Methods and systems for managing fusion and noise in cardiac pacing response classification
First Claim
1. A method for detecting cardiac signal noise during capture verification, comprising:
- delivering a pacing pulse to a heart chamber;
sensing a cardiac signal associated with the pacing pulse;
classifying a cardiac response to the pacing pulse based on the sensed cardiac signal, the cardiac response classification being one of a plurality of expected cardiac responses including capture and intrinsic activation;
sensing for unexpected signal content in the cardiac signal, the unexpected signal content being inconsistent with one or more of capture and intrinsic activation and comprising one or more of unexpected signal peaks, the one or more unexpected cardiac signal peaks having an opposite polarity relative to a polarity of one or more cardiac signal peaks indicative of capture or intrinsic activation; and
determining that the cardiac response classification is possibly erroneous if the unexpected signal content is detected, wherein at least one of delivering, classifying, and determining is implemented at least in part by circuitry.
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Abstract
Methods and systems for detecting noise in cardiac pacing response classification processes involve determining that a cardiac response classification is possibly erroneous if unexpected signal content is detected. The unexpected signal content may comprise signal peaks that have polarity opposite to the polarity of peaks used to determine the cardiac response to pacing. Fusion/noise management processes include pacing at a relatively high energy level until capture is detected after a fusion, indeterminate, or possibly erroneous pacing response classification is made. The relatively high energy pacing pulses may be delivered until capture is detected or until a predetermined number of paces are delivered.
87 Citations
35 Claims
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1. A method for detecting cardiac signal noise during capture verification, comprising:
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delivering a pacing pulse to a heart chamber; sensing a cardiac signal associated with the pacing pulse; classifying a cardiac response to the pacing pulse based on the sensed cardiac signal, the cardiac response classification being one of a plurality of expected cardiac responses including capture and intrinsic activation; sensing for unexpected signal content in the cardiac signal, the unexpected signal content being inconsistent with one or more of capture and intrinsic activation and comprising one or more of unexpected signal peaks, the one or more unexpected cardiac signal peaks having an opposite polarity relative to a polarity of one or more cardiac signal peaks indicative of capture or intrinsic activation; and determining that the cardiac response classification is possibly erroneous if the unexpected signal content is detected, wherein at least one of delivering, classifying, and determining is implemented at least in part by circuitry. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A cardiac rhythm management device, comprising:
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a pulse generator configured to deliver pacing pulses to a heart chamber; a sensing circuit configured to sense cardiac signals of the heart chamber, the sensed cardiac signals respectively associated with the pacing pulses; and a cardiac response classification processor, the processor coupled to the sensing circuit and configured to classify a cardiac response to a pacing pulse based on a sensed cardiac signal associated with the pacing pulse and to determine that the cardiac response classification is possibly erroneous if unexpected signal content is detected in the sensed cardiac signal, the cardiac response classification is one of a plurality of expected cardiac responses that the processor is configured to classify including capture, fusion, and intrinsic activation, and wherein the unexpected signal content is inconsistent with one or more of capture, fusion, and intrinsic activation. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. A system for detecting cardiac signal noise during capture verification, comprising:
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a pulse generator for delivering a pacing pulse to a heart chamber; a sensing circuit for sensing a cardiac signal associated with the pacing pulse; means for classifying a cardiac response to the pacing pulse based on the sensed cardiac signal using one or more classification detection windows, the cardiac response classification being one of a plurality of expected cardiac responses including capture and intrinsic activation; means for sensing for unexpected signal content in the cardiac signal using one or more noise detection windows, the unexpected signal content being inconsistent with capture and intrinsic activation; and means for determining that the cardiac response classification is possibly erroneous if the unexpected signal content is detected, wherein the one or more classification detection windows are different from the one or more noise detection windows. - View Dependent Claims (29, 30, 31, 32, 33, 34, 35)
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Specification