Dynamic morphology based atrial automatic threshold
First Claim
1. A method for determining a cardiac response to atrial pacing, comprising:
- delivering one or more sub-capture threshold pacing pulses to an atrium of a heart via a medical device;
determining a pacing artifact threshold based on peak values of one or more pacing artifact signals sensed in the atrium following each of the sub-capture threshold pacing pulses;
delivering a plurality of pacing pulses to the atrium of the heart via the medical device;
determining a capture detection threshold based on peak values of one or more evoked response signals sensed in the atrium;
comparing a peak value of a cardiac signal sensed following an atrial pacing pulse to the pacing artifact threshold and the capture detection threshold; and
discriminating between capture, noncapture, and fusion of the atrium based at least in part on the comparison, wherein capture is determined if the peak value of the sensed cardiac signal is greater than the capture detection threshold, noncapture is determined if the peak value is less than or equal to the pacing artifact threshold, and fusion is determined if the peak value is greater than the pacing artifact threshold and is outside of a peak timing interval.
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Abstract
Methods and systems for performing capture threshold tests are described. During an initialization procedure a capture detection interval and capture detection threshold are determined based on peak values of cardiac signals sensed following the supracapture threshold initialization pulses. Following initialization, a plurality of pacing pulses to the atrium are delivered and the peak values of the cardiac signals sensed following each of the plurality of pacing pulses are determined. The peak values are compared to the pacing artifact threshold and the capture detection threshold. A timing of each of the peak values is compared to the capture detection interval. For each pacing pulse, discrimination between a captured response, a noncaptured response, and a fusion response is based on the peak value and timing comparisons.
123 Citations
20 Claims
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1. A method for determining a cardiac response to atrial pacing, comprising:
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delivering one or more sub-capture threshold pacing pulses to an atrium of a heart via a medical device; determining a pacing artifact threshold based on peak values of one or more pacing artifact signals sensed in the atrium following each of the sub-capture threshold pacing pulses; delivering a plurality of pacing pulses to the atrium of the heart via the medical device; determining a capture detection threshold based on peak values of one or more evoked response signals sensed in the atrium; comparing a peak value of a cardiac signal sensed following an atrial pacing pulse to the pacing artifact threshold and the capture detection threshold; and discriminating between capture, noncapture, and fusion of the atrium based at least in part on the comparison, wherein capture is determined if the peak value of the sensed cardiac signal is greater than the capture detection threshold, noncapture is determined if the peak value is less than or equal to the pacing artifact threshold, and fusion is determined if the peak value is greater than the pacing artifact threshold and is outside of a peak timing interval. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method for determining a cardiac response to atrial pacing, comprising:
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delivering a plurality of pacing pulses to an atrium via a medical device; detecting peak values of cardiac signals sensed following each of the plurality of pacing pulses; comparing each of the peak values to a pacing artifact threshold and a capture detection threshold; comparing a timing of each of the peak values to a peak timing interval; and for each pacing pulse, discriminating between a captured response, a noncaptured response, and a fusion response based on the peak value and timing comparisons, wherein capture is determined if the peak value of the sensed cardiac signal is greater than the capture detection threshold, noncapture is determined if the peak value is less than or equal to the pacing artifact threshold, and fusion is determined if the peak value is greater than the pacing artifact threshold and is outside of the peak timing interval. - View Dependent Claims (9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A method for determining a cardiac response to atrial pacing, comprising:
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prior to capture threshold testing, delivering a plurality of supra-capture pacing threshold initialization pulses to an atrium of a heart via a medical device to initialize a capture detection threshold for an individual patient; delivering one or more sub-capture threshold paces to the atrium of the heart; determining a pacing artifact threshold based on peak values of one or more pacing artifact signals sensed in an atrium following the one or more sub-capture threshold paces; determining a capture detection threshold based on peak values of one or more evoked response signals sensed in the atrium based on peak magnitudes of one or more signals following the plurality of supra-capture pacing threshold initialization pulses; comparing a peak value of a cardiac signal sensed following an atrial pacing pulse to the pacing artifact threshold and the capture detection threshold during capture threshold testing; discriminating between capture, noncapture, and fusion of the atrium based at least in part on the comparison; and dynamically adjusting the capture detection threshold based at least in part on the peak value of the cardiac signal sensed following the atrial pacing pulse if the cardiac signal is classified as an evoked response signal.
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Specification