Method and apparatus for phrenic nerve activation detection with respiration cross-checking

摘要

The present invention concerns phrenic nerve activation detection algorithms for characterization of phrenic nerve activation and phrenic nerve activation avoidance in cardiac pacing therapy.;Various embodiments concern receiving a respiration signal indicative of respiratory activity of the patient, identifying respiratory phases based on the respiration signal, delivering cardiac pacing pulses within each of the identified respiratory phases, receiving a phrenic nerve activation signal indicative of activation of the patient's phrenic nerve, analyzing the phrenic nerve stimulation signal to determine if one or more of the pacing pulses activated the phrenic nerve of the patient, and determining if at least one of the delivered pacing pulses activated the phrenic nerve of the patient based on the phrenic nerve activation signal indicating activation of the patient's phrenic nerve associated with delivery of the at least one cardiac pacing pulse.

主权项

1. A cardiac rhythm management system for phrenic nerve activation characterization, comprising:
an implantable cardiac pacing device having a plurality of electrodes configured for implantation in a patient; circuitry configured to output a plurality of cardiac pacing pulses through the electrodes and modify one or more pacing parameters of the plurality of cardiac pacing pulses; a phrenic nerve activation sensor configured to output a phrenic nerve activation signal indicative of activation of the patient's phrenic nerve; a respiration sensor configured to output a respiration signal indicative of a respiratory activity of the patient; and a controller configured to execute program instructions stored in memory to:
cause the system to identify a plurality of different respiratory phases based on the respiration signal for each respiratory cycle of a plurality of respiratory cycles of the patient;in response to identifying the plurality of different respiratory phases, deliver the plurality of cardiac pacing pulses such that at least some of the plurality of cardiac pacing pulses are delivered during each respiratory phase of the identified plurality of different respiratory phases;analyze the phrenic nerve activation signal to determine if one or more of the delivered plurality of pacing pulses activated the phrenic nerve of the patient during one or more of the identified plurality of different respiratory phases based on the phrenic nerve activation signal; anddeliver a cardiac pacing pulse therapy using predetermined pacing parameter settings that do not induce phrenic nerve activation.