Method and apparatus for phrenic stimulation detection
First Claim
1. A cardiac rhythm management system, comprising:
- an implantable cardiac pacing device having a plurality of electrodes;
circuitry configured to output a plurality of cardiac pacing pulses through the electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters;
anda controller configured to determine a phrenic stimulation threshold based, at least in part, on the one or more signals indicative of sensed phrenic stimulation, and store information based on the determination, wherein when determining the phrenic stimulation threshold, the controller increasing a pacing parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pacing pulses until the phrenic stimulation threshold is detected or a cardiac pacing pulse is delivered at a maximum amplitude and/or width that the cardiac pacing device is programmed to deliver.
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Abstract
Approaches for characterizing a phrenic stimulation threshold, a cardiac capture threshold, a maximum device parameter, and a minimum device parameter are described. A plurality of cardiac pacing pulses can be delivered by using a cardiac pacing device, a pacing parameter of the plurality of cardiac pacing pulses being changed between delivery of at least some of the pulses. One or more sensor signals can be evaluated to detect stimulation of the phrenic nerve by one or more of the plurality of cardiac pacing pluses. The evaluation of the one or more sensor signals and the pacing parameter can be compared to determine if a phrenic stimulation threshold is at least one of higher than a maximum device parameter and lower than a minimum device parameter.
487 Citations
23 Claims
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1. A cardiac rhythm management system, comprising:
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an implantable cardiac pacing device having a plurality of electrodes; circuitry configured to output a plurality of cardiac pacing pulses through the electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters; and a controller configured to determine a phrenic stimulation threshold based, at least in part, on the one or more signals indicative of sensed phrenic stimulation, and store information based on the determination, wherein when determining the phrenic stimulation threshold, the controller increasing a pacing parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pacing pulses until the phrenic stimulation threshold is detected or a cardiac pacing pulse is delivered at a maximum amplitude and/or width that the cardiac pacing device is programmed to deliver. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cardiac rhythm management system, comprising:
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an implantable cardiac pacing device having a plurality of electrodes; means for delivering a plurality of cardiac pacing pulses through the plurality of electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters; signal processing means in communication with means for sensing stimulation of the phrenic nerve by one or more of the plurality of pacing pulses and for providing one or more signals indicative of sensed phrenic stimulation; and means for determining a phrenic stimulation threshold based, at least in part, on the one or more signals indicative of the sensed phrenic stimulation, the means for determining the phrenic stimulation threshold increasing a pacing parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pacing pulses until the phrenic stimulation threshold is detected or a cardiac pacing pulse is delivered at a maximum amplitude and/or width that the cardiac pacing device is set to deliver.
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12. A cardiac rhythm management system, comprising:
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an implantable cardiac pacing device having a plurality of electrodes; circuitry configured to output a plurality of cardiac pacing pulses through the electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters; a signal processor in communication with one or more sensors configured to sense for stimulation of the phrenic nerve by one or more of the plurality of pacing pulses and to produce one or more signals indicative of phrenic stimulation; and a controller configured to receive the one or more signals indicative of phrenic stimulation and to execute program instructions stored in memory to cause the system to compare the one or more signals indicative of phrenic stimulation and the one or more pacing parameters to identify relative relationships between each of a phrenic stimulation threshold, a maximum cardiac pacing parameter that the cardiac device is set to deliver, and a minimum cardiac pacing parameter that the cardiac device is set to deliver. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
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Specification