Pacing crosstalk detection

• US 9,789,317 B2
• Filed: 02/26/2015
• Issued: 10/17/2017
• Est. Priority Date: 02/26/2015
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Greenhut, Saul E, Demmer, Wade M, Sheldon, Todd J
• Primary Examiner(s): Tejani, Ankit D
• Application Number:
  US14/632,317
• Publication Number:
  US 20160250478A1
• Time in Patent Office: 964 Days
• Field of Search: None
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/37 Monitoring; Protecting

Abstract

An implantable pacemaker is configured to sense a cardiac electrical signal received by a pair of electrodes coupled to the pacemaker, start a pacing escape interval to control a time that a pacing pulse is delivered in a heart chamber, and detecting if the sensed cardiac electrical signal is a crosstalk event that is an electrical pulse delivered to the patient by a different device than the implantable pacemaker. The implantable pacemaker withholds restarting the pacing escape interval in response to sensing the cardiac electrical signal based on detecting the sensed cardiac electrical signal as the crosstalk event.

Claims

1. An implantable pacemaker, comprising:

a sensing module configured to sense cardiac electrical signals received by a pair of electrodes coupled to the pacemaker,

a pulse generator configured to generate and deliver pacing pulses to a heart chamber of a patient via the pair of electrodes, and

a control module coupled to the sensing module and the pulse generator and configured to;

start a pacing escape interval to control a time that a pacing pulse is delivered by the pulse generator;

detect a sensed cardiac electrical signal as a crosstalk event, the crosstalk event being an electrical pulse delivered to the patient by a different medical device than the implantable pacemaker,

withhold restarting the pacing escape interval in response to sensing the cardiac electrical signal based on detecting the sensed cardiac electrical signal as the crosstalk event;

wherein detecting the crosstalk event comprises;

determining a sensed event interval from the sensed cardiac electrical signal to a preceding cardiac event;

comparing the sensed event interval to an expected cardiac event interval; and

determining if crosstalk detection criteria are met if the sensed event interval is less than the expected cardiac event interval.

2. The pacemaker of claim 1, wherein the control module is configured to detect the sensed cardiac electrical signal as a crosstalk signal by comparing the sensed cardiac electrical signal to at least one crosstalk detection criterion.

3. The pacemaker of claim 1, further comprising a sensor producing a signal comprising mechanical cardiac events,

the control module configured to detect the crosstalk event by:

determining from the sensor signal whether a mechanical cardiac event is absent following the sensed cardiac electrical signal, and

detecting the crosstalk signal in response to determining that the mechanical cardiac event is absent following the sensed cardiac electrical signal.

4. The pacemaker of claim 1, wherein the control module is further configured to:

control the pulse generator to deliver a pacing pulse at a safety pace interval following the detected crosstalk event; and

restart the pacing escape interval in response to delivering the pacing pulse.

5. The pacemaker of claim 4, wherein the control module is further configured to:

detect an evoked response following the pacing pulse;

confirm the crosstalk event based on detecting the evoked response;

reclassify the detected crosstalk event as an intrinsic event if the evoked response to the pacing pulse is not detected; and

adjust the restarted pacing escape interval by the safety pace interval in response to reclassifying the detected crosstalk event as an intrinsic event.

6. The pacemaker of claim 5, wherein the control module is further configured to adjust a crosstalk detection criterion in response to reclassifying the detected crosstalk event.

7. The pacemaker of claim 1, wherein the control module is further configured to:

increase a count of detected crosstalk events in response to detecting the crosstalk event;

compare the count to a crosstalk frequency threshold; and

adjust a sensing control parameter in response to the count reaching the crosstalk frequency threshold.

8. The pacemaker of claim 1, wherein the control module is further configured to:

determine an event interval from a preceding event to the detected crosstalk event;

compare the determined event interval to a threshold interval; and

deliver a safety pacing pulse at a safety pace interval if the event interval is greater than the threshold interval.

9. The pacemaker of claim 1, wherein the control module is further configured to switch a pacing mode of the implantable pacemaker from an inhibiting mode to a non-inhibiting mode in response to detecting the crosstalk event.

10. A method performed by an implantable pacemaker, the pacemaker comprising:

sensing a cardiac electrical signal received by a pair of electrodes coupled to the pacemaker,

starting a pacing escape interval by a control module of the implantable pacemaker to control a time that a pacing pulse is delivered in a heart chamber of a patient;

detecting the sensed cardiac electrical signal as a crosstalk event, the crosstalk event being an electrical pulse delivered to the patient by a different medical device than the implantable pacemaker, and

withholding restarting the pacing escape interval in response to sensing the cardiac electrical signal based on detecting the sensed cardiac electrical signal as the crosstalk event;

wherein detecting the crosstalk event comprises;

determining a sensed event interval from the sensed cardiac electrical signal to a preceding cardiac event;

comparing the sensed event interval to an expected cardiac event interval; and

determining if crosstalk detection criteria are met if the sensed event interval is less than the expected cardiac event interval.

11. The method of claim 10, further comprising detecting the sensed cardiac electrical signal as a crosstalk signal by comparing the sensed cardiac electrical signal to at least one crosstalk detection criterion.

12. The method of claim 10, further comprising:

sensing a signal comprising mechanical cardiac events;

detecting the crosstalk event by determining whether a mechanical cardiac event occurs following the sensed cardiac electrical signal and detecting the crosstalk signal in response to not detecting a mechanical cardiac event from the sensor signal following the sensed cardiac electrical signal.

13. The method of claim 10, further comprising:

controlling a pulse generator to deliver a pacing pulse at a safety pace interval following the detected crosstalk event; and

restarting the pacing escape interval upon delivering the pacing pulse.

14. The method of claim 13, further comprising:

detecting an evoked response following the pacing pulse;

confirming the crosstalk event based on detecting the evoked response;

reclassifying the detected crosstalk event as an intrinsic event if the evoked response to the pacing pulse is not detected; and

adjusting the restarted pacing escape interval by the safety pace interval in response to reclassifying the detected crosstalk event as an intrinsic event.

15. The method of claim 14, further comprising adjusting a crosstalk detection criterion in response to reclassifying the detected crosstalk event.

16. The method of claim 10, further comprising:

increasing a count of detected crosstalk events in response to detecting the crosstalk event;

comparing the count to a crosstalk frequency threshold; and

adjusting a sensing control parameter in response to the count reaching the crosstalk frequency threshold.

17. The method of claim 10, further comprising:

determining an event interval from a preceding event to the detected crosstalk event;

comparing the determined event interval to a threshold interval; and

delivering a safety pacing pulse at a safety pace interval if the event interval is greater than the threshold interval.

18. The method of claim 10, further comprising automatically switching a pacing mode by the control module of the implantable pacemaker from an inhibiting mode to a non-inhibiting mode in response to detecting the crosstalk event.