SYSTEMS AND METHODS FOR RATE RESPONSIVE PACING WITH A LEADLESS CARDIAC PACEMAKER

• US 20150360036A1
• Filed: 06/11/2015
• Published: 12/17/2015
• Est. Priority Date: 06/12/2014
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kane, Michael J., Stahmann, Jeffrey E., Maile, Keith R.
• Granted Patent: US 9,962,550 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

Systems and methods for providing rate responsive pacing therapy to a heart of a patient. One example method for providing rate responsive pacing therapy includes sensing cardiac electrical data with a leadless cardiac pacemaker (LCP) that is implanted within or proximate the heart. From this location, the LCP may provide pacing therapy to the heart based at least in part on the sensed cardiac electrical data. An implantable medical device located remotely from the heart may sense patient activity, and may wirelessly communicate patient activity data from the implantable medical device to the LCP, sometimes using conducted communication. The LCP may be then determine an adjustment to the provided pacing therapy (e.g. adjust the pacing rate) based at least in part on the received patient activity data signal.

Claims

1. A method for providing rate responsive pacing therapy to a heart of a patient, the method comprising:

sensing cardiac electrical data with a leadless cardiac pacemaker (LCP) implanted within or proximate the heart of the patient;

providing pacing therapy to the heart of the patient with the LCP based at least in part on the sensed cardiac electrical data;

sensing patient activity with an implanted medical device from a location that is spaced from the heart of the patient;

wirelessly communicating a patient activity data signal from the implanted medical device to the LCP; and

the LCP determining an adjustment to the provided pacing therapy based at least in part on the received patient activity data signal, and adjusting the pacing therapy provided by the LCP.

2. The method of claim 1, wherein the pacing therapy comprises a pacing rate, and wherein the adjustment to the provided pacing therapy comprises an adjustment to the pacing rate of the provided pacing therapy.

3. The method of claim 1, wherein the patient activity data signal is wirelessly communicated to the LCP by conducted communication.

4. The method of claim 1, wherein the patient activity data signal comprises one or more of an electrical signal, a radiofrequency signal and an acoustic signal.

5. The method of claim 1, wherein the patient activity data signal is based, at least in part, on an output of an accelerometer of the implanted medical device.

7. The method of claim 1, wherein the patient activity data signal comprises accelerometer data.

8. The method of claim 1, wherein the patient activity data signal is based, at least in part, on a respiration signal.

9. The method of claim 8, wherein the respiration signal is based, at least in part, on a measure related to an impedance across at least a portion of a lung of the patient.

10. The method of claim 8, further comprising determining a measure related to a respiratory rate of the patient based, at least in part, on a difference in an amplitude of the patient activity data signal communicated by the implanted medical device and an amplitude of the patient activity data signal received at the LCP, and wherein the LCP determines the adjustment to the provided pacing therapy based at least in part on the measure related to the respiratory rate of the patient.

11. The method of claim 1, wherein the LCP determines the adjustment to the provided pacing therapy based at least in part on a sensed heart rate of the patient.

12. The method of claim 11, wherein sensed heart rate of the patient is sensed by one or more exposed electrodes of the LCP.

13. An implantable medical device system for providing adjustable rate pacing therapy to a heart of a patient, the system comprising:

a leadless cardiac pacemaker (LCP) implantable within or proximate the heart of the patient, wherein the LCP is configured to;

sense cardiac electrical data;

provide pacing therapy to the heart of the patient based at least in part on the sensed cardiac electrical data;

an implantable medical device implanted in a location that is spaced from the heart of the patient, wherein the implantable medical device is configured to;

sense patient activity, and

wirelessly communicate a patient activity data signal to the LCP; and

wherein the LCP is configured to determine an adjustment to the provided pacing therapy based at least in part on the received patient activity data signal and adjusts the pacing therapy.

14. The system of claim 13, wherein the pacing therapy comprises a pacing rate, and wherein the adjustment to the provided pacing therapy comprises an adjustment to the pacing rate of the provided pacing therapy.

15. The system of claim 13, wherein the patient activity data signal is wirelessly communicated to the LCP by conducted communication.

16. The system of claim 13, wherein the patient activity data signal is based, at least in part, on an output of an accelerometer of the implantable medical device.

17. The system of claim 16, wherein the LCP is further configured to determine the adjustment to the provided pacing therapy based at least in part on both the output of the accelerometer of the implantable medical device and a respiration rate of the patient that is determined at least in part using the implantable medical device.

18. An implantable medical device system for providing adjustable rate pacing therapy to a heart of a patient, the system comprising:

a leadless cardiac pacemaker (LCP) implantable within or proximate the heart of the patient;

an implantable medical device, wherein the implantable medical device comprises an accelerometer and is implantable remote from the heart of the patient, and is wirelessly communicatively coupled to the LCP;

wherein the implantable medical device is configured to generate patient activity data based at least in part on an output of the accelerometer, and is further configured to wirelessly communicate the patient activity data to the LCP; and

wherein the LCP is configured to;

provide rate responsive pacing therapy to the heart of the patient; and

adjust the rate of the rate responsive pacing therapy based at least in part on the patient activity data received from the implantable medical device.

6. The method of claim 20, wherein the LCP determines the adjustment to the provided pacing therapy based at least in part on both the output of the accelerometer of the implanted medical device and a respiration rate of the patient that is determined at least in part using the implanted medical device.

19. The implantable medical device system of claim 18, wherein the patient activity data is wirelessly communicated to the LCP by conducted communication.

20. The implantable medical device system of claim 18, wherein the patient activity data is wirelessly communicated to the LCP using one or more of an electrical signal, a radiofrequency signal and an acoustic signal.