System and method for identifying lead dislodgement

• US 9,572,990 B2
• Filed: 07/11/2012
• Issued: 02/21/2017
• Est. Priority Date: 07/11/2012
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gunderson, Bruce D.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): Bays, Pamela M
• Application Number:
  US13/546,602
• Publication Number:
  US 20140018873A1
• Time in Patent Office: 1,686 Days
• Field of Search: 600/521, 607/6, 607/9, 607/17, 607/18, 607/23, 607/27
• US Class Current: 1/1
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation

Abstract

A medical device system and method for detecting cardiac lead dislodgement measures intervals between sensed cardiac events for detecting an event interval pattern including at least one short event interval consecutively followed by a long event interval. Responsive to detecting the event interval pattern, a cardiac signal amplitude associated with a detected short event interval is measured. Dislodgement of the cardiac lead is detected in response to the measured amplitude.

Claims

1. A medical device system for detecting lead dislodgement, comprising:

a plurality of electrodes;

a cardiac lead carrying at least one of the plurality of electrodes;

a sensing module for receiving a first cardiac electrical signal using a first pair of the plurality of electrodes for sensing cardiac electrical events , the first pair comprising the at least one electrode of the plurality of electrodes carried by the cardiac lead; and

a control unit configured to;

measure intervals between the sensed cardiac electrical events for detecting short event intervals shorter than a first event interval threshold and long event intervals longer than a second event interval threshold, the second event interval threshold longer than the first event interval threshold;

detect an event interval pattern from the first cardiac electrical signal, the event interval pattern comprising at least one short event interval consecutively followed by a long event interval of the measured intervals;

responsive to detecting the event interval pattern, measure an amplitude of at least one of the sensed cardiac electrical events that is associated with the at least one detected short event interval;

compare the amplitude to a voltage range requirement, and

detect dislodgement of the cardiac lead in response to detecting the event interval pattern and the amplitude of the at least one of the sensed cardiac electrical events that is associated with the at least one detected short event interval being within the voltage range requirement, wherein measuring the amplitude comprises measuring a first amplitude of a first one of the sensed cardiac electrical events that is a leading cardiac event of the at least one short event interval and measuring a second amplitude of a second one of the sensed cardiac electrical events that is a trailing cardiac event of the at least one short event interval, and wherein the control module is further configured to compare both of the first amplitude and the second amplitude to the voltage range requirement, and detect the dislodgment in response to both the first amplitude and the second amplitude being within the voltage range requirement.

2. The system of claim 1, wherein detecting the event interval pattern comprises detecting a plurality of sequences comprising a short-long-short-long event interval pattern.

3. The system of claim 1, wherein the sensing module is enabled to receive a second cardiac electrical signal using a second pair of electrodes different than the first pair of electrodes and to sense a cardiac event from the second cardiac electrical signal;

and

the control unit configured to detect the lead dislodgment in response to the cardiac event from the second cardiac electrical signal being within a predetermined time range of one of the sensed cardiac electrical events of the first cardiac electrical signal that is a leading cardiac event of the at least one short interval.

4. The system of claim 1, further comprising means for generating an alert controlled by the control unit to generate the alert in response to detecting the lead dislodgment.

5. The system of claim 1, wherein the control unit is further configured to:

detect a cardiac rhythm episode in response to the sensed cardiac events; and

during cardiac rhythm episode detection, ignore one of the sensed cardiac electrical events of the first cardiac electrical signal that is a leading cardiac event of the at least one short event interval in response to detecting the lead dislodgement.

6. The system of claim 1, further comprising a therapy delivery module for delivering a therapy in response to a cardiac rhythm episode detection,

the control unit configured to detect the cardiac rhythm episode in response to the sensed cardiac electrical events and control the therapy delivery module to withhold the therapy as long as the lead dislodgement detection is being made.

7. The system of claim 1, further comprising switching circuitry to selectively couple selected ones of the plurality of electrodes to the sensing module,

the control unit configured to control the switching circuitry to selectively couple a second pair of electrodes, different than the first pair of electrodes, to the sensing module for sensing cardiac event signals in response to detecting lead dislodgement.

8. A medical device system for detecting lead dislodgement, comprising:

a plurality of electrodes;

a cardiac lead carrying at least one of the plurality of electrodes;

a sensing module for receiving a first cardiac electrical signal using a first pair of the plurality of electrodes for sensing cardiac electrical events , the first pair comprising the at least one electrode of the plurality of electrodes carried by the cardiac lead; and

a control unit configured to;

measure intervals between the sensed cardiac electrical events for detecting short event intervals shorter than a first event interval threshold and long event intervals longer than a second event interval threshold, the second event interval threshold longer than the first event interval threshold;

detect an event interval pattern from the first cardiac electrical signal, the event interval pattern comprising at least one short event interval consecutively followed by a long event interval of the measured intervals;

responsive to detecting the event interval pattern, measure an amplitude of at least one of the sensed cardiac electrical events that is associated with the at least one detected short event interval;

compare the amplitude to a voltage range requirement, and

detect dislodgement of the cardiac lead in response to detecting the event interval pattern and the amplitude of the at least one of the sensed cardiac electrical events that is associated with the at least one detected short event interval being within the voltage range requirement, wherein the control module is further configured to;

detect a zero crossing of the first cardiac electrical signal during the at least one short event interval, and

detect the dislodgment if the zero crossing of the first cardiac electrical signal is detected during the short interval.

9. A medical device system for detecting lead dislodgement, comprising:

a plurality of electrodes;

a cardiac lead carrying at least one of the plurality of electrodes;

a sensing module for receiving a first cardiac electrical signal using a first pair of the plurality of electrodes for sensing cardiac electrical events , the first pair comprising the at least one electrode of the plurality of electrodes carried by the cardiac lead; and

a control unit configured to;

measure intervals between the sensed cardiac electrical events for detecting short event intervals shorter than a first event interval threshold and long event intervals longer than a second event interval threshold, the second event interval threshold longer than the first event interval threshold;

detect an event interval pattern from the first cardiac electrical signal, the event interval pattern comprising at least one short event interval consecutively followed by a long event interval of the measured intervals;

responsive to detecting the event interval pattern, measure an amplitude of at least one of the sensed cardiac electrical events that is associated with the at least one detected short event interval;

compare the amplitude to a voltage range requirement, and

detect dislodgement of the cardiac lead in response to detecting the event interval pattern and the amplitude of the at least one of the sensed cardiac electrical events that is associated with the at least one detected short event interval being within the voltage range requirement, wherein the sensing module is enabled to receive a second cardiac electrical signal using a second pair of electrodes of the plurality of electrodes different than the first pair of electrodes;

the control unit further configured to;

measure a first amplitude of the second cardiac electrical signal corresponding to one of the sensed cardiac event signals that is a leading cardiac event of the at least one short event interval;

measure a second amplitude of the second cardiac signal corresponding to another of the sensed cardiac event signals that is a trailing cardiac event of the at least one short event interval;

compare the first amplitude to the second amplitude; and

detect the lead dislodgment in response to the second amplitude being greater than the first amplitude.