摘要:
An apparatus comprises a control circuit that initiates a normal pacing mode for delivery of electrostimulation energy to the heart chamber. In response to an indication to initiate a threshold test, the control circuit determines an electrode configuration used to deliver the electrostimulation energy in the normal pacing mode, selects a first threshold test mode when a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, wherein a cardiac activity signal is sensed using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and selects a second threshold test mode when a sensing electrode independent from the set of pacing electrodes is available for the heart chamber, wherein the cardiac activity signal is sensed using a set of sensing electrodes that excludes an electrode common to the set of pacing electrodes.
摘要:
Cardiac electrostimulation energy is delivered to a heart chamber of a subject according to a normal pacing mode using a set of implantable pacing electrodes. When a threshold test for the heart chamber is initiated and a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, cardiac electrostimulation energy is delivered to the subject according to a threshold test mode. The threshold test mode includes sensing a cardiac activity signal from a subject using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and changing the electrostimulation energy and sensing a resulting cardiac activity signal using the set of sensing electrodes to determine the optimum electrostimulation energy for capture of the heart chamber.
摘要:
An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.
摘要:
Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse.
摘要:
An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.
摘要:
Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse.
摘要:
A system can coordinate operation of a cardiac function management (CFM) device and a renal device, such as during a vulnerable period in which a patient has an increased risk of tachyarrhythmia.
摘要:
An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device.
摘要:
An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device.
摘要:
Cardiac anodal electrostimulation detection systems and methods are described, such as for distinguishing between cathodal-only capture and at least partially anodal capture (e.g., combined anodal and cathodal capture, or between two anodes of which only one captures nearby cardiac tissue, etc.).