Methods and systems for managing fusion and noise in cardiac pacing response classification
First Claim
1. A cardiac signal noise detection method, comprising:
- sensing a cardiac signal in one or more classification windows following delivery of a pacing pulse;
using the cardiac signal sensed in the one or more classification windows to classify a cardiac response to the pacing pulse;
sensing the cardiac signal in a noise detection window, wherein the noise detection window is shifted relative to the one or more classification windows;
determining a signal level of the cardiac signal in at least one of the classification windows;
determining a noise level of the cardiac signal in the noise detection window;
comparing the classification window signal level to the noise detection window noise level; and
determining a measure of cardiac signal noise based at least in part on the comparison.
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Abstract
Methods and systems for detecting noise in cardiac pacing response classification processes involve determining that a cardiac response classification is possibly erroneous if unexpected signal content is detected. The unexpected signal content may comprise signal peaks that have polarity opposite to the polarity of peaks used to determine the cardiac response to pacing. Fusion/noise management processes include pacing at a relatively high energy level until capture is detected after a fusion, indeterminate, or possibly erroneous pacing response classification is made. The relatively high energy pacing pulses may be delivered until capture is detected or until a predetermined number of paces are delivered.
80 Citations
18 Claims
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1. A cardiac signal noise detection method, comprising:
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sensing a cardiac signal in one or more classification windows following delivery of a pacing pulse; using the cardiac signal sensed in the one or more classification windows to classify a cardiac response to the pacing pulse; sensing the cardiac signal in a noise detection window, wherein the noise detection window is shifted relative to the one or more classification windows; determining a signal level of the cardiac signal in at least one of the classification windows; determining a noise level of the cardiac signal in the noise detection window; comparing the classification window signal level to the noise detection window noise level; and determining a measure of cardiac signal noise based at least in part on the comparison. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A cardiac signal noise detection method, comprising:
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sensing a cardiac signal in two or more classification windows following delivery of a pacing pulse; using the cardiac signal sensed in the two or more classification windows to classify a cardiac response to the pacing pulse; sensing the cardiac signal in each of two or more noise detection windows, wherein each of the two or more noise detection window is associated with a particular one of the two or more classification windows; and detecting noise based on the cardiac signal sensed in at least one of the two or more classification windows and the cardiac signal sensed in at least one of the two or more noise detection windows.
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11. A cardiac rhythm management device, comprising:
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a pulse generator configured to deliver pacing pulses to a heart chamber; a sensing circuit configured to sense cardiac signals of the heart chamber, the sensed cardiac signals respectively associated with the pacing pulses; and a processor coupled to the sensing circuit and the pulse generator, the processor configured to; sense a cardiac signal in one or more classification windows following delivery of a pacing pulse; classify a cardiac response to the pacing pulse using the cardiac signal sensed in the one or more classification windows; sense the cardiac signal in a noise detection window, wherein the noise detection window is shifted relative to the one or more classification windows; and detect the noise by determining a signal level of the cardiac signal in at least one of the classification windows, determining a noise level of the cardiac signal in the noise detection window, comparing the classification window signal level to the noise detection window noise level, and detecting cardiac signal noise based at least in part on the comparison. - View Dependent Claims (12, 13, 14, 15)
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16. A cardiac rhythm management device, comprising:
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a pulse generator configured to deliver pacing pulses to a heart chamber; a sensing circuit configured to sense cardiac signals of the heart chamber, the sensed cardiac signals respectively associated with the pacing pulses; and a controller coupled to the sensing circuit and the pulse generator, the controller configured to; sense a cardiac signal in two or more classification windows following delivery of a pacing pulse; classify a cardiac response to the pacing pulse using the cardiac signal sensed in the two or more classification windows; sense the cardiac signal in each of two or more noise detection windows, wherein each of the two or more noise detection window is associated with a particular one of the two or more classification windows and wherein each of the two or more noise detection window is shifted relative to the associated one of the two or more classification windows; and detect noise based at least in part on a signal level of the cardiac signal sensed in the two or more noise detection windows. - View Dependent Claims (17, 18)
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Specification