Methods and implantable medical systems that implement exposure modes of therapy that allow for continued operation during exposure to a magnetic disturbance
First Claim
1. A method of controlling an exposure mode of therapy of an implantable medical device, comprising:
- determining a device type of the implantable medical device by accessing device type information stored by the implantable medical device;
upon detecting a need to switch to the exposure mode, selecting the exposure mode of therapy of the implantable medical device based on the device type and a pre-exposure mode of therapy; and
after detecting the need to switch to the exposure mode, implementing the exposure mode of therapy at the implantable medical device by;
performing a first sensing of a heart rate using at least one sensing setting;
when the first sensing of heart rate indicates at least a first amount of noise is present, implementing an asynchronous pacing mode and then making adjustments to the at least one sensing setting prior to a next sensing of the heart rate that is subsequent to the first sensing and that uses the at least one sensing setting that has been adjusted; and
when the first sensing of heart rate indicates that at least the first amount of noise is not present, then implementing a triggered pacing mode.
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Abstract
Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.
28 Citations
16 Claims
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1. A method of controlling an exposure mode of therapy of an implantable medical device, comprising:
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determining a device type of the implantable medical device by accessing device type information stored by the implantable medical device; upon detecting a need to switch to the exposure mode, selecting the exposure mode of therapy of the implantable medical device based on the device type and a pre-exposure mode of therapy; and after detecting the need to switch to the exposure mode, implementing the exposure mode of therapy at the implantable medical device by;
performing a first sensing of a heart rate using at least one sensing setting;
when the first sensing of heart rate indicates at least a first amount of noise is present, implementing an asynchronous pacing mode and then making adjustments to the at least one sensing setting prior to a next sensing of the heart rate that is subsequent to the first sensing and that uses the at least one sensing setting that has been adjusted; and
when the first sensing of heart rate indicates that at least the first amount of noise is not present, then implementing a triggered pacing mode. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An implantable medical system comprising:
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a device for providing electrical sensing and pacing; and a controller that is in control of the device to provide an exposure mode of therapy by the device and that is configured to determine a device type, detect a need to switch to the exposure mode, select the exposure mode of therapy of the device based on the device type and a pre-exposure mode of therapy, and after detecting the need to switch to the exposure mode implement the exposure mode of therapy at the device by;
performing a first sensing of a heart rate using at least one sensing setting;
when the first sensing of heart rate indicates at least a first amount of noise is present, implementing an asynchronous pacing mode and then making adjustments to the at least one sensing setting prior to a next sensing of the heart rate that is subsequent to the first sensing and that uses the at least one sensing setting that has been adjusted; and
when the first sensing of heart rate indicates that at least the first amount of noise is not present, then implementing a triggered pacing mode.
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14. A method of controlling an exposure mode of therapy of an implantable medical device, comprising:
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determining a device type of the implantable medical device; upon detecting a need to switch to the exposure mode, selecting the exposure mode of therapy of the implantable medical device based on the device type and a pre-exposure mode of therapy; implementing the exposure mode of therapy at the implantable medical device by;
performing a first sensing of a heart rate using at least one sensing setting;
when the first sensing of heart rate indicates at least a first amount of noise is present, implementing an asynchronous pacing mode and then making adjustments to the at least one sensing setting prior to a next sensing of the heart rate that is subsequent to the first sensing and that uses the at least one sensing setting that has been adjusted; and
when the first sensing of heart rate indicates that at least the first amount of noise is not present, then implementing a triggered pacing mode;incrementing a revision counter upon making adjustments to the at least one sensing setting; and subsequent to the next sensing of the heart rate, determining whether the revision counter exceeds a revision counter threshold so that when the revision counter does not exceed the revision counter threshold then making further adjustments to the at least one sensing setting and when the revision counter does exceed the revision counter threshold then not making further adjustments to the at least one sensing setting.
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15. A method of controlling an exposure mode of therapy of an implantable medical device, comprising:
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determining a device type of the implantable medical device; upon detecting a need to switch to the exposure mode, selecting the exposure mode of therapy of the implantable medical device based on the device type and a pre-exposure mode of therapy; and implementing the exposure mode of therapy at the implantable medical device by;
performing a first sensing of a heart rate using at least one sensing setting;
when the first sensing of heart rate indicates at least a first amount of noise is present, implementing an asynchronous pacing mode and then making adjustments to the at least one sensing setting prior to a next sensing of the heart rate that is subsequent to the first sensing and that uses the at least one sensing setting that has been adjusted; and
when the first sensing of heart rate indicates that at least the first amount of noise is not present, then implementing a triggered pacing mode;wherein determining the type of implantable medical device comprises determining whether the implantable medical device is a type capable of providing a defibrillation therapy and when the implantable medical device is not a type capable of providing defibrillation therapy, then selecting the exposure mode based on device type and the pre-exposure mode comprises implementing a pacing mode that paces a same set of chambers of the heart as the pre-exposure mode.
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16. A method of controlling an exposure mode of therapy of an implantable medical device, comprising:
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determining a device type of the implantable medical device; upon detecting a need to switch to the exposure mode, selecting the exposure mode of therapy of the implantable medical device based on the device type and a pre-exposure mode of therapy; implementing the exposure mode of therapy at the implantable medical device by;
performing a first sensing of a heart rate using at least one sensing setting;
when the first sensing of heart rate indicates at least a first amount of noise is present, implementing an asynchronous pacing mode and then making adjustments to the at least one sensing setting prior to a next sensing of the heart rate that is subsequent to the first sensing and that uses the at least one sensing setting that has been adjusted; and
when the first sensing of heart rate indicates that at least the first amount of noise is not present, then implementing a triggered pacing mode;wherein prior to implementing the exposure mode of therapy there are pre-exposure rates of cardiac activity and wherein the exposure mode of therapy includes providing pacing from the implantable medical device, the method further comprising; upon detecting a need to switch to the exposure mode, selecting an exposure mode asynchronous pacing rate based on the pre-exposure rates where the exposure mode asynchronous pacing rate is used when in the asynchronous pacing mode; and implementing the exposure mode asynchronous pacing rate at the implantable medical device while implementing the exposure mode of therapy when the asynchronous pacing mode is being implemented.
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Specification