Implantable medical device responsive to MRI induced capture threshold changes

• US 9,561,378 B2
• Filed: 10/14/2013
• Issued: 02/07/2017
• Est. Priority Date: 10/02/2008
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stubbs, Scott R., Wika, Kevin G.
• Primary Examiner(s): Heller, Tammie K
• Application Number:
  US14/053,442
• Publication Number:
  US 20140046392A1
• Time in Patent Office: 1,212 Days
• US Class Current: 1/1
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold
• CPC Class Codes: A61N 1/3718 Monitoring of or protection against external electromagnetic fields or currents
• CPC Class Codes: A61N 1/3943 for threshold determination

Abstract

Energy delivered from an implantable medical device to stimulate tissue within a patient'"'"'s body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue.

Claims

1. An implantable medical device for delivering electrical stimulation to body tissue via a lead having at least one electrode, the implantable medical device comprising:

sensing circuitry configured to receive cardiac or neural signals through the lead based on electrical activity of the tissue;

therapy circuitry configured to deliver cardiac or neural electrical stimulation to the tissue through the lead, wherein the sensing and therapy circuitry is further configured to measure a capture threshold of the tissue;

magnetic field detection circuitry configured to detect magnetic resonance imaging (MRI) scan fields; and

control circuitry configured to change the energy delivered by the therapy circuitry from a normal energy state to an MRI mode energy state sufficient to capture the tissue including an adjustment of stimulus magnitude or duration of the cardiac or neural electrical stimulation when the magnetic detection circuitry detects a MRI scan field, and, after the magnetic field detection circuitry no longer detects the MRI scan field, to control the sensing and therapy circuitry to measure the capture threshold and then change the energy delivered by the therapy circuitry based on the capture threshold that was measured after the MRI scan field is no longer detected.

2. The implantable medical device of claim 1, wherein the control circuitry is configured to maintain the energy delivered by the therapy circuitry at the MRI mode energy level for a period of time after the magnetic field detection circuitry no longer detects the MRI scan field.

3. The implantable medical device of claim 1, wherein the control circuitry is configured to repeatedly adjust the energy delivered based on the measured capture threshold until the energy delivered returns to the normal energy state.

4. The implantable medical device of claim 1, wherein, to measure the capture threshold, the therapy circuitry is configured to deliver a sequence of pacing pulses of varying magnitude and/or duration to the tissue, and the sensing circuitry is configured to sense a response of the tissue to the pacing pulses.

5. The implantable medical device of claim 1, wherein the sensing circuitry is configured to measure the capture threshold of the tissue and the control circuitry is configured to adjust the energy delivered in response to a control signal from an external device.

6. The implantable medical device of claim 1, wherein the sensing circuitry, therapy circuitry, magnetic field detection circuitry, and control circuitry are included in a pulse generator.

7. The implantable medical device of claim 1, further comprising communication circuitry configured to communicate information about the measured capture threshold.

8. The implantable medical device of claim 1, wherein the MRI mode energy state has one or both of a signal magnitude and a duration that are respectively greater than the signal magnitude and the duration of the normal energy state.

9. The implantable medical device of claim 1, wherein the control circuitry is configured to change the energy delivered by the therapy circuitry from a first energy state to a second energy state sufficient to capture the tissue including an adjustment of stimulus magnitude or duration when the magnetic detection circuitry detects a MRI scan field, and, after the magnetic field detection circuitry no longer detects the MRI scan field, to control the sensing and therapy circuitry to measure the capture threshold and then change the energy delivered by the therapy circuitry from the MRI mode energy state to a post-MRI energy state based on the capture threshold that was measured after the MRI scan field is no longer detected.

10. The implantable medical device of claim 1, wherein:

the sensing circuitry is configured to receive cardiac signals through the lead based on electrical activity of the tissue; and

the therapy circuitry is configured to deliver cardiac electrical stimulation to the tissue through the lead, wherein the sensing and therapy circuitry is further configured to measure a capture threshold of the tissue during cardiac electrical stimulation.

11. The implantable medical device of claim 1, wherein:

the sensing circuitry is configured to receive neural signals through the lead based on electrical activity of the tissue; and

the therapy circuitry is configured to deliver neural electrical stimulation to the tissue through the lead, wherein the sensing and therapy circuitry is further configured to measure a capture threshold of the tissue during neural electrical stimulation.

12. An implantable medical device for delivering electrical stimulation to body tissue via a lead having at least one electrode, the implantable medical device comprising:

sensing circuitry operable to receive cardiac or neural signals through the lead based on electrical activity of the tissue;

therapy circuitry operable to deliver cardiac or neural electrical stimulation to the tissue through the lead, wherein the sensing and therapy circuitry is further operable to measure a capture threshold of the tissue;

magnetic field detection circuitry operable to detect magnetic resonance imaging (MRI) scan fields; and

control circuitry operable to set energy delivered by the therapy circuitry to stimulate the tissue from a normal energy state to an MRI mode energy state sufficient to capture the tissue including an adjustment of stimulus magnitude or duration of the cardiac or neural electrical stimulation when the magnetic detection circuitry detects the MRI scan fields, and, after the magnetic field detection circuitry no longer detects the MRI scan fields, to adjust the energy delivered based on the measured capture threshold of the tissue.

13. The implantable medical device of claim 12, wherein the control circuitry maintains the energy delivered by the therapy circuitry at the MRI mode energy level for a period of time after the magnetic field detection circuitry no longer detects the MRI scan fields.

14. The implantable medical device of claim 12, wherein the control circuitry repeatedly adjusts the energy delivered based on the measured capture threshold until the energy delivered returns to the normal energy state.

15. The implantable medical device of claim 12, wherein, to measure the capture threshold, the therapy circuitry delivers a sequence of pacing pulses of varying magnitude and/or duration to the tissue, and the sensing circuitry senses a response of the tissue to the pacing pulses.

16. The implantable medical device of claim 12, wherein the sensing circuitry measures the capture threshold of the tissue and the control circuitry adjusts the energy delivered in response to a control signal from an external device.

17. The implantable medical device of claim 12, wherein the sensing circuitry, therapy circuitry, magnetic field detection circuitry, and control circuitry are included in a pulse generator.

18. The implantable medical device of claim 12, and further comprising:

communication circuitry operable to communicate information about the measured capture threshold.

19. The implantable medical device of claim 12, wherein the MRI mode energy state has one or both of a signal magnitude and a duration that are respectively greater than the signal magnitude and the duration of the normal energy state.

20. An implantable medical device for delivering electrical stimulation to body tissue via a lead having at least one electrode, the implantable medical device comprising a control circuitry configured to:

in response to a presence of an MRI scan field, control the implantable medical device to deliver cardiac or neural electrical stimulation with an MRI mode energy state sufficient to capture the tissue; and

in response to an absence of the MRI scan field, change the MRI mode energy state to a post-MRI mode energy state based on a capture threshold when the MRI scan field is absent, and control the implantable medical device to deliver cardiac or neural electrical stimulation with the post-MRI mode energy state;

wherein the change from the MRI mode energy state to the post-MRI mode energy state includes an adjustment of stimulus magnitude or duration of the of the cardiac or neural electrical stimulation.