Abstract: The current invention describes a method and system to measure and validate the efficacy of cardiac resynchronization therapy pacing using electroanatomical position and motion sensing during the various phases of the cardiac cycle. In this method, electroanatomical position and motion sensors are utilized with sensing from the tip of both right ventricular pacing lead and left ventricular pacing lead. An operator can therefore obtain data not currently available to an implanter with current technology. This data includes the physical distance between both leads and the relative motion of both leads during cardiac resynchronization therapy biventricular pacing. If good lead positioning for both the right ventricular lead and left ventricular lead has been obtained, then the operator will be able to demonstrate good synchronization of the cardiac cycle.

Abstract: A method of diagnosing a malfunction of a pacing system includes the steps of receiving a biopotential signal, detecting a pacing system malfunction, detecting a cause of the malfunction, and displaying the detected malfunction and detected cause of the malfunction. A pacing system is also disclosed herein. The system includes an electrode array that receives a biopotential signal associated with the pacing system. A malfunction detector applies a malfunction logic to the biopotential signal to identify a pacing system malfunction and applies a morphology logic to the biopotential signal to identify a morphology of the biopotential signal. An output generator receives an indication of the identified pacing system malfunction and the identified cause of the malfunction and creates an output indicative of the identified pacing system malfunction and the identified cause.

Abstract: A system and method for automatically selecting among a plurality of pacing modes based upon capture detection. Patients suffering from heart failure may be optimally treated with different resynchronization pacing modes or configurations. By detecting whether capture is being achieved by a particular configuration or mode, a device is able to automatically switch to one that is both optimal in treating the patient and is successful in capturing the heart with pacing pulses.

Abstract: Detecting a lead fracture in an active implantable medical device for pacing, resynchronization and/or defibrillation of the heart. This device senses the heart rhythm through an endocardial lead comprising at least one endocardial electrode collecting the depolarization potentials, and detecting the myocardium contractions through an endocardial acceleration sensor. The device detects an incipient or total lead fracture by correlating the signals representative of successive ventricular and/or atrial depolarizations (P, R) with the signals representative of successive acceleration peaks (e.g., PEA I). In the case of a lack of correlation, a signal of suspicion of lead fracture is delivered, notably to generate an alarm signal through recording of markers in a memory of the device readable by an external programmer, RF transmission and/or production of an audible signal.

Abstract: An implantable medical device such as a cardiac pacemaker or implantable cardioverter/defibrillator with the capability of receiving communications in the form of speech spoken by the patient. An acoustic transducer is incorporated within the device which along with associated filtering circuitry enables the voice communication to be used to affect the operation of the device or recorded for later playback.

Abstract: An exemplary method for optimizing pacing configuration includes providing distances between electrodes of a series of three or more ventricular electrodes associated with a ventricle; selecting a ventricular electrode from the series; delivering energy to the ventricle via the selected ventricular electrode, the energy sufficient to cause an evoked response; acquiring signals of cardiac electrical activity associated with the evoked response via non-selected ventricular electrodes of the series; based on signals of cardiac electrical activity acquired via the non-selected ventricular electrodes and the distances, determining conduction velocities; based on the conduction velocities, deciding if the selected ventricular electrode is an optimal electrode for delivery of a cardiac pacing therapy; and, if the selected ventricular electrode comprises an optimal electrode for delivery of the cardiac pacing therapy, calling for delivery of the cardiac pacing therapy using the selected ventricular electrode.

Abstract: An external cardiac medical device for delivering Cardiac Potentiation Therapy (CPT). Techniques used with the device include initial diagnosis of the patient, delivery of the CPT, and configuration of the external device, so that CPT can be effectively and efficiently provided. In particular, these techniques include initially determining whether a patient should receive CPT, how to set the coupling interval for delivering CPT, how to configure the external medical device to deliver CPT stimulation pulses while not adversely affecting the device's ability to sense a patient's cardiac parameters and/or signals.

Abstract: Methods and systems for classifying cardiac responses to pacing stimulation and/or preventing retrograde cardiac conduction are described. Following delivery of a pacing pulse to an atrium of the patient's heart during a cardiac cycle, the system senses in the atrium for a retrograde P-wave. The system classifies the atrial response to the pacing pulse based on detection of the retrograde P-wave. The system may also sense for an atrial evoked response and utilize the atrial evoked response in classifying the cardiac pacing response.

Abstract: Multiple sensing configurations may be qualified based on one induced tachyarrhythmia, e.g., ventricular fibrillation, or other qualification event during an implantation procedure. Each sensing configuration comprises a different combination of two or more electrodes used for sensing electrical signals of the heart of the patient. In some examples, an implantable medical device or other device generates qualification information for each sensing configuration, which may indicate whether the sensing configuration is qualified for subsequent cardiac event detection based on an accuracy of the cardiac event detection for the sensing configuration during the qualification event. One of the qualified configurations may initially be selected as a primary sensing configuration for subsequent cardiac event detection. Switching to an alternate sensing configuration, e.g.

Abstract: The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector.

Abstract: In one embodiment, an external programming device is operable to determine and graphically display power consumption of an implantable medical device (“IMD”). In accordance with this particular embodiment, the external programming device includes a graphical user interface display and a communication interface operable to receive information from an IMD. In this embodiment, the external programming device is operable to receive IMD parameter settings and/or battery parameter values from the IMD, calculate a power consumption rate for the IMD, and then display the power consumption on the graphical user interface display using a graphical visual indicator.

Abstract: Techniques are provided for use by implantable medical devices such as pacemakers or by external systems in communication with such devices. An intracardiac electrogram (IEGM) is sensed within a patient in which the device is implanted using a cardiac signal sensing system. Cardiac events of interest such as arrhythmias, premature atrial contractions (PACs), premature ventricular contractions (PVCs) and pacemaker mediated tachycardias (PMTs) are detected within the patient using event detection systems and then portions of the IEGM representative of the events of interest are recorded in device memory. Subsequently, during an off-line or background analysis, the recorded IEGM data is retrieved and analyzed to identify false detections. In response to false detections, the cardiac signal sensing systems and/or the event detection systems of the implantable device are selectively adjusted or reprogrammed to reduce or eliminate any further false detections, including false-positives or false-negatives.

Abstract: A biventricular cardiac stimulator is disclosed, comprising a right ventricular stimulation unit, a left ventricular stimulation unit, and a pacemaker timer. In order to detect the effect of a particular atrioventricular delay time (AVD) and a particular interventricular delay time (VVD), the cardiac stimulator has a detector for sensing a hemodynamic benefit. To optimize AVD and VVD, the pacemaker timer is connected to a memory for a particular instantaneous value for the atrioventricular delay time (AVDinst) and the interventricular delay time (VVDinst), and may be used to trigger at certain points in time at least one right ventricular trigger signal and one left ventricular trigger signal, based on new values for the atrioventricular delay time (AVDtest) and the interventricular delay time (VVDtest) which differ from the instantaneous values for the atrioventricular delay time (AVDinst) and the interventricular delay time (VVDinst).

Abstract: Techniques for activating an alternative operating mode in an implantable medical device based on a determination that the device is within a relatively high noise environment or otherwise exposed to relatively high noise. The implantable medical device can automatically detect its presence in a high noise environment and automatically revert to the alternative operating mode, the device may be manually switched to alternative operating mode, or a hybrid manual/automatic approach may be used to switch the device to alternative operating mode.

Abstract: A method and apparatus for tracking and illustrating the location of leads positioned within the volume is disclosed. For example, the lead electrodes can be positioned within a heart of a patient that can be tracked over time. The lead electrodes can be tracked with an electrode potential or bioimpedance tracking system to determine the position of the lead electrodes. A method and apparatus is disclosed to analyze the position information for analyzing the selected position of the lead electrodes.

Abstract: A leadless cardiac pacemaker comprises a housing, a plurality of electrodes coupled to an outer surface of the housing, and a pulse delivery system hermetically contained with the housing and electrically coupled to the electrode plurality, the pulse delivery system configured for sourcing energy internal to the housing, generating and delivering electrical pulses to the electrode plurality. The pacemaker further comprises an activity sensor hermetically contained within the housing and adapted to sense activity and a processor hermetically contained within the housing and communicatively coupled to the pulse delivery system, the activity sensor, and the electrode plurality, the processor configured to control electrical pulse delivery at least partly based on the sensed activity.

Abstract: Techniques are provided for use by implantable medical devices for determining a preferred or optimal pair of electrodes for delivering biventricular pacing therapy. In one example, the implantable device is equipped with a right ventricular (RV) lead and a multi-pole left ventricular (LV) lead. Briefly, for each of a selected set of RV/LV electrode pairs, electrocardiac parameters are detected within a patient in which the device is implanted, including parameters representative of an intrinsic biventricular electrical separation between LV and RV and parameters representative of a mechanical contraction delay in the LV. An optimal RV/LV electrode pair is then determined for delivering biventricular pacing based on an analysis of the intrinsic biventricular electrical separation and the mechanical contraction delay. Pacing latency, pacing delay from LV to RV, and the maximum slope of an LV evoked response may be used as proxies or surrogates for mechanical contraction delay.

Abstract: A differential or relative measurement between an orthogonal measurement vector and another measurement vector can be used to determine the location where fluid accumulation is occurring or the local change in such fluid accumulation. This can help diagnose or treat infection or hematoma or seroma at a pocket of an implanted cardiac rhythm management device, other implanted medical device, or prosthesis. It can also help diagnose or treat pulmonary edema, pneumonia, pulmonary congestion, pericardial effusion, pericarditis, pleural effusion, hemodilution, or another physiological condition.

Abstract: An implantable signal generator including electronic circuitry, a computer readable medium, and a connector block with a lumen which receives at least one lead. The at least one lead has at least one electrode connector while the lumen of the connector block has a plurality of contacts operably coupled to the electronic circuitry. The computer readable medium contains instructions for carrying out a process to determine at least one piece of information regarding the at least one lead within the lumen based on an electrode connector being electrically connected with the at least one of the plurality of contacts, and an electrode connector not being electrically connected with the at least one of the plurality of contacts.

Abstract: An implantable cardiac device includes a housing (2), pulse generator (7) therein to generate physiologically effective electrical pulses, a shock lead (3), externally of the housing (2), connectable to the pulse generator (7) and implantable into a patient's body to apply physiologically effective electrical pulses to the patient's body, a monitor (8) to automatically detect a lead condition as to whether the shock lead (3) is implanted or not, and control (9), which due to the detected lead condition automatically enables or disables the pulse generator (7).

Abstract: Methods and devices for initializing templates for evoked response detection from pacing stimulation are described. A method of generating templates characterizing a cardiac response to pacing involves determining values associated with signal features for each of a number of sensed cardiac signals following pacing pulses. The median values of the features are used to generate a cardiac response template.

Abstract: Methods of detecting an error associated with an implantable device include powering up the implantable device with an external device, disabling a back-telemetry transmitter within the implanted device after the implanted device is powered up, detecting an error with the implanted device, generating a fault signal corresponding to the error with the implanted device, turning on the back-telemetry transmitter after the fault signal has been generated, and transmitting the fault signal to the external device with the back-telemetry transmitter.

Abstract: An implantable medical device (IMD) automatically determines at least a portion of the parameters and, in some instances all of the parameters, of an exposure operating mode based on stored information regarding sensed physiological events or therapy provided over a predetermined period of time. The IMD may configure itself to operate in accordance with the automatically determined parameters of the exposure operating mode in response to detecting a disruptive energy field. Alternatively, the IMD may provide the automatically determined parameters of the exposure operating mode to a physician as suggested or recommended parameters for the exposure operating mode. In other instances, the automatically determined parameters may be compared to parameters received manually via telemetry and, if differences exist or occur, a physician or patient may be notified and/or the manual parameters may be overridden by the automatically determined parameters.

Abstract: Methods and systems of identifying an electrode or combination of electrodes of a multi-electrode device for pacing include selecting a first electrode or electrode combination as a first candidate; delivering a pacing pulse through the first candidate and determining a measurement based on sensed cardiac electrical activity resulting from the first candidate pacing; selecting a second candidate; delivering a pacing pulse through the second candidate and determining a measurement based on sensed cardiac electrical activity resulting from the second candidate pacing; comparing the measurement for the first and second candidates; and identifying the first or second candidate for pacing based on the comparison. The measurement may be one or more of activation time ?Tact, activation recovery interval (ARI), a fractioned electrogram width, and a standard deviation of a fractioned electrogram feature.

Abstract: The present invention relates to materials and methods for monitoring and predicting a heart failure patient's physiological response to cardiac resynchronization therapy. More specifically, the present invention relates to the endogenous protein galectin-3 and its use in monitoring progression of disease in a patient undergoing cardiac resynchronization therapy, and as a predictor of response to cardiac resynchronization therapy.

Abstract: A monitoring system and method for monitoring signals from an implantable medical device are disclosed. The monitoring system and method include a monitor configured to detect a radio frequency artifact from the signals of the implantable medical device and circuitry for processing the radio frequency artifact from the signals of the implantable medical device.

Abstract: In general, the disclosure describes techniques for detecting lead related conditions, such as lead fractures or other lead integrity issues. As described herein, delivering an electrical signal through selected electrodes may result in, reveal, or amplify noise if a lead related condition is present. A processor may detect electrical noise indicative of the lead related condition subsequent to the delivery of the electrical signal, and identify a lead related condition in response to detecting the noise.

Abstract: A method and apparatus to detect anomalies in the conductors of leads attached to implantable medical devices based on the dynamical electrical changes these anomalies cause. In one embodiment, impedance is measured for weak input signals of different applied frequencies, and a conductor anomaly is detected based on differences in impedance measured at different frequencies. In another embodiment, a transient input signal is applied to the conductor, and an anomaly is identified based on parameters related to the time course of the voltage or current response, which is altered by anomaly-related changes in capacitance and inductance, even if resistance is unchanged. The method may be implemented in the implantable medical device or in a programmer used for testing leads.

Abstract: An exemplary method includes delivering a pacing pulse to a heart, acquiring a cardiac electrogram, comparing the cardiac electrogram to a template and, based on the comparing, deciding if the pacing pulse caused an evoked response. In such a method, the comparing may compare morphology of the cardiac electrogram to the template. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: This document discusses, among other things, systems and methods for automatic electrode integrity management. Interelectrode impedance is measured for various electrode combinations of an implantable cardiac function management device. The impedance data is processed, such as at an external remote server, to determine whether an electrode is failing or has failed, to select an alternate electrode configuration, to alert a physician or patient, to predict a time-to-failure such as by using population data, or to reprogram electrode configuration or other device parameters of the implantable cardiac function management device.

Abstract: A patient's response to therapy such as CRT is assessed by cross correlation of a patient's evoked response and physical activity surrogates. Based on the cross correlation, a determination may be made as to whether or how much the therapy is helping the patient's physical activity. For example, the degree of cross correlation index between IEGM parameters and activity threshold parameters may be used to assess whether the patient's heart condition improves the patient's physical activity. The therapy may then be modified as necessary in the event the patient is not sufficiently responding to the therapy.

Abstract: A method and device for detecting cardiac signals in a medical device that includes decomposing sensed cardiac signals using a wavelet function to form a corresponding wavelet transform, generating a first wavelet representation corresponding to the wavelet transform that is responsive to RR intervals of the sensed cardiac signals, generating a second wavelet representation that is not responsive to RR intervals associated with the sensed cardiac signals, and determining a device failure in response to the first wavelet representation and the second wavelet representation. The method and device may also include decomposing sensed cardiac signals using a wavelet function to form a corresponding wavelet transform, generating a wavelet representation that is not responsive to RR intervals of the sensed cardiac signals, determining RR intervals associated with the sensed cardiac signals, and determining a device failure in response to the first wavelet representation and the determined RR intervals.

Abstract: An implantable cardiac stimulation device recognizes and accommodates fusion beats without compromising autocapture or threshold searches. The device comprises a pulse generator that provides first and second pacing pulses to a chamber of a heart. The first pacing pulses have a normal operating output level and the second pacing pulses have an output level sufficient to assure capture. The device further comprises a fusion beat predicting circuit that predicts when a next paced event of the chamber will likely be a fusion beat and a fusion beat control that causes the pulse generator to provide a second pacing pulse to the chamber in response to the fusion beat predicting circuit predicting that a next paced event will likely be a fusion beat. Thereafter, the fusion beat is confirmed.

Abstract: A system (10) for managing data transmission for a medical device (20) has several data transmission protocols (15, 15?, 15?), each having a differentiating designation (30). Each of several medical devices (20) have an identification (45) which identifies the medical device (20), and a data transmission interface (35) for data transmission from and to the medical device (20). A management unit (25) has a query unit (45) for the designation (30) of the data transmission protocol (15, 15?, 15?) of a medical device (20) on the basis of its identification (30), and a storage unit (50) for storing data transmission protocols (15, 15?, 15?). The management unit (25) provides, on the basis of the designation query of an external device (55), a data transmission protocol (15, 15?, 15?) from the storage unit (50) which is compatible with the data transmission protocol (15, 15?, 15?) of the medical device (20).

Abstract: A medical device and associated method deliver cardiac pacing in a dual chamber pacing mode and schedule an atrial-ventricular (AV) conduction check during the dual chamber pacing mode to detect the presence of AV conduction. If AV conduction is detected during the scheduled AV conduction check, the medical device switches to an atrial pacing mode and switches back to the dual chamber pacing mode in response to an absence of AV conduction during the atrial pacing mode. The detected AV conduction is identified as a false positive detection in response to the pacing mode switch to the dual chamber pacing mode occurring within a predetermined interval of time from detecting the AV conduction.

Abstract: A pacing protocol is provided that reduces or minimizes ventricular pacing in favor of intrinsic conduction. When operating in a mode that provides ventricular pacing, a series of conduction checks are performed to determine if intrinsic conduction has returned. These conduction checks occur according to a predetermined pattern that general includes longer intervals between subsequent attempts. A maximum interval is provided such that conduction checks are not repeated sequentially at the same time of day when at this maximum interval.

Abstract: Systems and methods for determining the coronary sinus vein branch location of a left ventricle electrode are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart including sensing one or more of the electrical events with the electrode and then analyzing the electrical events to determine the electrode's position. The determination of electrode position may be used to automatically adjust operating parameters of a VRT device. Furthermore, the determination of electrode position may be made in real-time during installation of the electrode and a visual indication of the electrode position may be provided on a display screen.

Abstract: Techniques are provided for use by implantable medical devices for controlling ventricular pacing, particularly during atrial fibrillation. In one example, during a V sense test for use in optimizing ventricular pacing, the implantable device determines relative degrees of variation within antecedent and succedent intervals detected between ventricular events sensed on left ventricular (LV) and right ventricular (RV) sensing channels. Preferred or optimal ventricular pacing delays are then determined, in part, based on a comparison of the relative degrees of variation obtained during the V sense test. In another example, during RV and LV pace tests, the device distinguishes QRS complexes arising due to interventricular conduction from QRS complexes arising due to atrioventricular conduction from the atria, so as to permit the determination of correct paced interventricular conduction delays for the patient. The paced interventricular conduction delays are also used to optimize ventricular pacing.

Abstract: An exemplary method includes detecting a first atrial event, initiating a detection window after detecting the first atrial event, detecting a second atrial event during the detection window, classifying the second atrial event as a premature atrial contraction and calling for delivery of an atrial extrastimulus in response to the premature atrial contraction. Various other exemplary technologies are also disclosed.

Abstract: A method for detecting potential failures by a lead of an implantable medical device is provided. The method includes sensing a first signal over a first channel between a first combination of electrodes on the lead and sensing a second signal from a second channel between a second combination of electrodes on the lead. The method determines whether at least one of the first and second signals is representative of a potential failure in the lead and identifies a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure. Optionally, when the first and second sensed signals are both representative of the potential failure, the method further includes determining whether the first and second sensed signals are correlated with one another. When the first and second sensed signals are correlated, the method declares an electrode common to both of the first and second combinations to be associated with the failure.

Abstract: Circuitry for automatically powering on and maintaining activation of a powered down electronic component in a first device in RF communication with a second device, wherein the first and second devices are preferably an implantable medical device and an external control device, respectively. The system including power logic circuitry for generating a power on signal to automatically close a switch and energize an otherwise powered off electronic device when the power induced in the first device by external RF energy transmitted in the RF communication signal exceeds a minimum operating threshold of the power on logic circuitry. The electronic component while powered by the power source generates a hold signal and a second power signal that is transmitted to the power on logic circuitry to sustain power to the electronic component irrespective of interruptions of relatively short duration for less than a predetermined period of time in RF communication.

Abstract: Embodiments of the invention are related to managing noise in sensed signals in implantable medical devices, amongst other things. In an embodiment the invention includes a method for processing electrical signals obtained from a patient including gathering a first set of electrical signals using an implantable medical device, filtering to provide a second set of electrical signals, the second set including frequencies above a threshold frequency, and estimating the amount of noise present in the first set of electrical signals based on the magnitude of the second set. In an embodiment, the invention includes a medical device configured to gather a first set of electrical signals, filter the first set to provide a second set of electrical signals including frequencies above a threshold frequency, and estimate the amount of noise present in the first set based on the magnitude of the second set. Other embodiments are also included herein.

Abstract: An implantable medical system for delivering pacing pulses to HIS bundle of a heart of a patient when implanted in said patient includes a medical lead, which is adapted to be attached with a distal end to tissue of said heart, including a at least two electrodes arranged being electrically separated from each other. The implantable medical device connectable to the medical lead includes a pacing circuit adapted to deliver the pacing pulses to said heart via the medical lead, a selection device connected between the pacing circuit and the electrodes adapted to selectively activate at least one of said electrodes, and a processing device adapted to control the selection device to selectively activate at least one of the electrodes to direct the pacing pulses to the HIS bundle.

Abstract: A method and apparatus implementing the method, which is not dependent on monitoring the electrical impedance of the lead, detects imminent structural failure of an electrical lead in an implanted medical device, such as an implantable cardioverter-defibrillator (ICD) or a pacemaker. The approach is to monitor directly the mechanical load loss of the lead (a measure of the loss of structural integrity of the lead) rather than, as in the prior art, to infer it from the electrical impedance.

Abstract: In general, the invention is directed to a technique for selection of parameter configurations for a neurostimulator using neural networks. The technique may be employed by a programming device to allow a clinician to select parameter configurations, and then program an implantable neurostimulator to deliver therapy using the selected parameter configurations. The parameter configurations may include one or more of a variety of parameters, such as electrode configurations defining electrode combinations and polarities for an electrode set implanted in a patient. The electrode set may be carried by one or more implanted leads that are electrically coupled to the neurostimulator. In operation, the programming device executes a parameter configuration search algorithm to guide the clinician in the selection of parameter configurations. The search algorithm relies on a neural network that identifies potential optimum parameter configurations.

Abstract: An autonomic status indicator representative of a sympathetic/parasympathetic balance of a subject can use atrioventricular (AV) delays measured during recovery from (or in response to) elevated atrial pacing while the subject is at rest.

Abstract: A system comprising an implantable medical device that comprises at least one electrical input to receive sensed electrical activity of a heart of a patient, a memory, and a controller circuit. The controller circuit is coupled to the electrical input and memory and is operable to enter a memory scrubbing mode that increases a rate of detecting and correcting single bit errors in the memory when the controller circuit determines the implantable device is in a high-energy radiation environment.

Abstract: An implantable cardiac stimulation system and method having continuous capture management capabilities are provided. Continuous capture management is realized by continuously monitoring for secondary effects of loss of capture, thereby effectively providing continuous capture management in any heart chamber without encountering the limitations normally associated with evoked response sensing. A pacing threshold search is triggered upon detecting a secondary indicator of loss of capture. Secondary indicators of loss of capture may be lead-related changes, changes related to the occurrence of atrial sensed events, changes related related to the occurrence of ventricular sensed or paced events, and/or changes related to a monitored physiological condition.

Abstract: An implantable medical device system and method detect oversensing of cardiac signals. A cardiac signal including first events and second events is acquired. Cardiac events are sensed in response to the cardiac signal crossing a first threshold. A filtered cardiac signal is determined from the sensed cardiac signal, and a second threshold is determined from the filtered cardiac signal. A sensed cardiac event is classified either as a first event when the sensed cardiac event corresponds to a filtered cardiac signal peak crossing the second threshold or a second event when the sensed cardiac event corresponds to a filtered cardiac signal peak being less than the second threshold. Classification of sensed cardiac events as second events is used in determining oversensing.

Abstract: A method and apparatus for automatically identifying various types of cardiac and non-cardiac oversensing and automatically performing a corrective action to reduce the likelihood of 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. The corrective action may include, for example, adjusting sensing parameters such as blanking periods, decay constants, decay delays, threshold values, sensitivity values, electrode configurations and the like.