Template initialization for evoked response detection
First Claim
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1. A method of operating an implantable cardiac device to characterize a cardiac response to pacing, comprising:
- delivering a plurality of captured pacing pulses to a heart chamber that capture the heart chamber;
sensing a captured cardiac signal following delivery of each captured pacing pulse, each captured cardiac signal associated with a captured pacing response;
measuring a captured peak amplitude value and a captured peak timing value of each captured cardiac signal;
determining a median value of the captured peak timing values;
determining a captured peak threshold from the measured captured peak amplitude values;
delivering a plurality of non-captured pacing pulses to the heart chamber that do not capture the heart chamber;
sensing a non-captured cardiac signal following delivery of each non-captured pacing pulse, each non-captured cardiac signal associated with a non-captured pacing response;
measuring a non-captured peak amplitude value for each non-captured cardiac signal;
determining a non-captured peak threshold from the measured non-captured peak amplitude values;
comparing a peak timing of a cardiac signal of a subsequent paced cardiac cycle to the median value of the captured peak timing values;
comparing a peak amplitude of the cardiac signal of the subsequent paced cardiac cycle to the captured peak amplitude threshold and the noncaptured peak amplitude threshold;
determining the cardiac response to pacing of the heart chamber for the subsequent paced cardiac cycle based on comparing the peak timing of the cardiac signal to the median value of the captured peak timing values and comparing the peak amplitude of the cardiac signal to the captured peak amplitude threshold and the non-captured peak amplitude threshold; and
providing pacing therapy according to the cardiac pacing response determination.
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Abstract
Methods and devices for initializing templates for evoked response detection from pacing stimulation are described. A method of generating templates characterizing a cardiac response to pacing involves determining values associated with signal features for each of a number of sensed cardiac signals following pacing pulses. The median values of the features are used to generate a cardiac response template.
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Citations
14 Claims
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1. A method of operating an implantable cardiac device to characterize a cardiac response to pacing, comprising:
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delivering a plurality of captured pacing pulses to a heart chamber that capture the heart chamber; sensing a captured cardiac signal following delivery of each captured pacing pulse, each captured cardiac signal associated with a captured pacing response; measuring a captured peak amplitude value and a captured peak timing value of each captured cardiac signal; determining a median value of the captured peak timing values; determining a captured peak threshold from the measured captured peak amplitude values; delivering a plurality of non-captured pacing pulses to the heart chamber that do not capture the heart chamber; sensing a non-captured cardiac signal following delivery of each non-captured pacing pulse, each non-captured cardiac signal associated with a non-captured pacing response; measuring a non-captured peak amplitude value for each non-captured cardiac signal; determining a non-captured peak threshold from the measured non-captured peak amplitude values; comparing a peak timing of a cardiac signal of a subsequent paced cardiac cycle to the median value of the captured peak timing values; comparing a peak amplitude of the cardiac signal of the subsequent paced cardiac cycle to the captured peak amplitude threshold and the noncaptured peak amplitude threshold; determining the cardiac response to pacing of the heart chamber for the subsequent paced cardiac cycle based on comparing the peak timing of the cardiac signal to the median value of the captured peak timing values and comparing the peak amplitude of the cardiac signal to the captured peak amplitude threshold and the non-captured peak amplitude threshold; and providing pacing therapy according to the cardiac pacing response determination. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 12)
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11. A method of operating an implantable cardiac device to characterize a cardiac response to pacing, comprising:
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delivering captured and non-captured pacing pulses to a heart chamber; sensing a post-pace cardiac signal after delivery of each pacing pulse; measuring a peak amplitude value and a peak timing value from each post-pace cardiac signal; determining a median value from the peak amplitude values; determining a median value from the peak timing values; generating a template using the median values; using the template to determine the cardiac response to subsequent pacing pulses; and providing pacing therapy according to the cardiac pacing response determination. - View Dependent Claims (13)
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14. An implantable cardiac device, comprising:
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a pacing circuit configured to deliver captured and non-captured pacing pulses to a heart chamber; a sensing circuit configured to sense a post-pace cardiac signal after delivery of each pacing pulse; a template processor configured to measure a peak amplitude value and a peak timing value from each post-pace cardiac signal, determine a captured peak threshold value and a non-captured peak threshold value, determine at least one median value from the peak timing values, and generate a template using the median value and the threshold values; a cardiac response classification processor configured to use the template to determine the cardiac response to pacing for subsequent paced cardiac cycles; and a pacing therapy controller configured to control delivery of pacing therapy according to the cardiac pacing response determination.
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Specification