Method and Apparatus for Phrenic Nerve Activation Detection with Respiration Cross-Checking

A method for characterizing phrenic nerve stimulation in cardiac rhythm management therapy, comprising:

• receiving a respiration signal indicative of inhalation and exhalation respiratory activity of the patient;
• identifying a plurality of different respiratory phases based on the respiration signal for multiple respiratory cycles of the patient;
• delivering a plurality of cardiac pacing pulses within each of the identified plurality of different respiratory phases;
• receiving a phrenic nerve activation signal indicative of activation of the patient's phrenic nerve;
• analyzing the phrenic nerve stimulation signal to determine if one or more of the delivered plurality of pacing pulses activated the phrenic nerve of the patient;
• and
• determining if at least one of the delivered pacing pulses activated the phrenic nerve of the patient based on the phrenic nerve activation signal indicating activation of the patient's phrenic nerve associated with delivery of the at least one cardiac pacing pulse.

A cardiac rhythm management system, comprising:

• means for receiving a respiration signal indicative of inhalation and exhalation respiratory activity of the patient;
• means for identifying a plurality of different respiratory phases based on the respiration signal for multiple respiratory cycles of the patient;
• means for delivering a plurality of cardiac pacing pulses within each of the identified plurality of different respiratory phases;
• means for receiving a phrenic nerve activation signal indicative of activation of the patient's phrenic nerve;
• means for analyzing the phrenic nerve stimulation signal to determine if one or more of the delivered plurality of pacing pulses activated the phrenic nerve of the patient;
• and
• means for determining if at least one of the delivered pacing pulses activated the phrenic nerve of the patient based on the phrenic nerve activation signal indicating activation of the patient's phrenic nerve associated with delivery of the at least one cardiac pacing pulse.