# US 9,750,942 B2 · Systems and methods for determining parameters for each of a plurality of vectors > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,750,942 B2 - Document ID: US9750942B2 - Status: Granted - Kind: B2 - Application number: 14/575,099 - Filed: 2014-12-18 - Published: 2015-06-18 - Granted: 2017-09-05 - Earliest claimed: 2013-12-18 - Assignees: Cardiac Pacemakers, Inc. - Applicants: Cardiac Pacemakers, Inc. - Inventors: Sunipa Saha; Keith L. Herrmann; Yinghong Yu; David W. Yost; Holly E. Rockweiler - Web page: https://patentgrep.com/patent/US9750942B2 ## CPC - A61N 1/371: {Capture, i.e. successful stimulation} - A61N 1/3686: {configured for selecting the electrode configuration on a lead (A61N1/3688 takes precedence)} - A61N 1/36114: {Cardiac control, e.g. by vagal stimulation (stimulating the heart A61N1/362)} - A61N 1/37: Monitoring; Protecting - 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 Systems and methods for efficiently determining one or more parameters for vectors of a multi-electrode implantable medical device, and for identifying one or more suitable vectors for sensing cardiac electrical data and/or delivering electrical stimulation therapy based on one or more of the determined parameters. Reducing the time required to determine the one or more parameters for each vector can help reduce procedure time for implanting and/or configuring an implantable medical device, which can reduce costs and/or improved patient comfort. ## Claims ### Claim 1 A method of determining parameters for each of a plurality of vectors of a multi-electrode implantable medical device, the method comprising, in a single sequence having first, second, and third time periods: in the first time period: outputting one or more pacing pulses using a first vector of the multi-electrode implantable medical device at an initialization voltage, the first vector defined by a first pair of electrodes of the multi-electrode implantable medical device; determining a presence of phrenic stimulation and an impedance between the first pair of electrodes in response to the one or more pacing pulses output at the initialization voltage; storing a measure related to the presence of phrenic stimulation and a measure related to the determined impedance between the first pair of electrodes for the first vector at the initialization voltage; in the second time period: stepping down the initialization voltage to a second pacing voltage; outputting one or more pacing pulses using the first vector at the second pacing voltage; determining whether capture occurs in response to the one or more pacing pulses output at the second pacing voltage; storing a measure related to whether capture occurs for the first vector at the second pacing voltage; and in the third time period: stepping down the second pacing voltage to a third pacing voltage; outputting one or more pacing pulses using the first vector at the third pacing voltage; determining an electrical delay for the first vector in response to the one or more pacing pulses output at the third pacing voltage; and storing a measure related to the determined electrical delay for the first vector at the third pacing voltage. ### Claim 2 (depends on 1) The method of claim 1, further comprising: providing a set of parameters for the first vector to an external assembly, and wherein the set of parameters for the first vector include measures stored during the single sequence. ### Claim 3 (depends on 1) The method of claim 1, further comprising, in the third time period: determining a stability of the determined electrical delay during the third time period at the third pacing voltage; storing a measure related to the stability of the determined electrical delay timing for the first vector. ### Claim 4 (depends on 1) The method of claim 1, further comprising, in the second time period: stepping down the second pacing voltage until capture is not detected using the sensing circuit, and storing a measure related to a lowest voltage that capture is detected using the sensing circuit during the second time period. ### Claim 5 (depends on 1) The method of claim 1, wherein the initialization voltage is selectable by a user. ### Claim 6 (depends on 1) The method of claim 1, further comprising, in the first time period: terminating the single sequence if the presence of phrenic nerve stimulation is positive during the first time period at the initialization voltage. ### Claim 7 (depends on 1) The method of claim 1, wherein the electrical delay includes one or more of an RV-LV delay or a QLV delay. ### Claim 8 (depends on 1) The method of claim 1, further comprising, in the third time period: determining an R-wave amplitude for the first vector in response to the one or more pacing pulses output at the third pacing voltage; and storing a measure related to the R-wave amplitude for the first vector at the third pacing voltage. ### Claim 9 A multi-electrode implantable medical device for determining parameters for each of a plurality of vectors in a single sequence having first, second, and third time periods, the device comprising: a pulse generator; a sensing circuit; and a controller circuit, wherein, in the first time period: the pulse generator is configured to output one or more pacing pulses using a first vector of the multi-electrode implantable medical device at an initialization voltage, the first vector defined by a first pair of electrodes of the multi-electrode implantable medical device; the sensing circuit is configured to determine a presence of phrenic stimulation and an impedance between the first pair of electrodes in response to the one or more pacing pulses output at the initialization voltage; and the controller circuit configured to store a measure related to the presence of phrenic stimulation and a measure related to the determined impedance between the first pair of electrodes for the first vector at the initialization voltage, wherein, in the second time period: the controller is configured to step down the initial voltage to a second pacing voltage; the pulse generator is configured to output one or more pacing pulses using the first vector at the second pacing voltage; the sensing circuit is configured to determine whether capture occurs in response to the one or more pacing pulses output at the second pacing voltage; and the controller circuit is configured to store a measure related to whether capture occurs for the first vector at the second pacing voltage, and wherein, in the third time period: the controller is configured to step down the second pacing voltage to a third pacing voltage; the pulse generator is configured to output one or more pacing pulses using the first vector at the third pacing voltage; the sensing circuit is configured to determine an electrical delay for the first vector in response to the one or more pacing pulses output at the third pacing voltage; and the controller is configured to store a measure related to the determined electrical delay for the first vector at the third pacing voltage. ### Claim 10 (depends on 9) The system of claim 9, further comprising: a communication circuit configured to provide a set of parameters for the first vector to an external assembly, wherein the parameters for the first vector include measures stored during the single sequence. ### Claim 11 (depends on 10) The system of claim 10, wherein, in the third time period: the sensing circuit is configured to determine a stability of the determined electrical delay during the third time period at the third pacing voltage; and the controller circuit is configured to store a measure related to the stability of the determined electrical delay. ### Claim 12 (depends on 9) The system of claim 9, wherein, in the second time period: the controller circuit is configured to step down the second pacing voltage until the sensing circuit does not detect capture, and to store a measure related to a lowest voltage at which the sensing circuit determines that capture occurs. ### Claim 13 (depends on 9) The system of claim 9, wherein the initialization voltage is selectable by a user. ### Claim 14 (depends on 9) The system of claim 9, wherein, in the first time period: the controller is configured to terminate the single sequence if the sensing circuit determines that phrenic nerve stimulation occurs at the initialization voltage. ### Claim 15 (depends on 9) The system of claim 9, wherein the electrical delay includes one or more of an RV-LV delay or a QLV delay. ### Claim 16 (depends on 9) The system of claim 9, wherein, in the third time period: the sensing circuit is configured to determine an R-wave amplitude for the first vector in response to the one or more pacing pulses output at the third pacing voltage; and the controller circuit is configured to store a measure related to the determined R-wave amplitude for the first vector at the third pacing voltage. ### Claim 17 A non-transitory machine readable medium, the non-transitory machine readable medium containing instructions, which, when executed by a processor, cause the processor to perform operations for determining parameters for each of a plurality of vectors of a multi-electrode implantable medical device in a single sequence having first, second, and third time periods, the operations comprising: in the first time period: outputting one or more pacing pulses using a first vector of the multi-electrode implantable medical device at an initialization voltage, the first vector defined by a first pair of electrodes of the multi-electrode implantable medical device; determining a presence of phrenic stimulation and an impedance between the first pair of electrodes in response to the one or more pacing pulses output at the initialization voltage; storing a measure related to the presence of phrenic stimulation and a measure related to the impedance between the first pair of electrodes for the first vector at the initialization voltage; in the second time period: stepping down the initialization voltage to a second pacing voltage; outputting one or more pacing pulses using the first vector at the second pacing voltage; determining whether capture occurs in response to the one or more pacing pulses output at the second pacing voltage; storing a measure related to whether capture occurs for the first vector at the second pacing voltage; and in the third time period: stepping down the second pacing voltage to a third pacing voltage; outputting one or more pacing pulses using the first vector at the third pacing voltage; determining an electrical delay for the first vector in response to the one or more pacing pulses output at the third pacing voltage; and storing a measure related to the determined electrical delay for the first vector at the third pacing voltage. ### Claim 18 (depends on 17) The machine readable medium of claim 17, the operations further comprising: in the second time period: stepping down the second pacing voltage until capture is not detected using the sensing circuit; and storing a measure related to a lowest voltage that capture is detected using the sensing circuit during the second time period. ### Claim 19 (depends on 17) The machine readable medium of claim 17, wherein the electrical delay includes one or more of an RV-LV delay or a QLV delay. ### Claim 20 (depends on 17) The machine readable medium of claim 17, the operations further comprising: in the third time period: determining an R-wave amplitude for the first vector in response to the one or more pacing pulses output at the third pacing voltage; an storing a measure related to the determined R-wave amplitude for the first vector at the third pacing voltage.