Identification and remediation of oversensed cardiac events using far-field electrograms
First Claim
1. A method comprising:
- acquiring a first cardiac signal via a first sense electrode configuration;
acquiring a second cardiac signal via a second sense electrode configuration;
detecting a plurality of cardiac events in the first cardiac signal;
measuring a plurality of intervals between the cardiac events detected in the first cardiac signal;
analyzing one or more characteristics of the second cardiac signal to determine whether at least one of the plurality of cardiac events detected in the first cardiac signal comprises an oversensed event;
identifying at least one oversensed event of the plurality of cardiac events in the first cardiac signal based on the analysis of the one or more characteristics of the second cardiac signal; and
controlling delivery of a cardiac electrical stimulation therapy to a patient based on the identification of at least one oversensed event by;
withholding a first interval of the plurality of intervals from a therapy delivery control module in response to identifying the at least one oversensed event causing the first interval to have been measured;
obtaining a summed interval by summing the first interval with one or more next intervals of the plurality of intervals until a last of the next intervals that is not between oversensed events; and
providing the summed interval to the therapy delivery control module for use in controlling delivery of the cardiac electrical stimulation therapy.
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Accused Products
Abstract
In general, the disclosure is directed to techniques for identification and remediation of oversensed cardiac events using far-field electrograms (FFEGMs). Identification of oversensed cardiac events can be used in an ICD to prevent ventricular fibrillation (VF) detection, and thereby avoid delivery of an unnecessary defibrillation shock. Alternatively, or additionally, identification of oversensed cardiac events can be used in an ICD to support delivery of bradycardia pacing during an oversensing condition. In some cases, bradycardia pacing delivered in response to detection of oversensed cardiac events may include pacing pulses from multiple vectors to provide redundancy in the event the oversensing may be due to a lead-related condition.
137 Citations
39 Claims
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1. A method comprising:
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acquiring a first cardiac signal via a first sense electrode configuration; acquiring a second cardiac signal via a second sense electrode configuration; detecting a plurality of cardiac events in the first cardiac signal; measuring a plurality of intervals between the cardiac events detected in the first cardiac signal; analyzing one or more characteristics of the second cardiac signal to determine whether at least one of the plurality of cardiac events detected in the first cardiac signal comprises an oversensed event; identifying at least one oversensed event of the plurality of cardiac events in the first cardiac signal based on the analysis of the one or more characteristics of the second cardiac signal; and controlling delivery of a cardiac electrical stimulation therapy to a patient based on the identification of at least one oversensed event by; withholding a first interval of the plurality of intervals from a therapy delivery control module in response to identifying the at least one oversensed event causing the first interval to have been measured; obtaining a summed interval by summing the first interval with one or more next intervals of the plurality of intervals until a last of the next intervals that is not between oversensed events; and providing the summed interval to the therapy delivery control module for use in controlling delivery of the cardiac electrical stimulation therapy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. An implantable medical device comprising:
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an electrical sensing module configured to acquire a first cardiac signal via a first sense electrode configuration, and to acquire a second cardiac signal via a second sense electrode configuration; a stimulation module configured to deliver a cardiac electrical stimulation therapy to a patient via a plurality of stimulation electrodes; a therapy delivery control module configured to control the stimulation module configured to deliver the cardiac electrical stimulation therapy; and a processor configured to; detect a plurality of cardiac events in the first cardiac signal; measure a plurality of intervals between the plurality of cardiac events detected in the first cardiac signal; analyze one or more characteristics of the second cardiac signal to determine whether at least one of the plurality of cardiac events detected in the first cardiac signal comprises an oversensed event; and identify at least one oversensed event of the plurality of cardiac events in the first cardiac signal based on the analysis of the one or more characteristics of the second cardiac signal, and control the stimulation module to deliver the cardiac electrical stimulation therapy to the patient based on the identification of at least one oversensed event by; withholding a first interval of the plurality of intervals from the therapy delivery control module in response to identifying the at least one oversensed event causing the first interval to have been measured; obtaining a summed interval by summing the first interval with one or more next intervals of the plurality of intervals until a last of the next intervals that is not between oversensed events; and providing the summed interval to the therapy delivery control module for use in controlling delivery of the cardiac electrical stimulation therapy by the stimulation module. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. An implantable medical device comprising:
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means for acquiring a first cardiac signal via a first sense electrode configuration; means for acquiring a second cardiac signal via a second sense electrode configuration; means for detecting a plurality of cardiac events in the first cardiac signal; means for measuring a plurality of intervals between the plurality of cardiac events detected in the first cardiac signal; means for analyzing one or more characteristics of the second cardiac signal to determine whether at least one of the plurality of cardiac events detected in the first cardiac signal comprises an oversensed event; means for identifying at least one oversensed event of the plurality of cardiac events in the first cardiac signal based on the analysis of the whether one or more characteristics of the second cardiac; and means for controlling delivery of a cardiac electrical stimulation therapy to a patient based on the identification of at least one oversensed event by; withholding a first interval of the plurality of intervals from a therapy control module in response to identifying the at least one oversensed event causing the first interval to have been measured; obtaining a summed interval by summing the first interval with one or more next intervals of the plurality of intervals until a last of the next intervals that is not between oversensed events; and providing the summed interval to the therapy delivery control module for use in controlling delivery of the cardiac electrical stimulation therapy. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30)
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31. A non-transitory computer-readable storage medium comprising instructions that, when executed by a processor in an implantable medical device, cause the processor to:
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detect a plurality of cardiac events in a first cardiac signal acquired via a first sense electrode configuration; measure a plurality of intervals between the plurality of cardiac events detected in the first cardiac signal; analyze one or more characteristics of a second cardiac signal acquired via a second sense electrode configuration to determine whether at least one of the plurality of cardiac events detected in the first cardiac signal comprises an oversensed event; identify at least one oversensed event of the plurality of cardiac events in the first cardiac signal based on the analysis of the one or more characteristics of the second cardiac signal; and control a stimulation module to deliver a cardiac electrical stimulation therapy to a patient based on the identification of at least one oversensed event by; withholding a first interval of the plurality of intervals from a therapy delivery control module in response to identifying at least one oversensed event causing the first interval to have been measured; obtaining a summed interval by summing the first interval with one or more next intervals of the plurality of intervals until a last of the next intervals that is not between oversensed events; and providing the summed interval to the therapy delivery control module for use in controlling delivery of the cardiac electrical stimulation therapy. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39)
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Specification