Cardiac response classification using multisite sensing and pacing

摘要

Methods and devices for classifying a cardiac pacing response involve using a first electrode combination for pacing and a second electrode combination for sensing a cardiac signal following pacing. The cardiac response to pacing may be classified using the sensed cardiac signal. One process involves using the sensed cardiac signal to detect the cardiac response as a fusion/pseudofusion beat. Another process involves using the sensed cardiac signal to classify the cardiac response to pacing as one of at least three cardiac response types.

主权项

1. A method of determining a cardiac response to a pacing pulse, comprising:
delivering two or more initialization pacing pulses to a heart using a first electrode combination of a plurality of electrodes that are electrically coupled to the heart, wherein the two or more initialization pacing pulses are provided at a pacing energy that is sufficient to result in capture of the heart; sensing for a cardiac response following each of the two or more initialization pacing pulses using a second electrode combination; for each of the two or more initialization pacing pulses, determining a delay interval between when an initialization pacing pulse was delivered using the first electrode combination until when a corresponding cardiac response was sensed using the second electrode combination; following delivery of the two or more initialization pacing pulses:
delivering a pacing pulse to the heart using the first electrode combination;sensing a cardiac response to the pacing pulse using the second electrode combination;positioning a classification window according to a predetermined signal template morphology feature, wherein the positioning includes beginning the classification window a predetermined time delay following the pacing pulse, wherein the time delay is predetermined using the determined delay interval of the two or more initialization pulses; andclassifying the cardiac response to the pacing pulse as one of a captured response and a non-captured response, the classifying step including: determining if the sensed cardiac response to the pacing pulse includes the predetermined signal morphology feature within the classification window.