Method and apparatus for identifying oversensing using far-field intracardiac electrograms and marker channels
First Claim
1. A method of detecting an occurrence of intrinsic depolarizations of a heart chamber comprising:
- obtaining a far-field electrogram (FF EGM) signal comprising a stream of digital sample points;
identifying possible intrinsic depolarizations by applying amplitude change criteria to subsets of the stream of digital sample points, the subsets comprising at least 3 digital sample points within the stream;
removing, from the identified possible intrinsic depolarizations, possible intrinsic depolarizations that have amplitudes below an amplitude threshold criterion to generate first updated identified possible intrinsic depolarizations;
thenremoving, from the first updated identified possible intrinsic depolarizations, possible intrinsic depolarizations that occur within a blanking interval period immediately after a preceding intrinsic depolarization to generate second updated identified possible depolarizations; and
marking the second updated identified possible intrinsic depolarizations as sensed events from the FF EGM signal.
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Accused Products
Abstract
A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.
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Citations
8 Claims
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1. A method of detecting an occurrence of intrinsic depolarizations of a heart chamber comprising:
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obtaining a far-field electrogram (FF EGM) signal comprising a stream of digital sample points; identifying possible intrinsic depolarizations by applying amplitude change criteria to subsets of the stream of digital sample points, the subsets comprising at least 3 digital sample points within the stream; removing, from the identified possible intrinsic depolarizations, possible intrinsic depolarizations that have amplitudes below an amplitude threshold criterion to generate first updated identified possible intrinsic depolarizations;
thenremoving, from the first updated identified possible intrinsic depolarizations, possible intrinsic depolarizations that occur within a blanking interval period immediately after a preceding intrinsic depolarization to generate second updated identified possible depolarizations; and marking the second updated identified possible intrinsic depolarizations as sensed events from the FF EGM signal. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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Specification