System and method for automatically selecting electrode polarity during sensing and stimulation
First Claim
1. A method of automatically selecting sensing or stimulation polarities of a plurality of sensing and stimulation electrodes that are positioned in multiple cardiac chambers, for use with a multi-site cardiac stimulation device, the method comprising the steps of:
- defining a plurality of sensing electrode configurations and a plurality of stimulation electrode configurations;
detecting the presence of a cardiac signal in any one of the multiple cardiac chambers with a sensing electrode configuration that corresponds to a first sensing electrode positioned in a right cardiac chamber and a second sensing electrode positioned in a left cardiac chamber;
selectively delivering a stimulus, on demand, to a cardiac chamber with a stimulation electrode configuration that corresponds to a first stimulation electrode positioned in a right cardiac chamber and a second stimulation electrode positioned in a left cardiac chamber; and
independently selecting the polarities of the first sensing electrode, the second sensing electrode, the first stimulation electrode, and the second stimulation electrode.
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Abstract
An implantable multi-chamber cardiac stimulation device includes flexibly programmable electrode stimulation configurations, and is capable of precisely controlling the stimulation sequence between multiple sites. The stimulation device provides a plurality of connection ports that allow independent connection of each electrical lead associated with a particular stimulation site in the heart. Each connection port further provides a unique terminal for making electrical contact with only one electrode such that no two electrodes are required to be electrically coupled. Furthermore, each electrode, whether residing on a unipolar, bipolar or multipolar lead, may be selectively connected or disconnected through programmable switching circuitry that determines the electrode configurations to be used for sensing and for stimulating at each stimulation site. The stimulation device allows for the programmable selection of each electrode terminal connection to a relatively positive or negative battery potential. In this way, each electrode, when electrically connected, may be programmed to act as the cathode or as the anode during sensing or stimulation delivery. Thus, directionality of the depolarization wave may be controlled by programming the cathode and anode assignments of the stimulation electrodes.
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Citations
22 Claims
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1. A method of automatically selecting sensing or stimulation polarities of a plurality of sensing and stimulation electrodes that are positioned in multiple cardiac chambers, for use with a multi-site cardiac stimulation device, the method comprising the steps of:
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defining a plurality of sensing electrode configurations and a plurality of stimulation electrode configurations;
detecting the presence of a cardiac signal in any one of the multiple cardiac chambers with a sensing electrode configuration that corresponds to a first sensing electrode positioned in a right cardiac chamber and a second sensing electrode positioned in a left cardiac chamber;
selectively delivering a stimulus, on demand, to a cardiac chamber with a stimulation electrode configuration that corresponds to a first stimulation electrode positioned in a right cardiac chamber and a second stimulation electrode positioned in a left cardiac chamber; and
independently selecting the polarities of the first sensing electrode, the second sensing electrode, the first stimulation electrode, and the second stimulation electrode. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A multi-site cardiac stimulation device capable of automatically selecting sensing or stimulation polarities of a plurality of sensing and stimulation electrodes that are positioned in multiple cardiac chambers, from among a plurality of sensing electrode configurations and a plurality of stimulation electrode configurations, the stimulation device comprising:
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a discriminator, coupled to the plurality of sensing electrodes and to the plurality of stimulation electrodes, that detects the presence of a cardiac signal in any one of the multiple cardiac chambers with a sensing electrode configuration that corresponds to a first sensing electrode positioned in a right cardiac chamber and a second sensing electrode positioned in a left cardiac chamber;
a pulse generator, connected to the stimulation electrodes, to selectively deliver a stimulus, on demand, to a cardiac chamber with a stimulation electrode configuration that corresponds to a first stimulation electrode positioned in a right cardiac chamber and a second stimulation electrode positioned in a left cardiac chamber; and
control circuitry, connected to the sensing electrodes, the stimulation electrodes, the pulse generator, and the discriminator to independently select the polarities of the first sensing electrode, the second sensing electrode, the first stimulation electrode, and the second stimulation electrode. - View Dependent Claims (9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A multi-site cardiac stimulation device capable of automatically selecting sensing or stimulation polarities of a plurality of sensing and stimulation electrodes that are positioned in multiple cardiac chambers, the stimulation device comprising:
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means for detecting the presence of a cardiac signal with a sensing electrode configuration;
means for selectively delivering a stimulus, on demand, to a cardiac chamber with a stimulation electrode configuration;
means for independently selecting the polarities of the sensing electrodes and the stimulation electrodes;
means for switching the polarities of the sensing electrodes on demand; and
means for switching the polarities of the stimulation electrodes on demand. - View Dependent Claims (22)
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Specification