Method and apparatus to perform electrode combination selection

• US 10,022,548 B2
• Filed: 04/24/2013
• Issued: 07/17/2018
• Est. Priority Date: 08/07/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Brooke, M. Jason, Acuna, Andrea
• Primary Examiner(s): Porter, Jr., Allen
• Application Number:
  US13/869,741
• Publication Number:
  US 20130268018A1
• Time in Patent Office: 1,910 Days
• Field of Search: 607 29, 607 60
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/3686 configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/3708 for power depletion
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/37241 providing test stimulations
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

Electrical stimulation may be delivered to a patient'"'"'s heart using a plurality of cardiac electrodes. Each electrode combination may be evaluated based on one or more first parameters and one or more second parameters. In many cases, the one or more first parameters are supportive of cardiac function consistent with a prescribed therapy and the one or more second parameters are not supportive of cardiac function consistent with the prescribed therapy. The electrode combination selected to deliver a cardiac pacing therapy may be more associated with the one or more first parameters supportive of cardiac function consistent with the prescribed therapy and less associated with the one or more second parameters inconsistent with cardiac function.

Claims

1. An implantable medical device system, comprising:

a programmer comprising a processor, a user interface and a telemetry module; and

an implantable medical device comprising a battery, a telemetry circuit, a module, and a processor and associated memory, the implantable medical device configured to establish a programmable parameter and a plurality of values of the parameter to be compared;

enable the module to perform a measurement for each of the plurality of values and related to energy expenditure of the battery when operating according to each of the plurality of values;

implement the processor to compute an energy expenditure for each of the plurality of values using the measurements; and

transmit energy expenditure information to the programmer, the programmer configured to generate a graphical user interface displaying information corresponding to the computed energy expenditure for the plurality of values.

2. The system of claim 1, wherein establishing a programmable parameter and plurality of values of the parameter comprises storing in memory of the implantable medical device a plurality of pacing electrode vectors available for pacing a heart chamber.

3. The system of claim 2, wherein enabling the module to perform measurements comprises enabling a capture threshold measurement module to perform capture threshold measurements for each of the plurality of pacing electrode vectors and enabling an impedance measurement module to perform impedance measurements fix each of the plurality of pacing electrode vectors.

4. The system of claim 3, further comprising implementing the processor to compute the energy expenditure for each of the plurality of values using the capture threshold measurements, the impedance measurements, and a safety pacing margin.

5. The system of claim 2, wherein the implantable medical device is enabled to automatically select one of the plurality of pacing vectors having a minimum computed energy expenditure for pacing the heart chamber.

6. The system of claim 1, wherein the processor is further configured to establish a predicted frequency of therapy delivery and using the predicted frequency in computing the energy expenditures.

7. The system of claim 1, wherein generating the graphical user interface comprises computing an estimated longevity of the implantable medical device power source for each of the at least two parameter values.

8. The system of claim 7, wherein generating the graphical user interface further comprises establishing a reinforce longevity and displaying a difference in longevity relative to the reference longevity for each of the parameter values.

9. The system of claim 1, wherein the implantable medical device is further configured to measure a physiological benefit associated with each of the plurality of parameter values, determine a relative physiological benefit for each of the plurality of parameter values with respect to one of the parameter values, wherein generating the graphical user interface comprises displaying the relative physiological benefit corresponding to each of the plurality of parameter values in the graphical user interface.

10. The system of claim 1, wherein the implantable medical device is further configured to determine whether an undesired side effect is associated with each of the plurality of parameter values and generating the graphical user interface further comprises displaying information corresponding to the presence of an undesired side effect for each of the plurality of parameter values.

11. An implantable cardiac medical device system, comprising:

a programmer comprising a processor, a user interface and a telemetry module; and

an implantable cardiac medical device comprising a battery, a telemetry circuit, and a processor and associated memory,

the implantable cardiac medical device having a programmable parameter and a plurality of values of the parameter to be compared, the implantable cardiac medical device configured to;

perform a measurement for each of the plurality of values related to energy expenditure of the battery when operating the implantable cardiac medical device according to each of the plurality of values;

compute an energy consumption of the implantable cardiac medical device for each of the plurality of values using the measurements; and

transmit energy expenditure information to the programmer,

the programmer configured to generate a graphical user interface displaying information corresponding to the computed energy consumption of the implantable cardiac medical device for each of the plurality of values.

12. The system of claim 11, wherein each of the plurality of values corresponds to a different cardiac electrode combination of the implantable cardiac medical device.

13. The system of claim 11, wherein the parameter is a capture threshold parameter.