Identification of healthy versus unhealthy substrate for pacing from a multipolar lead

摘要

A medical device system performs a method for determining presence of scar tissue through an implanted lead having an electrode for cardiac pacing and sensing. A sensing module senses heart activity with the electrode to produce a unipolar electrogram (EGM) waveform. A processor receives the unipolar EGM waveform and extracts two or more features representative of heart activity at the electrode. Scar tissue is identified at the site of the first electrode based upon at least two of the extracted features indicating scar tissue.

主权项

1. A method for determining presence of scar tissue through an implanted lead having a plurality of electrodes positionable in the right or left ventricle for cardiac pacing and sensing, wherein the plurality of electrodes includes a first electrode, the method comprising:
sensing heart activity with the first electrode to produce a first unipolar electrogram (EGM) waveform, wherein the sensed heart activity is not a result from pacing of the ventricle in which the first electrode is positioned; extracting by a medical device processor receiving the first unipolar EGM waveform two or more features from the first unipolar EGM waveform representative of heart activity at the first electrode; identifying scar tissue at a site of the first electrode based upon at least two of the extracted features indicating scar tissue; and providing a response to identifying the scar tissue, wherein providing the response comprises at least one of generating a notification of identified scar tissue at the first electrode site and automatically excluding the first electrode for pacing therapy delivery.