METHOD AND SYSTEM FOR IDENTIFYING A POTENTIAL LEAD FAILURE IN AN IMPLANTABLE MEDICAL DEVICE

• US 20110009918A1
• Filed: 07/07/2009
• Published: 01/13/2011
• Est. Priority Date: 07/07/2009
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Poore, John W., Williamson, Richard, Mouchawar, Gabriel A., Fain, Eric S., Bornzin, Gene A.
• Granted Patent: US 8,391,980 B2
• Time in Patent Office: Days
• US Class Current: 607/27
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: G01R 31/54 Testing for continuity

Abstract

A method for detecting potential failures by a lead of an implantable medical device is provided. The method includes sensing a first signal over a first channel between a first combination of electrodes on the lead and sensing a second signal from a second channel between a second combination of electrodes on the lead. The method determines whether at least one of the first and second signals is representative of a potential failure in the lead and identifies a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure. Optionally, when the first and second sensed signals are both representative of the potential failure, the method further includes determining whether the first and second sensed signals are correlated with one another. When the first and second sensed signals are correlated, the method declares an electrode common to both of the first and second combinations to be associated with the failure.

Claims

1. A method for detecting potential failures by an implantable medical lead, comprising:

sensing a first signal over a first channel between a first combination of electrodes on the lead;

sensing a second signal from a second channel between a second combination of electrodes on the lead;

determining whether at least one of the first and second signals is representative of a potential failure in the lead; and

identifying a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure.

2. The method of claim 1, further comprising:

when the first and second sensed signals are both representative of the potential failure, determining whether the first and second sensed signals are correlated with one another; and

when the first and second sensed signals are correlated, declaring an electrode common to both of the first and second combinations to be associated with the failure.

3. The method of claim 1, further comprising changing at least one of a pacing configuration and a pacer sensing configuration based on the electrode associated with the failure.

4. The method of claim 1, further comprising comparing at least one of amplitude, rate and slew rate of the first and second sensed signals to a predetermined threshold representative of a physiologically acceptable limit for the corresponding one of amplitude, rate and slew rate.

5. The method of claim 1, further comprising disabling sensing over at least one of the first and second channels that is associated with the failure, and enabling a different third channel to sense signals from a third combination of electrodes.

6. The method of claim 1, further comprising notifying a physician of existence of the failure and of the type of failure.

7. The method of claim 1, wherein the first combination of electrodes includes a ring electrode and a tip electrode and the second combination of electrodes includes a coil electrode and the tip electrode.

8. The method of claim 1, further comprising declaring a failure of an electrode of the first combination of electrodes when the first signal is representative of a non-physiologic signal and the second signal is representative of a physiologic signal.

9. The method of claim 1, further comprising declaring a failure of an electrode common to both the first and second combinations of electrodes when the first and second signals are both representative of non-physiologic signals.

10. An implantable medical device, comprising:

a lead configured to be positioned within a heart, the lead including first combination of electrodes that sense a first signal over a first channel, the lead including a second channel between a second combination of the electrodes that sense a second signal over a second channel;

a channel selection module configured to control which of the electrodes are included in the first and second combinations of electrodes; and

a failure detection module determining whether at least one of the first and second signals is representative of a potential failure in the lead and identifying a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure.

11. The implantable medical device of claim 10, wherein the failure detection module identifies a tip electrode to be associated with the failure when the first and second signals are correlated with one another and are representative of non-physiologic signals.

12. The implantable medical device of claim 10, wherein the failure detection module compares at least one of an amplitude, a rate and a slew rate of the first and second signals to a predetermined threshold representative of a physiologically acceptable limit for the corresponding one of the amplitude, rate and slew rate.

13. The implantable medical device of claim 10, wherein the channel selection module is configured to enable a different third channel to sense cardiac signals from a third combination of electrodes when a failure is identified by the failure detection module.

14. The implantable medical device of claim 10, wherein the channel selection module is configured to disable sensing over a one of the first and second channels that utilizes an electrode associated with the failure.

15. The implantable medical device of claim 10, wherein the failure detection module is configured to declare a failure of an electrode of the first combination of electrodes when the first signal is representative of a non-physiologic signal and the second signal is representative of a physiologic signal.

16. The implantable medical device of claim 10, wherein the failure detection module is configured to declare a failure of an electrode common to both the first and second combinations of electrodes when the first and second signals are both representative of non-physiologic signal.

17. A method for detecting potential failures by an implantable medical lead, comprising:

sensing a first signal over a first channel between a first combination of electrodes on the lead;

determining whether the first signal is representative of a potential failure in the lead;

obtaining a secondary indicator of heart condition; and

utilizing the secondary indicator to confirm an arrhythmia of the heart when the determining operation identifies the lead to include the potential failure.

18. The method according to claim 17, wherein the secondary indicator represents a hemodynamic indicator from one of an impedance plethysmography measurement indicative of stroke volume in the heart, a pressure sensor located in a heart chamber, a heart sound sensor and a peak endocardial acceleration sensor.

19. The method according to claim 17, wherein the secondary indicator is obtained from a hemodynamic sensor, the secondary indicator being tested after the determining operation identifies the potential failure based on the first signal, the secondary indicator being analyzed before delivery of a therapy.

20. The method according to claim 17, wherein the secondary indicator is obtained from a hemodynamic sensor, the method further comprising performing additional analysis of a heart, when the secondary indicator is representative of normal sinus rhythm, before delivering a therapy.