Method and apparatus for selecting an optimal electrode configuration of a medical electrical lead having a multiple electrode array

• US 6,978,178 B2
• Filed: 04/30/2002
• Issued: 12/20/2005
• Est. Priority Date: 04/30/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sommer, John L., McClure, Lawrence C., Cho, Yong Kyun
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US10/137,248
• Publication Number:
  US 20030204232A1
• Time in Patent Office: 1,330 Days
• Field of Search: 607 8- 9, 607 27- 28, 607120-123, 607/126
• US Class Current: 607/28
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/7217 of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/3686 configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control

Abstract

An electrical medical lead is provided having two or more electrodes, electrically insulated from each other and electrically coupled to individually insulated filars in a multi-filar coiled conductor. When the lead is used with a medical device equipped with a switch matrix, electrodes are selected individually or simultaneously to serve as an anode or cathode in any unipolar, bipolar or multi-polar configuration for delivering stimulation and/or sensing signals in excitable tissue. In one embodiment, a tip electrode array is expandable for improving electrode contact with targeted tissue and stabilizing lead position.

Claims

1. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the microprocessor routine includes making a sensing threshold search comprising a sensing threshold measurement.

2. The implantable medical device of claim 1, wherein the microprocessor routine further includes determining a signal-to-noise ratio.

3. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the microprocessor routine includes making a pacing threshold search comprising a pacing threshold measurement.

4. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the plurality of electrodes are arranged in a staggered relative position.

5. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the microprocessor routine includes making an electrode scan that is enabled and disabled by a telemetry signal.

6. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the microprocessor routine includes selecting electrodes to be used for sensing cardiac depolarizations and for delivering cardiac pacing pulses, and wherein selecting the electrodes for the optimal sensing and pacing threshold is performed automatically.

7. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the lead further comprises an expansion member expanding the plurality of electrodes to vary an inter-electrode distance.

8. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the microprocessor routine comprises a set of instructions to automatically determine a combination of the electrodes that provides an optimal stimulation configuration and a combination of the electrodes that provides an optimal sensing configuration by performing an electrode scan wherein the pacing and sensing thresholds of electrode combinations are measured.

9. The implantable medical device of claim 8, wherein the optimal sensing configuration is identified as the electrode combination having the highest signal amplitude.

10. The implantable medical device of claim 8, wherein the optimal sensing configuration is identified as the electrode combination having the highest signal-to-noise ratio.

11. The implantable medical device of claim 8, wherein the optimal stimulation configuration is identified as the electrode combination having the lowest pacing threshold that captures targeted tissue without depolarizing non-targeted tissue.

12. An implantable medical device sensing cardiac depolarizations and delivering cardiac stimulation pulses, comprising:

an implantable electrical lead having a plurality of electrodes located along a distal end;

a pacer timing and control circuit coupled to the electrical lead; and

a microprocessor coupled to the pacer timing and control circuit and executing a routine comprising a set of instructions to perform a threshold search to determine a combination of lead electrodes that provides an optimal threshold for sensing cardiac depolarizations and delivering cardiac stimulation pulses, wherein the microprocessor routine adopts a default electrode configuration for pacing and sensing until a more optimal configuration is identified.