US 12,357,834 B2
His-Purkinje system capture detection
Jian Cao, Shoreview, MN (US); Wade M. Demmer, Coon Rapids, MN (US); Elizabeth A. Mattson, Eagan, MN (US); Todd J. Sheldon, North Oaks, MN (US); and Xiaohong Zhou, Woodbury, MN (US)
Assigned to Medtronic, Inc., Minneapolis, MN (US)
Filed by Medtronic, Inc., Minneapolis, MN (US)
Filed on Nov. 22, 2021, as Appl. No. 17/533,005.
Application 17/533,005 is a continuation in part of application No. 16/901,110, filed on Jun. 15, 2020, granted, now 11,607,550.
Claims priority of provisional application 62/866,037, filed on Jun. 25, 2019.
Prior Publication US 2022/0080210 A1, Mar. 17, 2022
Int. Cl. A61N 1/37 (2006.01); A61N 1/372 (2006.01)
CPC A61N 1/3706 (2013.01) [A61N 1/37247 (2013.01); A61N 1/37282 (2013.01)] 17 Claims
OG exemplary drawing
 
1. A medical device system, comprising:
a memory configured to store at least a first capture detection morphology template corresponding to a first type of cardiac pacing capture that includes capture of a first portion of a His-Purkinje system; and
a processing circuit configured to:
receive a cardiac electrical signal;
determine a first plurality of morphology matching scores from the cardiac signal and the first capture detection morphology template; and
establish a first match threshold based on at least the first plurality of morphology matching scores by:
determining the first plurality of morphology matching scores from the cardiac signal associated with pacing pulse delivery at each of a plurality of different pacing pulse outputs;
determining a frequency distribution of the first plurality of morphology matching scores; and
establishing the first match threshold based on the frequency distribution of the first plurality of morphology matching scores;
determine a first morphology matching score from the cardiac electrical signal and the first capture detection morphology template;
determine that the first morphology matching score is less than the first match threshold;
detect a second type of cardiac pacing capture in response to the first morphology matching score being less than the first match threshold, the second type of cardiac pacing capture being different than the first type of cardiac pacing capture; and
select a pacing pulse output in response to detecting the second type of cardiac pacing capture; and
a therapy delivery circuit configured to generate pacing pulses according to the pacing pulse output selected by the processing circuit.