Method and apparatus for capture verification based on propagated electrical activity
AssigneeCardiac Pacemakers, Inc.
InventorsJiang Ding, Yinghong Yu, Julio C. Spinelli, Qingsheng Zhu
Life of this patent
Estimating the term…
Abstract
An implantable cardiac rhythm/function management device that automatically determines whether or not a pacing stimulus to the ventricles results in capture by detecting propagated depolarizations at stimulating and non-stimulating electrodes. The device of the present invention is suitable for use in either a single or multiple electrode pacing/sensing configuration and may be utilized to verify either atrial or ventricular capture of a heart having either normal or abnormal intrinsic AV conduction.
Claims45
A cardiac electrical stimulation system having a capture verification configuration for use in the ventricles, said cardiac electrical stimulation system being configured to include:
- at least one stimulating electrode;
- at least one passive electrode;
- a pulse generator electrically coupled to said stimulating electrodes for providing an electrical stimulus to at least one ventricle of a heart;
- and
- a sensing circuit electrically coupled to said at least one stimulating electrode and said at least one passive electrode, said sensing circuit sensing a response by the heart to the electrical stimulus, said sensing circuit including a timing circuit, a detection circuit coupled to said at least one stimulating electrode and said at least one passive electrode, wherein a capture of the heart by the electrical stimulus is confirmed if depolarization is detected at said at least one passive electrode but no depolarization is detected at said at least one stimulating electrode during a predetermined detection interval and non-capture is confirmed if depolarization is detected at said at least one stimulating electrode, or no depolarization is detected at said at least one stimulating electrode and said at least one passive electrode during the said pre-determined detection interval.
A cardiac electrical stimulation system having a capture verification configuration for use in the ventricles, said cardiac electrical stimulation system including:
- a left ventricular electrode;
- a right ventricular electrode;
- stimulating means for delivering electrical stimulus to said left ventricular electrode;
- and
- sensing means electrically coupled to said left and right ventricular electrodes, said sensing means for sensing a response by the heart to electrical stimulus generated by said stimulating means, said sensing means further including a timing circuit, and a detection circuit coupled to said left and right ventricular electrodes, wherein a capture of the heart by the electrical stimulus is confirmed if the detection circuit detects depolarization at said right ventricular electrode but does not detect depolarization at said left ventricular electrode during a predetermined detection interval, and non-capture is confirmed if depolarization is detected at said left ventricular electrode, or no depolarization is detected at any of said left and right ventricular electrodes during the predetermined detection interval.
A cardiac electrical stimulation system having a stimulation/sensing configuration for use in the ventricles, said cardiac electrical stimulation system including:
- stimulating electrodes;
- a pulse generator electrically coupled to said stimulating electrodes for providing an electrical stimulus to at least one ventricle of a heart;
- and
- a sensing circuit electrically coupled to said stimulating electrodes, said sensing circuit sensing a response by the heart to the electrical stimulus, said sensing circuit including a timing circuit, and a detection circuit coupled to said stimulating electrodes.
A method of verifying capture of a patient's heart by an electrical stimulus delivered to at least one ventricle of the heart, said method including the steps of:
- positioning at least a first and second electrode in the heart;
- delivering an electrical stimulus from a stimulation system to said first electrode;
- sensing at both the first and second electrodes for a response by the heart to the electrical stimulus, wherein a capture of the heart by the electrical stimulus is confirmed if depolarization in excess of a predetermined threshold is sensed at the second electrode but depolarization is not sensed at the first electrode during a predetermined detection interval and non-capture is confirmed if depolarization in excess of the predetermined threshold is sensed at the first electrode or no depolarization is sensed at the second electrode during the predetermined detection interval.
A method of verifying capture of a patient's heart by an electrical stimulus delivered to the ventricles of the heart, comprising the steps of:
- (a) positioning a first electrode proximate a left ventricle, a second electrode proximate a right ventricle and a reference electrode within the patient;
- (b) delivering an electrical stimulus simultaneously to the first and second electrodes;
- and
- (c) sensing at both the first and second electrodes and the reference electrode for a response by the heart to the electrical stimulus wherein capture of the heart by the electrical stimulus is confirmed if depolarization is sensed at the reference electrode and not at the first and second electrodes during a predetermined detection interval, and non-capture is confirmed if no depolarization is sensed at the reference electrode or depolarization is sensed at either of the first and second electrode during the predetermined detection interval.
A method of verifying capture of a patient's heart by an electrical stimulus delivered the heart comprising the steps of:
- (a) providing stimulus simultaneously to both right and left ventricle;
- (b) providing sensing circuits active during a detection window following delivery of a pacing pulse for sensing intrinsic and evoked ventricular depolarizations and detecting propagated depolarizations, the cardiac stimulation system further incorporating an autocapture algorithm for controlling the amplitude of delivered pacing pulses;
- (c) testing for presence of propagated depolarizations at either of the left ventricular electrode and the right ventricular electrode or absence of an evoked depolarization at both left and right ventricular electrodes during a predetermined detection window to establish lack of capture;
- and
- (d) testing for absence of propagated depolarization at both the left ventricular electrode and the right ventricular electrode and presence of evoked ventricular depolarization at any of the left and right ventricular electrodes to establish capture.
Dependencies are inferred from the claim text.