Self-diagnostic method and system for implantable cardiac device
First Claim
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1. A cardiac rhythm management device, comprising:
- one or more sensing amplifiers for connecting to intra-cardiac electrodes to form sensing channels for generating intra-cardiac electrogram signals;
a sensing amplifier for connecting to a subcutaneous electrode to form a subcutaneous ECG channel for generating a subcutaneous ECG signal;
a pulse generator for connecting to an electrode and pacing a cardiac chamber;
a controller for receiving sensing signals and controlling the delivery of pacing pulses in accordance with a programmed mode; and
,wherein the controller is programmed to detect chamber senses in the subcutaneous ECG and an intra-cardiac electrogram signal, cross-check the chamber senses detected in the subcutaneous ECG signal and the intra-cardiac electrogram signal, and set an alarm flag if it is determined that a chamber sense is detected in one signal but not the other.
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Abstract
A self-diagnostic system for an implantable cardiac device such as a pacemaker, cardioverter, or resynchronization device which utilizes a subcutaneous ECG channel is described. The subcutaneous ECG channel allows the device to, in real time and independent of the standard pacing and sensing circuitry, verify the presence of pacing spikes, chamber senses, and other device outputs and hence establish and verify device integrity.
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Citations
20 Claims
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1. A cardiac rhythm management device, comprising:
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one or more sensing amplifiers for connecting to intra-cardiac electrodes to form sensing channels for generating intra-cardiac electrogram signals; a sensing amplifier for connecting to a subcutaneous electrode to form a subcutaneous ECG channel for generating a subcutaneous ECG signal; a pulse generator for connecting to an electrode and pacing a cardiac chamber; a controller for receiving sensing signals and controlling the delivery of pacing pulses in accordance with a programmed mode; and
,wherein the controller is programmed to detect chamber senses in the subcutaneous ECG and an intra-cardiac electrogram signal, cross-check the chamber senses detected in the subcutaneous ECG signal and the intra-cardiac electrogram signal, and set an alarm flag if it is determined that a chamber sense is detected in one signal but not the other. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cardiac rhythm management device, comprising:
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one or more sensing amplifiers for connecting to intra-cardiac electrodes to form sensing channels for generating intra-cardiac electrogram signals; a sensing amplifier for connecting to a subcutaneous electrode to form a subcutaneous ECG channel for generating a subcutaneous ECG signal; a pulse generator for connecting to an electrode and pacing a cardiac chamber; a controller for receiving sensing signals and controlling the delivery of pacing pulses in accordance with a programmed mode; and
,wherein the controller is programmed to detect pacing outputs in the subcutaneous ECG signal and set an alarm flag if a programmable number of paces fail to be detected. - View Dependent Claims (12, 13, 14, 15, 16)
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17. A cardiac rhythm management device, comprising:
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one or more sensing amplifiers for connecting to intra-cardiac electrodes to form sensing channels for generating intra-cardiac electrogram signals; a sensing amplifier for connecting to a subcutaneous electrode to form a subcutaneous ECG channel for generating a subcutaneous ECG signal; a pulse generator for connecting to an electrode and pacing a cardiac chamber; a controller for receiving sensing signals and controlling the delivery of pacing pulses in accordance with a programmed mode; and
,a minute ventilation sensor which outputs bursts of excitation current for measuring trans-thoracic impedance; and
,wherein the controller is programmed to detect excitation current bursts in the subcutaneous ECG signal and set an alarm flag if a programmable number of such bursts fail to be detected. - View Dependent Claims (18, 19, 20)
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Specification