METHOD AND APPARATUS TO PERFORM ELECTRODE COMBINATION SELECTION

• US 20130296961A1
• Filed: 06/24/2013
• Published: 11/07/2013
• Est. Priority Date: 08/07/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers
• Original Assignee: Cardiac Pacemakers
• Inventors: Brooke, M. Jason, Acuna, Andrea
• Granted Patent: US 9,533,160 B2
• Time in Patent Office: Days
• US Class Current: 607/28
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• 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 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/3708 for power depletion
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/37241 providing test stimulations
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

Electrical stimulation may be delivered to a patient'"'"'s heart using a plurality of cardiac electrodes. Each electrode combination may be evaluated based on one or more first parameters and one or more second parameters. In many cases, the one or more first parameters are supportive of cardiac function consistent with a prescribed therapy and the one or more second parameters are not supportive of cardiac function consistent with the prescribed therapy. The electrode combination selected to deliver a cardiac pacing therapy may be more associated with the one or more first parameters supportive of cardiac function consistent with the prescribed therapy and less associated with the one or more second parameters inconsistent with cardiac function.

Claims

1-20. -20. (canceled)

21. A programmer for programming an implantable CRM device, wherein the CRM device includes an implantable lead having two or more electrodes, and wherein the CRM device is capable of selecting an electrode combination from a plurality of electrode combinations for use during therapy, the programmer comprising:

a user interface including a display;

an I/O unit for communicating with an implantable CRM device;

a data processor coupled to the display and the I/O unit, the data processor programmed to;

read values for two or more parameters for each of two more electrode combinations of the implantable medical device, wherein at least one of the two or more parameters relates to battery consumption; and

display the values for each of two or more of the parameters for at least two of the two or more electrode combinations on the display of the user interface;

allow a user to select an electrode combination based on the values of the two or more parameters for the at least two of the two or more electrode combinations via the user interface; and

upload the selected electrode combination to the CRM device via the I/O unit.

22. The programmer of claim 21, wherein the data processor is programmed to display the values for each of two or more of the parameters for at least two of the two or more electrode combinations in a table format.

23. The programmer of claim 21, wherein the two or more parameters include a parameter related to a capture threshold, a parameter related to an impedance, and a parameter related to phrenic nerve stimulation.

24. The programmer of claim 21, wherein the two or more parameters include a parameter related to a capture threshold and a parameter related to phrenic nerve stimulation.

25. A method for programming an implantable CRM device using an external programmer that has a display, wherein the CRM device includes an implantable lead having two or more electrodes, and wherein the CRM device is capable of selecting an electrode combination from a plurality of electrode combinations for use during therapy, the method comprising:

establishing communication between the implantable CRM device and the external programmer;

measuring or estimating two or more parameter values for each of two or more of the electrode combinations; and

displaying on the display of the external programmer a table that associates at least two of the two or more electrode combinations with one or more of the corresponding two or more parameter values.

26. The method of claim 25, wherein the table is a multi-dimensional table.

27. The method of claim 25, wherein the two or more parameter values include a value related to an expected battery consumption for the corresponding electrode combination.

28. The method of claim 25, wherein the two or more parameter values include a value related to a measured capture threshold for the corresponding electrode combination.

29. The method of claim 25, wherein the two or more parameters include a value related to an impedance for the corresponding electrode combination.

30. The method of claim 25, wherein the two or more parameters include a value related to phrenic nerve stimulation for the corresponding electrode combination.

31. The method of claim 25, wherein the two or more parameter values include:

a value related to a capture threshold for the corresponding electrode combination; and

a value related to phrenic nerve stimulation for the corresponding electrode combination.

32. The method of claim 25, wherein the two or more parameter values include:

a value related to an expected battery consumption for the corresponding electrode combination; and

a value related to a capture threshold for the corresponding electrode combination.

33. The method of claim 25, wherein the two or more parameter values include:

a value related to depolarization and/or repolarization wave characteristics of the heart.

34. The method of claim 25, wherein the two or more parameter values include:

a value related to ventricular synchronization.

35. The method of claim 34, wherein the two or more parameter values further include:

a value related to an impedance for the corresponding electrode combination;

a value related to a capture threshold for the corresponding electrode combination; and

a value related to phrenic nerve stimulation for the corresponding electrode combination.

36. The method of claim 25, further comprising:

using the external programmer to select an electrode combination for therapy based on one or more of the two or more parameter values for two or more of the electrode combinations; and

uploading the selected electrode combination to the CRM device.

37. A method, comprising:

measuring or estimating values for two or more parameters for each of two more electrode combinations of an implantable medical device, wherein at least one of the two or more parameters relates to battery consumption; and

displaying the values for two or more of the parameters for each of two or more electrode combinations on a display.

38. The method of claim 37, wherein at least one of the two or more parameters relates to a capture threshold measured by the implantable medical device, and at least one of the two or more parameters relates to whether phrenic nerve stimulation was identified or not.

39. The method of claim 37, wherein at least one of the two or more parameters relates to an impedance measured using the implantable device.

40. The method of claim 37, wherein the values for each of the two or more parameters are displayed for each of the two or more electrode combinations in a table format.