Method and apparatus for identifying cardiac and non-cardiac oversensing using intracardiac electrograms
First Claim
1. A method comprising:
- operating an implanted medical device in accordance with sensing parameters for a plurality of cardiac cycles;
identifying oversensing by the implanted medical device by performing real-time electrogram (EGM) analysis;
automatically adjusting at least one of the sensing parameters of the implanted medical device in response to identifying the oversensing to invoked corrective action to avoid future oversensing;
without inducing a cardiac episode,prospectively assessing whether the implanted medical device will appropriately detect a cardiac episode with the adjusted sensing parameters; and
resetting the sensing parameter to an original setting upon determining the implanted medical device will not appropriately detect the cardiac episode with the adjusted sensing parameters.
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Abstract
A method and apparatus for automatically identifying various types of cardiac and non-cardiac oversensing and automatically performing a corrective action to reduce the likelihood of oversensing is provided. EGM data, including time intervals between sensed and paced events and signal morphologies, are analyzed for patterns indicative of various types of oversensing, including oversensing of far-field R-waves, R-waves, T-waves, or noise associated with electromagnetic interference, non-cardiac myopotentials, a lead fracture, or a poor lead connection. Identification of oversensing and its suspected cause are reported so that corrective action may be taken. The corrective action may include, for example, adjusting sensing parameters such as blanking periods, decay constants, decay delays, threshold values, sensitivity values, electrode configurations and the like.
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Citations
32 Claims
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1. A method comprising:
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operating an implanted medical device in accordance with sensing parameters for a plurality of cardiac cycles; identifying oversensing by the implanted medical device by performing real-time electrogram (EGM) analysis; automatically adjusting at least one of the sensing parameters of the implanted medical device in response to identifying the oversensing to invoked corrective action to avoid future oversensing; without inducing a cardiac episode, prospectively assessing whether the implanted medical device will appropriately detect a cardiac episode with the adjusted sensing parameters; and resetting the sensing parameter to an original setting upon determining the implanted medical device will not appropriately detect the cardiac episode with the adjusted sensing parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A computer-readable medium comprising instructions to cause a processor to:
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operate an implanted medical device in accordance with sensing parameters for a plurality of cardiac cycles; identify oversensing by the implanted medical device by performing real-time electrogram (EGM) analysis; and automatically adjust at least one sensing parameter of the implanted medical device in response to identifying the oversensing; without inducing a cardiac episode, prospectively assess whether the implanted medical device will appropriately detect a cardiac episode with the adjusted sensing parameters; and
,reset the sensing parameter to an original setting upon determining the implanted medical device will not appropriately detect the cardiac episode with the adjusted sensing parameters. - View Dependent Claims (15, 16)
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17. An implantable medical device comprising:
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at least one sensing electrode to sense cardiac data from a heart of a patient in accordance with programmed sensing parameters for a plurality of cardiac cycles; and a processor to identify oversensing by the implantable medical device based on the sensed cardiac data and automatically adjust at least one of the sensing parameter of the implantable medical device in response to identifying the oversensing; wherein the processor prospectively assesses, without inducing a cardiac episode, whether the implantable medical device will appropriately detect a cardiac episode with the adjusted sensing parameter and resets the sensing parameter to an original setting upon determining the implantable medical device will not appropriately detect the cardiac episode with the adjusted sensing parameter. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. An implantable medical device comprising:
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means for operating an implantable medical device in accordance with sensing parameters for a plurality of cardiac cycles; means for identifying oversensing by the implantable medical device; means for automatically performing a corrective action to reduce the likelihood of oversensing automatically by adjusting at least one of the sensing parameters; means for prospectively assessing, without inducing a cardiac episode, whether the implanted medical device will appropriately detect a cardiac episode with the adjusted sensing parameters; and means for resetting the sensing parameter to an original setting upon determining the implanted medical device will not appropriately detect the cardiac episode with the adjusted sensing parameters. - View Dependent Claims (29, 30, 31, 32)
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Specification