Dual-chamber pacemaker system for simultaneous bi-chamber pacing and sensing
First Claim
1. A method of pacing opposing chambers of a heart with a pacing system, the pacing system comprising a first bipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second bipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second bipolar medical electrical leads, the implantable pulse generator further comprising an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode, the method comprising:
- determining a primary electrode configuration;
selecting a cathode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
selecting an anode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration;
delivering a first pulse between the cathode and the anode;
determining a first threshold of the first opposing chamber;
determining a second threshold of the second opposing chamber; and
selecting the first electrode as the cathode if the first threshold is higher than the second threshold.
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Abstract
A method of pacing opposing chambers of a heart with a pacing system is provided. The pacing system comprises a first bipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second bipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second bipolar medical electrical leads. The implantable pulse generator further comprises a hermetically sealed housing capable of serving as a can electrode. The method designates a primary electrode configuration by selecting a cathode and an anode from either the first electrode, second electrode, or the can. Selection of the cathode is based on a comparison of thresholds measured in each chamber. Systems, programs and devices using the method are also provided.
25 Citations
16 Claims
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1. A method of pacing opposing chambers of a heart with a pacing system, the pacing system comprising a first bipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second bipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second bipolar medical electrical leads, the implantable pulse generator further comprising an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode, the method comprising:
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determining a primary electrode configuration; selecting a cathode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration; selecting an anode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration; delivering a first pulse between the cathode and the anode; determining a first threshold of the first opposing chamber; determining a second threshold of the second opposing chamber; and selecting the first electrode as the cathode if the first threshold is higher than the second threshold. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A computer usable medium including a program for opposing chambers of a heart with a pacing system, the pacing system comprising a first unipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second unipolar medical electrical leads, the implantable pulse generator further comprising an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode, the program comprising:
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computer program code that determines a primary electrode configuration; computer program code that selects a cathode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration; computer program code that selects an anode from the first electrode, the second electrode arid the can electrode based on the primary electrode configuration; computer program code that delivers a first pulse between the cathode and the anode; computer program code that determines a first threshold of the first opposing chamber; computer program code that determines a second threshold of the second opposing chamber; and computer program code that selects the first electrode as the cathode if the first threshold is higher than the second threshold. - View Dependent Claims (10, 11, 12, 13, 14, 15)
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16. A computer usable medium including a program for opposing chambers of a heart with a pacing system, the pacing system comprising a first bipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second bipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second bipolar medical electrical leads, the implantable pulse generator further comprising an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode, the program comprising:
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computer program code that determines a primary electrode configuration; computer program code that selects a cathode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration; computer program code that selects an anode from the first electrode, the second electrode and the can electrode based on the primary electrode configuration; computer program code that delivers a first pulse between the cathode and the anode; computer program code that determines a first threshold of the first opposing chamber; computer program code that determines a second threshold of the second opposing chamber; and computer program code that selects the first electrode as the cathode if the first threshold is higher than the second threshold.
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Specification