# US 7,613,508 B2 · Implantable cardiac stimulation device, system and method which provides an electrogram signal facilitating measurement of slow-changing electrogram features

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- Number: US 7,613,508 B2
- Document ID: US7613508B2
- Status: Granted
- Kind: B2
- Application number: 11/871,873
- Filed: 2007-10-12
- Published: 2008-02-07
- Granted: 2009-11-03
- Earliest claimed: 2001-09-25
- Assignees: Pacesetter, Inc.
- Inventors: Peter Boileau; Gene A. Bornzin; Jong Gill
- Web page: https://patentgrep.com/patent/US7613508B2

## CPC

- A61N 1/3702: {Physiological parameters (A61N1/365 takes precedence; evoked response A61N1/371)}
- A61B 5/29: for permanent or long-term implantation
- A61B 5/358: Detecting ST segments
- A61N 1/368: comprising more than one electrode co-operating with different heart regions {(A61N1/3622, A61N1/3627 take precedence)}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

An implantable cardiac system including an implantable cardiac stimulation device provides a heart activity signal of a heart facilitating measurement of slowly changing electrogram features. The system comprises at least one implantable electrode arrangement that senses cardiac electrical activity and provides an intracardiac electrogram signal, a first high pass filter that filters the electrogram and an equalizer that filters the filtered electrogram signal. The equalizer has a transfer function that is non-decreasing for frequencies up to a lower frequency breakpoint that is less than the upper frequency breakpoint, decreasing for frequencies between the lower frequency breakpoint and the upper frequency breakpoint, and generally flat for frequencies above the upper frequency breakpoint through a bandpass region of interest.

## Claims

### Claim 1

An implantable cardiac system including an implantable cardiac stimulation device, the system providing a heart activity signal of a heart facilitating measurement of slowly changing electrogram features, the system comprising:
at least one implantable electrode arrangement that senses cardiac electrical activity and provides an intracardiac electrogram signal;
a first high-pass filter with a cutoff frequency at an upper frequency breakpoint that filters the intracardiac electrogram signal, and
an equalizer that filters the filtered intracardiac electrogram signal, the equalizer having a transfer function derived by multiplying a reciprocal of the transfer function of the first high pass filter by a transfer function of a second high pass filter with a cutoff frequency at a lower frequency breakpoint, wherein the transfer function of the equalizer is non-decreasing for frequencies up to the lower frequency breakpoint.

### Claim 2 (depends on 1)

The system of claim 1 wherein the implantable cardiac stimulation device includes a memory that stores the intracardiac electrogram signal prior to being filtered.

### Claim 3 (depends on 1)

The system of claim 1 wherein the transfer function of the equalizer increases for frequencies up to the lower frequency breakpoint.

### Claim 4 (depends on 1)

The system of claim 1 wherein the transfer function of the equalizer has a second order response from the lower frequency breakpoint to the upper frequency breakpoint.

### Claim 5 (depends on 1)

The system of claim 1 wherein the upper frequency breakpoint is on the order of 1 Hertz.

### Claim 6 (depends on 1)

The system of claim 1 wherein the lower frequency breakpoint is less than about 0.25 Hertz.

### Claim 7 (depends on 1)

The system of claim 1 wherein the at least one electrode arrangement comprises an electrode adapted for implant in the right atrium of the heart.

### Claim 8 (depends on 1)

The system of claim 1 wherein the at least one electrode arrangement comprises an electrode adapted for implant in, on or proximate to a ventricle of the heart.

### Claim 9 (depends on 1)

The system of claim 1 wherein the at least one electrode arrangement comprises a first electrode adapted for implant in, on or proximate to an atrium of the heart and a second electrode adapted for implant in, on or proximate to a ventricle of the heart.

### Claim 10

In an implantable cardiac system, a method of providing a heart activity signal of a heart which facilitates measurement of slowly changing electrogram features, the method comprising:
sensing cardiac electrical activity with at least one implanted electrode arrangement to provide an electrogram signal;
filtering the electrogram signal with a first high-pass filter with a cutoff frequency at an upper frequency breakpoint; and
filtering the filtered electrogram signal with a equalizer having a transfer function that is: non-decreasing for frequencies up to a lower frequency breakpoint that is less than the upper frequency breakpoint, decreasing for frequencies between the lower frequency breakpoint and the upper frequency breakpoint, and generally flat for frequencies above the upper frequency breakpoint through a bandpass region of interest.

### Claim 11 (depends on 10)

The method of claim 10 wherein the transfer function of the equalizer increases for frequencies up to the lower frequency breakpoint.

### Claim 12 (depends on 10)

The method of claim 10 wherein the transfer function of the equalizer has a second order response from the lower frequency breakpoint to the upper frequency breakpoint.

### Claim 13 (depends on 10)

The method of claim 10 wherein filtering the filtered electrogram comprises twice filtering the intracardiac signal with the equalizer to obtain a second order response.

### Claim 14

An implantable cardiac system including an implantable cardiac stimulation device, the system providing a heart activity signal of a heart facilitating measurement of slowly changing electrogram features, the system comprising:
at least one implantable electrode arrangement that senses cardiac electrical activity and provides an electrogram signal;
a first high-pass filter with a cutoff frequency at an upper frequency breakpoint that filters the electrogram signal, and
a plurality of serially arranged equalizers that filter the filtered electrogram signal, each equalizer having a transfer function derived as a function of a reciprocal of the transfer function of the first high pass filter and a transfer function of a second high pass filter with a cutoff frequency at a lower frequency breakpoint.

### Claim 15 (depends on 14)

The system of claim 14 wherein the transfer function of at least one of the equalizers is non-decreasing for frequencies up to the lower frequency breakpoint.

### Claim 16 (depends on 14)

The system of claim 14 wherein the transfer function of at least one of the equalizers increases for frequencies up to the lower frequency breakpoint.
