System and method to evaluate electrode position and spacing

• US 7,941,213 B2
• Filed: 07/31/2008
• Issued: 05/10/2011
• Est. Priority Date: 12/28/2006
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sowelam, Sameh, Falkner, Phillip, Hettrick, Douglas A., Markowitz, H. Toby
• Primary Examiner(s): Manuel; George
• Assistant Examiner(s): Wieland; Robert N
• Application Number:
  US12/183,796
• Publication Number:
  US 20090093857A1
• Time in Patent Office: 1,013 Days
• Field of Search: 607/2, 607/27, 607/11, 607/36, 607/4, 607/44, 607/9, 607/45, 600/508, 600/509, 606/1
• US Class Current: 607/2
• 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 1/3706 Pacemaker parameters stimulation threshold A61N1/371

Abstract

An IMD can be implanted into a patient to address various conditions. The IMD case and leads can have various electrodes and other portions to measure various physiological conditions. For example, a selected current can be generated between two electrodes, either external or internal in the patient, and a voltage can be measured by one or more electrodes of the IMD. A voltage can be measured at two or more locations to determine a relative motion of different electrodes. If the electrodes are in different portions of the heart, a determination can be made of a relative motion or position of the heart or portions of the heart.

Claims

1. A system to determine a location of an electrode within a volume, comprising:

a medical device sized and shaped to be positioned by implantation and contained within the volume, the medical device including;

a lead having a first implantable electrode;

an implantable case containing an electronics system operable to receive a signal from the first implantable electrode, wherein the first implantable electrode is operable to move based on contact with a surface within the volume and relative to the implantable medical device;

a connector extending from the lead to be connected to the electronics system; and

a current injecting system operable to inject a current into the volume between a first injecting electrode and a second injecting electrode;

wherein the first implantable electrode is operable to sense a voltage at a location due at least in part to the current injected into the volume.

2. The system of claim 1, wherein the current injecting system includes:

a generator positioned exterior to the volume;

wherein the generator is operable to deliver the current into the volume with the first injecting electrode and the second injecting electrode;

wherein the first implantable electrode of the lead is operable to sense a voltage within the volume.

3. The system of claim 2, further comprising:

a third injecting electrode, a fourth injecting electrode, a fifth injecting electrode, and a sixth injecting electrode;

wherein two of each of the first, second, third, fourth, fifth and sixth injecting electrodes are paired to define three axes in the volume;

wherein the generator is operable to determine a period for injecting a current into the volume between each of the pairs of the injecting electrodes.

4. The system of claim 3, wherein the injected current has a frequency of about 1 kHz to about 10 kHz;

wherein the generator is operable to inject a current between the respective pairs of the injecting electrodes for about 10 cycles to about 200 cycles;

wherein after the selected number of cycles a current is injected with a different pair of the injecting electrodes from the previous pair of injecting electrodes.

5. The system of claim 3, further comprising:

a null period where no current is injected by the generator;

wherein the null period is operable to synchronize the current injecting system and the implantable medical device.

6. The system of claim 1, wherein the current injecting system includes:

a current source contained with the implantable medical device;

a second implantable electrode and a third implantable electrode;

wherein the third implantable electrode is a case of the implantable medical device;

wherein the current source is operable to inject a current using the first injecting electrode and the second injecting electrode selected from at least two of the first implantable electrode, the second implantable electrode, and the third implantable electrode;

wherein at least one of the first implantable electrode, the second implantable electrode, and the third implantable electrode is operable to sense a voltage due at least in part to the injected current.

7. The system of claim 6, wherein the implantable medical device further includes a processor operable to execute instructions to determine at least a relative position of a first sensed voltage and a second sensed voltage of at least one of the first implantable electrode, the second implantable electrode and the third implantable electrode due to the injected current.

8. The system of claim 7, wherein the processor is further operable to execute instructions to determine a pacing signal generated by the implantable medical device.

9. The system of claim 2, wherein the implantable medical device further includes an internal telemetry system;

wherein the internal telemetry system is operable to synchronize the signal received from the electrode and the current generated into the volume with the generator.

10. The system of claim 1, wherein the implantable medical device further includes:

a pacing and sensing module having an amplifier module through which a signal is transmitted and amplified from the first implantable electrode.

11. The system of claim 10,

wherein the signal from the amplifier module is transmitted to at least an impedance/position signal detection system and one of an electrogram filter, a myocardial infarction detection system, a sensing system for timing and rhythm detection, and an evoked response detection system.

12. The system of claim 10, wherein the implantable medical device further includes:

a filter having a band pass range of at least the injected current frequency.

13. The system of claim 12, wherein the band pass range is about 25 kHz to about 35 kHz.

14. The system of claim 11, wherein the implantable medical device includes a processor that undersamples the signal from the impedance/position signal detection system with intentional aliasing.

15. The system of claim 14, wherein the undersampled signal is operable to transmitted from the implantable medical device that includes substantially necessary information at a selected current drain.

16. The system of claim 14, wherein the processor is further operable to transform the undersampled signal in a selected frequency domain to identify three signal components;

wherein the signals are measured over time to determined information regarding the position of the electrodes.

17. The system of claim 14, wherein the processor is further operable to determine the position information of the first implantable electrode.

18. A system to measure a position of a surface of a portion of an anatomy, comprising:

a medical device sized to be implanted with the anatomy, including;

a lead including a first electrode fixed to a surface of the anatomy;

a position sensing system operable to sense a voltage at the first electrode at least a first time and a second time to generate a first sensed voltage signal and a second sensed voltage signal with the first electrode; and

a processor operable to compare a first sensed voltage and a second sensed voltage at the first electrode; and

a current injecting system operable to inject a current into the anatomical system to generate the voltage sensed by the first electrode;

wherein the processor undersamples the first sensed voltage signal and the second sensed voltage signal from the position sensing system with intentional aliasing.

19. The system of claim 18, further comprising a power source having a finite power supply.

20. The system of claim 19, further comprising:

a telemetry system wherein the undersampled signal is operable to transmitted from the medical device that includes substantially necessary information regarding a position of the first electrode at a selected current drain from the finite power supply.

21. The system of claim 20, further comprising:

a processor system having a second processor positioned exterior to the anatomy;

wherein the second processor is operable to transform the undersampled signal in a selected frequency domain to identify three signal components;

wherein the signals are measured over time to determine information regarding a position of the first electrode.

22. The system of claim 19, wherein the processor is operable to transform the undersampled signal in a selected frequency domain to identify three signal components;

wherein the signals are measured over time to determined information regarding the position of the electrodes.

23. The system of claim 19, wherein the processor is further operable to determine a position information of the first electrode.

24. The system of claim 19,

wherein the current injecting system is included in the medical device and the injected current is powered by the power source;

wherein the implantable medical device further includes;

a second electrode and a third electrode;

wherein the current injecting system is operable to use the power source as a current source system to inject a current between at least the first electrode and the second electrode;

wherein the position sensing system is operable to sense a voltage with at least the third electrode.

25. The system of claim 24,

wherein at least the first electrode is implanted within a surface of a heart in the anatomical system;

wherein the first sensed voltage signal and the second sensed voltage signal is operable by the processor to determine a position of at least the surface of a wall of the heart at least two times;

wherein the processor is operable to execute instructions to determine a change in position of the surface of the wall of the heart between the first time and the second time.

26. The system of claim 25, wherein the change in position is determined to be at least one of a heart wall thickness, a left ventricle volume, a left ventricle dimension, a right ventricle volume, a right ventricle dimension, a stoke volume, or combinations thereof.

27. A system to determine a location of an electrode with a volume, comprising:

a medical device sized to be positioned and contained within the volume, including;

an implantable case;

a lead connected to a connector associated with the implantable case having a first implantable electrode, wherein the first implantable electrode is operable to contact and move with a surface within the volume; and

a processor positioned within the implantable case and operable to execute a first set of instructions when a signal from the lead is received to affect the volume in a first manner; and

a current injecting system operable to inject a current into the volume between a first injecting electrode and a second injecting electrode and the first implantable electrode is operable to sense a voltage at a location due at least in part to the injected current;

wherein the processor is operable to change the first set of instructions based upon the sensed voltage to affect the volume in a second manner different from the first manner.

28. The system of claim 27, wherein the current injecting system includes three pairs of injecting electrodes that are operable to define three substantially orthogonal axes of current within the volume;

wherein the processor is operable to undersample a signal based the sensed voltage to produce an undersampled signal; and

wherein the implantable medical device further includes a telemetry system operable to transmit the undersampled signal that relates to the voltage sensed at the location.

29. The system of claim 28, wherein the processor is operable to execute instructions to determine a position of the first implantable electrode based at least in part on the voltage sensed at the location;

wherein the determined position can be transmitted from the implantable medical device.

30. The system of claim 29, further comprising:

an external processor system;

wherein the external processor system is operable to receive the transmitted determined position;

wherein the external processor system is operable to determine a condition of an anatomical feature within the volume based upon the transmitted determined position.

31. The system of claim 30, further comprising:

a second implantable electrode;

wherein the first implantable electrode is operable to sense a voltage at a first location and a second implantable electrode is operable to sense a voltage at a second location;

wherein at least one of the processor or the external processor system is operable to determine a dimension between the first implantable electrode and the second implantable electrode at the respective locations.

32. The system of claim 31, wherein the dimension is determined to be at least one of a heart wall thickness, a left ventricle volume, a left ventricle dimension, a right ventricle volume, a right ventricle dimension, a stoke volume, or combinations thereof.

33. A method of measuring movement of an electrode within a volume, comprising:

providing an implantable device;

implanting a lead extending from the implantable device into a surface within the volume, the lead having a first electrode;

injecting a current in the volume;

sensing a voltage in the volume with the first electrode;

sending a sensed voltage signal based on the sensed voltage to an electronics system of the implantable device; and

undersampling the sent sensed voltage signal.

34. The method of claim 33, wherein sensing a voltage includes:

sensing a first voltage at a first time and sensing a second voltage at a second time;

determining a first position of the first electrode with the first sensed voltage; and

determining a second position of the first electrode with the second sensed voltage.

35. The method of claim 34, further comprising:

implanting the first electrode in a surface;

determining a first position of the surface with the determined first position of the first electrode; and

determining a second position of the surface with the determined second position of the first electrode.

36. The method of claim 34, further comprising:

providing a processor in the implantable device;

providing a pacing system operable to deliver a pacing signal based upon first instructions executed by the processor; and

executing second instructions with the processor based upon the determined first position and the determined second position to alter the pacing signal.

37. The method of claim 34, further comprising:

placing a second electrode;

determining a third position of the second electrode; and

determining a distance between at least one of the determined first position and the determined second position and the determined third position.

38. The method of claim 37, further comprising:

implanting a second lead having the second electrode.

39. The method of claim 37, wherein the distance between one of the first position, the second position, or the third position is a thickness of an anatomical structure.

40. The method of claim 34, further comprising:

transmitting the undersampled signal that includes substantially necessary information at a selected current drain on a finite power supply to an external processor system; and

determining an anatomical definition based upon the transmitted undersampled signal.

41. The method of claim 33, further comprising:

generating the current to be injected into the volume with a generator that is external to the volume; and

synchronizing the external generation of the current from the generator with the sensing of the voltage with the first electrode.

42. The method of claim 41, wherein synchronizing the external generation includes sending a synchronization signal between the external generator and the provided implantable medical device or sensing a null voltage period in a pattern of generating the current.

43. A system to measure a position of a surface of a portion of an anatomy, comprising:

an implantable medical device including;

a lead including a first electrode;

a position sensing system operable to sense a voltage at the first electrode, the position sensing includes at least one of an electrogram filter, a myocardial infarction detection system, a sensing system for timing and rhythm detection, and an evoked response detection system;

a first processor operable to compare a first sensed voltage and a second sensed voltage at the first electrode;

a power source having a finite power supply; and

a first telemetry system operable to transmit and receive information regarding at least the first electrode; and

a current injecting system operable to inject a current into the anatomy to generate the voltage sensed by the first electrode, including;

a first pair of injecting electrodes and a second pair of injecting electrodes;

a current source system operable to inject a current between the first pair of injecting electrodes and the second pair of injecting electrodes; and

a second telemetry system operable to communicate with the first telemetry system;

wherein the first processor undersamples a signal from the first electrode to include intentional aliasing, wherein the undersampled signal is operable to be transmitted with the first telemetry system from the implantable medical device to the second telemetry system of the current injecting system, wherein the undersampled signal includes substantially all necessary information and is transmitted at a selected current drain from the finite power supply;

wherein a second processor of the current injecting system is operable to transform the undersampled signal in a selected frequency domain to identify three signal components;

wherein the signals are measured over time to determine information regarding the position of the first electrode.

44. The system of claim 43, wherein the implantable medical device further includes:

a second electrode;

wherein a voltage at the first electrode is compared to a voltage sensed at the second electrode;

wherein the processor is operable to execute instructions to determine a relative position of the first electrode and the second electrode, to identify a dimension of the anatomy.

45. The system of claim 43, wherein at least one of the first pair of injecting electrodes and the second pair of injecting electrodes are implanted within the anatomy with the implantable medical device.