Remote pace detection in an implantable medical device

• US 8,942,799 B2
• Filed: 04/10/2014
• Issued: 01/27/2015
• Est. Priority Date: 07/15/2009
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ternes, David J., Baker, Kenneth L.
• Primary Examiner(s): Wieland, Robert N
• Application Number:
  US14/249,632
• Publication Number:
  US 20140222115A1
• Time in Patent Office: 292 Days
• Field of Search: 607/2
• US Class Current: 607/2
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A system embodiment for stimulating a neural target comprises a neural stimulator, a pace detector, and a controller. The neural stimulator is electrically connected to at least one electrode, and is configured to deliver a neural stimulation signal through the at least one electrode to stimulate the neural target. The pace detector is configured to use at least one electrode to sense cardiac activity and distinguish paced cardiac activity in the sensed cardiac activity from non-paced cardiac activity in the sensed cardiac activity. The controller is configured to control a programmed neural stimulation therapy using the neural stimulator and using detected paced cardiac activity as an input for the neural stimulation therapy.

Claims

1. A system, comprising:

an implantable stimulator configured to generate and deliver stimulation;

a sensor configured to receive information in a cardiac pacing signal, the cardiac pacing signal being a signal configured to capture myocardial tissue; and

a controller operably connected to the stimulator and the sensor, the controller configured to control the stimulator to provide a stimulation therapy, and to control the stimulation therapy using the received information from the cardiac pacing signal.

2. The system of claim 1, wherein the sensor is configured to sense a pulse width of the cardiac pacing signal to receive information from the cardiac pacing signal.

3. The system of claim 1, wherein the received information indicates where the cardiac pacing signal originates.

4. The system of claim 3, wherein the information includes identifying information for a heart chamber being paced by the cardiac pacing signal.

5. The system of claim 1, wherein the implantable stimulator includes an implantable neural stimulator, and wherein the controller is configured to control the implantable neural stimulator to provide a neural stimulation therapy.

6. The system of claim 1, further comprising an ECG sensor or a heart sound sensor.

7. The system of claim 1, wherein the controller is configured to synchronize the stimulation therapy with the cardiac pacing signal.

8. A system, comprising:

a first implantable device having a first implantable device housing, the first implantable device configured to deliver a cardiac pace embedded with information, the cardiac pace being a signal configured to capture myocardial tissue;

a second implantable device having a second implantable device housing, the second implantable device including;

an implantable stimulator configured to generate and deliver stimulation;

a sensor configured to receive information from a cardiac pacing signal; and

a controller operably connected to the stimulator and the sensor, the controller configured to control the stimulator to provide a stimulation therapy, and to control the stimulation therapy using the received information from the cardiac pacing signal.

9. The system of claim 8, wherein the sensor is configured to sense a pulse width of the cardiac pacing signal to receive information from the cardiac pacing signal.

10. The system of claim 8, wherein the received information dudes origination information for the cardiac pacing signal.

11. The system of claim 10, wherein the origination information includes identifying information for a heart chamber being paced by the cardiac pacing signal.

12. The system of claim 8, further comprising an ECG sensor.

13. The system of claim 8, further comprising a heart sound sensor.

14. A method, comprising:

delivering electrical stimulation using a first implantable device;

receiving information in a cardiac pacing signal, the cardiac pacing signal provided by a second implantable device, the cardiac pacing signal being a signal configured to capture myocardial tissue; and

controlling the delivered electrical stimulation using the information in the cardiac pacing signal.

15. The method of claim 14, wherein the information is communicated in a pulse width of the cardiac pacing signal.

16. The method of claim 14, wherein the received information includes origination information for the cardiac pacing signal.

17. The method of claim 16, wherein the origination information includes identifying information for a heart chamber being paced by the cardiac pacing signal.

18. The method of claim 14, wherein delivering electrical stimulation using the first implantable device includes delivering a neural stimulation therapy.

19. The method of claim 14, further comprising sensing a pacing rate of the cardiac pacing signal.

20. The method of claim 14, further comprising:

using an implantable ECG sensor to sense electrical activity;

or

sensing heart sounds using an implantable heart sound sensor.