Sensing vector selection in a cardiac stimulus device with postural assessment

• US 8,483,843 B2
• Filed: 06/07/2012
• Issued: 07/09/2013
• Est. Priority Date: 02/07/2007
• Status: Active Grant

• Current Assignee: Cameron Health Inc (Boston Scientific Corporation)
• Original Assignee: Cameron Health Inc (Boston Scientific Corporation)
• Inventors: Sanghera, Rick, Allavatam, Venugopal
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US13/491,529
• Publication Number:
  US 20120245651A1
• Time in Patent Office: 397 Days
• Field of Search: 607116-117, 600508-509
• US Class Current: 607/116
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• 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 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

Methods, implantable medical devices and systems configured to perform analysis of captured signals from implanted electrodes to identify cardiac arrhythmias. In an illustrative embodiment, signals captured from two or more sensing vectors are analyzed, where the signals are captured with a patient in at least first and second body positions. Analysis is performed to identify primary or default sensing vectors and/or templates for event detection.

Claims

1. An implantable cardiac stimulus system comprising:

an implantable medical device including a canister housing operational circuitry and at least three electrodes coupled to the operational circuitry for sensing cardiac activity while implanted; and

a programmer configured to communicate with the implantable medical device after the implantable medical device is implanted in a patient;

wherein the system is configured to perform the following method after the implantable medical device is implanted in a patient such that the at least three electrodes define at least first and second sensing vectors analyzable by the operational circuitry;

the programmer indicates that the patient is to hold a first body position while a first analysis is performed;

the implantable medical device captures data using at least the first and second sensing vectors;

the implantable medical device indicates to the programmer that a first data capture for sensing vector analysis using the first and second sensing vectors is complete;

the programmer, once the implantable medical device indicates completion of the first data capture for sensing vector analysis, indicates that the patient is to hold a second body position while a second analysis is performed;

the implantable medical device again captures data using at least the first and second sensing vectors;

the implantable medical device indicates to the programmer that a second data capture for sensing vector analysis using the first and second sensing vectors is completed; and

the programmer indicates that the second analysis is complete.

2. The system of claim 1 wherein the implantable medical device is configured to perform analysis of the data captured during at least the first and second data captures and to select a primary sensing vector for use in cardiac event detection regardless of the patient'"'"'s body position.

3. The system of claim 1 wherein the implantable medical device is configured to transmit data to the programmer from the first and second data captures, and the programmer is configured to select one of the sensing vectors as a primary sensing vector for use by the implantable medical device to perform cardiac event detection regardless of the patient'"'"'s body position.

4. The system of claim 1 wherein the implantable medical device is configured to perform analysis directed toward identifying cardiac events in a sensed data stream and, if difficulties occur in identifying cardiac events in the captured data, the implantable medical device is adapted to identify such difficulties, and communicate data to the programmer related to such difficulties and, if data related to difficulties in identifying cardiac events in the captured data is communicated to the programmer, the programmer is adapted to present one or more queries to an operator of the programmer in order to resolve such difficulties.

5. The system of claim 1 wherein the implantable medical device identifies primary and secondary sensing vectors.

6. The system of claim 1, wherein the programmer is configured to receive an input indicating that the patient is in the first body position in response to the programmer indicating that the patient is to hold the first body position.

7. The system of claim 6, wherein the programmer is configured to receive an input indicating that the patient is in the second body position in response to the programmer indicating that the patient is to hold the second body position.

8. An implantable cardiac stimulus system comprising:

an implantable medical device including a canister housing operational circuitry coupled to at least three electrodes;

a programmer configured to communicate with the implantable medical device when the implantable medical device is implanted in a patient;

wherein, once the implantable medical device is implanted in a patient such that the at least three electrodes define at least first and second sensing vectors analyzable by the operational circuitry, the system is configured to select a first sensing vector for analysis and perform the following steps to analyze the first sensing vector;

a. the programmer indicates that the patient is to hold a first body position while a first analysis is performed;

b. the implantable medical device captures data using the selected sensing vector;

c. the implantable medical device indicates to the programmer that a first data capture for sensing vector analysis using the selected sensing vector is completed;

d. the programmer, once the implantable medical device indicates completion of the first data capture, indicates that the patient is to hold a second body position while a second analysis is performed;

e. the implantable medical device captures data using the selected sensing vector;

f. the implantable medical device indicates to the programmer that a second data capture for sensing vector analysis using the selected sensing vector is completed; and

g. the programmer indicates that the second analysis is complete.

9. The system of claim 8, further configured to determine whether the selected sensing vector is suitable for detection of cardiac events in each of the body positions and, if not, the system is also configured to select a second sensing vector for analysis and repeat steps a-g.

10. The system of claim 8, wherein the programmer is configured to receive an input indicating that the patient is in the first body position in response to the programmer indicating that the patient is to hold the first body position.

11. The system of claim 10, wherein the programmer is configured to receive an input indicating that the patient is in the second body position in response to the programmer indicating that the patient is to hold the second body position.