US 2010/0076513 A1 · Multiple Electrode Vectors for Implantable Cardiac Treatment Devices

Abstract

The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity.

Claims17

Dependent claims

A method of cardiac signal analysis in an implantable medical device comprising a canister and a lead system, the implantable medical device including at least first, second and third electrodes, and being configured such that one or more pairs of electrodes can be selected for use in cardiac signal sensing, the method comprising:

selecting and using a default sensing vector defined between a selected pair of electrodes to monitor a patient's cardiac rhythm;
analyzing, monitoring and, if necessary, treating the patient's cardiac rhythm by:
a) detecting electrical events using the selected default sensing vector
b) determining whether detected events appear to be cardiac beats by performing beat validation of the detected events;
c) using those events that appear to be cardiac beats to identify whether the patient is experiencing a malignant cardiac rhythm;
and
d) if a malignant cardiac rhythm is identified, delivering electrical stimulus to the patient;
if detected events consistently fail to pass beat validation, determining the default sensing vector is unsuitable for cardiac signal analysis;
and
in response to determining that the default sensing vector is unsuitable, selecting a different default sensing vector.

7 more elements

An implantable cardiac therapy system (ICTS) comprising:

a canister housing operational circuitry for the system, the operational circuitry configured to receive and analyze cardiac signals of a patient and, when indicated by sensed conditions, to provide therapeutic energy for the patient, the housing comprising at least one electrode disposed thereon;
and
a lead electrode assembly coupled to the canister with at least first and second lead electrodes disposed thereon and electrically coupled to operational circuitry;
wherein the operational circuitry is configured to perform a method comprising:
selecting and using a default sensing vector defined between a selected pair of electrodes to monitor a patient's cardiac rhythm;
analyzing, monitoring and, if necessary, treating the patient's cardiac rhythm by:
a) detecting electrical events using the selected default sensing vector
b) determining whether detected events appear to be cardiac beats by performing beat validation of the detected events;
c) using those events that appear to be cardiac beats to identify whether the patient is experiencing a malignant cardiac rhythm;
and
d) if a malignant cardiac rhythm is identified, delivering electrical stimulus to the patient;
if detected events consistently fail to pass beat validation, determining the default sensing vector is unsuitable for cardiac signal analysis;
and
in response to determining that the default sensing vector is unsuitable, selecting a different default sensing vector.

11 more elements

An implantable cardiac therapy system (ICTS) comprising:

a plurality of implantable electrodes configured for tissue interfacing to capture electrical signals;
operational circuitry configured to receive and analyze cardiac signals of a patient from the implantable electrodes, the operational circuitry further configured to provide electrical stimulus therapy to the patient when indicated;
and
a housing for containing the operational circuitry for implantation in a patient;
wherein the operational circuitry is configured to perform a method comprising:
selecting and using a default sensing vector defined between a selected pair of electrodes to monitor a patient's cardiac rhythm;
analyzing, monitoring and, if necessary, treating the patient's cardiac rhythm by:
a) detecting electrical events using the selected default sensing vector
b) determining whether detected events appear to be cardiac beats by performing beat validation of the detected events;
c) using those events that appear to be cardiac beats to identify whether the patient is experiencing a malignant cardiac rhythm;
and
d) if a malignant cardiac rhythm is identified, delivering electrical stimulus to the patient;
if detected events consistently fail to pass beat validation, determining the default sensing vector is unsuitable for cardiac signal analysis;
and
in response to determining that the default sensing vector is unsuitable, selecting a different default sensing vector.

12 more elements

Dependencies are inferred from the claim text.

Multiple Electrode Vectors for Implantable Cardiac Treatment Devices

Life of this patent

Multiple Electrode Vectors for Implantable Cardiac Treatment Devices

Life of this patent

Abstract

Claims17