Cardiac Pacing Capture Threshold Detection Fusion Beat Reclassification
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Solution Overview
Problem
Existing cardiac pacing devices face challenges in accurately detecting capture during capture threshold determination due to misclassification of beats as fusion beats, caused by phenomena such as pacing voltage-dependent voltage shifts and double peaks in the evoked response waveform, which can lead to ineffective pulse delivery and energy wastage.
Innovation Solution
The cardiac pacing device is configured to adjust parameters such as blanking/recharge intervals and capture detection windows, and to reevaluate sensing electrodes, allowing for continued capture threshold determination even if initial criteria are not met, and to reclassify fusion beats as capture beats based on additional morphology features.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If capture detection uses fixed amplitude and location criteria, then detection simplicity is maintained, but misclassification of capture beats as fusion beats occurs due to voltage shifts and double peaks
Solution Approach 1:
The patent implements dynamic adjustment of capture detection parameters including blanking interval, recharge interval, and capture detection window based on the specific waveform characteristics observed. This allows the system to adapt to voltage shifts and double peak phenomena rather than relying on fixed criteria, thereby maintaining both operational simplicity and detection accuracy
Solution Approach 2:
The system changes detection parameters (amplitude thresholds, time windows, blanking intervals) based on the observed evoked response characteristics. When double peaks or voltage shifts are detected, the parameters are adjusted to accommodate these variations, preventing misclassification while maintaining detection effectiveness
2Reliability
If capture threshold determination is aborted on fusion beat detection, then false positive errors are reduced, but determination time and energy consumption increase due to repeated testing
Solution Approach 1:
The patent performs preliminary analysis of the evoked response waveform characteristics before making the decision to continue or abort threshold determination. By examining the presence of double peaks, voltage shifts, or other characteristic patterns, the system can proactively adjust parameters to prevent future misclassifications, avoiding the need for repeated testing and reducing overall determination time
Solution Approach 2:
The system uses feedback from detected fusion beats to adjust detection parameters for subsequent measurements. When a fusion beat is detected with specific characteristics, the system modifies the capture detection parameters to account for these findings, preventing false aborts in future measurements and reducing the need for repeated threshold determination cycles
Data Source
AI summary
An improved technique is described for dealing with the detection of fusion beats when capture verification is performed by a cardiac pacing device such as during a capture threshold determination procedure. Schemes for classifying heart beats may misclassify beats as fusion beats due to feature/morphology changes in the test electrogram waveform that may occur even when capture is achieved.