Methods and systems for selection of cardiac pacing electrode configurations

• US 20060074454A1
• Filed: 09/30/2004
• Published: 04/06/2006
• Est. Priority Date: 09/30/2004
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Freeberg, Scott M.
• Granted Patent: US 7,647,108 B2
• Time in Patent Office: Days
• US Class Current: 607/28
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/3686 configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

Methods and systems involve selecting lead configurations in a pulse generator capture verification system. Capture threshold data is collected from at least one alternative electrode configuration. The capture threshold data from the at least one alternative electrode configuration is compared with capture threshold data collected using a primary electrode configuration. A pacing electrode configuration is selected based on the comparison. Backup safety pacing is provided using the primary electrode configuration.

Claims

1. A method for selecting an electrode configuration for pacing, comprising:

collecting capture threshold data from an alternative pacing electrode configuration;

comparing the capture threshold data from the alternative pacing electrode configuration with capture threshold data collected using a primary pacing electrode configuration; and

selecting a pacing electrode configuration based on the comparison.

2. The method of claim 1, wherein at least two of collecting, comparing and selecting is performed implantably.

3. The method of claim 1, further comprising:

collecting lead impedance data; and

selecting the pacing electrode configuration using the lead impedance data.

4. The method of claim 1, further comprising:

collecting cardiac signal amplitude measurement data; and

selecting the pacing electrode configuration using the cardiac signal amplitude measurement data.

5. The method of claim 1, wherein collecting the capture threshold data comprises:

delivering one or more pacing pulses using the alternative pacing electrode configuration during a capture threshold test; and

collecting the capture threshold data from the alternative pacing electrode configuration during the capture threshold test.

6. The method of claim 5, wherein delivering the one or more pacing pulses using the alternative pacing electrode configuration comprises:

delivering the one or more pacing pulses using a unipolar electrode configuration if the primary pacing electrode configuration is bipolar; and

delivering the one or more pacing pulses using a bipolar electrode configuration if the primary pacing electrode configuration is unipolar.

7. The method of claim 5, further comprising delivering a safety backup pacing pulse using the primary electrode configuration following delivery of the one or more pacing pulses.

8. The method of claim 5, further comprising delivering a safety backup pacing pulse using an electrode configuration other than the alternative pacing electrode configuration following delivery of the one or more pacing pulses.

9. The method of claim 1, wherein selecting the pacing electrode configuration comprises selecting the alternative pacing electrode configuration as the pacing electrode configuration if the alternative pacing electrode configuration is associated with a lower capture threshold that the primary pacing electrode configuration.

10. A system for selecting a pacing electrode configuration, comprising:

a plurality of electrodes configured to electrically couple to a heart, wherein the plurality of electrodes are configurable to include a primary pacing electrode configuration and at least one alternative pacing electrode configuration;

a pulse generator coupled to the plurality of electrodes, the pulse generator configured to deliver electrical stimulation pulses to the heart using configurations of the plurality of electrodes; and

a processor configured to collect capture threshold data associated with the at least one alternative pacing electrode configuration, compare the capture threshold data from the alternative pacing electrode configuration with capture threshold data collected using the primary pacing electrode configuration, and select a pacing electrode configuration based on the comparison.

11. The system of claim 10, wherein the processor comprises at least one implantable component.

12. The system of claim 10, wherein the processor is further configured to collect lead impedance data and to select the pacing electrode configuration based on the lead impedance data.

13. The system of claim 10, wherein the processor is further configured to collect cardiac signal amplitude data and to select the pacing electrode configuration based on the cardiac signal amplitude data.

14. The system of claim 10, wherein:

the pulse generator is configured to deliver one or more pacing pulses using the at least one alternative pacing electrode configuration during a capture threshold test; and

the processor is configured to collect the capture threshold data associated with the alternative pacing electrode configuration during the capture threshold test.

15. The system of claim 14, wherein the pulse generator is configured to deliver a safety pulse using the primary pacing electrode configuration following each of the one or more pacing pulses.

16. The system of claim 14, wherein the pulse generator is configured to deliver a safety pulse using a safety pacing electrode configuration other than the alternative pacing electrode configuration following each of the one or more pacing pulses.

17. The system of claim 10, wherein the alternative pacing electrode configuration comprises a unipolar electrode configuration if the primary pacing electrode configuration is bipolar.

18. The system of claim 10, wherein the alternative electrode configuration comprises a bipolar electrode configuration if the primary pacing electrode configuration is unipolar.

19. The system of claim 10, wherein the processor is configured to select the alternative pacing electrode configuration as the pacing electrode configuration if the alternative pacing electrode configuration is associated with a lower capture threshold than the primary pacing electrode configuration.

20. A system for selecting an electrode configuration for pacing, comprising:

means for collecting capture threshold data from at least one alternative electrode configuration;

means for comparing the capture threshold data from the at least one alternative electrode configuration with capture threshold data collected using a primary electrode configuration; and

means for selecting a pacing electrode configuration based on the comparison.

21. The system of claim 20, further comprising:

means for delivering one or more pacing pulses using the at least one alternative electrode configuration during a capture threshold test; and

means for collecting the capture threshold data from the at least one alternative electrode configuration during the capture threshold test.

22. The system of claim 21, further comprising means for delivering a safety backup pacing pulse using an electrode configuration other than the at least one alternative electrode configuration.

23. The system of claim 20, further comprising means for selecting the at least one alternative pacing electrode configuration as the pacing electrode configuration if the at least one alternative pacing electrode configuration is associated with a lower capture threshold than the primary pacing electrode configuration.