Systems and methods to synchronize commands sent to a multi-electrode lead (MEL) with a portion of a cardiac pacing cycle

• US 9,233,250 B2
• Filed: 12/29/2009
• Issued: 01/12/2016
• Est. Priority Date: 08/18/2009
• Status: Expired due to Fees

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Shelchuk, Anne, Wu, Yongjian, Pontiga, Chris, Pixley, April, Iranitalab, Pajhand, Clem, Elisabeth M., Hossain, Shohan, Yi, Jianchun
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): Hankins, Lindsey G
• Application Number:
  US12/648,599
• Publication Number:
  US 20110046690A1
• Time in Patent Office: 2,205 Days
• Field of Search: 607 4- 38, 607119-132
• US Class Current: 1/1
• 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 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/3686 configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/3912 Output circuitry therefor, e.g. switches

Abstract

Embodiments of the present invention concern the timing of sending one or more commands to control circuitry of a multi-electrode lead (MEL). In one embodiment, the one or more commands are sent to control circuitry within the MEL during a predetermined portion of a cardiac pacing cycle to avoid potential problems of prior systems that were not synchronized with the cardiac pacing cycle. In one embodiment, the one or more commands are sent when cardiac tissue is refractory from a cardiac pacing pulse, to prevent the command(s) from potentially undesirably stimulating cardiac tissue. The command sending can occur such that the one or more commands are sent between instances when sensing circuitry of the implantable cardiac stimulation device is being used to obtain one or more signals indicative of cardiac electrical activity, to prevent interference between the one or more commands with the signals indicative of cardiac electrical activity that are sensed.

Claims

1. A method for use by an implantable cardiac stimulation device to which a multi-electrode lead (MEL) is attached, the implantable cardiac stimulation device including

sensing circuitry adapted to selectively obtain, using electrodes selectively connected to the sensing circuitry, one or more signals indicative of cardiac electrical activity,

storage circuitry adapted to store data indicative of at least one of the one or more signals obtained using the sensing circuitry,

a controller adapted to generate one or more commands that are to be sent to control circuitry within the MEL attached to the implantable cardiac stimulation device, the control circuitry within the MEL adapted to configure electrodes of the MEL attached to the implantable cardiac stimulation device, and

pulse generator circuitry adapted to selectively produce cardiac pacing pulses,

wherein the MEL, which is attached to the implantable cardiac stimulation device, comprises a multi-conductor bus that includes two conductors,

the method for use when sending one or more commands to the control circuitry within the MEL attached to the implantable cardiac stimulation device, the method comprising:

selectively connecting the sensing circuitry to, and disconnecting the sensing circuitry from, the multi-conductor bus of the MEL; and

sending one or more commands, over at least one of the two conductors of the multi-conductor bus of the MEL, to the control circuitry within the MEL, between instances when the sensing circuitry is connected to the multi-conductor bus of the MEL and is being used to obtain the one or more signals indicative of cardiac electrical activity.

2. The method of claim 1, further comprising, prior to the sending step:

using switching circuitry of the implantable cardiac stimulation device to disconnect the sensing circuitry from the two conductors of the multi-conductor bus of the MEL and connect the pulse generator circuitry to the two conductors of the multi-conductor bus of the MEL;

while the sensing circuitry is disconnected from the two conductors of the multi-conductor bus of the MEL and the pulse generator circuitry is connected to the two conductors of the multi-conductor bus of the MEL, using the pulse generator circuitry to produce a cardiac pacing pulse that includes a primary pace pulse portion followed by an initial charge balancing portion and a later charge balancing portion, wherein the charge balancing of the initial charge balancing portion is done at a faster rate than the charge balancing of the later charge balancing portion; and

during the initial charge balancing portion of the cardiac pacing pulse, disconnecting the pulse generator circuitry from the two conductors of the multi-conductor bus of the MEL and connecting at least one of the two conductors of the multi-conductor bus of the MEL to the controller that is adapted to generate the one or more commands sent over the multi-conductor bus of the MEL during the sending step.

3. The method of claim 1, wherein

each of the cardiac pacing pulses, produced by the pulse generator circuitry, includes a primary pace pulse portion followed by an initial charge balancing portion and a later charge balancing portion, wherein the charge balancing of the initial charge balancing portion is done at a faster rate than the charge balancing of the later charge balancing portion, and

the sending step comprises:

sending the one or more commands over the at least one of the two conductors of the multi-conductor bus of the MEL to the control circuitry within the MEL during the initial charge balancing portion of the cardiac pacing pulse.

4. The method of claim 1, wherein the sending step, relative to a cardiac pacing pulse produced by the pulse generator circuitry, begins a predetermined delay after a specified feature of a primary pace pulse portion of the cardiac pacing pulse.

5. The method of claim 1, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode.

6. The method of claim 1, wherein:

the pulse generator circuitry is adapted to produce a cardiac pacing pulse that includes a zero volt primary pace pulse portion; and

the sending of the one or more commands is timed relative to the zero volt primary pace pulse portion.

7. The method of claim 1, further comprising sending one or more further commands, over the at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to the control circuitry within the MEL, instructing the MEL to enter or exit a low power mode, between instances when the sensing circuitry is connected to the multi-conductor bus of the MEL and is being used to obtain the one or more signals indicative of cardiac electrical activity.

8. The method of claim 1, wherein at least one of the one or more commands, being sent over the at least one of the two conductors of the multi-conductor bus of the MEL, between instances when the sensing circuitry is connected to the multi-conductor bus of the MEL and is being used to obtain the one or more signals indicative of cardiac electrical activity, is used to at least one of query, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode.

9. An implantable cardiac stimulation device, comprising:

sensing circuitry adapted to selectively obtain, using electrodes selectively connected to the sensing circuitry, one or more signals indicative of cardiac electrical activity;

storage circuitry adapted to store data indicative of at least one of the one or more signals obtained using the sensing circuitry;

pulse generator circuitry adapted to selectively produce cardiac pacing pulses;

switching circuitry adapted to selectively connect and disconnect the sensing circuitry to and from a multi-conductor bus of a multi-electrode lead (MEL) attached to the implantable cardiac stimulation device and selectively connect and disconnect the pulse generator circuitry to and from the multi-conductor bus of the MEL, wherein the multi-conductor bus of the MEL includes two conductors; and

a controller adapted to send one or more commands over at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to control circuitry within the MEL attached to the implantable cardiac stimulation device, between instances when sensing circuitry is connected by the switching circuitry to the multi-conductor bus of the MEL and is being used to obtain the one or more signals indicative of cardiac electrical activity.

10. The implantable cardiac stimulation device of claim 9, wherein:

the cardiac pacing pulses produced by the pulse generator circuitry include a primary pace pulse portion followed by an initial charge balancing portion and a later charge balancing portion, wherein the charge balancing of the initial charge balancing portion is done at a faster rate than the charge balancing of the later charge balancing portion; and

the controller is adapted to send the one or more commands over the at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to the control circuitry within the MEL, such that the one or more commands begin to be sent after the initial charge balancing portion begins, and the one or more commands are finished being sent prior to the initial charge balancing portion ending.

11. The implantable cardiac stimulation device of claim 9, wherein:

cardiac pacing pulses, produced by the pulse generator circuitry, include a primary pace pulse portion followed by an initial charge balancing portion and a later charge balancing portion, wherein the charge balancing of the initial charge balancing portion is done at a faster rate than the charge balancing of the later charge balancing portion; and

the controller is adapted to send the one or more commands, over the at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to the control circuitry within the MEL, during the initial charge balancing portion.

12. The implantable cardiac stimulation device of claim 9, wherein:

the controller is adapted to send the one or more commands, over the at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to the control circuitry within the MEL, beginning a predetermined delay after a specified feature of a primary pace pulse portion of a cardiac pacing pulse produced by the pulse generator circuitry.

13. The implantable cardiac stimulation device of claim 9, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode.

14. The implantable cardiac stimulation device of claim 9, wherein the pulse generator circuitry is adapted to produce a zero volt primary pace pulse portion and the controller is adapted to time the sending of the one or more commands relative to the zero volt primary pace pulse portion.

15. The implantable cardiac stimulation device of claim 9, wherein the controller is further adapted to send one or more further commands, over the at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to the control circuitry within the MEL attached to the implantable cardiac stimulation device, instructing the MEL to enter or exit a low power mode, between instances when the switching circuitry is causing the sensing circuitry to be connected to the multi-conductor bus of the MEL and used to obtain the one or more signals indicative of cardiac electrical activity.

16. A method for use by an implantable cardiac stimulation device, the method for use when sending one or more commands to control circuitry within a multi-electrode lead (MEL) attached to the implantable cardiac stimulation device, wherein the MEL, which is attached to the implantable cardiac stimulation device, comprises a multi-conductor bus that includes two conductors, the method comprising:

sending one or more commands, over at least one of the two conductor of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to control circuitry within the MEL, during a predetermined portion of a cardiac pacing cycle such that the one or more commands are sent when cardiac tissue is refractory from a cardiac pacing pulse, wherein the cardiac pacing pulse includes a primary pace pulse portion and an initial charge balancing portion and a later charge balancing portion, wherein the charge balancing of the initial charge balancing portion is done at a faster rate than the charge balancing of the later charge balancing portion and wherein the sending step begins a predetermined delay after a specified feature of the primary pace pulse portion and during the initial charge balancing portion.

17. The method of claim 16, wherein the sending step is performed such that the one or more commands are sent between instances when sensing circuitry of the implantable cardiac stimulation device is connected to the multi-conductor bus of the MEL and is being used to obtain one or more signals indicative of cardiac electrical activity.

18. The method of claim 16, wherein the sending of the one or more commands interrupts charge balancing during the initial charge balancing portion.

19. The method of claim 16, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode.

20. The method of claim 16, further comprising sending one or more further commands, over the at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to the control circuitry within the MEL, instructing the MEL to enter or exit a low power mode, between instances when the sensing circuitry is connected to the multi-conductor bus of the MEL and is being used to obtain the one or more signals indicative of cardiac electrical activity.

21. An implantable cardiac stimulation device, comprising:

sensing circuitry adapted to selectively obtain, using electrodes selectively connected to the sensing circuitry, one or more signals indicative of cardiac electrical activity;

storage circuitry adapted to store data indicative of at least one of the one or more signals obtained using the sensing circuitry;

pulse generator circuitry adapted to selectively produce cardiac pacing pulses, wherein the said cardiac pacing pulses each includes a primary pace pulse portion and an initial charge balancing portion, wherein said initial charge balancing portion occurs after the primary pace pulse portion; and

a controller adapted to send one or more electrode configuration commands, over at least one of two conductors of a multi-conductor bus of a multi-electrode lead (MEL) attached to the implantable cardiac stimulation device, to control circuitry within the MEL attached to the implantable cardiac stimulation device, during a predetermined portion of a cardiac pacing cycle such that the one or more electrode configuration commands are sent over the at least one of two conductors of the multi-conductor bus of the MEL when cardiac tissue is refractory from the cardiac pacing pulse, and wherein the controller is adapted to send the one or more electrode configuration commands over the at least one of the two conductors of the multi-conductor bus of the MEL beginning a predetermined delay after a specified feature of the primary pace pulse portion and during the initial charge balancing portion.

22. The implantable cardiac stimulation device of claim 21, wherein the controller is adapted to send the one or more commands over the at least one of the two conductors of the multi-conductor bus of the MEL between instances when sensing circuitry of the implantable cardiac stimulation device is connected to the multi-conductor bus of the MEL and is being used to obtain one or more signals indicative of cardiac electrical activity.

23. The implantable cardiac stimulation device of claim 21, wherein the controller is adapted to interrupt charge balancing in the initial charge balancing portion to send the one or more commands.

24. The implantable cardiac stimulation device of claim 21, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode.

25. The implantable cardiac stimulation device of claim 21, wherein the controller is further adapted to send one or more further commands, over the at least one of the two conductors of the multi-conductor bus of the MEL attached to the implantable cardiac stimulation device, to control circuitry within the MEL attached to the implantable cardiac stimulation device, instructing the MEL to enter or exit a low power mode, between instances when the switching circuitry is causing the sensing circuitry to be connected to the multi-conductor bus of the MEL and used to obtain the one or more signals indicative of cardiac electrical activity.