Multiple electrode vectors for implantable cardiac treatment devices
First Claim
1. An implantable electrical cardiac treatment device comprising:
- first, second, and third electrodes, the second electrode provided at a first distance from the first electrode along a lead assembly, the third electrode provided at a second distance from the first electrode along a lead assembly; and
operational circuitry electrically coupled to the first, second and third electrodes such that sensing can be performed using any pair chosen therefrom;
wherein the operational circuitry is adapted to perform the following steps;
observe a signal metric between at least two of the following sensor pairs;
first-second, first-third, and second-third; and
select a default sensor pair for use in cardiac signal analysis by determining which pair performs the best as measured by the signal metric;
and further wherein the operational circuitry is adapted to perform the following data analysis;
analyzing a first signal captured from the default electrode pair and determining whether;
a normal sinus rhythm has been sensed;
an arrhythmia has been sensed;
orambiguity is present; and
if ambiguity is present, selecting a second electrode pair using the signal metric and analyzing a second signal captured from the second electrode pair.
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Abstract
The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity.
284 Citations
22 Claims
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1. An implantable electrical cardiac treatment device comprising:
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first, second, and third electrodes, the second electrode provided at a first distance from the first electrode along a lead assembly, the third electrode provided at a second distance from the first electrode along a lead assembly; and operational circuitry electrically coupled to the first, second and third electrodes such that sensing can be performed using any pair chosen therefrom; wherein the operational circuitry is adapted to perform the following steps; observe a signal metric between at least two of the following sensor pairs;
first-second, first-third, and second-third; andselect a default sensor pair for use in cardiac signal analysis by determining which pair performs the best as measured by the signal metric; and further wherein the operational circuitry is adapted to perform the following data analysis; analyzing a first signal captured from the default electrode pair and determining whether; a normal sinus rhythm has been sensed; an arrhythmia has been sensed;
orambiguity is present; and if ambiguity is present, selecting a second electrode pair using the signal metric and analyzing a second signal captured from the second electrode pair. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method of cardiac signal analysis comprising:
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implanting an implantable electrical cardiac treatment device and associated lead assembly into a patient such that operational circuitry housed in the device is coupled to first, second, and third electrodes; observing a signal metric between two pairs of electrodes chosen from the first, second and third electrodes; identifying a default electrode pair based upon observation of the signal metric; and using the default electrode pair for sensing of cardiac signals; analyzing a first signal captured from the default electrode pair and determining whether; a normal sinus rhythm has been sensed; an arrhythmia has been sensed;
orambiguity is present; and if ambiguity is present, selecting a second electrode pair and analyzing a second signal captured from the second electrode pair. - View Dependent Claims (9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A method of operating an implantable electrical cardiac treatment device having operational circuitry for performing cardiac performance evaluation and treatment, the method comprising:
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coupling first, second, and third implanted electrodes to the operational circuitry; observing a sensing metric for selected pairs of the implanted electrodes; identifying a default electrode pair for use in evaluation of cardiac signals; identifying a second best electrode pair for use in evaluation of cardiac signals; analyzing a first signal captured using the default electrode pair and determining whether; the first signal indicates a normal sinus rhythm; the first signal indicates a particular arrhythmia;
orthe first signal indicates ambiguity; and if the first signal indicates ambiguity, analyzing a second signal captured using the second best electrode pair. - View Dependent Claims (22)
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Specification