Ambulatory phrenic nerve stimulation detection
First Claim
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1. A system, comprising:
- an implantable medical device (IMD) for implantation in a patient indicated for a prescribed myocardial therapy to provide a therapeutic benefit to the patient in an ambulatory setting, wherein the prescribed myocardial therapy has at least a first pacing configuration having a first pacing vector and a second pacing configuration having a second pacing vector, the IMD including a cardiac pace generator, a cardiac activity sensor, a memory, a controller and a phrenic nerve stimulation (PS) sensor, wherein the PS sensor is configured to provide a signal for use in detecting PS, and the controller is configured to provide the prescribed myocardial therapy by implementing a cardiac pacing algorithm to use sensed cardiac activity from the cardiac sensor to determine times for cardiac paces, and is operably connected to the cardiac pace generator to operate in different pacing configurations to generate cardiac paces at the determined times using different pacing vectors representing different combinations of source and sink electrodes, the different pacing configurations including the first pacing configuration and the second pacing configuration of the prescribed myocardial therapy,wherein the controller is configured to avoid PS when providing the prescribed myocardial therapy by implementing a process including;
monitor the signal provided from the PS sensor when providing the prescribed myocardial therapy using the first pacing configuration that has the first pacing vector, and detect an amplitude of the monitored signal provided from the PS sensor,compare the detected amplitude to a PS threshold to detect PS, and continue to provide the prescribed myocardial therapy using the first pacing configuration that has the first pacing vector when the detected amplitude is less than the threshold, andautomatically perform a pacing vector change to change the first pacing configuration to the second pacing configuration that has the second pacing vector to avoid PS when the detected amplitude is higher than the threshold and then continue to provide the prescribed myocardial therapy using the second pacing configuration.
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Abstract
An example of a system includes an implantable medical device (IMD) for implantation in a patient, where the IMD includes a cardiac pace generator, phrenic nerve stimulation (PS) sensor, a memory, and a controller, and where the controller is operably connected to the cardiac pace generator to generate cardiac paces. The controller is configured to provide a trigger for conducting a PS detection procedure and perform the PS detection procedure in response to the trigger. In performing the PS detection procedure the controller is configured to receive a signal from the sensor, detect PS using the signal from the sensor, and record the PS detection in storage within the IMD.
53 Citations
20 Claims
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1. A system, comprising:
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an implantable medical device (IMD) for implantation in a patient indicated for a prescribed myocardial therapy to provide a therapeutic benefit to the patient in an ambulatory setting, wherein the prescribed myocardial therapy has at least a first pacing configuration having a first pacing vector and a second pacing configuration having a second pacing vector, the IMD including a cardiac pace generator, a cardiac activity sensor, a memory, a controller and a phrenic nerve stimulation (PS) sensor, wherein the PS sensor is configured to provide a signal for use in detecting PS, and the controller is configured to provide the prescribed myocardial therapy by implementing a cardiac pacing algorithm to use sensed cardiac activity from the cardiac sensor to determine times for cardiac paces, and is operably connected to the cardiac pace generator to operate in different pacing configurations to generate cardiac paces at the determined times using different pacing vectors representing different combinations of source and sink electrodes, the different pacing configurations including the first pacing configuration and the second pacing configuration of the prescribed myocardial therapy, wherein the controller is configured to avoid PS when providing the prescribed myocardial therapy by implementing a process including; monitor the signal provided from the PS sensor when providing the prescribed myocardial therapy using the first pacing configuration that has the first pacing vector, and detect an amplitude of the monitored signal provided from the PS sensor, compare the detected amplitude to a PS threshold to detect PS, and continue to provide the prescribed myocardial therapy using the first pacing configuration that has the first pacing vector when the detected amplitude is less than the threshold, and automatically perform a pacing vector change to change the first pacing configuration to the second pacing configuration that has the second pacing vector to avoid PS when the detected amplitude is higher than the threshold and then continue to provide the prescribed myocardial therapy using the second pacing configuration. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A system, comprising:
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an implantable cardiac pacemaker configured to sense cardiac activity and provide a prescribed myocardial therapy to a patient indicated for the prescribed myocardial therapy to provide a therapeutic benefit to the patient in an ambulatory setting, wherein the prescribed myocardial therapy has at least a first pacing configuration having a first pacing vector and a second pacing configuration having a second pacing vector, and the prescribed myocardial therapy is implemented using a cardiac pacing algorithm to use sensed cardiac activity to determine times for cardiac paces, wherein the implantable cardiac pacemaker is configured to deliver cardiac paces at the determined times, and to deliver cardiac paces using different pacing vectors representing different combinations of source and sink electrodes; and a phrenic nerve stimulation (PS) sensor configured to provide a signal for use in detecting PS, wherein the implantable cardiac pacemaker includes a controller configured to implement the cardiac pacing algorithm and avoid PS when providing the prescribed myocardial therapy by implementing a process including;
monitor the signal provided from the PS sensor when providing the prescribed myocardial therapy to using the first pacing configuration that has the first pacing vector, detect an amplitude of the monitored signal provided from the PS sensor;
compare the detected amplitude to a PS threshold to detect PS, and continue to provide the prescribed myocardial therapy using the first pacing configuration that has the first pacing vector when the detected amplitude is less than the threshold; and
automatically perform a pacing vector change to the second pacing configuration that has the second pacing vector to avoid PS when the sensed amplitude is higher than the threshold, and then continuing to implement the prescribed myocardial therapy using the second pacing configuration that has the second pacing vector. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification