초록

An implantable cardiac stimulation device is equipped to differentiate fusion beats, intrinsic activity, and evoked responses. The device optionally responds to improve cardiac activity.

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1. A method for operating an implantable stimulation device, comprising:obtaining information related to at least one of cardiac depolarization or cardiac contraction using at least one sensor;processing the information using a module to provide a value;comparing the value with an evoked response pa

1. A method for operating an implantable stimulation device, comprising:obtaining information related to at least one of cardiac depolarization or cardiac contraction using at least one sensor;processing the information using a module to provide a value;comparing the value with an evoked response parameter and a loss of capture parameter using a microcontroller; andimplementing a technique in response to the comparing using the stimulation device wherein the technique comprises at least one of capture techniques or fusion avoidance techniques.2. The method of claim 1, wherein the processing comprises a process selected from the group consisting of integrating using an integration module and deriving using a derivation module.3. The method of claim 1, wherein the evoked response parameter and the loss of capture parameter comprise statistical parameters.4. The method of claim 3, wherein the statistical parameters comprise parameters based on historic information related to at least one of cardiac depolarization and cardiac contraction.5. The method of claim 1, wherein the at least one parameter corresponds to a probability.6. One or more computer-readable media having computer-readable instructions thereon which, when executed by a programmable stimulation device cause the stimulation device to execute the method of claim 1.7. A method for operating an implantable stimulation device, the method comprising:stimulating heart tissue with stimulation energy;obtaining information related to at least one of cardiac depolarization or cardiac contraction;integrating the information to provide a value;comparing the value with an evoked response parameter and a loss of capture parameter; andimplementing a technique in response to the comparing wherein the technique comprises at least one of capture techniques or fusion avoidance techniques.8. The method of claim 7, wherein the obtaining comprises receiving sensor data from at least one sensor positioned in one of the heart and proximal to the heart.9. The method of claim 7, wherein the integrating comprises integration of at least one of voltage and current information over a time interval.10. The method of claim 7, wherein the evoked response parameter and the loss of capture parameter comprise statistical parameters.11. The method of claim 10, wherein the statistical parameters are based on historic information related to cardiac depolarization.12. The method of claim 7, further comprising storing the value.13. The method of claim 12, further comprising repeating the obtaining, the integrating and the storing to store a plurality of values.14. The method of claim 13, further comprising determining a statistical parameter of the plurality of values.15. The method of claim 7, wherein the evoked response parameter and the loss of capture parameter correspond to probability parameters.16. One or more computer-readable media having computer-readable instructions thereon which, when executed by a programmable stimulation device, cause the stimulation device to execute the method of claim 7.17. A method for operating an implantable stimulation device, the method comprising:stimulating heart tissue with stimulation energy;obtaining information related to at least one of cardiac depolarization or cardiac contraction;integrating the information to provide a value;comparing the value with an evoked response parameter and a loss of capture parameter; andimplementing a fusion avoidance technique if the comparison indicates that fusion occurred.18. The method of claim 17, wherein the evoked response parameter comprises a sample mean of historic integral values minus a product, the product equal to a factor times a calculated deviation corresponding to the sample mean.19. The method of claim 18, wherein the factor comprises a number between approximately 1 and approximately 6.20. The method of claim 17, wherein the evoked response parameter comprises a calculated deviation of historic integral values.21. The method of claim 17, wherein the fusion avoidance technique comprises pulse inhibition.22. The method of claim 17, wherein integrating the information comprises integrating the information starting at cardiac depolarization.23. The method of claim 17, wherein integrating the information comprises integrating the information starting at cardiac depolarization and ending at a baseline potential.24. The method of claim 17, wherein the evoked response parameter corresponds to a probability.25. One or more computer-readable media having computer-readable instructions thereon which, when executed by a programmable stimulation device, cause the stimulation device to execute the method of claim 17.26. A method for operating an implantable stimulation device, comprising:obtaining information related to at least one of cardiac depolarization or cardiac contraction;processing the information to provide at least one value, the at least one value comprising a value selected from the group consisting of integral values and derivative values;repeating the obtaining and the processing to provide a plurality of values;determining an evoked response parameter and a loss of capture parameter from the plurality of values, the evoked response parameter and the loss of capture parameter comprising statistics;obtaining additional information related to at least one of cardiac depolarization and cardiac contraction;processing the additional information to provide at least one additional value;comparing the at least one additional value to the evoked response parameter and the loss of capture parameter;implementing a technique in response to the comparing wherein the technique comprises at least one of capture techniques and fusion avoidance techniques.27. A cardiac stimulation device comprising:a sensor that is operative to obtain information related to at least one of cardiac depolarization or cardiac contraction; anda processor operably coupled to the sensor, the processor being configured to determine a value from the information, the value comprising at least one of an integral value and a derivative value, and being configured to determine a fusion parameter and a loss of capture parameter from the information, the fusion parameter and the loss of capture parameter comprising statistics.28. The device of claim 27, wherein the parameter corresponds to a probability.29. The device of claim 27, wherein the processor is configured to compare the value and the parameter.30. The device of claim 27, wherein the processor is configured to implement a technique, the technique selected from the group consisting of fusion avoidance techniques and capture techniques.31. An implantable cardiac stimulation device, comprising:means for obtaining information related to at least one of cardiac depolarization or cardiac contraction; andmeans for determining a value from the information, the value comprising at least one of an integral value and a derivative value, and determining a fusion parameter and a loss of capture parameter from the information, the fusion parameter and the loss of capture parameter comprising statistics.32. The device of claim 31, wherein the parameter corresponds to a probability.33. The device of claim 31, further comprising means for comparing the value and the fusion parameter and the loss of capture parameter.