Method and apparatus for phrenic stimulation detection
First Claim
1. A method for operating a cardiac pacing device, comprising;
- determining if a phrenic stimulation threshold of the cardiac pacing device is greater than a device limit;
if it is determined that the phrenic stimulation threshold is greater than the device limit, perform a capture threshold test without performing a phrenic stimulation threshold test; and
if it is determined that the phrenic stimulation threshold is not greater than the device limit, perform a capture threshold test and a phrenic stimulation threshold test.
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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.
483 Citations
20 Claims
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1. A method for operating a cardiac pacing device, comprising;
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determining if a phrenic stimulation threshold of the cardiac pacing device is greater than a device limit; if it is determined that the phrenic stimulation threshold is greater than the device limit, perform a capture threshold test without performing a phrenic stimulation threshold test; and if it is determined that the phrenic stimulation threshold is not greater than the device limit, perform a capture threshold test and a phrenic stimulation threshold test. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 19)
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12. A method, comprising:
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delivering a plurality of cardiac pacing pulses 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 cardiac pacing pulses; evaluating one or more sensor signals to detect stimulation of the phrenic nerve by one or more of the plurality of cardiac pacing pluses; comparing the evaluation of the one or more sensor signals and the pacing parameter of one or more of the plurality of cardiac pacing pulses 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; and altering an operation of the cardiac pacing device if it is determined that the phrenic stimulation threshold is at least one of higher than the maximum device parameter and lower than the minimum device parameter. - View Dependent Claims (13, 14, 15, 16, 17)
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18. A method of operating a cardiac pacing device, wherein the cardiac pacing device includes a plurality of electrode combinations where each electrode combination defines a pacing vector, the method, comprising:
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delivering a plurality of cardiac pacing pulses using a selected pacing vector of the cardiac pacing device, a pacing parameter of the plurality of cardiac pacing pulses being changed between delivery of at least some of the pulses; evaluating one or more sensor signals to detect stimulation of the phrenic nerve by one or more of the plurality of cardiac pacing pluses; evaluating one or more sensor signals to detect whether the heart was captured by one or more of the plurality of cardiac pacing pluses; comparing the evaluation of the one or more sensor signals and the pacing parameter of one or more of the plurality of cardiac pacing pulses to determine if a phrenic stimulation threshold is higher than a maximum device parameter, and if not, higher than a capture threshold; and delivering pacing therapy to the heart via a plurality of cardiac pacing pulses that are above the capture threshold but below the phrenic stimulation threshold if it is determined that the phrenic stimulation threshold is higher than the maximum device parameter, and if not, higher than the capture threshold. - View Dependent Claims (20)
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Specification