Monitoring of pacing capture using acceleration
First Claim
Patent Images
1. An implantable medical device, comprising:
- an activity sensor configured to generate a signal indicative of motion of a heart of a patient and physical activity of the patient;
a pulse generator configured to generate and deliver pacing pulses to the patient'"'"'s heart via a pair of electrodes coupled to the implantable medical device; and
a control module coupled to the pulse generator and the activity sensor, the control module being configured to;
compute an activity metric from the activity sensor signal over an activity metric interval;
compare the activity metric to a loss of capture detection threshold;
detect loss of capture by the delivered pacing pulses in response to the activity metric being less than the loss of capture detection threshold; and
increase a pacing pulse output in response to detecting the loss of capture; and
wherein the control module is further configured to;
determine a sensor indicated pacing rate based on the activity metric; and
set a pacing pulse rate responsive to the sensor indicated pacing rate.
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Abstract
An implantable medical device includes an activity sensor, a pulse generator, and a control module. The control module is configured to determine an activity metric from the activity sensor signal over an activity metric interval and compare the activity metric to a loss of capture detection threshold. The control module may detect loss of capture in response to the activity metric being less than the loss of capture detection threshold and increase a pacing pulse output in response to detecting the loss of capture.
31 Citations
10 Claims
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1. An implantable medical device, comprising:
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an activity sensor configured to generate a signal indicative of motion of a heart of a patient and physical activity of the patient; a pulse generator configured to generate and deliver pacing pulses to the patient'"'"'s heart via a pair of electrodes coupled to the implantable medical device; and a control module coupled to the pulse generator and the activity sensor, the control module being configured to; compute an activity metric from the activity sensor signal over an activity metric interval; compare the activity metric to a loss of capture detection threshold; detect loss of capture by the delivered pacing pulses in response to the activity metric being less than the loss of capture detection threshold; and increase a pacing pulse output in response to detecting the loss of capture; and wherein the control module is further configured to; determine a sensor indicated pacing rate based on the activity metric; and set a pacing pulse rate responsive to the sensor indicated pacing rate. - View Dependent Claims (2, 3, 4, 5, 6)
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7. An implantable medical device, comprising:
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an activity sensor configured to generate a signal indicative of motion of a heart of a patient and physical activity of the patient; a pulse generator configured to generate and deliver pacing pulses to the patient'"'"'s heart via a pair of electrodes coupled to the implantable medical device; and a control module coupled to the pulse generator and the activity sensor, the control module being configured to; compute an activity metric from the activity sensor signal over an activity metric interval; compare the activity metric to a loss of capture detection threshold; detect loss of capture by the delivered pacing pulses in response to the activity metric being less than the loss of capture detection threshold; and increase a pacing pulse output in response to detecting the loss of capture; and wherein the control module is configured to determine the activity metric by one of; rectifying the activity sensor signal and counting a number of activity threshold crossings of the activity sensor signal during the activity metric interval, and rectifying the activity sensor signal and summing all sample point amplitudes of the rectified activity sensor signal during the activity metric interval.
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8. An implantable medical device, comprising:
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an activity sensor configured to generate a signal indicative of motion of a heart of a patient and physical activity of the patient; a pulse generator configured to generate and deliver pacing pulses to the patient'"'"'s heart via a pair of electrodes coupled to the implantable medical device; and a control module coupled to the pulse generator and the activity sensor, the control module being configured to; compute an activity metric from the activity sensor signal over an activity metric interval; compare the activity metric to a loss of capture detection threshold; detect loss of capture by the delivered pacing pulses in response to the activity metric being less than the loss of capture detection threshold; and increase a pacing pulse output in response to detecting the loss of capture; and further comprising a sensing module configured to receive a cardiac electrical signal from the heart developed across a sensing electrode pair coupled to the implantable medical device, sense an intrinsic cardiac event from the cardiac electrical signal, and pass a cardiac sense event signal to the control module in response to sensing the intrinsic cardiac event, wherein the control module is further configured to; receive cardiac sense event signals from the sensing module, responsive to the activity metric being greater than the loss of capture threshold, determine if an intrinsic sensed event occurs during the activity metric interval based on the received cardiac sense event signals; and responsive to occurrence of the intrinsic sensed event during the activity metric interval, adjusting a loss of capture detection control parameter. - View Dependent Claims (9)
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10. An implantable medical device, comprising:
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an activity sensor configured to generate a signal indicative of motion of a heart of a patient and physical activity of the patient; a pulse generator configured to generate and deliver pacing pulses to the patient'"'"'s heart via a pair of electrodes coupled to the implantable medical device; and a control module coupled to the pulse generator and the activity sensor, the control module being configured to; compute an activity metric from the activity sensor signal over an activity metric interval; compare the activity metric to a loss of capture detection threshold; detect loss of capture by the delivered pacing pulses in response to the activity metric being less than the loss of capture detection threshold; and increase a pacing pulse output in response to detecting the loss of capture; and further comprising a memory, wherein the control module is further configured to; detect an occurrence of capture subsequent to increasing the pacing pulse output; if capture is not detected, adjust the pacing pulse output incrementally up to a maximum pacing pulse output until capture is verified; and record a date and time stamp in the memory in response to the maximum pacing pulse output being reached without the detection of capture.
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Specification