Method and apparatus for capture verification and threshold determination
First Claim
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1. A cardiac pacemaker, comprising:
- pulse generators for incorporating into first and second pacing channels;
a controller for controlling the operation of the pulse generators and programmed to deliver pacing pulses to either both of the ventricles or both of the atria through the first and second pacing channels in accordance with a programmed pacing mode;
a sense amplifier for incorporating into an evoked response sensing channel for sensing an evoked response generated after a pacing pulse; and
,wherein the controller is programmed to;
deliver first and second pacing pulses from the first and second pacing channels, respectively, during a cardiac cycle;
record a test electrogram from the evoked response sensing channel during delivery of the first and second pacing pulses;
compare the test electrogram with template electrograms representing the following capture events;
capture of the heart by both of the first and second pacing pulses, capture by a pacing pulse delivered only from the first pacing channel, and capture by a pacing pulse delivered only from the second pacing channel;
determine whether or not each of the first and second pacing pulses have achieved capture in accordance with which of the template electrograms is most similar to the test electrogram.
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Abstract
An apparatus and method for verifying capture by a pacing pulse in which a test depolarization waveform recorded during a pacing event is compared with a template waveform representing capture by the pacing pulse. Capture verification in this manner may be used in pacemakers having multiple pacing channels for the atrial and/or ventricles where the multiple paces can interfere with conventional sensing of evoked responses in order to verify capture.
71 Citations
20 Claims
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1. A cardiac pacemaker, comprising:
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pulse generators for incorporating into first and second pacing channels; a controller for controlling the operation of the pulse generators and programmed to deliver pacing pulses to either both of the ventricles or both of the atria through the first and second pacing channels in accordance with a programmed pacing mode; a sense amplifier for incorporating into an evoked response sensing channel for sensing an evoked response generated after a pacing pulse; and
,wherein the controller is programmed to; deliver first and second pacing pulses from the first and second pacing channels, respectively, during a cardiac cycle; record a test electrogram from the evoked response sensing channel during delivery of the first and second pacing pulses; compare the test electrogram with template electrograms representing the following capture events;
capture of the heart by both of the first and second pacing pulses, capture by a pacing pulse delivered only from the first pacing channel, and capture by a pacing pulse delivered only from the second pacing channel;determine whether or not each of the first and second pacing pulses have achieved capture in accordance with which of the template electrograms is most similar to the test electrogram. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method comprising:
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delivering first and second pacing pulses from first and second pacing channels, respectively, during a cardiac cycle, wherein the first and second pacing pulses are delivered to either the right and left ventricles or the right and left atria; recording a test electrogram from an evoked response sensing channel during delivery of the first and second pacing pulses; comparing the test electrogram with template electrograms representing the following capture events;
capture of the heart by both of the first and second pacing pulses, capture by a pacing pulse delivered only from the first pacing channel, and capture by a pacing pulse delivered only from the second pacing channel;determining whether or not each of the first and second pacing pulses have achieved capture in accordance with which of the template electrograms is most similar to the test electrogram. - View Dependent Claims (12, 13, 14, 15)
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16. A system comprising:
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means for delivering first and second pacing pulses from first and second pacing channels, respectively, during a cardiac cycle; means for recording a test electrogram from an evoked response sensing channel during delivery of the first and second pacing pulses; means for comparing the test electrogram with template electrograms representing the following capture events;
capture of the heart by both of the first and second pacing pulses, capture by a pacing pulse delivered only from the first pacing channel, and capture by a pacing pulse delivered only from the second pacing channel;means for determining whether or not each of the first and second pacing pulses have achieved capture in accordance with which of the template electrograms is most similar to the test electrogram. - View Dependent Claims (17, 18, 19, 20)
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Specification