Electrogram classification algorithm
First Claim
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1. A method comprising:
- receiving EGM signal data for a cardiac episode detected by an implantable medical device (IMD), wherein the EGM signal data includes at least ventricular sensed events and atrial sensed events;
determining, using a probabilistic analysis, whether the EGM signal data indicates ventricular over-sensing (VOS), wherein a determination that the EGM signal data indicates VOS further comprises classifying the cardiac episode as inappropriately shocked;
determining, when there is a determination that the EGM signal data does not indicate VOS, whether the EGM signal data indicates an atrial sensing issue, the atrial sensing issue including one of atrial over-sensing or atrial under-sensing, wherein;
when there is a determination of the atrial sensing issue, the method further comprises determining whether the atrial sensing issues are repairable;
when there is a determination that the atrial sensing issues are repairable, the method further comprises repairing the sensing issues and classifying the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events;
when there is a determination that the atrial sensing issues are not repairable, the method further comprises classifying the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events; and
the classification of the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events, and the classification of the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events comprises one of ventricular tachycardia/ventricular fibrillation, inappropriately shocked, or indeterminate.
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Abstract
The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data using a probabilistic ventricular oversensing algorithm. The algorithm may look at a plurality of factors weighing for and against a determination of ventricular oversensing. In some examples, the algorithm may also determine whether the cardiac episode includes atrial sensing issues.
195 Citations
29 Claims
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1. A method comprising:
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receiving EGM signal data for a cardiac episode detected by an implantable medical device (IMD), wherein the EGM signal data includes at least ventricular sensed events and atrial sensed events; determining, using a probabilistic analysis, whether the EGM signal data indicates ventricular over-sensing (VOS), wherein a determination that the EGM signal data indicates VOS further comprises classifying the cardiac episode as inappropriately shocked; determining, when there is a determination that the EGM signal data does not indicate VOS, whether the EGM signal data indicates an atrial sensing issue, the atrial sensing issue including one of atrial over-sensing or atrial under-sensing, wherein; when there is a determination of the atrial sensing issue, the method further comprises determining whether the atrial sensing issues are repairable; when there is a determination that the atrial sensing issues are repairable, the method further comprises repairing the sensing issues and classifying the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events; when there is a determination that the atrial sensing issues are not repairable, the method further comprises classifying the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events; and the classification of the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events, and the classification of the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events comprises one of ventricular tachycardia/ventricular fibrillation, inappropriately shocked, or indeterminate. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A system comprising:
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a communication module configured to receive EGM signal data for a cardiac episode detected by an implantable medical device (IMD), wherein the EGM signal data includes at least ventricular sensed events and atrial sensed events; and a processor configured to; determine, using a probabilistic analysis, whether the EGM signal data indicates ventricular over-sensing (VOS), wherein the determination is based at least in part on a probabilistic determination of whether the EGM signal data indicates T-wave over-sensing (TWOS) and wherein a determination of VOS further comprises classifying the cardiac episode as inappropriately shocked; determine, when there is a determination of no VOS, whether the EGM signal data indicates an atrial sensing issue, the atrial sensing issue including one of atrial over-sensing or atrial under-sensing, wherein when there is a determination of the atrial sensing issue, determine whether the atrial sensing issues are repairable, when there is a determination that the atrial sensing issues are repairable, repair the sensing issues and classifying the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events; when there is a determination that the atrial sensing issues are not repairable, classify the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events; and wherein the classification based on a set of classification rules that consider both the ventricular and atrial sensed events, and the classification of the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events comprises ventricular tachycardia/ventricular fibrillation, inappropriately shocked, or indeterminate. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. A system comprising:
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means for receiving EGM signal data for a cardiac episode detected by an implantable medical device (IMD), wherein the EGM signal data includes at least ventricular sensed events and atrial sensed events; means for determining, using a probabilistic analysis, whether the EGM signal data indicates ventricular over-sensing (VOS), wherein a determination that the EGM signal data indicates VOS further comprises classifying the cardiac episode as inappropriately shocked; means for determining, when there is a determination that the EGM signal data does not indicate VOS, whether the EGM signal data indicates an atrial sensing issue, the atrial sensing issue including one of atrial over-sensing or atrial under-sensing, wherein; when there is a determination of the atrial sensing issue, the method further comprises determining whether the atrial sensing issues are repairable; when there is a determination that the atrial sensing issues are repairable, the method further comprises repairing the sensing issues and classifying the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events; when there is a determination that the atrial sensing issues are not repairable, the method further comprises classifying the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events; and the classification of the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events, and the classification of the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events comprises one of ventricular tachycardia/ventricular fibrillation, inappropriately shocked, or indeterminate.
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29. A non-transitory computer-readable medium comprising instructions for causing a programmable processor to:
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receive EGM signal data for a cardiac episode detected by an implantable medical device (IMD), wherein the EGM signal data includes at least ventricular sensed events and atrial sensed events; determine, using a probabilistic analysis, whether the EGM signal data indicates ventricular over-sensing (VOS), wherein the determination is based at least in part on a probabilistic determination of whether the EGM signal data indicates T-wave over-sensing (TWOS) and wherein a determination of VOS further comprises classifying the cardiac episode as inappropriately shocked; determine, when there is a determination of no VOS, whether the EGM signal data indicates an atrial sensing issue, the atrial sensing issue including one of atrial over-sensing or atrial under-sensing, wherein when there is a determination of the atrial sensing issue, determine whether the atrial sensing issues are repairable, when there is a determination that the atrial sensing issues are repairable, repair the sensing issues and classifying the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events; when there is a determination that the atrial sensing issues are not repairable, classify the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events; and wherein the classification of the cardiac episode based on a set of classification rules that consider both the ventricular and atrial sensed events, and the classification of the cardiac episode based on at least one classification rule that considers the ventricular sensed events but not the atrial sensed events comprises ventricular tachycardia/ventricular fibrillation, inappropriately shocked, or indeterminate.
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Specification