Automatic electrode integrity management systems and methods

• US 7,899,535 B2
• Filed: 06/16/2006
• Issued: 03/01/2011
• Est. Priority Date: 06/16/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Bohn, Derek D., Sathaye, Alok S., Brooke, M. Jason, Gandhi, Rajesh Krishan, McCabe, Aaron
• Primary Examiner(s): Bertram; Eric D.
• Application Number:
  US11/424,579
• Publication Number:
  US 20070293903A1
• Time in Patent Office: 1,719 Days
• Field of Search: 607/27, 607/28
• US Class Current: 607/27
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• 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 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network

Abstract

This document discusses, among other things, systems and methods for automatic electrode integrity management. Interelectrode impedance is measured for various electrode combinations of an implantable cardiac function management device. The impedance data is processed, such as at an external remote server, to determine whether an electrode is failing or has failed, to select an alternate electrode configuration, to alert a physician or patient, to predict a time-to-failure such as by using population data, or to reprogram electrode configuration or other device parameters of the implantable cardiac function management device.

Claims

1. A method comprising:

measuring an electrode impedance for a combination of two or more electrodes connected to an implantable cardiac function management device;

comparing the measured electrode impedance to a set of population data, the population data including electrode impedances for similar electrode combinations used in various patients in a patient population;

determining, based on the comparison of the measured electrode impedance to the set of population data, whether the measured electrode impedance represents a significant change for the combination of two or more electrodes; and

determining, if the measured electrode impedance represents a significant change, a reconfiguration option for the implantable cardiac function management device.

2. The method of claim 1, wherein the set of population data includes predictive laboratory or simulation modeled data when data from electrode impedances for similar electrode combinations used in various patients in a patient population is unavailable or otherwise insufficient.

3. The method of claim 1, wherein the set of population data includes predictive laboratory or simulation modeled data for similar electrode combinations.

4. The method of claim 1, further including creating a population trend over time from the set of population data;

and

wherein determining whether the measured electrode impedance represents a significant change includes determining where the measured electrode impedance falls within the population data trend over time.

5. The method of claim 4, wherein determining where the measured electrode impedance falls within the population data trend over time indicates a predicted time-to-failure for at least one of the two or more electrodes.

6. The method of claim 5, wherein determining the reconfiguration option includes adjusting one or more implantable cardiac function management device parameters based on the predicted time-to-failure for at least one of the two or more electrodes.

7. The method of claim 1, wherein the set of population data includes data from implantable cardiac function devices that exhibited a similar failure mode.

8. The method of claim 1, wherein comparing the measured electrode impedance to the set of population data includes normalizing the measured electrode impedance to compare a change in impedance to the set of population data.

9. The method of claim 1, wherein determining the reconfiguration option includes selecting an alternative electrode to replace one of the two or more electrodes.

10. The method of claim 9, wherein selecting an alternative electrode includes selecting the alternative electrode from an ordered list of electrodes.

11. The method of claim 9, wherein selecting an alternative electrode includes selecting the alternative electrode based on a measured electrode impedance between the alternative electrode and one or more other electrodes.

12. An implantable cardiac function management device comprising,

a processor;

a memory communicatively coupled to the processor, the memory including instructions, which when executed by the processor cause the implantable cardiac function management device to;

measure an electrode impedance for a combination of two or more electrodes connected to the implantable cardiac function management device;

compare the measured electrode impedance to a set of population data, the set of population data including electrode impedances for similar electrode combinations used in various patients in a patient population;

determine, based on the comparison of the measured electrode impedance to the set of population data, whether the measured electrode impedance represents a significant change for the combination of two or more electrodes; and

determine, if the measured electrode impedance represents a significant change, a reconfiguration option for the implantable cardiac function management device.

13. The implantable cardiac function management device of claim 12, wherein the set of population data includes predictive laboratory or simulation modeled data for similar electrode combinations when data from electrode impedances for similar electrode combinations used in various patients in a patient population is unavailable or otherwise insufficient.

14. The implantable cardiac function management device of claim 12, further including instructions which when executed cause the device to:

create a population trend over time from the set of population data; and

wherein instructions to determine whether the measured electrode impedance represents a significant change include instructions to determine where the measured electrode impedance falls within the population data trend over time.

15. The implantable cardiac function management device of claim 14, wherein instructions to determine where the measured electrode impedance falls within the population data trend over time include instructions to create a predicted time-to-failure for at least one of the two or more electrodes.

16. The implantable cardiac function management device of claim 15, wherein instructions to determine the reconfiguration option include instructions to adjust one or more implantable cardiac function management device parameters based on the predicted time-to-failure for at least one of the two or more electrodes.

17. The implantable cardiac function management device of claim 12, wherein the set of population data includes data from implantable cardiac function devices that exhibited a similar failure mode.

18. The implantable cardiac function management device of claim 12, wherein instructions to compare the measured electrode impedance to the set of population data include instructions to normalize the measured electrode impedance to compare a change in impedance to the set of population data.

19. The implantable cardiac function management device of claim 12, wherein instructions to determine the reconfiguration option include instructions to select an alternative electrode to replace one of the two or more electrodes.