Methods and systems for managing fusion and noise in cardiac pacing response classification

摘要

Methods and systems for detecting noise in cardiac pacing response classification processes involve determining that a cardiac response classification is possibly erroneous if unexpected signal content is detected. The unexpected signal content may comprise signal peaks that have polarity opposite to the polarity of peaks used to determine the cardiac response to pacing. Fusion/noise management processes include pacing at a relatively high energy level until capture is detected after a fusion, indeterminate, or possibly erroneous pacing response classification is made. The relatively high energy pacing pulses may be delivered until capture is detected or until a predetermined number of paces are delivered.

主权项

1. A cardiac signal noise detection method, comprising:
sensing a cardiac signal in one or more classification windows following delivery of a pacing pulse; using the cardiac signal sensed in the one or more classification windows to classify a cardiac response to the pacing pulse; sensing the cardiac signal in a noise detection window, wherein the noise detection window is shifted relative to the one or more classification windows; determining a signal level of the cardiac signal in at least one of the classification windows; determining a noise level of the cardiac signal in the noise detection window; comparing the classification window signal level to the noise detection window noise level; and determining a measure of cardiac signal noise based at least in part on the comparison.