Adaptive windowing for cardiac waveform discrimination
First Claim
1. A method of operating a cardiac device, comprising:
- sensing a cardiac signal that follows a pacing pulse;
detecting at least one feature of the cardiac signal;
comparing the cardiac signal feature to a detection window;
determining a cardiac response to the pacing pulse based on comparison of the cardiac signal feature to the detection window;
prior to the comparison of the cardiac signal feature to the detection window, defining a preferred direction for modifying the detection window;
modifying the detection window more aggressively toward the cardiac signal feature if the preferred direction is toward the cardiac signal feature and modifying the detection window less aggressively toward the cardiac signal feature if the preferred direction is not toward the cardiac signal feature;
using the modified detection window to determine a subsequent cardiac pacing response to a subsequent pacing pulse; and
delivering pacing therapy based on the cardiac pacing response.
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Abstract
Cardiac devices and methods provide adaptation of detection windows used to determine a cardiac response to pacing. Adapting a detection window involves sensing a cardiac signal indicative of a particular type of cardiac pacing response, and detecting a feature of the sensed cardiac signal. The cardiac response detection window associated with the type of cardiac pacing response is preferentially adjusted based on the location of the detected cardiac feature. Preferential adjustment of the detection window may involve determining a direction of change between the detection window and the detected feature. The detection window may be adapted more aggressively in a more preferred direction and less aggressively in a less preferred direction.
102 Citations
21 Claims
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1. A method of operating a cardiac device, comprising:
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sensing a cardiac signal that follows a pacing pulse; detecting at least one feature of the cardiac signal; comparing the cardiac signal feature to a detection window; determining a cardiac response to the pacing pulse based on comparison of the cardiac signal feature to the detection window; prior to the comparison of the cardiac signal feature to the detection window, defining a preferred direction for modifying the detection window; modifying the detection window more aggressively toward the cardiac signal feature if the preferred direction is toward the cardiac signal feature and modifying the detection window less aggressively toward the cardiac signal feature if the preferred direction is not toward the cardiac signal feature; using the modified detection window to determine a subsequent cardiac pacing response to a subsequent pacing pulse; and delivering pacing therapy based on the cardiac pacing response. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A system, comprising:
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a pulse generator configured to generate pacing pulses for delivery to a heart; a sensing system configured to sense a cardiac signal following a pacing pulse delivered to the heart, the cardiac signal associated with a type of cardiac response to the pacing pulse; and a processor coupled to the sensing system, the processor configured to; detect at least one feature of the cardiac signal; to preferentially adjust the detection window based on a location of the cardiac signal feature; define a preferred direction for modifying the detection window, and thereafter compare the cardiac signal feature to the detection window; determine a cardiac response to the pacing pulse based on the comparison of the cardiac signal feature to the detection window; modify the detection window more aggressively toward the cardiac signal feature if the preferred direction is toward the cardiac signal feature and modify the detection window less aggressively toward the cardiac signal feature if the preferred direction is not toward the cardiac signal feature; and use the modified detection window to determine a subsequent cardiac pacing response to a subsequent pacing pulse; and a therapy delivery unit configured to deliver pacing therapy to the heart based on the cardiac pacing response. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A system, comprising:
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means for delivering pacing pulses to a heart; means for sensing a cardiac signal that follows a pacing pulse delivered to the heart; means for detecting at least one feature of the cardiac signal; means for comparing the cardiac signal feature to a detection window; means for determining a cardiac response to the pacing pulse based on comparison of the cardiac signal feature to the detection window; means for defining, prior to the comparison of the cardiac signal feature to the detection window, a preferred direction for modifying the detection window; means for modifying the detection window more aggressively toward the cardiac signal feature if the preferred direction is toward the cardiac signal feature and for modifying the detection window less aggressively toward the cardiac signal feature if the preferred direction is not toward the cardiac signal feature; means for using the modified detection window to determine a subsequent cardiac pacing response to a subsequent pacing pulse; and means for delivering pacing therapy to the heart based on the cardiac pacing response.
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Specification