US 6,606,516 B2 · System and method for programmably controlling stimulation electrode configurations and activation sequence in a multi-site cardiac stimulation device

Abstract

An implantable multi-chamber cardiac stimulation device includes flexibly programmable electrode stimulation configurations, and is capable of precisely controlling the stimulation sequence between multiple sites. The stimulation device provides a plurality of connection ports that allow independent connection of each electrical lead associated with a particular stimulation site in the heart. Each connection port further provides a unique terminal for making electrical contact with only one electrode such that no two electrodes are required to be electrically coupled. Furthermore, each electrode, whether residing on a unipolar, bipolar or multipolar lead, may be selectively connected or disconnected through programmable switching circuitry that determines the electrode configurations to be used for sensing and for stimulating at each stimulation site. The stimulation device possesses unique sensing and output configurations associated with each stimulation site, such that depolarizations occurring at each stimulation site can be detected independently of events occurring at other sites within the heart, and such that each site can be stimulated independently of other sites or on a precisely timed basis triggered by events occurring at other sites. The stimulation device is further capable of uniquely programming coupling intervals for precisely controlling the activation sequence of stimulated sites. Coupling intervals are selected so as to provide optimal hemodynamic benefit to the patient.

Claims48

Dependent claims

A method of automatically configuring a plurality of stimulation electrodes that are positioned in multiple cardiac chambers, for use in a multi-site cardiac stimulation device, comprising the steps of:

defining a plurality of electrode configurations corresponding to a plurality of activation sequences of the stimulation electrodes;
detecting a first cardiac signal in one of the multiple cardiac chambers when cardiac signals are present;
delivering a first stimulus to one of the multiple chambers when cardiac signals are not present;
initiating coupling intervals for the multiple cardiac chambers based on the first cardiac signal that is detected or the first stimulus that is delivered;
setting an activation sequence of the stimulation electrodes by altering the electrode configurations based on the coupling intervals;
and
delivering a second stimulus on demand, in any one or more of the cardiac chambers, in accordance with the activation sequence.

4 more elements

A multi-site cardiac stimulation device for automatically configuring a plurality of stimulation electrodes positioned in multiple cardiac chambers into a plurality of configurations that correspond to a plurality of activation sequences, the stimulation device comprising:

a discriminator, coupled to the plurality of stimulation electrodes, which is capable of detecting the presence of a cardiac signal in each of the cardiac chambers, and that identifies a cardiac chamber of origin in which the cardiac signal originates;
a pulse generator, connected to the stimulation electrodes, to selectively deliver a stimulation pulse to each of the cardiac chambers;
timing control circuitry, connected to the stimulation electrodes, the pulse generator, and the discriminator, to initiate coupling intervals for the multiple cardiac chambers based on the cardiac chamber of origin in which the cardiac signal is sensed or the stimulation pulse is delivered;
and
a processor, responsive to the timing control circuitry, that sets an activation sequence of the stimulation electrodes by automatically adjusting the stimulation electrode configurations based on the coupling intervals.

2 more elements

Dependencies are inferred from the claim text.

System and method for programmably controlling stimulation electrode configurations and activation sequence in a multi-site cardiac stimulation device

Life of this patent

System and method for programmably controlling stimulation electrode configurations and activation sequence in a multi-site cardiac stimulation device

Life of this patent

Abstract

Claims48