Method for detecting and localizing insulation failures of implantable device leads
First Claim
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1. A method for detecting an insulation failure of an implantable defibrillation lead, the defibrillation lead connected to an implanted electromedical device and in electrical communication with a heart of a patient comprising:
- delivering at least one low amplitude test electrical pulse that is below a pacing threshold having a pacing rate faster than a spontaneous ventricular rate through at least one conductor in the defibrillation lead;
recording an electrical potential at recording sites, said recording sites being located at one or more body locations spaced apart from and relative to a path of the defibrillation lead;
wherein recording said electrical potential is accomplished via a single roving electrode placed sequentially at different exterior body surface locations; and
analyzing said electrical potential recorded from said recording sites to determine a presence of an insulation failure by recognizing a local maximum voltage spike in said electrical potential recorded from said recording sites wherein a local maximum voltage spike is recognized when said electrical potential at one of more of said recording sites is significantly higher than an electrical potential at other recording sites.
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Abstract
The invention relates to a method and apparatus for diagnosis of conductor anomalies, such as insulation failures, in an implantable medical device, such as an implantable cardioverter defibrillator (ICD), a pacemaker, or a neurostimulator. Insulation failures are detected and localized by identifying changes in electrical fields via surface (skin) potentials. Small variations in potential are detected along the course of the electrode near the site of insulation failure.
84 Citations
15 Claims
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1. A method for detecting an insulation failure of an implantable defibrillation lead, the defibrillation lead connected to an implanted electromedical device and in electrical communication with a heart of a patient comprising:
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delivering at least one low amplitude test electrical pulse that is below a pacing threshold having a pacing rate faster than a spontaneous ventricular rate through at least one conductor in the defibrillation lead; recording an electrical potential at recording sites, said recording sites being located at one or more body locations spaced apart from and relative to a path of the defibrillation lead; wherein recording said electrical potential is accomplished via a single roving electrode placed sequentially at different exterior body surface locations; and analyzing said electrical potential recorded from said recording sites to determine a presence of an insulation failure by recognizing a local maximum voltage spike in said electrical potential recorded from said recording sites wherein a local maximum voltage spike is recognized when said electrical potential at one of more of said recording sites is significantly higher than an electrical potential at other recording sites. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method for detecting an insulation failure of an implantable defibrillation lead, the defibrillation lead connected to an implanted electromedical device and in electrical communication with a heart of a patient comprising:
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delivering at least one low amplitude test electrical pulse that is below a pacing threshold having a pacing rate faster than a spontaneous ventricular rate through at least one conductor in the defibrillation lead; recording an electrical potential at recording sites, said recording sites being located at one or more body locations spaced apart from and relative to the path of the defibrillation lead; and analyzing said electrical potential recorded from said recording sites to determine a presence of an insulation failure by recognizing a local maximum voltage spike in said electrical potential recorded from said recording sites wherein a local maximum voltage spike is recognized when said electrical potential at one of more of said recording sites is significantly higher than an electrical potential at other recording sites; wherein recording the electrical potential is accomplished via one or more electrodes located within the body, the electrodes not being connected to the implantable lead being analyzed for said insulation failure; and
wherein the electrodes include;an implantable cardioverter defibrillator housing; and an electrode temporarily implanted within the surgical pocket.
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Specification