# US 2024/0189604 A1 · Method and system for implanting a septal wall electrode > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2024/0189604 A1 - Document ID: US20240189604A1 - Status: Published application - Kind: A1 - Application number: 18/581,210 - Filed: 2024-02-19 - Published: 2024-06-13 - Earliest claimed: 2021-07-06 - Assignees: Pacesetter, Inc. - Applicants: Pacesetter, Inc. - Inventors: Jan O. Mangual-Soto; Wenwen Li; Yun Qiao; Kyungmoo Ryu - Web page: https://patentgrep.com/patent/US20240189604A1 ## CPC - A61N 1/3702: {Physiological parameters (A61N1/365 takes precedence; evoked response A61N1/371)} - A61N 1/056: {Transvascular endocardial electrode systems} - A61N 1/0573: {chacterised by means penetrating the heart tissue, e.g. helix needle or hook} - A61N 1/368: comprising more than one electrode co-operating with different heart regions {(A61N1/3622, A61N1/3627 take precedence)} - A61N 1/3756: {Casings with electrodes thereon, e.g. leadless stimulators} - A61N 2001/083: {Monitoring integrity of contacts, e.g. by impedance measurement} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract A system is provided that includes a first electrode configured to be located within a septal wall, and a second electrode configured to be located outside of the septal wall. The system also includes an impedance circuit configured to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes. One or more processors are also provided that are configured to obtain impedance data indicative of an impedance along the IM vector with the first electrode located at different depths within the septal wall, the impedance data including a set of data values associated with different depths of the first electrode within the septal wall. The one or more processors are also configured to determine when the first electrode is located at a target depth within the septal wall based on the impedance data. ## Claims ### Claim 1 A system, comprising: a first electrode configured to be located within a septal wall; a second electrode configured to be located outside of the septal wall; wherein the first electrode and the second electrode are configured to measure the impedance data, an impedance circuit configured to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes; a memory configured to store program instructions; one or more processors that, when executing the program instructions, are configured to: obtain impedance data indicative of an impedance along the IM vector with the first electrode located at different depths within the septal wall as the first electrode advances through the septal wall, the impedance data including a set of data values associated with the different depths of the first electrode within the septal wall as the first electrode advances through the septal wall; determine when the first electrode is located at a target depth within the septal wall based on the impedance data; and communicate the target depth for the first electrode based the impedance data measured by the first electrode and the second electrode. ### Claim 2 (depends on 1) The system of claim 1, wherein the target depth locates the first electrode proximate to the left bundle branch (LBB). ### Claim 3 (depends on 1) The system of claim 1, wherein the one or more processors are configured to determine that the first electrode is located proximate the LBB when the impedance data decreases from a first data value above a threshold to a second data value below the threshold. ### Claim 4 (depends on 1) The system of claim 1, wherein the one or more processors are configured to determine that the first electrode is located proximate the LBB based at least in part on a slope of the data value changes from positive to negative. ### Claim 5 (depends on 1) The system of claim 1, wherein the one or more processors are configured to determine that the first electrode is located proximate the LBB when the impedance data decreases from a first data value to a second data value at a rate greater than a rate threshold percentage. ### Claim 6 (depends on 1) The system of claim 1, wherein the determine operation includes determining when the data values satisfy a criteria of interest. ### Claim 7 (depends on 1) The system of claim 1, wherein the determine operation further comprises comparing the data values, within the set of data values, to one another to determine a relation; and determining when the relation satisfies the criteria of interest. ### Claim 8 (depends on 1) The system of claim 1, wherein the criteria of interest is at least one of change in impedance value, a slope value, a change in impedance rate value, a change in impedance percentage, or a change in impedance rate percentage. ### Claim 9 (depends on 1) The system of claim 1, wherein the target depth includes a point where the first electrode is proximate the LBB and does not perforate a LV septum side wall distal wall of the septal wall. ### Claim 10 (depends on 1) The system of claim 1, further comprising a leadless IMD having the first electrode. ### Claim 11 (depends on 1) The system of claim 1, wherein the impedance data includes a septal wall component, a left ventricle or left atrial (LV/LA) chamber blood component, an outer heart wall component, and a secondary component for a region outside of the heart wall. ### Claim 12 (depends on 1) The system of claim 1, wherein the first electrode provided proximate a distal tip of a lead located in the right ventricle RV, the second electrode located remote from the RV. ### Claim 13 (depends on 12) The system of claim 12, wherein the second electrode is located on a housing of an implantable pulse generator, or in one of the right atrium, right ventricle, left ventricle, or left atrium. ### Claim 14 A computer implemented method, wherein under control of one or more processors configured with specific executable instructions, the method comprises: measuring impedance data with a first electrode and a second electrode, the impedance data indicative of an impedance along an impedance monitoring (IM) vector with the first electrode located at different depths within a septal wall as the first electrode advances through the septal wall, the impedance data including a set of data values associated with the different depths of the first electrode within the septal wall as the first electrode advances through the septal wall; determining when the first electrode is located at a target depth within the septal wall based on the impedance data; and communicating the target depth for the first electrode based the impedance data measured by the first electrode and the second electrode. ### Claim 15 (depends on 14) The method of claim 14 further comprising: determining that the first electrode is located proximate the LBB when the impedance data decreases from a first data value above a threshold to a second data value below the threshold. ### Claim 16 (depends on 14) The method of claim 14, further comprising determining that the first electrode is located proximate the LBB based at least in part on a slope of the data values changing from positive to negative. ### Claim 17 (depends on 14) The method of claim 14, wherein the determining operation includes determining when the data values satisfy a criteria of interest. ### Claim 18 (depends on 14) The method of claim 14, wherein the determining operation further comprises comparing the data values, within the set of data values, to one another to determine a relation; and determining when the relation satisfies the criteria of interest. ### Claim 19 (depends on 14) The method of claim 14, wherein the first electrode is provided proximate a distal tip of a lead located in the right ventricle RV, and the second electrode is located remote from the RV. ### Claim 20 (depends on 14) The method of claim 14, further comprising determining that the first electrode is located proximate the LBB when the impedance data decreases from a first data value to a second data value at a rate greater than a rate threshold percentage.