Unwanted stimulation detection during cardiac pacing

摘要

The disclosure relates to systems and methods for cardiac rhythm management. In some cases, a system may include a pulse generator for generating pacing pulses for stimulating a heart of a patient; a memory; and a sensor configured to sense a response to a unwanted stimulation and to produce a corresponding sensor signal. A processing circuit may receive the sensor signal for a time after one or more pacing pulses, and may derive a time-frequency representation of the sensor signal based on the received sensor signal. The processing circuit may use the time-frequency representation of the sensor signal to help identify unwanted stimulation. Once unwanted stimulation is detected, the processing circuit may change the pacing pulses to help reduce or eliminate the unwanted stimulation.

主权项

1. A system for cardiac rhythm management comprising:
a pulse generator for generating pacing pulses for stimulating a heart of a patient; a memory; a sensor configured to sense a response to a stimulation of a phrenic nerve of the patient and to produce a corresponding sensor signal; a processing circuit in communication with the memory and the sensor, the processing circuit configured to:
receive the sensor signal for a time after one or more pacing pulses; derive a time-frequency representation of the sensor signal based on the received sensor signal using wavelets; identify a dominant frequency component in the time-frequency representation of sensor signal; determine if the dominant frequency component falls within a predetermined frequency range; identify a time of occurrence of the dominant frequency component relative to a corresponding pacing pulse; determine if the time of occurrence of the dominant frequency component occurs within a predetermined time window; determine if the phrenic nerve of the patient has been stimulated based, at least in part, on the time-frequency representation of the sensor signal such that the dominant frequency component falls within the predetermined frequency range and the dominant frequency component occurs within the predetermined time window; store a phrenic nerve stimulation event identifier in the memory if the processing circuit determines that the phrenic nerve of the patient has been stimulated.