Cardiac therapy system using subcutaneously sensed P-waves for resynchronization pacing management
First Claim
1. An implantable medical device comprising:
- a lead comprising a plurality of implantable electrodes including at least first and second sensing electrodes separated by a defibrillation coil;
a housing containing operational circuitry for analyzing signals captured using the plurality of implantable electrodes, the housing also including at least one electrode; and
communication circuitry configured to communicate with a second implantable medical device;
wherein the operational circuitry is configured to perform an initialization sequence for detecting an atrial event, the initialization sequence comprising;
detecting at least first and second cardiac cycles of a patient;
establishing a window for detection of the atrial event by sensing when atrial events occurs relative to ventricular events of the first and second cardiac cycles, wherein the window for detection is adjustable relative to a beat rate of the patient;
wherein the operational circuitry is configured to observe cardiac signals of the patient during the window for detection of the atrial event in order to detect the atrial event by sensing a pacing output from a first medical device or a ventricular event of the patient, determining when the window for detection of the atrial event will start, and sensing the atrial event in the window; and
wherein the operational circuitry is configured to use the communication circuitry to issue a communication to the second implantable medical device in response to detecting an atrial event in the window for detection of the atrial event.
1 Assignment
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Accused Products
Abstract
Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.
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Citations
15 Claims
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1. An implantable medical device comprising:
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a lead comprising a plurality of implantable electrodes including at least first and second sensing electrodes separated by a defibrillation coil; a housing containing operational circuitry for analyzing signals captured using the plurality of implantable electrodes, the housing also including at least one electrode; and communication circuitry configured to communicate with a second implantable medical device; wherein the operational circuitry is configured to perform an initialization sequence for detecting an atrial event, the initialization sequence comprising; detecting at least first and second cardiac cycles of a patient; establishing a window for detection of the atrial event by sensing when atrial events occurs relative to ventricular events of the first and second cardiac cycles, wherein the window for detection is adjustable relative to a beat rate of the patient; wherein the operational circuitry is configured to observe cardiac signals of the patient during the window for detection of the atrial event in order to detect the atrial event by sensing a pacing output from a first medical device or a ventricular event of the patient, determining when the window for detection of the atrial event will start, and sensing the atrial event in the window; and wherein the operational circuitry is configured to use the communication circuitry to issue a communication to the second implantable medical device in response to detecting an atrial event in the window for detection of the atrial event. - View Dependent Claims (2)
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3. An implantable device system comprising:
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a first medical device configured to deliver a pacing therapy to a heart of a patient, the first medical device comprising a housing adapted for placement in the heart of the patient, a pulse generator adapted for issuing pacing pulses, and at least first and second electrodes coupled to the pulse generator, and a first communications module adapted for communicating with other medical devices either via an antenna or using the electrodes; and a second medical device configured to sense activity of the heart of the patient, the second medical device comprising a processor adapted for sensing cardiac activity and a plurality of electrodes coupled to input/output circuitry adapted to provide a signal to the processor, the second medical device including communication circuitry for communicating at least to the first communications module; wherein the second medical device processor is configured for an initialization sequence to use the input/output circuitry for detecting an atrial event, the initialization sequence comprising; detecting at least first and second cardiac cycles of the patient; and establishing a window for detection of the atrial event by sensing when atrial events occur relative to ventricular events of the first and second cardiac cycles, wherein the window for detection is adjustable relative to a beat rate of the patient; wherein the second medical device is configured to observe cardiac signals of the patient during the window for detection of the atrial event in order to detect the atrial event; wherein the first medical device is configured to receive communication from the second medical device; wherein the second medical device is configured to detect the atrial event in the heart of the patient and issue a communication to the first medical device, by sensing a pacing output of the first medical device or a ventricular event of the patient, determining when the window for detection of the atrial event will start, and sensing the atrial event in the window; wherein the first medical device is configured to deliver therapy to the heart of the patient in response to the communication issued by the second medical device. - View Dependent Claims (4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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Specification