Medtronic, Inc.

Chad A Bounds

Bruce D Gunderson

Amisha Somabhai Patel

Mark L Brown

Li Ping Wang

Edwin G Duffin

Ravi Xavier

An implantable cardioverter defibrillator (ICD) senses ventricular depolarizations (R-waves) in an electrogram signal to detect a ventricular tachycardia or fibrillation episodes. The EGM signal is also monitored in real time for characteristics that uniquely identify instances of T-wave oversensing. The ICD determines whether detection of a tachycardia or fibrillation episode is appropriate based upon counts of each of the unique characteristics evidencing T-wave oversensing.

Implantable medical device with real time T-wave oversensing detection

A method for identifying oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), is described. A near-field electrogram signal and a far-field electrogram signal are obtained via a near-field electrode pair and a far-field electrode pair. The near-field electrogram signal is compared to the far-field electrogram signal and a determination of whether oversensing exists is made based on the comparison. In some instances, a scheduled therapy is withheld in response to determining that oversensing exists.

Method and apparatus for identifying oversensing using far-field intracardiac electrograms and marker channels

A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.

A method and apparatus for detecting a lead-related condition that includes determining whether a first oversensing criteria is satisfied, determining whether a second oversensing criteria is satisfied, determining whether an impedance criteria has been satisfied, and generating an alert in response to more than one of the first oversensing criteria, the second over sensing criteria and the impedance criteria being satisfied.

Method and apparatus for identifying lead-related conditions using impedance trends and oversensing criteria

A method and apparatus for automatically identifying various types of cardiac and non-cardiac oversensing is provided. EGM data, including time intervals between sensed and paced events and signal morphologies, are analyzed for patterns indicative of various types of oversensing, including oversensing of far-field R-waves, R-waves, T-waves, or noise associated with electromagnetic interference, non-cardiac myopotentials, a lead fracture, or a poor lead connection. Identification of oversensing and its suspected cause are reported so that corrective action may be taken.

Method and apparatus for identifying cardiac and non-cardiac oversensing using intracardiac electrograms

A method and apparatus for automatically detecting and diagnosing lead-related conditions is provided. Specifically, relatively short-term and relatively long-term impedance parameters are determined for detecting an impedance trend indicative of a lead-related condition such as an open circuit, which may be due to a conductor fracture or poor connection to an associated implantable medical device, or a short circuit due to an insulation breach. Monitoring of multiple lead impedance parameters is performed to diagnose a lead-related condition based on a number of diagnostic criteria. Supplementary analysis of multiple lead impedance parameter trends may be performed to identify lead-specific conditions, such as metal ion oxidation induced insulation degradation. A lead-related condition diagnosis and supporting data are stored in memory for uplinking to an external device for review by a clinician. A recommended corrective action and/or a patient notification signal for a lead-related condition may optionally be provided.

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Minneapolis, MN, United States of America

Chad A Bounds