Method and apparatus for selecting a sensing vector configuration in a medical device
First Claim
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1. A method of determining sensing vectors in a medical device, comprising:
- sensing cardiac signals on a plurality of sensing vectors formed from a plurality of electrodes;
determining, for each of the plurality of sensing vectors, a sensing vector metric of the sensed cardiac signals;
determining, for each of the plurality of sensing vectors, a morphology metric associated with a morphology of the sensed cardiac signals, wherein determining the morphology metric comprises;
sensing an R-wave in response to the cardiac signal exceeding a sensing threshold;
determining pulses associated with the sensed R-wave;
determining, for each pulse, whether a pulse width of the pulse is less than a pulse width threshold;
determining, for each pulse, whether a pulse amplitude of the pulse is greater than a pulse amplitude threshold;
determining a number of the determined pulses having both a pulse width less than the pulse width threshold and a pulse amplitude greater than the pulse amplitude threshold; and
setting the morphology metric equal to the determined number of pulses;
determining, for each of the plurality of sensing vectors, vector selection metrics based on at least the determined sensing vector metric and the determined morphology metric; and
selecting a sensing vector of the plurality of sensing vectors based on at least the determined selection metrics.
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Abstract
A method and medical device for determining sensing vectors that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, determining a sensing vector metric in response to the sensed cardiac signals, determining a morphology metric associated with a morphology of the sensed cardiac signals, determining vector selection metrics in response to the determined sensing vector metric and the determined morphology setting, and selecting a sensing vector of the plurality of sensing vectors in response to the determined vector selection metrics.
214 Citations
21 Claims
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1. A method of determining sensing vectors in a medical device, comprising:
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sensing cardiac signals on a plurality of sensing vectors formed from a plurality of electrodes; determining, for each of the plurality of sensing vectors, a sensing vector metric of the sensed cardiac signals; determining, for each of the plurality of sensing vectors, a morphology metric associated with a morphology of the sensed cardiac signals, wherein determining the morphology metric comprises; sensing an R-wave in response to the cardiac signal exceeding a sensing threshold; determining pulses associated with the sensed R-wave; determining, for each pulse, whether a pulse width of the pulse is less than a pulse width threshold; determining, for each pulse, whether a pulse amplitude of the pulse is greater than a pulse amplitude threshold; determining a number of the determined pulses having both a pulse width less than the pulse width threshold and a pulse amplitude greater than the pulse amplitude threshold; and setting the morphology metric equal to the determined number of pulses; determining, for each of the plurality of sensing vectors, vector selection metrics based on at least the determined sensing vector metric and the determined morphology metric; and selecting a sensing vector of the plurality of sensing vectors based on at least the determined selection metrics. - View Dependent Claims (2, 3, 4, 5)
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6. A method of determining sensing vectors in a medical device, comprising:
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sensing cardiac signals on a plurality of sensing vectors formed from a plurality of electrodes; determining, for each of the sensed cardiac signals, a plurality of sensing vector metrics; determining, for each of the sensed cardiac signals, a plurality of morphology metrics associated with a morphology; determining, for each of the plurality of sensing vectors, selection metrics based on at least the plurality of determined sensing vector metrics and the plurality of determined morphology metrics, wherein the selection metrics include a sensing vector selection metric and a morphology selection metric; and ranking vectors of the plurality of sensing vectors based on the determined sensing vector selection metric to determine a first vector ranking; ranking vectors of the plurality of sensing vectors based on the determined morphology selection metric to determine a second vector ranking; comparing the first vector ranking and the second vector ranking; updating the first vector ranking in response to the comparing, wherein the first vector ranking comprises at least a first sensing vector, a second sensing vector and a third sensing vector and the second vector ranking comprises at least a low morphology selection metric associated with a low number of pulses, a medium morphology selection metric and a high morphology selection metric, and wherein comparing the first vector ranking and the second vector ranking comprises determining whether the second vector ranking of one of the first sensing vector and the second sensing vector corresponds to the high morphology metric; and selecting a sensing vector of the plurality of sensing vectors based on at least one of the first or second vector rankings and at least some of the determined selection metrics. - View Dependent Claims (7, 8, 9, 10)
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11. A medical device, comprising:
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a plurality of electrodes capable of forming a plurality of sensing vectors for sensing cardiac signals; and a processor configured to obtain the cardiac signals sensed via the plurality of sensing vectors, determine, for each of the plurality of sensing vectors, at least one sensing vector metric of the sensed cardiac signals, determine, for each of the plurality of sensing vectors, at least one morphology metric associated with a morphology of the sensed cardiac signals by sensing an R-wave in response to the cardiac signal exceeding a sensing threshold, determining pulses associated with the sensed R-wave, determining, for each pulse, whether a pulse width of the pulse is less than a pulse width threshold, determining, for each pulse, whether a pulse amplitude of the pulse is greater than a pulse amplitude threshold, determining a number of the determined pulses having both a pulse width less than the pulse width threshold and a pulse amplitude greater than the pulse amplitude threshold, and setting the morphology metric equal to the determined number of pulses, determine, for each of the plurality of sensing vectors, selection metrics based on at least the determined sensing vector metric and the determined morphology metric, and select a sensing vector of the plurality of sensing vectors based on at least the determined selection metrics. - View Dependent Claims (12, 13, 14, 15)
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16. A medical device, comprising:
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a plurality of electrodes capable of forming a plurality of sensing vectors for sensing cardiac signals; and a processor configured to obtain the cardiac signals sensed via the plurality of sensing vectors, determine, for each of the sensed cardiac signals, a plurality of sensing vector metrics, determine, for each of the sensed cardiac signals, a plurality of morphology metrics associated with a morphology, determine, for each of the plurality of sensing vectors, selection metrics based on at least the plurality of determined sensing vector metrics and the plurality of determined morphology metrics, wherein the selection metrics include a sensing vector selection metric and a morphology selection metric, rank vectors of the plurality of sensing vectors based on the determined sensing vector selection metric to determine a first vector ranking, rank vectors of the plurality of sensing vectors based on the determined morphology selection metric to determine a second vector ranking, compare the first vector ranking and the second vector ranking, and update the first vector ranking in response to the comparing, wherein the first vector ranking comprises at least a first sensing vector, a second sensing vector and a third sensing vector and the second vector ranking comprises at least a low morphology selection metric associated with a low number of pulses, a medium morphology selection metric and a high morphology selection metric, and wherein the processor is further configured to determine whether the second vector ranking of one of the first sensing vector and the second sensing vector corresponds to the high morphology selection metric, and select a sensing vector of the plurality of sensing vectors based on at least one of the first or second vector rankings and at least some of the determined selection metrics. - View Dependent Claims (17, 18, 19, 20)
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21. A non-transitory, computer-readable storage medium storing instructions for causing a processor included in a medical device to perform a method for determining sensing vectors, the method comprising:
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sensing cardiac signals on a plurality of sensing vectors formed from a plurality of electrodes; determining, for each of the plurality of sensing vectors, at least one sensing vector metric of the sensed cardiac signals; determining, for each of the plurality of sensing vectors, at least one morphology metric associated with a morphology of the sensed cardiac signals, wherein determining a morphology metric comprises; sensing an R-wave in response to the cardiac signal exceeding a sensing threshold; determining pulses associated with the sensed R-wave; determining, for each pulse, whether a pulse width of the pulse is less than a pulse width threshold; determining, for each pulse, whether a pulse amplitude of the pulse is greater than a pulse amplitude threshold; determining a number of the determined pulses having both a pulse width less than the pulse width threshold and a pulse amplitude greater than the pulse amplitude threshold; and setting the morphology metric equal to the determined number of pulses; determining, for each of the plurality of sensing vectors, selection metrics based on at least the determined sensing vector metric and the determined morphology metric; selecting a sensing vector of the plurality of sensing vectors based on at least the determined selection metrics analyzing electrical signals sensed on the selected sensing vector; detecting tachycardia based on the analysis; and delivering an electrical therapy to a heart in response to detecting the tachycardia.
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Specification