IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION

• US 20100114224A1
• Filed: 01/30/2009
• Published: 05/06/2010
• Est. Priority Date: 10/31/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Krause, Paul G., Donofrio, William T., Zhou, Xiaohong, Reinke, James D., Arne, Gerald P., Peichel, David J., Burnes, John E.
• Granted Patent: US 8,249,708 B2
• Time in Patent Office: Days
• US Class Current: 607/8
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/37258 Alerting the patient
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient

Abstract

Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Claims

1. A method comprising:

determining a first electrical parameter value indicative of an impedance of an electrical path coupled to a first implantable medical device (IMD);

activating delivery of electrical stimulation to a patient by a second IMD after determining the first electrical parameter value;

determining a second electrical parameter value indicative of the impedance of the electrical path while the second IMD delivers electrical stimulation;

determining whether the first and second electrical parameter values are within a threshold range of each other; and

generating an indication if the first and second electrical parameter values are not within the threshold range of each other.

2. The method of claim 1, further comprising, if the first and second electrical parameter values are not within the threshold range of each other, modifying at least one stimulation parameter with which the second implantable medical device generates the electrical stimulation.

3. The method of claim 2, wherein the at least one stimulation parameter comprises at least one of a current amplitude, a voltage amplitude, a pulse width, a pulse rate, a frequency, a duty cycle or an electrode combination.

4. The method of claim 1, wherein the first implantable medical device (IMD) delivers at least one of pacing, cardioversion or defibrillation therapy to a heart of the patient, and the second IMD delivers the electrical stimulation to a tissue site within the patient.

5. The method of claim 4, wherein the tissue site comprises at least one of a nonmyocardial tissue site or a nonvascular cardiac tissue site.

6. The method of claim 4, wherein the tissue site comprises at least one of an extravascular tissue site or the tissue site proximate to a nerve of the patient.

7. The method of claim 1, wherein the first implantable medical device (IMD) delivers the electrical stimulation to a tissue site within the patient and the second IMD delivers at least one of pacing, cardioversion or defibrillation signal to a heart of the patient.

8. The method of claim 1, further comprising suspending delivery of electrical stimulation by the second implantable medical device (IMD), wherein determining the first electrical parameter value comprises determining the first electrical parameter value while the delivery of electrical stimulation by the second IMD is suspended.

9. The method of claim 1, further comprising adjusting the delivery of electrical stimulation by the second implantable medical device if the first and second electrical parameter values are not within the threshold range of each other.

10. The method of claim 9, wherein adjusting the delivery of electrical stimulation by the second implantable medical device (IMD) comprises suspending the delivery of electrical stimulation by the second IMD.

11. The method of claim 1, wherein the threshold range comprises about five percent to about 20 percent.

12. The method of claim 1, wherein generating the indication comprises generating at least one of an auditory, visual or somatosensory notification.

13. The method of claim 1, wherein the indication comprises a first indication, the method further comprising:

determining a difference between the first and electrical parameter values;

determining a trend in the difference between the first and electrical parameter values over time; and

generating a second indication based on the trend.

14. The method of claim 13, wherein generating the second indication based on the trend comprises generating the second indication if the difference between the first and electrical parameter values increases over time.

15. A system comprising:

a first implantable medical device (IMD) implanted within a patient;

a second IMD implanted within the patient; and

a processor that determines a first electrical parameter value indicative of an impedance of an electrical path coupled to the first IMD, determines a second electrical parameter value indicative of the impedance of the electrical path while the second IMD delivers electrical stimulation to the patient, determines whether the first and second electrical parameter values are within a threshold range of each other, and generates an indication if the first and second electrical parameter values are not within the threshold range of each other.

16. The system of claim 15, wherein, if the first and second electrical parameter values are not within the threshold range of each other, the processor initiates a modification to at least one stimulation parameter with which the second implantable medical device generates the electrical stimulation.

17. The system of claim 16, wherein the processor initiates the modification to the at least one stimulation parameter by at least providing a control signal to the second implantable medical device (IMD), wherein the second IMD modifies the at least one stimulation parameter.

18. The system of claim 16, wherein the processor initiates the modification to the at least one stimulation parameter by at least providing the modified at least one stimulation parameter to the second implantable medical device.

19. The system of claim 15, wherein the first implantable medical device (IMD) delivers at least one of pacing, cardioversion or defibrillation therapy to a heart of the patient, and the second IMD delivers the electrical stimulation to a tissue site within the patient.

20. The system of claim 19, wherein the tissue site comprises at least one of a nonmyocardial tissue site or a nonvascular cardiac tissue site.

21. The system of claim 19, wherein the tissue site comprises at least one of an extravascular tissue site or the tissue site proximate to a nerve of the patient.

22. The system of claim 15, wherein the first implantable medical device (IMD) delivers the electrical stimulation to a tissue site within the patient and the second IMD delivers at least one of pacing, cardioversion or defibrillation therapy to a heart of the patient.

23. The system of claim 15, wherein the processor controls the second implantable medical device to suspend the delivery of electrical stimulation if the first and second electrical parameter values are not within a threshold range of each other.

24. The system of claim 15, wherein the processor controls the second implantable medical device (IMD) to suspend the delivery of electrical stimulation and the processor determines the first electrical parameter value while the delivery of electrical stimulation by the second IMD is suspended.

25. The system of claim 15, wherein the threshold range comprises about five percent to about 20 percent.

26. The system of claim 15, wherein the indication comprises a first indication, and the processor determines a difference between the first and electrical parameter values, determines a trend in the difference between the first and electrical parameter values over time, and generates a second indication based on the trend.

27. The system of claim 26, wherein the processor generates the second indication based on the trend by at least generating the second indication if the difference between the first and electrical parameter values increases over time.

28. The system of claim 15, further comprising a medical device programmer, wherein the processor presents the indication via a user interface of the medical device programmer.

29. A system comprising:

means for determining a first electrical parameter value indicative of an impedance of an electrical path coupled to a first implantable medical device (IMD);

means for activating delivery of electrical stimulation to a patient by a second IMD after determining the first electrical parameter value;

means for determining a second electrical parameter value indicative of the impedance of the electrical path while the second IMD delivers electrical stimulation;

means for determining whether the first and second electrical parameter values are within a threshold range of each other; and

means for generating an indication if the first and second electrical parameter values are not within the threshold range of each other.

30. The system of claim 29, further comprising means for modifying at least one stimulation parameter with which the second implantable medical device generates the electrical stimulation if the first and second electrical parameter values are not within the threshold range of each other.

31. A computer-readable medium comprising instructions that cause a programmable processor to:

determine a first electrical parameter value indicative of an impedance of an electrical path coupled to a first implantable medical device (IMD);

activate delivery of electrical stimulation to a patient by a second IMD after determining the first electrical parameter value;

determine a second electrical parameter value indicative of the impedance of the electrical path while the second IMD delivers electrical stimulation;

determine whether the first and second electrical parameter values are within a threshold range of each other; and

generate an indication if the first and second electrical parameter values are not within the threshold range of each other.