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Management of fusion beat detection during capture threshold determination

  • US 9,020,596 B2
  • Filed: 07/11/2012
  • Issued: 04/28/2015
  • Est. Priority Date: 07/15/2011
  • Status: Active Grant
First Claim
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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.

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