Atrial capture verification
First Claim
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1. An implantable cardiac device, comprising:
- a plurality of implantable cardiac electrodes configured to be electrically coupled to a heart;
sensing circuitry configured to sense cardiac signals;
a processor configured tocontrol delivery of a first pacing pulse to an atrium during a first cardiac cycle,sense for an atrial evoked response following delivery of and associated with the first atrial pacing pulse,sense for an intrinsic activation of a ventricle during the first cardiac cycle,deliver a pacing pulse to the ventricle if the intrinsic ventricular activation is not sensed during the first cardiac cycle,sense in the atrium for a retrograde P-wave, the retrograde P-wave responsive to the ventricular pacing pulse or the intrinsic ventricular activation,classify the cardiac response to the first atrial pacing pulse as a non-captured response if the retrograde P-wave is detected and the atrial evoked response is not detected,classify the cardiac response to the first atrial pacing pulse as a captured response if the atrial evoked response is detected, and,deliver, during a second cardiac cycle immediately following the first cardiac cycle, a second atrial pacing pulse to the atrium, the second atrial pacing pulse having a scheduled delivery time, but the second atrial pacing pulse being delivered at a time that is delayed relative to the scheduled delivery time if the cardiac response of the first atrial pacing pulse is classified as a non-captured response and if a time period between the detected retrograde P-wave and the scheduled delivery time is no greater than an atrial effective refractory period (AERP).
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Abstract
Methods and systems for classifying cardiac responses to pacing stimulation and/or preventing retrograde cardiac conduction are described. Following delivery of a pacing pulse to an atrium of the patient'"'"'s heart during a cardiac cycle, the system senses in the atrium for a retrograde P-wave. The system classifies the atrial response to the pacing pulse based on detection of the retrograde P-wave. The system may also sense for an atrial evoked response and utilize the atrial evoked response in classifying the cardiac pacing response.
111 Citations
19 Claims
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1. An implantable cardiac device, comprising:
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a plurality of implantable cardiac electrodes configured to be electrically coupled to a heart; sensing circuitry configured to sense cardiac signals; a processor configured to control delivery of a first pacing pulse to an atrium during a first cardiac cycle, sense for an atrial evoked response following delivery of and associated with the first atrial pacing pulse, sense for an intrinsic activation of a ventricle during the first cardiac cycle, deliver a pacing pulse to the ventricle if the intrinsic ventricular activation is not sensed during the first cardiac cycle, sense in the atrium for a retrograde P-wave, the retrograde P-wave responsive to the ventricular pacing pulse or the intrinsic ventricular activation, classify the cardiac response to the first atrial pacing pulse as a non-captured response if the retrograde P-wave is detected and the atrial evoked response is not detected, classify the cardiac response to the first atrial pacing pulse as a captured response if the atrial evoked response is detected, and, deliver, during a second cardiac cycle immediately following the first cardiac cycle, a second atrial pacing pulse to the atrium, the second atrial pacing pulse having a scheduled delivery time, but the second atrial pacing pulse being delivered at a time that is delayed relative to the scheduled delivery time if the cardiac response of the first atrial pacing pulse is classified as a non-captured response and if a time period between the detected retrograde P-wave and the scheduled delivery time is no greater than an atrial effective refractory period (AERP). - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. An implantable cardiac device, comprising:
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a plurality of implantable cardiac electrodes configured to be electrically coupled to a heart; sensing circuitry configured to sense cardiac signals; circuitry configured to control delivery of a first pacing pulse to an atrium during a first cardiac cycle, sense for an atrial evoked response following delivery of and associated with the first atrial pacing pulse, sense for an intrinsic activation of a ventricle during the first cardiac cycle, deliver a pacing pulse to the ventricle if the intrinsic ventricular activation is not sensed during the first cardiac cycle, sense in the atrium for a retrograde P-wave, the retrograde P-wave responsive to the ventricular pacing pulse or the intrinsic ventricular activation, classify the cardiac response to the first atrial pacing pulse as a non-captured response if the retrograde P-wave is detected and the atrial evoked response is not detected, classify the cardiac response to the first atrial pacing pulse as a captured response if the atrial evoked response is detected, deliver, during a second cardiac cycle immediately following the first cardiac cycle, a next atrial pacing pulse to the atrium, delay the next atrial pacing pulse if the retrograde P-wave is detected and the next atrial pacing pulse is scheduled to occur before an atrial effective refractory period (AERP), and delay the next atrial pacing pulse if the cardiac response of the first atrial pacing pulse is classified as a non-captured response and if a time period between the detected retrograde P-wave and the scheduled delivery time is no greater than the AERP. - View Dependent Claims (15, 16, 17, 18, 19)
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Specification