Dual-chamber pacemaker system for simultaneous bi-chamber pacing and sensing

A method of pacing opposing chambers of a heart with a pacing system, the pacing system comprising a first bipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second bipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second bipolar medical electrical leads, the implantable pulse generator further comprising an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode, the method comprising:

• determining a primary electrode configuration;
• selecting a cathode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
• selecting an anode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
• and
• delivering a first pulse between the cathode and the anode.

A method of pacing opposing chambers of a heart with a pacing system, the pacing system comprising a first unipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second unipolar medical electrical leads, the implantable pulse generator further comprising an hermetically sealed housing capable of serving as a can electrode, the method comprising:

• determining a primary electrode configuration;
• selecting a cathode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
• selecting an anode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
• and
• delivering a first pulse between the cathode and the anode.

An implantable medical device, comprising:

• an implantable pulse generator within a housing, the housing operatively adapted to serve as a can electrode;
• a first unipolar medical electrical lead operably connected to the implantable pulse generator, the first unipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart;
• a second unipolar medical electrical lead operably connected to the implantable pulse generator, the second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart,
• selecting means for selecting at least one of the first electrode, the second electrode and the can electrode;
• wherein a primary electrode configuration is determined and a cathode is selected with the selecting means, an anode is selected with the selecting means and a pulse is delivered between the cathode and the anode.

An implantable medical system, comprising:

• a pulse generator;
• a first unipolar medical electrical lead operably connected to the pulse generator, the first unipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart;
• a second unipolar medical electrical lead operably connected to the pulse generator, the second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, and
• selecting means for selecting at least one of the first electrode, the second electrode and the can electrode, wherein a primary electrode configuration is determined and a cathode is selected with the selecting means, an anode is selected with the selecting means and a pulse is delivered by the pulse generator between the cathode and the anode.

A computer usable medium including a program for opposing chambers of a heart with a pacing system, the pacing system comprising a first unipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second unipolar medical electrical leads, the implantable pulse generator further comprising an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode, the program comprising:

• computer program code that determining a primary electrode configuration;
• computer program code that selecting a cathode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
• computer program code that selecting an anode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
• and
• computer program code that delivering a first pulse between the cathode and the anode.