US 11,878,174 B2
Implantable medical systems and methods used to detect, characterize or avoid atrial oversensing within a His IEGM
Yun Qiao, Sunnyvale, CA (US); Wenwen Li, Studio City, CA (US); Jan Mangual, Rho (IT); and Luke C. McSpadden, Studio City, CA (US)
Assigned to Pacesetter, Inc., Sylmar, CA (US)
Filed by Pacesetter, Inc., Sylmar, CA (US)
Filed on Feb. 9, 2021, as Appl. No. 17/171,762.
Prior Publication US 2022/0249849 A1, Aug. 11, 2022
Int. Cl. A61N 1/37 (2006.01); A61N 1/368 (2006.01); A61N 1/05 (2006.01); A61B 5/33 (2021.01); A61B 5/283 (2021.01)
CPC A61N 1/3714 (2013.01) [A61B 5/283 (2021.01); A61B 5/33 (2021.01); A61N 1/056 (2013.01); A61N 1/3682 (2013.01); A61N 1/3688 (2013.01)] 18 Claims
OG exemplary drawing
 
1. A medical system configured to selectively perform His capture management, the system comprising:
one or more implantable electrodes that can be used for sensing and pacing;
a sensing circuit configured to sense a His intracardiac electrogram (IEGM) using at least one of the one or more implantable electrodes configured to be implanted in or proximate to a patient's His bundle;
a pulse generator configured to selectively produce pacing pulses that are to be delivered to the patient's His bundle using the at least one of the one or more implantable electrodes configured to be implanted in or proximate to the patient's His bundle; and
a controller configured to
cause pacing of the patient's right atrium using at least one of the one or more implantable electrodes configured to be implanted in the patient's right atrium to thereby cause a paced atrial event;
determine whether a portion of the His IEGM exceeds a specified sense threshold within a specified window that begins at an end of an atrioventricular delay (AVD) following the paced atrial event;
detect atrial oversensing based on results of the determining whether the portion of the His IEGM exceeds the specified sense threshold within the specified window;
prevent performance of the His capture management in response to the atrial oversensing being detected; and
after the atrial oversensing has been detected, at a later point in time that the atrial oversensing is no longer detected, cause the His capture management to be performed, which includes causing pacing of the patient's His bundle, using the at least one of the one or more implantable electrodes configured to be implanted in or proximate to the patient's His bundle, and determine a capture threshold associated with the patient's His bundle.