second capture detection window; and

means for classifying the cardiac response as capture if the first peak is detected in the first capture detection window and the second peak is detected in the second capture detection window.

11. The system of claim 10, wherein the first and the second capture detection windows have dimensions of time and amplitude.

12. The system of claim 10, further comprising means for classifying the cardiac response as fusion if the first peak is not detected in the first capture detection window or the second peak is not detected in the second capture detection window.

13. A system for classifying a cardiac response to a pacing pulse, comprising:

means for sensing a cardiac response to a pacing pulse via multiple sense channels, each sense channel comprising a distinct combination of sense electrodes and sensing circuitry;

means for classifying the cardiac response to the pacing pulse based on morphology of cardiac response signals sensed via the multiple sense channels, the classifying means comprising means for discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity;

wherein the classifying means further comprises;

means for discriminating between capture and non-capture with intrinsic activity using a first cardiac response signal sensed via a first sense channel of the multiple sense channels; and

means for detecting fusion using a second cardiac response signal sensed via a second sense channel of the multiple sense channels.

14. The system of claim 13, wherein the means for discriminating between capture and non-capture with intrinsic activity comprises means for determining if an amplitude of the first cardiac response signal exceeds a threshold value.