Ambulatory phrenic nerve stimulation detection
First Claim
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1. A system, comprising:
- an implantable medical device (IMD) for implantation in a patient, the IMD including a cardiac pace generator, a phrenic nerve stimulation (PS) sensor, a memory, and a controller, wherein the PS sensor is configured to provide a signal for use in detecting PS, and the controller is operably connected to the cardiac pace generator to operate in a pacing configuration to generate cardiac paces,wherein the controller is configured to;
perform a base test when the cardiac pace generator is operating in the pacing configuration, including;
monitor the signal provided from the PS sensor, including detect an amplitude of the monitored signal provided from the PS sensor,compare the sensed amplitude to a threshold to detect PS, andprovide a trigger when the sensed amplitude is higher than the threshold which indicates a PS detection from the monitored signal provided from the PS sensor;
respond to the trigger from the base test, wherein respond to the trigger includes;
store a portion of the signal from the PS sensor in the memory of the IMD when the cardiac pace generator is operating in the pacing configuration, wherein the stored portion is more than was used by the base test, the stored portion including N beats where a beat is a signal from the PS sensor associated with a cardiac pace; and
analyze the stored portion of the signal including determining that M of N beats indicate PS to confirm the PS detection from the base test, thereby providing a confirmed PS detection having a higher level of confidence than provided by the base test that PS is detected; and
record, based on the confirmed PS detection, that PS is detected in the memory storage within the IMD.
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Abstract
An example of a system includes an implantable medical device (IMD) for implantation in a patient, where the IMD includes a cardiac pace generator, phrenic nerve stimulation (PS) sensor, a memory, and a controller, and where the controller is operably connected to the cardiac pace generator to generate cardiac paces. The controller is configured to provide a trigger for conducting a PS detection procedure and perform the PS detection procedure in response to the trigger. In performing the PS detection procedure the controller is configured to receive a signal from the sensor, detect PS using the signal from the sensor, and record the PS detection in storage within the IMD.
50 Citations
18 Claims
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1. A system, comprising:
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an implantable medical device (IMD) for implantation in a patient, the IMD including a cardiac pace generator, a phrenic nerve stimulation (PS) sensor, a memory, and a controller, wherein the PS sensor is configured to provide a signal for use in detecting PS, and the controller is operably connected to the cardiac pace generator to operate in a pacing configuration to generate cardiac paces, wherein the controller is configured to; perform a base test when the cardiac pace generator is operating in the pacing configuration, including; monitor the signal provided from the PS sensor, including detect an amplitude of the monitored signal provided from the PS sensor, compare the sensed amplitude to a threshold to detect PS, and provide a trigger when the sensed amplitude is higher than the threshold which indicates a PS detection from the monitored signal provided from the PS sensor; respond to the trigger from the base test, wherein respond to the trigger includes; store a portion of the signal from the PS sensor in the memory of the IMD when the cardiac pace generator is operating in the pacing configuration, wherein the stored portion is more than was used by the base test, the stored portion including N beats where a beat is a signal from the PS sensor associated with a cardiac pace; and analyze the stored portion of the signal including determining that M of N beats indicate PS to confirm the PS detection from the base test, thereby providing a confirmed PS detection having a higher level of confidence than provided by the base test that PS is detected; and record, based on the confirmed PS detection, that PS is detected in the memory storage within the IMD. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A system, comprising:
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an implantable medical device (IMD) for implantation in a patient, the IMD including a cardiac pace generator, a memory, a controller and a phrenic nerve stimulation (PS) sensor including an accelerometer, wherein the PS sensor is configured to provide a signal for use in detecting PS, and the controller is operably connected to the cardiac pace generator to operate in a pacing configuration to generate cardiac paces, wherein the controller is configured to; perform a base test when the cardiac pace generator is operating in the pacing configuration, including; monitor the signal provided from the PS sensor, including detect an amplitude of the monitored signal provided from the PS sensor, compare the sensed amplitude to a threshold to detect PS, and provide a trigger when the sensed amplitude is higher than the threshold which indicates a PS detection from the monitored signal provided from the PS sensor; respond to the trigger from the base test, wherein respond to the trigger includes; store a portion of the signal from the PS sensor in the memory of the IMD when the cardiac pace generator is operating in the pacing configuration, wherein the stored portion that is more than was used by the base test , the stored portion including N beats where a beat is a signal from the PS sensor associated with a cardiac pace; and analyze the stored portion of the signal including determining that M of N beats indicate PS, thereby providing a confirmed PS detection, having a higher level of confidence than provided by the base test that PS is detected; respond to the confirmed PS detection, including further analyze the signal from the PS sensor using a different PS detection test to provide greater confidence that PS is detected; and record, based on the confirmed PS detection, PS detection in the memory storage within the IMD and; automatically change a current pacing configuration to another pacing configuration based at least in part on the confirmed PS detection;
orcommunicate an alert to an external device based at least in part on the confirmed PS detection. - View Dependent Claims (11)
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12. A system, comprising:
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an implantable medical device (IMD) for implantation in a patient, the IMD including a cardiac pace generator, phrenic nerve stimulation (PS) sensor, a memory, and a controller, wherein the PS sensor is configured to provide a signal for use in detecting PS, and the controller is operably connected to the cardiac pace generator to operate in a pacing configuration to generate cardiac paces, wherein the controller is configured to; perform a base test when the cardiac pace generator is operating in the pacing configuration, including; monitor the signal provided from the PS sensor, including detect an amplitude of the monitored signal provided from the PS sensor, compare the sensed amplitude to a threshold to detect PS, and provide a trigger when the sensed amplitude is higher than the threshold which indicates a PS detection from the monitored signal provided from the PS sensor; respond to the trigger from the base test, wherein respond to the trigger includes; store a portion of the signal from the PS sensor in the memory of the IMD when the cardiac pacing generator is operating in the pacing configuration, wherein the stored portion is more than was used by the base test, the stored portion including N beats where a beat is a signal from the PS sensor associated with a cardiac pace; and analyze the stored portion of the signal including determining that M of N beats are consistent with PS to confirm the PS detection from the base test, thereby providing a confirmed PS detection having a higher level of confidence than provided by the base test that PS is detected; and record, based on the confirmed PS detection, that PS is detected in the memory storage within the IMD and automatically change a current pacing configuration to another pacing configuration based at least in part on the confirmed PS detection. - View Dependent Claims (13, 14, 15, 16, 17, 18)
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Specification