Management of fusion beat detection during capture threshold determination
First Claim
Patent Images
1. A method for operating a cardiac rhythm management device, comprising:
- performing a capture threshold determination procedure by;
delivering a pacing pulse to a cardiac site;
recording a test electrogram after delivery of the pacing pulse;
classifying the test electrogram as representing a capture beat, a fusion beat, or a non-capture beat;
initiating delivery of pacing pulses with a pacing pulse energy that achieves capture and decreasing the pacing pulse energy of each successive pacing pulse until the lowest energy pacing pulse that results in a test electrogram classified as a capture beat is found, wherein test electrograms classified as fusion beats are disregarded;
wherein the test electrogram is classified as a capture beat if the test electrogram meets both an amplitude criterion that specifies a peak amplitude and a location criterion that specifies a time window within which the peak amplitude must occur;
wherein the test electrogram is classified as a non-capture beat if asystole is detected;
wherein the test electrogram is classified as a fusion beat if it cannot be classified as either a capture beat or a non-capture beat; and
,wherein the test electrogram is also classified as a capture beat if;
1) a non-zero number of immediately preceding test electrograms have been classified as fusion beats, and
2) the test electrogram meets only one of either the amplitude criterion or the location criterion.
1 Assignment
0 Petitions
Accused Products
Abstract
An improved technique is described for dealing with the detection of fusion beats when capture verification is performed by a cardiac pacing device such as during a capture threshold determination procedure. Schemes for classifying heart beats may misclassify beats as fusion beats due to feature/morphology changes in the test electrogram waveform that may occur even when capture is achieved.
72 Citations
12 Claims
-
1. A method for operating a cardiac rhythm management device, comprising:
-
performing a capture threshold determination procedure by; delivering a pacing pulse to a cardiac site; recording a test electrogram after delivery of the pacing pulse; classifying the test electrogram as representing a capture beat, a fusion beat, or a non-capture beat; initiating delivery of pacing pulses with a pacing pulse energy that achieves capture and decreasing the pacing pulse energy of each successive pacing pulse until the lowest energy pacing pulse that results in a test electrogram classified as a capture beat is found, wherein test electrograms classified as fusion beats are disregarded; wherein the test electrogram is classified as a capture beat if the test electrogram meets both an amplitude criterion that specifies a peak amplitude and a location criterion that specifies a time window within which the peak amplitude must occur; wherein the test electrogram is classified as a non-capture beat if asystole is detected; wherein the test electrogram is classified as a fusion beat if it cannot be classified as either a capture beat or a non-capture beat; and
,wherein the test electrogram is also classified as a capture beat if;
1) a non-zero number of immediately preceding test electrograms have been classified as fusion beats, and
2) the test electrogram meets only one of either the amplitude criterion or the location criterion. - View Dependent Claims (2, 3, 4, 5, 6)
-
-
7. A cardiac rhythm management device, comprising:
-
pulse generation and sensing circuitry for connecting to electrodes and forming sensing and pacing channels; a controller for controlling the delivery of pacing pulses by the pulse generation circuitry and for receiving electrogram signals from the sensing circuitry; wherein the controller is programmed to; perform a capture threshold determination procedure by; delivering a pacing pulse to a cardiac site; recording a test electrogram after delivery of the pacing pulse; classifying the test electrogram as representing a capture beat, a fusion beat, or a non-capture beat; initiating delivery of pacing pulses with a pacing pulse energy that achieves capture and decreasing the pacing pulse energy of each successive pacing pulse until the lowest energy pacing pulse that results in a test electrogram classified as a capture beat is found, wherein test electrograms classified as fusion beats are disregarded; wherein the test electrogram is classified as a capture beat if the test electrogram meets both an amplitude criterion that specifies a peak amplitude and a location criterion that specifies a time window within which the peak amplitude must occur; wherein the test electrogram is classified as a non-capture beat if asystole is detected; wherein the test electrogram is classified as a fusion beat if it cannot be classified as either a capture beat or a non-capture beat; and
,wherein the test electrogram is also classified as a capture beat if;
1) a non-zero number of immediately preceding test electrograms have been classified as fusion beats, and
2) the test electrogram meets only one of either the amplitude criterion or the location criterion. - View Dependent Claims (8, 9, 10, 11, 12)
-
Specification