Subcutaneous P-Wave Centric Insertable Cardiac Monitor For Long Term Electrocardiographic Monitoring

A P-wave centric subcutaneous insertable cardiac monitor (ICM) for use in performing long term electrocardiographic (ECG) monitoring, comprising:

• an implantable housing comprised of a biocompatible material that is suitable for implantation within a living body;
• at least three ECG sensing electrodes provided on a ventral surface and on opposite ends of the implantable housing with two of the ECG sensing electrodes provided on opposite ends of the implantable housing, each of the ECG sensing electrodes operatively placed to facilitate sensing in closest proximity to the low amplitude, low frequency content cardiac action potentials of P-wave signals that are generated during atrial activation;
• and
• electronic circuitry provided within the implantable housing comprising:
• a low power microcontroller operable to execute under modular micro program control as specified in firmware,
• programmatic selection of at least one pairing of the ECG sensing electrodes to facilitate the sensing of the cardiac action potentials of the P-wave signals based on a patient's physiology,
• an ECG front end circuit interfaced to the microcontroller and configured to specifically capture the cardiac action potentials of the P-wave signals sensed by the pairing of the ECG sensing electrodes, and
• non-volatile memory electrically interfaced with the microcontroller and operable to continuously store samples of the cardiac action potentials of the P-wave signals.