Detection of lead electrode dislodgement using cavitary electrogram
AssigneeLambda Nu Technology LLC
InventorCharles Swerdlow
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Abstract
Methods and systems for identifying dislodgement of an electrode, operably coupled to an implanted medical device, from fixation with the endocardium of a chamber of the heart of a patient can include obtaining a test electrogram, and measuring at least two parameters indicating a cavitary electrogram and taking an action, such as generating an electrode dislodgement alert and/or configuring the implanted medical device to disable therapy, when the cavitary electrogram is indicated. In embodiments, the two parameters include a test positive component magnitude and a test negative component magnitude. In embodiments, the test component magnitudes are compared to baseline component magnitudes determined from a baseline electrogram.
Claims29
A method of identifying dislodgement of a lead from fixation with the endocardium of a chamber of the heart of a patient, the lead having an electrode being positioned proximate a distal tip of a lead that is configured for fixation with the endocardium of the chamber of the heart of the patient at implant of an implanted medical device, the electrode being operably coupled proximate a proximal end of the lead to an implanted medical device, the method comprising:
- obtaining a test electrogram for the electrode;
- using a processor to:
- determine at least two parameters of the test electrogram indicative of fixation of the electrode with the endocardium, wherein the at least two parameters include:
- a test positive component magnitude based on an absolute magnitude of a greatest positive component of the test electrogram, and
- a test negative component magnitude based on an absolute magnitude of a greatest negative component of the test electrogram;
- and
- determine whether a cavitary electrogram indicative of the test electrogram sensing electrical activity from the electrode proximate the distal tip of the lead being free within the cavity of the chamber of the heart and not in fixation with the endocardium is indicated based on the at least two parameters, wherein the cavitary electrogram is indicated based on comparison of the test positive component magnitude and the test negative component magnitude;
- and
- performing at least one action when the cavitary electrogram is indicated, wherein the at least one action is selected from the group consisting of:
- generating an electrode dislodgement alert, and/or configuring the implanted medical device to disable therapy.
A method of identifying dislodgement of a lead from fixation with the endocardium of a chamber of the heart of a patient, the lead having an electrode being positioned proximate a distal tip of a lead that is configured for fixation with the endocardium of the chamber of the heart of the patient at implant of an implanted medical device, the electrode being operably coupled proximate a proximal end of the lead to an implanted medical device, the method comprising:
- obtaining a test electrogram for the electrode;
- obtaining a baseline electrogram at a time before obtaining the test electrogram when the electrode is known to be in fixation with the endocardium;
- using a processor to determine:
- a baseline positive component magnitude based on an absolute magnitude of a greatest positive component of the baseline electrogram, and
- a baseline negative component magnitude on an absolute magnitude of a greatest negative component of the baseline electrogram;
- and
- whether a cavitary electrogram indicative of the test electrogram sensing electrical activity from the electrode proximate the distal tip of the lead being free within the cavity of the chamber of the heart and not in fixation with the endocardium is indicated based on the at least two parameters, wherein the cavitary electrogram is indicated based on comparison of the test electrogram to at least one of the baseline positive component magnitude and the baseline negative component magnitude;
- and
- performing at least one action when the cavitary electrogram is indicated, wherein the at least one action is selected from the group consisting of:
- generating an electrode dislodgement alert, and/or configuring the implanted medical device to disable therapy.
Dependencies are inferred from the claim text.