Apparatus and method for testing and adjusting a bipolar stimulation configuration
AssigneeCardiac Pacemakers, Inc.
InventorsJulio C. Spinelli, Qingsheng Zhu
Life of this patent
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Abstract
A system and method for measuring the capture threshold of a bipolar lead in order to determine an appropriate value for the stimulus pulse energy to be used with the lead by a cardiac rhythm management device. An appropriate bipolar stimulating configuration can also be determined. The method is particularly useful in testing bipolar leads used to excite the left ventricle such as when delivering cardiac resynchronization therapy.
Claims26
A method for determining an appropriate bipolar stimulus pulse energy for a cardiac rhythm management device, wherein bipolar stimulation pulses are delivered through a bipolar lead having anodal and cathodal electrodes, comprising:
- measuring a unipolar capture threshold for the cathodal electrode with a structure or electrode other than the anodal electrode of the bipolar lead acting as a reference;
- and
- determining an appropriate stimulus pulse energy for bipolar stimulation to be a value corresponding to the measured unipolar capture threshold.
A method for determining an appropriate bipolar stimulus pulse energy for a cardiac rhythm management device, wherein bipolar stimulation pulses are delivered through a bipolar lead having anodal and cathodal electrodes, comprising:
- measuring a unipolar capture threshold for the cathodal electrode with a structure or electrode other than the anodal electrode of the bipolar lead acting as a reference;
- measuring a bipolar capture threshold using the anodal electrode and cathodal electrodes;
- and,
- determining an appropriate stimulus pulse energy for bipolar stimulation to be a value corresponding to the greater of the measured bipolar capture threshold and the measured unipolar threshold.
A method for determining a bipolar stimulus configuration for a cardiac rhythm management device, wherein bipolar stimulus pulses are delivered through a bipolar lead having proximal and distal electrodes, comprising:
- measuring unipolar capture thresholds for the proximal electrode with a structure or electrode other than the distal electrode of the bipolar lead acting as a reference;
- measuring unipolar capture thresholds for the distal electrode with a structure or electrode other than the proximal electrode of the bipolar lead acting as a reference;
- and,
- selecting the electrode of the bipolar lead having the lowest unipolar capture threshold as the cathode for bipolar stimulation, with the other electrode serving as the anode.
A cardiac rhythm management device, comprising:
- at least one sensing/stimulation channel which includes a bipolar lead with anodal and cathodal electrodes for disposing in proximity to a chamber of the heart, a pulse generator for outputting stimulus pulses, and a sense amplifier for detecting sense signals;
- a controller for controlling the operation of the pulse generator in response to sensed events and lapsed time intervals and in accordance with a programmed pacing mode;
- a switching circuit for switching the output of the pulse generator to selected electrodes of the bipolar lead and to a reference electrode;
- and,
- wherein the controller is programmed to measure a unipolar capture threshold for the cathodal electrode with a structure or electrode other than the anodal electrode of the bipolar lead acting as a reference in order to determine an appropriate stimulus pulse energy for bipolar stimulation.
A cardiac rhythm management device, comprising:
- at least one sensing/stimulation channel which includes a bipolar lead with anodal and cathodal electrodes for disposing in proximity to a chamber of the heart, a pulse generator for outputting stimulus pulses, and a sense amplifier for detecting sense signals;
- a controller for controlling the operation of the pulse generator in response to sensed events and lapsed time intervals and in accordance with a programmed pacing mode;
- a switching circuit for switching the output of the pulse generator to selected electrodes of the bipolar lead and to a reference electrode;
- and,
- wherein the controller is programmed to determine a bipolar stimulus pulse energy by measuring a unipolar capture threshold for the cathodal electrode with a structure or electrode other than the electrodes of the bipolar lead acting as a reference and measuring a bipolar capture threshold using the anodal and cathodal electrodes, with the bipolar stimulus pulse energy determined as a value corresponding to the greater of the bipolar and unipolar capture thresholds.
A cardiac rhythm management device, comprising:
- at least one sensing/stimulation channel which includes a bipolar lead with proximal and distal electrodes for disposing in proximity to a chamber of the heart, a pulse generator for outputting stimulus pulses, and a sense amplifier for detecting sense signals;
- a controller for controlling the operation of the pulse generators in response to sensed events and lapsed time intervals and in accordance with a programmed pacing mode;
- a switching circuit for switching the output of the pulse generator to selected electrodes of the bipolar lead and to a reference electrode;
- and,
- wherein the controller is programmed to measure unipolar capture thresholds for the proximal and distal electrodes with a structure or electrode other than the distal electrode of the bipolar lead acting as a reference, and select the electrode of the bipolar lead having the lowest unipolar capture threshold as the cathode for bipolar stimulation, with the other electrode serving as the anode.
A method for determining a bipolar capture threshold for a cardiac rhythm management device, wherein bipolar stimulation pulses are delivered through a bipolar lead having anodal and cathodal electrodes, comprising:
- measuring a unipolar capture threshold for the cathodal electrode with a structure or electrode other than the anodal electrode of the bipolar lead acting as a reference;
- and
- reporting the bipolar capture threshold as a value corresponding to the measured unipolar capture threshold.
A method for determining a bipolar capture threshold for a cardiac rhythm management device, wherein bipolar stimulation pulses are delivered through a bipolar lead having anodal and cathodal electrodes, comprising:
- measuring a unipolar capture threshold for the cathodal electrode with a structure or electrode other than the anodal electrode of the bipolar lead acting as a reference;
- measuring a bipolar capture threshold using the anodal electrode and cathodal electrodes;
- and,
- reporting the bipolar capture threshold as a value corresponding to the greater of the measured bipolar capture threshold and the measured unipolar threshold.
Dependencies are inferred from the claim text.