Method for collection of biventricular histograms

Abstract

A method for operating a cardiac pacemaker in which paces and senses are counted during each cardiac cycle and associated with an R-R interval or other interval defining a cardiac cycle. An event frequency for each sense and pace is calculated which can be displayed as a histogram. The method is particularly suited for calculating such frequencies in resynchronization pacing modes.

1. A method for operating a cardiac pacemaker in resynchronization pacing mode, comprising:
 sensing rate and synchronized heart chambers through separate channels and generating sense signals upon detection of depolarization occurring in a chamber;  
 pacing the rate chamber in accordance with bradycardia pacing mode based upon rate chamber senses and paces;  
 pacing the synchronized chamber in accordance with a resynchronization pacing mode;  
 measuring a rate chamber event interval for each cardiac cycle, wherein the interval is the time between the chamber senses and paces that define a cardiac cycle;  
 counting the number of senses and paces occurring in each rate and synchronized chamber for a specified period of time and assigning each counted sense or pace to an interval bin representing the rate chamber event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each chamber;  
 calculating an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber.  
 
     
     
       2. The method of  claim 1  wherein the rate and synchronized chambers are the right and left ventricles, respectively, and the rate chamber event interval is an R-R interval. 
     
     
       3. The method of  claim 2  wherein the R-R interval is measured with respect to right ventricular senses and paces. 
     
     
       4. The method of  claim 1  wherein the rate and synchronized chambers are the right and left atria, respectively. 
     
     
       5. The method of  claim 1  further comprising sensing and pacing the synchronized chamber through one or more additional synchronized channels and wherein the event frequency for the senses and paces in each interval bin over the specified period of time is calculated by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber, where only one synchronized chamber pace is counted per cardiac cycle if one or more occurs. 
     
     
       6. A cardiac rhythm management device, comprising:
 sensing channels for sensing depolarizations in a pair of heart chambers and generating sense signals in accordance therewith;  
 right and left pacing channels for delivering paces to the right and left chambers, wherein one chamber is designated as the synchronized chamber and the other chamber as the rate chamber;  
 a controller for controlling the delivery of paces to the rate chamber in accordance with a bradycardia pacing mode and to pace the synchronized chamber in accordance with a resynchronization pacing mode;  
 wherein the controller is programmed to measure a rate chamber event interval for each cardiac cycle, wherein the interval is the time between rate chamber senses and paces that define a cardiac cycle, and to count the number of senses and paces occurring in each rate and synchronized chamber for a specified period of time and assign each counted sense or pace to an interval bin representing the rate chamber event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each chamber; and,  
 wherein the controller is programmed to calculate an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber.  
 
     
     
       7. The device of  claim 6  wherein the rate and synchronized chambers are the right and left ventricles, respectively, and the rate chamber event interval is an R-R interval. 
     
     
       8. The device of  claim 7  wherein the controller is programmed to measure the R-R interval with respect to right ventricular senses and paces. 
     
     
       9. The device of  claim 6  wherein the rate and synchronized chambers are the right and left atria, respectively. 
     
     
       10. The device of  claim 6  further comprising one or more additional synchronized channels and wherein the controller is programmed to calculate the event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber, where only one synchronized chamber pace is counted per cardiac cycle if one or more occurs. 
     
     
       11. The device of  claim 6  further comprising a telemetry interface and wherein the controller is programmed to transmit the event frequencies for senses and paces in each interval bin as a percentage of cardiac cycles to an external programmer. 
     
     
       12. A cardiac rhythm management system, comprising:
 an external programmer;  
 a pacemaker having sensing channels for sensing depolarizations in a pair of heart chambers and generating sense signals in accordance therewith, right and left pacing channels for delivering paces to the right and left chambers, wherein one chamber is designated as the synchronized chamber and the other chamber as the rate chamber, a controller for controlling the delivery of paces to the rate chamber in accordance with a bradycardia pacing mode and to pace the synchronized chamber in accordance with a resynchronization pacing mode, and a telemetry interface for transmitting data to the external programmer;  
 wherein the pacemaker controller is programmed to measure a rate chamber event interval for each cardiac cycle, wherein the interval is the time between rate chamber senses and paces that define a cardiac cycle, and to count the number of senses and paces occurring in each rate and synchronized chamber for a specified period of time and assign each counted sense or pace to an interval bin representing the rate chamber event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each chamber;  
 wherein the controller is programmed to transmit the counts in each interval bin to an external programmer; and,  
 wherein the external programmer is configured to calculate an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber.  
 
     
     
       13. The system of  claim 12  wherein the rate and synchronized chambers are the right and left ventricles, respectively, and the rate chamber event interval is an R-R interval. 
     
     
       14. The system of  claim 13  wherein the controller is programmed to measure the R-R interval with respect to right ventricular senses and paces. 
     
     
       15. The system of  claim 12  wherein the rate and synchronized chambers are the right and left atria, respectively. 
     
     
       16. The device of  claim 12  further comprising one or more additional synchronized channels and wherein the external programmer is configured to calculate the event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber, where only one synchronized chamber pace is counted per cardiac cycle if one or more occurs. 
     
     
       17. A method for operating a cardiac pacemaker in a resynchronization pacing mode, comprising:
   sensing a rate chamber and generating sense signals upon detection of depolarization occurring in the chamber;        pacing the rate chamber in accordance with a bradycardia pacing mode based upon rate chamber senses and paces;        pacing a synchronized chamber in accordance with a resynchronization pacing mode;        measuring a rate chamber event interval for each cardiac cycle, wherein the interval is the time between rate chamber senses and paces that define a cardiac cycle; and,        counting the number of paces occurring in each rate and synchronized chamber and the number of rate chamber senses for a specified period of time and assigning each counted sense or pace to an interval bin representing the rate chamber event interval for that cardiac cycle so that each interval bin contains a rate chamber sense count and a pace count for each chamber.      
     
     
       18. The method of  claim 17  further comprising calculating an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber.  
     
     
       19. A cardiac rhythm management device, comprising:
   a sensing channel for sensing depolarizations in a rate heart chamber and generating sense signals in accordance therewith;        right and left pacing channels for delivering paces to the right and left chambers, wherein one chamber is designated as the synchronized chamber and the other chamber as the rate chamber;        a controller for controlling the delivery of paces to the rate chamber in accordance with a bradycardia pacing mode and to pace the synchronized chamber in accordance with a resynchronization pacing mode; and        wherein the controller is programmed to measure a rate chamber event interval for each cardiac cycle, wherein the interval is the time between rate chamber senses and paces that define a cardiac cycle, and to count the number of rate chamber senses and the number of paces occurring in each rate and synchronized chamber for a specified period of time and assign each counted sense or pace to an interval bin representing the rate chamber event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each chamber.      
     
     
       20. The device of  claim 19  wherein the controller is programmed to calculate an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber.  
     
     
       21. A cardiac rhythm management system, comprising:
   an external programmer;        a pacemaker having a sensing channel for sensing depolarizations in a rate heart chamber and generating sense signals in accordance therewith, right and left pacing channels for delivering paces to the right and left chambers, wherein one chamber is designated as the synchronized chamber and the other chamber as the rate chamber, a controller for controlling the delivery of paces to the rate chamber in accordance with a bradycardia pacing mode and to pace the synchronized chamber in accordance with a resynchronization pacing mode, and a telemetry interface for transmitting data to the external programmer;        wherein the pacemaker controller is programmed to measure a rate chamber event interval for each cardiac cycle, wherein the interval is the time between rate chamber senses and paces that define a cardiac cycle, and to count the number of rate chamber senses and the number of paces occurring in each rate and synchronized chamber for a specified period of time and assign each counted sense or pace to an interval bin representing the rate chamber event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each chamber; and,        wherein the controller is programmed to transmit the counts in each interval bin to an external programmer.      
     
     
       22. The system of  claim 21  wherein the external programmer is configured to calculate an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the rate chamber, the total pace counts for the rate chamber, and the total pace counts for the synchronized chamber only for those cardiac cycles in which no pace was delivered to the rate chamber.  
     
     
       23. A method for operating a cardiac pacemaker, comprising:
   sensing a first ventricle and generating sense signals upon detection of depolarization occurring in the first ventricle;        pacing the first ventricle and a second ventricle contralateral to the first ventricle;        measuring a first ventricle event interval for each cardiac cycle, wherein the interval is the time between first ventricle senses and paces that define a cardiac cycle; and,        counting the number of paces occurring in each of the first and second ventricles and the number of first ventricle senses for a specified period of time and assigning each counted sense or pace to an interval bin representing the first ventricle event interval for that cardiac cycle so that each interval bin contains a first ventricle sense count and a pace count for each chamber.      
     
     
       24. The method of  claim 23  further comprising calculating an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the first ventricle, the total pace counts for the first ventricle, and the total pace counts for the second ventricle only for those cardiac cycles in which no pace was delivered to the first ventricle.  
     
     
       25. The method of  claim 23  wherein the first ventricle is the right ventricle.  
     
     
       26. The method of  claim 23  further comprising:
   sensing the second ventricle and generating sense signals upon detection of depolarization occurring in the second ventricle; and,        counting the number of second ventricle senses for a specified period of time and assigning each counted second ventricle sense to an interval bin representing the first ventricle event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each of the first and second ventricles.      
     
     
       27. A cardiac rhythm management device, comprising:
   a sensing channel for sensing depolarizations in a first ventricle and generating sense signals in accordance therewith;        first and second pacing channels for delivering paces to the first and second ventricles;        a controller for controlling the delivery of paces to the first and second ventricles; and,        wherein the controller is programmed to measure a first ventricle event interval for each cardiac cycle, wherein the interval is the time between first ventricle senses and paces that define a cardiac cycle, and to count the number of first ventricle senses and the number of paces occurring in each of the first and second ventricles for a specified period of time and assign each counted sense or pace to an interval bin representing the first ventricle event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each ventricle.      
     
     
       28. The device of  claim 27  wherein the controller is programmed to calculate an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of total sense counts for the first ventricle, the total pace counts for the first ventricle, and the total pace counts for the second ventricle only for those cardiac cycles in which no pace was delivered to the first ventricle.  
     
     
       29. The device of  claim 27  further comprising:
   a sensing channel for sensing depolarizations in the second ventricle and generating sense signals in accordance therewith; and,        wherein the controller is further programmed to count the number of second ventricle senses occurring in a specified period of time and assign each counted second ventricle sense to an interval bin representing the first ventricle event interval for that cardiac cycle.      
     
     
       30. A cardiac rhythm management system, comprising:
   an external programmer;        a pacemaker having a sensing channel for sensing depolarizations in a first ventricle and generating sense signals in accordance therewith, first and second pacing channels for delivering paces to the first ventricle and a second ventricle contralateral to the first ventricle, a controller for controlling the delivery of paces to the first and second ventricles, and a telemetry interface for transmitting data to the external programmer;        wherein the pacemaker controller is programmed to measure a first ventricle event interval for each cardiac cycle, wherein the interval is the time between first ventricle senses and paces that define a cardiac cycle, and to count the number of first ventricle senses and the number of paces occurring in each of the first and second ventricles for a specified period of time and assign each counted sense or pace to an interval bin representing the first ventricle event interval for that cardiac cycle so that each interval bin contains a sense count and a pace count for each ventricle; and,        wherein the pacemaker controller is programmed to transmit the counts in each interval bin to an external programmer.      
     
     
       31. The system of  claim 30  wherein the external programmer is configured to calculate an event frequency for the senses and paces in each interval bin over the specified period of time by dividing the sense and pace count in each bin by a denominator equal to the sum of the total sense counts for the first ventricle, the total pace counts for the first ventricle, and the total pace counts for the second ventricle only for those cardiac cycles in which no pace was delivered to the first ventricle.  
     
     
       32. The system of  claim 30  wherein the pacemaker includes a sensing channel for sensing depolarizations in the second ventricle and generating sense signals in accordance therewith, and wherein the pacemaker controller is further programmed to count the number of second ventricle senses occurring in a specified period of time and assign each counted second ventricle sense to an interval bin representing the first ventricle event interval for that cardiac cycle.