Capture confirmation for multi-site pacing
First Claim
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1. A medical device, comprising:
- implantable electrodes including at least a first electrode configured to be disposed at a first site of a heart chamber and a second electrode configured to be disposed at a second site of the heart chamber;
pacing circuitry configured to deliver a first pacing pulse to the first site using the first electrode as a cathode electrode for the first pacing pulse and to deliver a second pacing pulse to the second site using the second electrode as a cathode electrode for the second pacing pulse, the first pacing pulse and the second pacing pulse delivered during a cardiac cycle;
sensing circuitry configured to sense a cardiac response to the pacing pulses including sensing cardiac electrical activity using the implantable electrodes, the sensing circuitry further configured to generate a differential signal between sensed cardiac electrical activity at the first electrode and sensed cardiac electrical activity at the second electrode; and
capture circuitry configured to discriminate between single site capture, comprising capture by one of the first pacing pulse or the second pacing pulse, and multi-site capture, comprising capture by both the first pacing pulse and the second pacing pulse, based on the differential signal.
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Abstract
A medical device includes pacing circuitry configured to deliver during a cardiac cycle a first pacing pulse to a first site using a first electrode as a cathode electrode for the first pacing pulse and to deliver a second pacing pulse to a second site using a second electrode as a cathode electrode for the second pacing pulse. Sensing circuitry is configured to generate a differential signal between cardiac electrical activity sensed at the first electrode and cardiac electrical activity sensed at the second electrode. Capture circuitry discriminates between single site capture and multi-site capture based on the differential signal.
28 Citations
20 Claims
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1. A medical device, comprising:
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implantable electrodes including at least a first electrode configured to be disposed at a first site of a heart chamber and a second electrode configured to be disposed at a second site of the heart chamber; pacing circuitry configured to deliver a first pacing pulse to the first site using the first electrode as a cathode electrode for the first pacing pulse and to deliver a second pacing pulse to the second site using the second electrode as a cathode electrode for the second pacing pulse, the first pacing pulse and the second pacing pulse delivered during a cardiac cycle; sensing circuitry configured to sense a cardiac response to the pacing pulses including sensing cardiac electrical activity using the implantable electrodes, the sensing circuitry further configured to generate a differential signal between sensed cardiac electrical activity at the first electrode and sensed cardiac electrical activity at the second electrode; and capture circuitry configured to discriminate between single site capture, comprising capture by one of the first pacing pulse or the second pacing pulse, and multi-site capture, comprising capture by both the first pacing pulse and the second pacing pulse, based on the differential signal. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A medical device, comprising:
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a plurality of electrodes configured to be respectively coupled to a heart chamber at a plurality of sites; a pulse generator configured to deliver during a cardiac cycle; a first pacing pulse using a first pacing cathode electrode of the plurality of electrodes, and a second pacing pulse using a second pacing cathode electrode of the plurality of electrodes; sensing circuitry comprising a first sensing electrode and a second sensing electrode, the sensing circuitry configured to sense a cardiac response to the pacing pulses, including sensing cardiac electrical activity at the first sensing electrode and at the second sensing electrode, the sensing circuitry further configured to develop a differential signal between cardiac electrical activity sensed at the first sensing electrode from cardiac electrical activity sensed at the second sensing electrode; and capture circuitry configured to discriminate between single site capture by one of the first or second pacing pulses and multi-site capture by both the first and second pacing pulses based on the differential signal. - View Dependent Claims (13, 14, 15, 16)
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17. A method, comprising:
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delivering a first pacing pulse to a first site of a cardiac chamber using a first electrode as a cathode electrode for the first pacing pulse; delivering a second pacing pulse to a second site of the cardiac chamber using a second electrode as a cathode electrode for the second pacing pulse, the first and second pacing pulses delivered during a cardiac cycle; sensing cardiac activity at the first and second electrodes; generating a differential signal between the cardiac activity sensed at the first electrode and the cardiac activity sensed at the second electrode following delivery of the first and second pacing pulses; determining capture status of the first and second pacing pulses including discriminating between single site capture by one of the first or second pacing pulses and multi-site capture by both the first and second pacing pulses based on the differential signal; and modifying one or both of an energy of a subsequent first pacing pulse and an energy of a subsequent second pacing pulse based on the capture status. - View Dependent Claims (18, 19, 20)
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Specification