IMPLANTABLE DEVICE WITH POST-MRI CARDIAC SIGNAL SENSING ADJUSTMENT

• US 20110160602A1
• Filed: 11/01/2010
• Published: 06/30/2011
• Est. Priority Date: 12/30/2009
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stubbs, Scott R., Stahmann, Jeffrey E.
• Granted Patent: US 9,603,549 B2
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 2560/0271 using a remote monitoring unit
• CPC Class Codes: A61B 2560/0276 Determining malfunction
• CPC Class Codes: A61B 5/063 using impedance measurements
• CPC Class Codes: A61N 1/086 Magnetic resonance imaging [MRI] compatible leads
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control

Abstract

An implantable device, such as a pacer, defibrillator, or other cardiac rhythm management device, can include an automatic testing and adjusting of cardiac signal sensing after an MRI scanning procedure, such as to accommodate an MRI-induced physiological change in sensed cardiac depolarization amplitude or in lead impedance such as at an electrode/tissue interface.

Claims

1. An apparatus comprising:

an ambulatory or implantable medical device comprising;

a cardiac signal sensing circuit; and

a controller circuit, coupled to the cardiac signal sensing circuit, the controller configured to receive an indication that a magnetic resonance imaging (MRI) scanning procedure has completed and, in response, to automatically test a cardiac signal sensing of the cardiac signal sensing circuit, and to adjust a cardiac signal sensing parameter when a physiological change in depolarization amplitude or lead impedance causes a post-MRI scanning procedure loss of cardiac depolarization sensing.

2. The apparatus of claim 1, wherein the implantable medical device comprises an MR-mode, and wherein the indication that the MRI scanning procedure has completed comprises a transition from the MR-mode.

3. The apparatus of claim 1, wherein the implantable medical device comprises an MRI detector circuit, coupled to the controller circuit, the MRI detector circuit configured to detect whether an MRI scanner device is present near the implantable medical device, and wherein the MRI detector circuit is configured to use information about whether the MRI scanner is present near the implantable medical device to provide the indication that the MRI scanning procedure has completed.

4. The apparatus of claim 1, wherein the indication that the MRI scanning procedure has completed is based on information about a detected fault condition associated with an MRI scanning procedure.

5. The apparatus of claim 1, comprising a communication module, coupled to the controller circuit, wherein the communication module is configured to communicate from the implantable medical device a report indicative of a cardiac signal sensing parameter that was automatically altered in response to post-MRI scanning procedure testing of the cardiac signal sensing.

6. The apparatus of claim 1, comprising a communication module, coupled to the controller circuit, wherein the communication module is configured to communicate from the implantable medical device an alert indicative of loss of cardiac signal sensing after the MRI scanning procedure.

7. The apparatus of claim 1, wherein the controller is configured to repeatedly automatically test the cardiac signal sensing over a period of time associated with post-MRI scanning procedure physiological variability of a cardiac signal amplitude or lead impedance.

8. An apparatus comprising:

an ambulatory or implantable medical device comprising;

a cardiac signal sensing circuit; and

a controller circuit, coupled to the cardiac signal sensing circuit, the controller configured to receive an indication that a magnetic resonance imaging (MRI) scanning procedure has completed and, in response, to automatically test a cardiac signal sensing of the cardiac signal sensing circuit, and to adjust a cardiac signal sensing parameter when a physiological change in depolarization amplitude or lead impedance causes a post-MRI scanning procedure loss of cardiac depolarization sensing; and

a communication circuit, coupled to the controller circuit, wherein the communication circuit is configured to communicate from the implantable medical device at least one of;

a report indicative of a cardiac signal sensing parameter that was automatically altered in response to post-MRI scanning procedure testing of the cardiac signal sensing;

or, an alert indicative of loss of cardiac signal sensing after the MRI scanning procedure; and

wherein the indication that the MRI scanning procedure has completed comprises at least one of;

a transition from an MR-mode of the implantable medical device;

information from an MRI detector circuit; and

information about a detected fault condition.

9. The apparatus of claim 8, comprising:

a local external interface device, configured to be communicatively coupled with the implantable medical device, the local external interface device configured to receive a report indicative of a cardiac signal sensing parameter that was automatically altered in response to post-MRI scanning procedure testing of the cardiac signal sensing;

or, an alert indicative of loss of cardiac signal sensing after the MRI scanning procedure.

10. The apparatus of claim 8, comprising:

a local external interface device, configured to be communicatively coupled with the implantable medical device, the local external interface device configured to receive an alert indicative of loss of cardiac signal sensing after the MRI scanning procedure.

11. The apparatus of claim 8, comprising:

a remote external interface device, configured to be communicatively coupled with the implantable medical device, the remote external interface device configured to receive a report indicative of a cardiac signal sensing parameter that was automatically altered in response to post-MRI scanning procedure testing of the cardiac signal sensing;

or, an alert indicative of loss of cardiac signal sensing after the MRI scanning procedure.

12. The apparatus of claim 8, comprising:

a remote external interface device, configured to be communicatively coupled with the implantable medical device, the remote external interface device configured to receive an alert indicative of loss of cardiac signal sensing after the MRI scanning procedure.

13. A method comprising:

receiving an indication that a magnetic resonance imaging (MRI) scanning procedure has completed; and

in response to the MRI scanning procedure completion, automatically testing a cardiac signal sensing of an implantable medical device; and

when a physiological change in depolarization amplitude or lead impedance causes a post-MRI scanning procedure loss of cardiac depolarization sensing, adjusting a cardiac signal sensing parameter of the implantable medical device to help re-establish cardiac depolarization sensing.

14. The method of claim 13, comprising determining MRI scanning procedure completion by detecting a switch from an MR-mode.

15. The method of claim 13, comprising determining MRI scanning procedure completion using a MRI scanner detector circuit that is configured to detect when an MRI scanner is present near the implantable medical device.

16. The method of claim 13, comprising determining MRI scanning procedure completion by detecting a fault condition associated with an MRI scanning procedure.

17. The method of claim 13, comprising communicating to a user a report indicative of a cardiac signal sensing parameter that was automatically altered in response to post-MRI scanning procedure testing of the cardiac signal sensing.

18. The method of claim 13, comprising communicating to a user an alert indicative of loss of cardiac signal sensing after the MRI scanning procedure.

19. The method of claim 13, comprising repeating the automatically testing the cardiac signal sensing over a period of time associated with post-MRI scanning procedure physiological variability of a cardiac signal amplitude or lead impedance.

20. The method of claim 13, comprising declaring MRI scanning procedure completion in response to:

detecting a switch from an MR-mode;

detecting when an MRI scanner is no longer present near the implantable medical device; and

detecting a fault condition associated with an MRI scanning procedure.