Systems and methods for facilitating selecting of one or more vectors in a medical device

• US 10,434,318 B2
• Filed: 12/18/2014
• Issued: 10/08/2019
• Est. Priority Date: 12/18/2013
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Rockweiler, Holly E., Saha, Sunipa, Herrmann, Keith L., Yu, Yinghong, Krueger, Joel A.
• Primary Examiner(s): Lee, Erica S
• Application Number:
  US14/574,908
• Publication Number:
  US 20150165205A1
• Time in Patent Office: 1,755 Days
• Field of Search: None
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/3686 configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Some systems and methods may facilitate selection of a vector for delivering electrical stimulation to a patient'"'"'s heart. One method may include displaying a plurality of vectors on a display screen wherein each vector represents a different combination of three or more electro-stimulation electrodes, determining an electrical impedance for each of the plurality of vectors, displaying on the display screen the electrical impedance for each of the plurality of vectors, receiving a selection of a set of the plurality of vectors, determining, for each of the vectors in the set of vectors, a capture threshold, displaying on the display screen the capture threshold for each of the vectors in the set of vectors, receiving a selection of a vector from the set of vectors for delivery of electrical stimulation to the patient'"'"'s heart, and programming the electro-stimulation device electrical stimulation to the patient'"'"'s heart via the selected vector.

Claims

1. A method of facilitating selection of a vector for delivering electrical stimulation to a patient'"'"'s heart via an electro-stimulation device having three or more electro-stimulation electrodes using a device-based cardiac capture threshold test, the method comprising:

displaying a plurality of vectors on a display screen, wherein each vector represents a different combination of the three or more electro-stimulation electrodes;

measuring an electrical pacing impedance for each of the plurality of vectors using the electro-stimulation electrodes;

displaying on the display screen the measured electrical pacing impedance for each of the plurality of vectors;

receiving a selection of a set of the plurality of vectors as a selected first sub-set of the plurality of vectors in response to the displaying on the display screen the measured electrical pacing impedance for each of the plurality of vectors;

determining a capture threshold for each of the vectors of the first subset of the plurality of vectors;

displaying on the display screen the determined capture threshold for each of the vectors of the first subset of the plurality of vectors;

receiving a further selection of a vector from the received first subset of the plurality of vectors, in response to the displaying on the display screen the determined capture threshold, for delivery of electrical stimulation to the patient'"'"'s heart; and

programming the electro-stimulation device to use the selected vector when delivering electrical stimulation to the patient'"'"'s heart.

2. The method of claim 1, wherein after displaying the plurality of vectors on the display screen but before receiving the selection of the set of the plurality of vectors, the method further comprises:

determining an electrical delay for each of the plurality of vectors; and

displaying on the display screen the determined electrical delay and the measured electrical impedance for each of the plurality of vectors.

3. The method of claim 2, further comprising displaying on the display screen the determined electrical delay and the measured electrical impedance for each of the plurality of vectors in a table format, wherein the plurality of vectors are each represented in a row, and the determined electrical delay and the measured electrical impedance are represented in columns.

4. The method of claim 3, further comprising:

selecting a first column; and

sorting the table by the selected first column.

5. The method of claim 4, further comprising:

selecting a second column after selecting the first column; and

sorting the table by the first column, and then if duplicate entries exist in the first column, sorting the duplicate entries by the second column.

6. The method of claim 4, further comprising:

selecting one or more rows from the table that is sorted by the first column;

selecting a second column; and

sorting the selected rows by the selected second column.

7. The method of claim 2, wherein determining an electrical delay includes determining an RV-LV delay for each of the plurality of vectors,

wherein displaying on the display screen the measured electrical pacing impedance for each of the plurality of vectors includes displaying the determined RV-LV delay for each of the plurality of vectors, and

wherein receiving the selection of the set of the plurality of vectors as the selected first sub-set of the plurality of vectors in response to the displaying on the display screen

the measured electrical pacing impedance for each of the plurality of vectors and the determined RV-LV delay for each of the plurality of vectors.

8. The method of claim 1, further comprising determining a phrenic nerve stimulation value for the first sub-set of the plurality of vectors, and displaying on the display screen the determined phrenic nerve stimulation value for each of the vectors.

9. The method of claim 8, further comprising sorting the plurality of vectors based on the measured pacing impedance and the determined phrenic nerve stimulation value.

10. The method of claim 1, wherein the selected subsets of the plurality of vectors include less than all of the plurality of vectors.

11. A system for facilitating selection of at least one vector for delivering electrical stimulation to a chamber of a patient'"'"'s heart via an electro-stimulation device, the system comprising:

a display screen; and

a controller configured to initiate capture threshold testing including;

present, at the display screen, a plurality of vectors, wherein each vector represents a different combination of electro-stimulation electrodes used to deliver the electrical stimulation;

measure an electrical pacing impedance for each of the plurality of vectors using the electro-stimulation electrodes;

present, at the display screen, the measured electrical pacing impedance for each of the plurality of vectors;

receive a selection of a set of vectors from the plurality of vectors as a selected first subset of the plurality of vectors in response to the presenting on the display screen the measured electrical pacing impedance for each of the plurality of vectors;

determine a capture threshold for each of the vectors of the first subset of the plurality of vectors;

present, at the display screen, the determined capture threshold for each of the vectors of the first subset of the plurality of vectors;

receive a further selection of a vector from the received first subset of the plurality of vectors, in response to the presented determined capture threshold, for delivery of electrical stimulation to the patient'"'"'s heart; and

program the electro-stimulation device to use the selected vector when delivering electrical stimulation to the patient'"'"'s heart.

12. The system of claim 11, wherein the controller is further configured to:

determine an electrical delay for the plurality of vectors;

present, at the display screen, the determined electrical delay and the measured electrical pacing impedance for each of the plurality of vectors; and

sort on the display screen the plurality of vectors based on the electrical delay.

13. The system of claim 11, wherein the controller is further configured to sort on the display screen the plurality of vectors based on the measured electrical impedance.

14. The system of claim 11, wherein the controller is further configured to determine a phrenic nerve stimulation threshold value for the first sub-set of the plurality of vectors.

15. The system of claim 14, wherein the controller is further configured to sort the vectors based, at least in part, on the phrenic nerve stimulation threshold.

16. The system of claim 11, further comprising:

a pulse generator configured to deliver electrical stimulation pulses to the patient'"'"'s heart,

wherein the controller is configured to program the pulse generator to deliver electrical stimulation pulses to the patient'"'"'s heart using the selected vector.