Method of automatic evoked response sensing vector selection using evoked response waveform analysis
First Claim
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1. A method for automatically selecting evoked response sensing electrodes, comprising:
- selecting an evoked response sensing electrode pair;
delivering a sequence of test pulses including a first set of test pulses having a first pulse energy exceeding a capture threshold and a second set of test pulses having a second pulse energy less than the capture threshold;
setting a capture detection time window following each test pulse during which a signal is sensed using the selected evoked response sensing electrode pair;
determining a maximum signal amplitude of the sensed signal occurring during the capture detection window following each of the test pulses included in the first set and the second set;
determining a minimum value of the determined maximum signal amplitudes corresponding to the first set of test pulses;
determining a signal quality parameter based on the minimum value of the maximum signal amplitudes corresponding to the first set of test pulses; and
accepting the selected evoked response sensing electrode pair in response to the signal quality parameter.
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Abstract
A cardiac pacing device and method for automatically selecting an optimal evoked response sensing vector based on an evaluation of the evoked response signal quality are provided. Electrode switching circuitry allows selection of multiple sensing electrode vectors. Capture detection circuitry provides capture and loss of capture signal characteristics determined during a pacing threshold search to be used in determining evoked response signal quality parameters. An optimal evoked response sensing vector is selected based on evoked response signal quality parameters meeting predetermined criteria for reliable evoked response sensing.
67 Citations
23 Claims
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1. A method for automatically selecting evoked response sensing electrodes, comprising:
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selecting an evoked response sensing electrode pair; delivering a sequence of test pulses including a first set of test pulses having a first pulse energy exceeding a capture threshold and a second set of test pulses having a second pulse energy less than the capture threshold; setting a capture detection time window following each test pulse during which a signal is sensed using the selected evoked response sensing electrode pair; determining a maximum signal amplitude of the sensed signal occurring during the capture detection window following each of the test pulses included in the first set and the second set; determining a minimum value of the determined maximum signal amplitudes corresponding to the first set of test pulses; determining a signal quality parameter based on the minimum value of the maximum signal amplitudes corresponding to the first set of test pulses; and accepting the selected evoked response sensing electrode pair in response to the signal quality parameter. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A system implemented in an implantable medical device, the system comprising:
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means for selecting an evoked response sensing electrode pair; a pulse generator for delivering a sequence of test pulses including a first set of test pulses having a first pulse energy exceeding a capture threshold and a second set of test pulses having a second pulse energy less than the capture threshold; a capture detection module for receiving a signal from the selected evoked response sensing electrode pair; and a processor for receiving a signal from the selected evoked response sensing electrode pair, determining a maximum signal amplitude of the received signal following each of the test pulses included in the first set and the second set, determining a minimum value of the determined maximum signal amplitudes corresponding to the first set of test pulses, determining a signal quality parameter based on the minimum value, and accepting the selected evoked response sensing electrode pair in response to the signal quality parameter. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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20. A computer readable medium for storing a set of instructions which when implemented in an implantable medical device system cause the system to:
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select an evoked response sensing electrode pair; deliver a sequence of test pulses including a first set of test pulses having a first pulse energy exceeding a capture threshold and a second set of test pulses having a second pulse energy less than the capture threshold; set a capture detection time window following each test pulse during which a signal is sensed using the selected evoked response sensing electrode pair; determine a maximum signal amplitude of the sensed signal occurring during the capture detection window following each test pulse; determine a minimum value of the determined maximum signal amplitudes corresponding to the first set of test pulses; determine a signal quality parameter based on the minimum value of the determined maximum signal amplitudes corresponding to the first set of test pulses; and accept the selected evoked response sensing electrode pair in response to the signal quality parameter. - View Dependent Claims (21, 22, 23)
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Specification