Multi-device cardiac resynchronization therapy with timing enhancements
First Claim
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1. An implantable medical device (IMD) system comprising:
- a leadless cardiac pacemaker (LCP) having a plurality of LCP electrodes, pacing circuitry configured to issue cardiac pacing outputs via the plurality of LCP electrodes, LCP communication circuitry configured to communicate to a second device, and operational circuitry configured to control the pacing circuitry to generate cardiac resynchronization therapy (CRT) using data received with the communication circuitry, the LCP further comprising a sensing input circuit to receive one or more biological signals to determine whether the CRT is achieving a desired result;
an extracardiac device (ED) comprising;
a plurality of electrodes for sensing cardiac signals;
ED communication circuitry configured to communicate with at least the LCP communication circuitry; and
ED operational circuitry configured to receive sensed cardiac signals from the plurality of electrodes and analyze cardiac activity;
wherein the ED operational circuitry is configured to obtain a cardiac signal from the plurality of electrodes, identify occurrence of a P-wave in the cardiac signal using a set of P-wave detection parameters, and use the ED communication circuitry to communicate to the LCP timing information related to the identified P-wave to assist in the CRT, such that the ED serves as a second device for purposes of the LCP communication circuitry; and
wherein the ED and LCP are configured to cooperatively adjust the P-wave detection parameters.
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Abstract
Methods, systems and devices for providing cardiac resynchronization therapy (CRT) to a patient using a leadless cardiac pacemaker (LCP) and an extracardiac device (ED). The system is configured to identify atrial events to use as timing markers for the LCP to deliver CRT, and further to determine whether the timing markers are incorrectly sensed and to make adjustment or call for re-initialization as needed.
1209 Citations
20 Claims
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1. An implantable medical device (IMD) system comprising:
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a leadless cardiac pacemaker (LCP) having a plurality of LCP electrodes, pacing circuitry configured to issue cardiac pacing outputs via the plurality of LCP electrodes, LCP communication circuitry configured to communicate to a second device, and operational circuitry configured to control the pacing circuitry to generate cardiac resynchronization therapy (CRT) using data received with the communication circuitry, the LCP further comprising a sensing input circuit to receive one or more biological signals to determine whether the CRT is achieving a desired result; an extracardiac device (ED) comprising; a plurality of electrodes for sensing cardiac signals; ED communication circuitry configured to communicate with at least the LCP communication circuitry; and ED operational circuitry configured to receive sensed cardiac signals from the plurality of electrodes and analyze cardiac activity; wherein the ED operational circuitry is configured to obtain a cardiac signal from the plurality of electrodes, identify occurrence of a P-wave in the cardiac signal using a set of P-wave detection parameters, and use the ED communication circuitry to communicate to the LCP timing information related to the identified P-wave to assist in the CRT, such that the ED serves as a second device for purposes of the LCP communication circuitry; and wherein the ED and LCP are configured to cooperatively adjust the P-wave detection parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. An implantable medical device (IMD) system comprising:
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a leadless cardiac pacemaker (LCP) for delivering cardiac resynchronization therapy (CRT), the LCP comprising; a plurality of electrodes for delivering pacing therapy; a sensing input circuit to receive one or more biological signals; a pacing output circuit; LCP communication circuitry; and LCP operational circuitry configured to receive and analyze signals from the sensing input; an extracardiac device (ED) comprising; a plurality of electrodes for sensing cardiac signals; ED communication circuitry configured to communicate with at least the LCP communication circuit; and ED operational circuitry configured to receive sensed cardiac signals from the plurality of electrodes and analyze cardiac activity; wherein the ED operational circuitry is configured to obtain a cardiac signal from the plurality of electrodes, identify occurrence of a P-wave in the cardiac signal, and use the ED communication circuitry to communicate to the LCP that the P-wave has been detected; and wherein the LCP operational circuitry is configured to determine from its analysis of signals received from the sensing input whether the ED is incorrectly detecting the P-wave. - View Dependent Claims (18)
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19. An implantable medical device (IMD) system comprising:
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a leadless cardiac pacemaker (LCP) for delivering cardiac resynchronization therapy (CRT), the LCP comprising; a plurality of electrodes for delivering pacing therapy; a sensing input circuit to receive one or more biological signals; a pacing output circuit; LCP communication circuitry; and LCP operational circuitry configured to receive and analyze signals from the sensing input; an extracardiac device (ED) comprising; a plurality of electrodes for sensing cardiac signals; ED communication circuitry configured to communicating with at least the LCP communication circuit; and ED operational circuitry configured to receive sensed cardiac signals from the plurality of electrodes and analyze cardiac activity; wherein the ED operational circuitry is configured to obtain a cardiac signal from the plurality of electrodes, identify occurrence of a P-wave in the cardiac signal, and use the ED communication circuitry to communicate to the LCP that the P-wave has been detected; wherein the LCP operational circuitry is configured to use the pacing output circuit to deliver pace therapy and to use the sensing input circuit to determine whether a cardiac response to the pace therapy matches a desired metric; and wherein the LCP operational circuitry is configured to communicate to the ED operational circuitry to indicate that the pace therapy does not match the desired metric. - View Dependent Claims (20)
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Specification