Determination of septal perforation during electrode implantation

A method to assist in implanting an implantable electrode comprising an implantable electrode proximate a patient's cardiac conduction system, the method comprising, during implantation of the implantable electrode:

• monitoring internal electrical activity using the implantable electrode during implantation of the implantable electrode,
• monitoring external electrical activity using an external electrode during implantation of the implantable electrode,
• determining cardiac conduction system capture based on at least one of the internal and external monitored electrical activity during implantation of the implantable electrode,
• determining injury of current based on at least one of the monitored internal and external electrical activity during implantation of the implantable electrode,
• determining impedance based on at least one of the monitored internal and external electrical activity during implantation of the implantable electrode, and
• issuing a first notification in response to determining that the implantable electrode is implanted in the interventricular septal wall proximate the cardiac conduction system and prior to perforation into the left ventricular (LV) chamber based on at least one of the cardiac conduction system capture, the injury of current, and the impedance.

A system for use in assisting implantation of an implantable electrode, the system comprising:

• an implantable electrode configured to deliver cardiac conduction system pacing proximate a portion of a patient's cardiac conduction system;
• and
• a computing apparatus comprising processing circuitry, the computing apparatus operably coupled to the implantable electrode, wherein the computing apparatus is configured to, during implantation of the implantable electrode:
• monitor internal electrical activity using the implantable electrode during implantation of the implantable electrode,
• determine cardiac conduction system capture, injury of current, and impedance based on the monitored internal electrical activity during implantation of the implantable electrode, and
• issue a first notification in response to determining that the implantable electrode is implanted in the interventricular septal wall proximate the cardiac conduction system and prior to perforation into the left ventricular (LV) chamber based on at least one of the determined cardiac conduction system capture, the injury of current, and the impedance.