Method and device for verifying atrial activity oversensing consistency on his sensing channel

Abstract

Methods and systems are provided herein and include an HIS electrode configured to be located proximate to a HIS bundle and to at least partially define a HIS sensing channel. The system includes memory to store cardiac activity (CA) signals obtained over the HIS sensing channel, the memory to store program instructions; and one or more processors that, when executing the program instructions, are configured for utilizing an atrial oversensing (AO) process to analyze the CA signals, obtained over the HIS sensing channel during an AO avoidance (AOA) window, for an atrial activity (AA) component to identify AA beats. The system applies a consistency criteria to the AA beats to determine a number of the AA beats that are indicative of consistent AO. Based on the consistency criteria and the number of AA beats indicative of consistent AO, the system performs at least one of adjusting an AO parameter utilized by the AO process or disabling the AO process and manages HIS bundle pacing based on a ventricular event.

What is claimed is: 
     
         1 . A system, comprising:
 a HIS electrode configured to be located proximate to a HIS bundle and to at least partially define a HIS sensing channel;   memory to store cardiac activity (CA) signals obtained over the HIS sensing channel, the memory to store program instructions; and   one or more processors that, when executing the program instructions, are configured for:
 utilizing an atrial oversensing (AO) process to analyze the CA signals, obtained over the HIS sensing channel during an AO avoidance (AOA) window, for an atrial activity (AA) component to identify AA beats; 
 applying a consistency criteria to the AA beats to determine a number of the AA beats that are indicative of consistent AO; 
 based on the consistency criteria and the number of AA beats indicative of consistent AO, performing at least one of adjusting an AO parameter utilized by the AO process or disabling the AO process; and 
 managing HIS bundle pacing based on a ventricular event. 
   
     
     
         2 . The system of  claim 1 , wherein the one or more processors are further configured to determine, for at least a portion of the AA beats, an interval between a paced or sensed atrial (A) event and a characteristic of interest (COI) within the AA component (A/AA interval) of the corresponding AA beat, the applying the consistency criteria including identifying a subset of the AA beats, for which the A/AA interval is within a first connection criteria. 
     
     
         3 . The system of  claim 1 , wherein the one or more processors are further configured to determine, for at least a portion of the AA beats, a peak of the AA component (AA peak) of the corresponding AA beat, the applying the consistency criteria including identifying a subset of the AA beats, for which the AA peak is within a second connection criteria. 
     
     
         4 . The system of  claim 1 , wherein the one or more processors are further configured to identify first and second subsets of the AA beats, for which first and second characteristics of interest (COI) of the AA components fall within the corresponding first and second limits; and determining whether a number of beats in the first and second subsets of the AA beats is indicative of consistent AO. 
     
     
         5 . The system of  claim 4 , wherein the consistency criteria correspond to limits about first and second median values for corresponding first and second COI, the one or more processors further configured to utilize the consistency criteria to distinguish between candidate AA beats and outlier AA beats. 
     
     
         6 . The system of  claim 1 , wherein the one or more processors are further configured to adjust an AO parameter utilized by the AO process when the number of AA beats indicative of AO exceed a threshold, the AO parameter representing at least one of i) a start time for the AOA window, a duration for the AOA window, or an AO sensitivity profile utilized to analyze the CA signals over the HIS sensing channel during the AOA window. 
     
     
         7 . The system of  claim 1 , wherein the one or more processors are further configured to disable the AO process when the number of AA beats indicative of AO fall below a threshold. 
     
     
         8 . The system of  claim 1 , wherein the one or more processors are further configured to manage the HIS pacing by lowering a sensitivity level of a ventricular event (VE) sensitivity profile for the HIS sensing channel. 
     
     
         9 . The system of  claim 1 , wherein the one or more processors are further configured to maintain a count of a number of AA components over a series of beats and, based on the count, determine whether to maintain or change current settings for the length of the AOA window and/or sensitivity profile. 
     
     
         10 . The system of  claim 1 , wherein the AOA window represents a time window enclosing atrial component activity components. 
     
     
         11 . A method for pacing a HIS bundle of a patient heart using an implantable medical device (IMD), the method comprising:
 obtaining cardiac activity (CA) signals over a HIS sensing channel, the HIS sensing channel utilizing a HIS electrode;   utilizing an atrial oversensing (AO) process to analyze the CA signals, obtained over the HIS sensing channel during an AO avoidance (AOA) window, for an atrial activity (AA) component to identify AA beats;   applying a consistency criteria to the AA beats to determine a number of the AA beats that are indicative of consistent AO;   based on the consistency criteria and the number of AA beats indicative of consistent AO, performing at least one of adjusting an AO parameter utilized by the AO process or disabling the AO process; and   managing HIS bundle pacing based on a ventricular event.   
     
     
         12 . The method of  claim 11 , further comprising determining, for at least a portion of the AA beats, an interval between a paced or sensed atrial (A) event and a characteristic of interest (COI) within the AA component (A/AA interval) of the corresponding AA beat, the applying the consistency criteria including identifying a subset of the AA beats, for which the A/AA interval is within a first connection criteria. 
     
     
         13 . The method of  claim 12 , further comprising determining, for at least a portion of the AA beats, a peak of the AA component (AA peak) of the corresponding AA beat, the applying the consistency criteria including identifying a subset of the AA beats, for which the AA peak is within a second connection criteria. 
     
     
         14 . The method of  claim 11 , wherein the applying the consistency criteria further comprises identifying first and second subsets of the AA beats, for which first and second characteristics of interest (COI) of the AA components fall within the corresponding first and second limits; and determining whether a number of beats in the first and second subsets of the AA beats is indicative of consistent AO. 
     
     
         15 . The method of  claim 14 , wherein the consistency criteria correspond to limits about first and second median values for corresponding first and second COI, the method further comprising utilizing the consistency criteria to distinguish between candidate AA beats and outlier AA beats. 
     
     
         16 . The method of  claim 11 , wherein the performing includes adjusting an AO parameter utilized by the AO process when the number of AA beats indicative of AO exceed a threshold, the AO parameter representing at least one of i) a start time for the AOA window, a duration for the AOA window, or an AO sensitivity profile utilized to analyze the CA signals over the HIS sensing channel during the AOA window. 
     
     
         17 . The method of  claim 11 , wherein the performing includes disabling the AO process when the number of AA beats indicative of AO fall below a threshold. 
     
     
         18 . The method of  claim 11 , wherein the managing the HIS pacing includes lowering a sensitivity level of a ventricular event (VE) sensitivity profile for the HIS sensing channel. 
     
     
         19 . The method of  claim 11 , further comprising maintaining a count of a number of AA components over a series of beats and, based on the count, determining whether to maintain or change current settings for the length of the AOA window and/or sensitivity profile. 
     
     
         20 . The method of  claim 11 , wherein the AOA window represents a time window enclosing atrial component activity components.