Lead monitoring frequency based on lead and patient characteristics

• US 9,302,100 B2
• Filed: 02/13/2014
• Issued: 04/05/2016
• Est. Priority Date: 02/13/2014
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gunderson, Bruce D
• Primary Examiner(s): Wieland, Robert N
• Application Number:
  US14/180,182
• Publication Number:
  US 20150224302A1
• Time in Patent Office: 782 Days
• Field of Search: 607/28
• US Class Current: 1/1
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371

Abstract

A method and device for updating a frequency of determining whether a lead condition is occurring in a medical device that includes sensing a cardiac signal, determining whether a lead condition is occurring in response to the sensed cardiac signal, determining whether a first patient characteristic is satisfied during a plurality of predetermined update periods, performing a first update of a virtual lead days value associated with a number of days since implant of the lead in response to the first patient characteristic being satisfied, determining whether a patient characteristic update is satisfied in response to a second patient characteristic, different than the first patient characteristic, being satisfied, performing a second update of the virtual lead days value in response to the patient characteristic update being satisfied, and updating a frequency of determining whether the lead condition is occurring in response to the updated virtual lead days value.

Claims

1. A medical device, comprising:

a device housing containing electronic circuitry;

a lead electrically coupled to the housing;

an electrode positioned along the lead to sense a cardiac signal and to deliver cardiac therapy; and

a processor positioned within the housing and configured to determine whether a lead condition is occurring in response to the sensed cardiac signal, determine whether a first patient characteristic is satisfied during a plurality of predetermined update periods, perform a first update of a virtual lead days value associated with a number of days since implant of the lead in response to the first patient characteristic being satisfied, determine whether a patient characteristic update is satisfied in response to a second patient characteristic, different than the first patient characteristic, being satisfied, perform a second update of the virtual lead days value in response to the patient characteristic update being satisfied, and update a frequency of determining whether the lead condition is occurring in response to the updated virtual lead days value.

2. The medical device of claim 1, wherein the first patient characteristic comprises a patient age and the processor is configured to perform the first update of the virtual lead days value in response to the patient age being within a predetermined patient age range and to not perform the first update of the virtual lead days value in response to the patient age being outside the predetermined patient age range.

3. The medical device of claim 2, wherein the second patient characteristic comprises a patient activity level and processor is configured to determine the patient characteristic update is satisfied in response to the patient activity level being greater than a predetermined patient activity level threshold.

4. The medical device of claim 1, wherein the processor is configured to compare the updated virtual lead days to a plurality of predetermined thresholds, and increase the frequency of determining whether the lead condition is occurring in response to the comparing.

5. The medical device of claim 1, wherein the second patent characteristic comprises a number of cardiac cycles and the processor is configured to determine the patient characteristic update is satisfied in response to the number of cardiac cycles being greater than a predetermined cardiac cycles threshold.

6. The medical device of claim 5, wherein the first patient characteristic comprises a patient age and the processor is configured to perform the first update of the virtual lead days value in response to the patient age being within a predetermined patient age range and to not perform the first update of the virtual lead days value in response to the patient age being outside the predetermined patient age range.

7. The medical device of claim 1, wherein the processor is configured to compare the updated virtual lead days to a plurality of predetermined thresholds, and increase the frequency of determining whether the lead condition id occurring in response to the comparing.

8. The medical device of claim 1, wherein second patient characteristic comprises a patient activity level and a number of cardiac cycles, and the processor is configured to determine the patient characteristic update is satisfied in response to one or both the patient activity level being greater than a predetermined patient activity level threshold and the number of cardiac cycles being greater than a predetermined cardiac cycles threshold.

9. The medical device of claim 8, wherein the first patient characteristic comprises a patient age and the processor is configured to perform the first update of the virtual lead days value in response to the patient age being within a predetermined patient age range and to not perform the first update of the virtual lead days value in response to the patient age being outside the predetermined patient age range.

10. The medical device of claim 1, wherein the processor is configured to compare the updated virtual lead days to a plurality of predetermined thresholds, and increase the frequency of determining whether the lead condition is occurring in response to the comparing.

11. The medical device of claim 1, wherein the processor is configured to determine one or more impedance values in response to the delivered therapy a predetermined number of times during a predetermined time period, determine whether the lead condition is occurring in response to the determined one or more impedance values, and update the frequency of determining whether the lead condition is occurring in response to the increased predetermined number of times.

12. A method for updating a frequency of determining whether a lead condition is occurring in a medical device, comprising:

sensing a cardiac signal;

determining whether a lead condition is occurring in response to the sensed cardiac signal;

determining whether a first patient characteristic is satisfied during a plurality of predetermined update periods;

performing a first update of a virtual lead days value associated with a number of days since implant of the lead in response to the first patient characteristic being satisfied;

determining whether a patient characteristic update is satisfied in response to a second patient characteristic, different than the first patient characteristic, being satisfied;

performing a second update of the virtual lead days value in response to the patient characteristic update being satisfied; and

updating a frequency of determining whether the lead condition is occurring in response to the updated virtual lead days value.

13. The method of claim 12, wherein the first patient characteristic comprises a patient age and further comprising:

performing the first update of the virtual lead days value in response to the patient age being within a predetermined patient age range; and

not perform the first update of the virtual lead days value in response to the patient age being outside the predetermined patient age range.

14. The method of claim 13, wherein the second patient characteristic comprises a patient activity level and further comprising determining the patient characteristic update is satisfied in response to the patient activity level being greater than a predetermined patient activity level threshold.

15. The method of claim 12, further comprising:

comparing the updated virtual lead days to a plurality of predetermined thresholds; and

increasing the frequency of determining whether the lead condition is occurring in response to the comparing.

16. The method of claim 12, wherein the second patent characteristic comprises a number of cardiac cycles and further comprising determining the patient characteristic update is satisfied in response to the number of cardiac cycles being greater than a predetermined cardiac cycles threshold.

17. The method of claim 16, wherein the first patient characteristic comprises a patient age and further comprising:

performing the first update of the virtual lead days value in response to the patient age being within a predetermined patient age range; and

not performing the first update of the virtual lead days value in response to the patient age being outside the predetermined patient age range.

18. The method of claim 12, further comprising:

comparing the updated virtual lead days to a plurality of predetermined thresholds; and

increasing the frequency of determining whether the lead condition id occurring in response to the comparing.

19. The method of claim 12, wherein the first patient characteristic comprises a patient age and further comprising:

performing the first update of the virtual lead days value in response to the patient age being within a predetermined patient age range; and

not performing the first update of the virtual lead days value in response to the patient age being outside the predetermined patient age range.

20. The method of claim 19, wherein second patient characteristic comprises a patient activity level and a number of cardiac cycles, and further comprising determining the patient characteristic update is satisfied in response to one or both the patient activity level being greater than a predetermined patient activity level threshold and the number of cardiac cycles being greater than a predetermined cardiac cycles threshold.

21. The method of claim 12, wherein the processor is configured to compare the updated virtual lead days to a plurality of predetermined thresholds, and increase the frequency of determining whether the lead condition id occurring in response to the comparing.

22. The method of claim 12, further comprising:

determining one or more impedance values in response to the delivered therapy a predetermined number of times during a predetermined time period;

determining whether the lead condition is occurring in response to the determined one or more impedance values; and

updating the frequency of determining whether the lead condition is occurring in response to the increased predetermined number of times.

23. A non-transitory computer readable medium storing a set of instructions which when implemented in a medical device cause the device to perform a method for updating a frequency of determining whether a lead condition is occurring, the method comprising:

sensing a cardiac signal;

determining whether a lead condition is occurring in response to the sensed cardiac signal;

determining whether a first patient characteristic is satisfied during a plurality of predetermined update periods;

performing a first update of a virtual lead days value associated with a number of days since implant of the lead in response to the first patient characteristic being satisfied;

determining whether a patient characteristic update is satisfied in response to a second patient characteristic, different than the first patient characteristic, being satisfied;

performing a second update of the virtual lead days value in response to the patient characteristic update being satisfied; and

updating a frequency of determining whether the lead condition is occurring in response to the updated virtual lead days value.