Wireless ECG in implantable devices

• US 8,301,234 B2
• Filed: 11/03/2011
• Issued: 10/30/2012
• Est. Priority Date: 03/05/2004
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: McCabe, Aaron R., Scheiner, Avram, Zhang, Geng, Ni, Quan, Daum, Douglas R., Zhang, Yi
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): So, Elizabeth K
• Application Number:
  US13/288,105
• Publication Number:
  US 20120053474A1
• Time in Patent Office: 362 Days
• Field of Search: None
• US Class Current: 600/515
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/329 Load diagnosis, e.g. cardiac stress tests
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Claims

1. An implantable medical device configured to be coupled to electrodes suitable for sensing a cardiac signal approximating a surface electrocardiogram (ECG), the implantable medical device comprising:

a command receiver configured to receive an ECG acquisition command;

a sensing circuit configured to be programmed in response to the ECG acquisition command to sense the cardiac signal approximating the surface ECG, the sensing circuit including a frequency response programmable for at least a surface ECG pass band selectable for sensing the cardiac signal approximating the surface ECG and an intracardiac electrogram pass band selectable for sensing an intracardiac electrogram; and

a sense interface configured to be programmed in response to the ECG acquisition command to provide electrical connections for sensing the cardiac signal approximating the surface ECG, the electrical connections connecting the sensing circuit to the electrodes.

2. The implantable medical device of claim 1, wherein the frequency response comprises a low cutoff frequency and a high cutoff frequency, wherein at least one of the low cutoff frequency and the high cutoff frequency is programmable.

3. The implantable medical device of claim 2, wherein the low cutoff frequency is programmable in a range of about 0.1 Hz to 30 Hz.

4. The implantable medical device of claim 2, wherein the high cutoff frequency is programmable in a range of 30 Hz to 150 Hz.

5. The implantable medical device of claim 1, wherein the surface ECG pass band has a low cutoff frequency of 4 Hz or less.

6. The implantable medical device of claim 5, wherein the surface ECG pass band has a low cutoff frequency between about 0.1 Hz to 0.5 Hz.

7. The implantable medical device of claim 2, wherein the surface ECG pass band has a high cutoff frequency of 50 Hz or less.

8. A cardiac rhythm management system, comprising:

electrodes suitable for sensing a cardiac signal approximating a surface electrocardiogram (ECG); and

an implantable medical device comprising;

a command receiver configured to receive an ECG acquisition command;

a sensing circuit configured to be programmed in response to the ECG acquisition command to sense the cardiac signal approximating the surface ECG, the sensing circuit including a frequency response programmable for at least a surface ECG pass band selectable for sensing the cardiac signal approximating the surface ECG and an intracardiac electrogram pass band selectable for sensing an intracardiac electrogram; and

a sense interface configured to be programmed in response to the ECG acquisition command to provide electrical connections for sensing the cardiac signal approximating the surface ECG, the electrical connections connecting the sensing circuit to the electrodes.

9. The system of claim 8, comprising a first pacing lead configured to be coupled to the implantable device, the first pacing lead including a first electrode of the electrodes.

10. The system of claim 9, further comprising a second pacing lead configured to be coupled to the implantable device, the second pacing lead including a second electrode of the electrodes.

11. The system of claim 8, wherein the electrodes comprise a first electrode incorporated onto the implantable medical device.

12. The system of claim 11, wherein the electrodes comprise a second electrode incorporated onto the implantable medical device.

13. The system of claim 11, wherein the implantable medical device comprises:

a can housing a circuit including the command receiver, the sensing circuit, and the sense interface; and

a header attached to the can, the header including connectors providing for electrical access to the circuit,

and wherein the first electrode is incorporated onto the can.

14. The system of claim 13, wherein the electrodes comprise a second electrode incorporated onto the can.

15. The system of claim 13, wherein the electrodes comprise a second electrode incorporated onto the header.