Methods and systems for determining whether R-wave detections should be classified as false due to T-wave oversensing (TWO) or P-wave oversensing (PWO)

Patent metadata

Field	Value
Publication number	US-12390167-B2
Application number	US-202217723207-A
Country	US
Kind code	B2
Filing date	Apr 18, 2022
Priority date	Jun 22, 2021
Publication date	Aug 19, 2025
Grant date	Aug 19, 2025

Abstract

Described herein are methods, devices and systems for determining whether an R-wave detection should be classified as a false R-wave detection due to T-wave oversensing (TWO) or P-wave oversensing (PWO). One such method includes comparing a specific morphological characteristic (e.g., peak amplitude) associated with the R-wave detection to the specific morphological characteristic associated with each R-wave detection in a first set of earlier detected R-wave detections to thereby determine whether first TWO or PWO morphological criteria are met, and in a second set of earlier detected R-wave detections to thereby determine whether second TWO or PWO morphological criteria are met, wherein the second set differs from the first set but may have some overlap with the first set.

First claim

What is claimed is:

1. A method for use by an implantable medical device (IMD), the method comprising:
sensing a signal indicative of electrical activity of a patient's heart;
detecting R-waves based on comparisons of the signal indicative of electrical activity of the patient's heart, or samples thereof, to an R-wave detection threshold;
detecting an arrhythmic episode based on the R-wave detections;
in response to the arrhythmic episode detection, for each R-wave detection of at least some of the R-wave detections in a window leading up to the arrhythmic episode detection, determining whether the R-wave detection should be classified as a false R-wave detection due to T-wave oversensing (TWO) or P-wave oversensing (PWO) by:
comparing a specific morphological characteristic associated with the R-wave detection to the specific morphological characteristic associated with each R-wave detection in a first set of earlier detected R-wave detections including R-wave detections that were one, two, and three R-wave detections earlier to thereby determine whether first TWO or PWO morphological criteria are met, and in a second set of earlier detected R-wave detections including R-wave detections that were two, three, and four R-wave detections earlier to thereby determine whether second TWO or PWO morphological criteria are met, wherein the second set differs from the first set but has some overlap with the first set; and
classifying the R-wave detection as a false R-wave detection based on whether one of the first or second TWO or PWO morphological criteria being met; and

based on an extent of the R-wave detections classified as being false R-wave detections due to TWO or PWO, performing at least one of: selectively preventing or aborting delivery of therapy by the IMD intended to treat the arrhythmic episode; selectively preventing transmission by the IMD to an external device of data corresponding to the arrhythmic episode that can be used for diagnostic purposes; or selectively adjusting at least one parameter of the R-wave detection threshold that can be used by the IMD for detecting further R-waves and thereby detecting a further arrhythmic episode.

2. The method of claim 1 , wherein:
the specific morphological characteristic comprises a peak amplitude (A);
the first TWO or PWO morphological criteria are met when a peak amplitude A (n) associated with the R-wave detection is at least a specified extent lower than a peak amplitude A (n−1) associated with the R-wave detection that was one R-wave detection earlier, is not at least the specified extent lower than a peak amplitude A (n−2) associated with the R-wave detection that was two R-wave detections earlier, and is at least the specified extent lower than a peak amplitude A (n−3) associated with the R-wave detection that was three R-wave detections earlier; and
the second TWO or PWO morphological criteria are met when the peak amplitude A (n) associated with the R-wave detection is at least the specified extent lower than the peak amplitude A (n−2) associated with the R-wave detection that was two R-wave detections earlier, is not at least the specified extent lower than the peak amplitude A (n−3) associated with the R-wave detection that was three R-wave detections earlier, and is at least the specified extent lower than a peak amplitude A (n−4) associated with the R-wave detection that was four R-wave detections earlier.

3. The method of claim 1 , wherein:
the specific morphological characteristic comprises an area under the curve (AUC);
the first TWO or PWO morphological criteria are met when an AUC (n) associated with the R-wave detection is at least a specified extent less than an AUC (n−1) associated with the R-wave detection that was one R-wave detection earlier, is not at least the specified extent less than an AUC (n−2) associated with the R-wave detection that was two R-wave detections earlier, and is at least the specified extent less than an AUC (n−3) associated with the R-wave detection that was three R-wave detections earlier; and
the second TWO or PWO morphological criteria are met when the AUC (n) associated with the R-wave detection is at least the specified extent less than the AUC (n−2) associated with the R-wave detection that was two R-wave detections earlier, is not at least the specified extent less than the AUC (n−3) associated with the R-wave detection that was three R-wave detections earlier, and is at least the specified extent less than an AUC (n−4) associated with the R-wave detection that was four R-wave detections earlier.

4. The method of claim 1 , wherein:
the specific morphological characteristic comprises a width (W);
the first TWO or PWO morphological criteria are met when a width W (n) associated with the R-wave detection is at least a specified extent longer than a width W (n−1) associated with the R-wave detection that was one R-wave detection earlier, is not at least the specified extent longer than a width W (n−2) associated with the R-wave detection that was two R-wave detections earlier, and is at least the specified extent longer than a width W (n−3) associated with the R-wave detection that was three R-wave detections earlier;
the second TWO or PWO morphological criteria are met when the width W (n) associated with the R-wave detection is at least the specified extent longer than the width W (n−2) associated with the R-wave detection that was two R-wave detections earlier, is not at least the specified extent longer than the width W (n−3) associated with the R-wave detection that was three R-wave detections earlier, and is at least the specified extent longer than a width W (n−4) associated with the R-wave detection that was four R-wave detections earlier; and
each said width can be a measure of a full width at a crossing of the R-wave detection threshold, a full width at half maximum (FWHM), or a half width at half maximum (HWHM) associated with respective R-wave detections.

5. The method of claim 1 , wherein:
the specific morphological characteristic comprises a maximum slope (MS);
the first TWO or PWO morphological criteria are met when a MS (n) associated with the R-wave detection is at least a specified extent less than an MS (n−1) associated with the R-wave detection that was one R-wave detection earlier, is not at least the specified extent less than an MS (n−2) associated with the R-wave detection that was two R-wave detections earlier, and is at least the specified extent less than an MS (n−3) associated with the R-wave detection that was three R-wave detections earlier; and
the second TWO or PWO morphological criteria are met when the MS (n) associated with the R-wave detection is at least the specified extent less than the MS (n−2) associated with the R-wave detection that was two R-wave detections earlier, is not at least the specified extent less than the MS (n−3) associated with the R-wave detection that was three R-wave detections earlier, and is at least the specified extent less than an MS (n−4) associated with the R-wave detection that was four R-wave detections earlier.

6. The method of claim 1 , further comprising:
comparing an R-R interval duration associated with the R-wave detection to an R-R interval duration associated with each R-wave detection in a third set of earlier detected R-wave detections to thereby determine whether first TWO or PWO temporal criteria are met, and in a fourth set of earlier detected R-wave detections to thereby determine whether second TWO or PWO temporal criteria are met, wherein the fourth set differs from the third set but has some overlap with the third set; and
classifying the R-wave detection as a false R-wave detection, is also based on one of the first or the second TWO or PWO temporal criteria are met.

7. The

Assignees

• Pacesetter Inc

Inventors

• Badie Nima
• Li Wenwen
• Qu Fujian
• Gill Jong

Classifications

• A61B5/349

  Detecting specific parameters of the electrocardiograph cycle · CPC title

• A61B5/686

  Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence) · CPC title

• A61B5/352 Primary

  Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval · CPC title

• A61B5/353

  Detecting P-waves · CPC title

• A61B5/355

  Detecting T-waves · CPC title