Implantable medical device with dual-use communication module

• US 9,808,632 B2
• Filed: 01/23/2015
• Issued: 11/07/2017
• Est. Priority Date: 01/23/2015
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Reinke, James D., Carney, James K., Cinbis, Can, Peichel, David J., Ballis, Joseph
• Primary Examiner(s): Wu, Eugene T
• Application Number:
  US14/603,733
• Publication Number:
  US 20160213937A1
• Time in Patent Office: 1,019 Days
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37229 Shape or location of the implanted or external antenna
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

An implantable medical device comprises a communication module that comprises at least one of a receiver module and a transmitter module. The receiver module is configured to both receive from an antenna and demodulate an RF telemetry signal, and receive from a plurality of electrodes and demodulate a tissue conduction communication (TCC) signal. The transmitter module is configured to modulate and transmit both an RF telemetry signal via the antenna and a TCC signal via the plurality of electrodes. The RF telemetry signal and the TCC signal are both within a predetermined band for RF telemetry communication. In some examples, the IMD comprises a switching module configured to selectively couple one of the plurality of electrodes and the antenna to the receiver module or transmitter module.

Claims

1. An implantable medical device configured for implantation in a patient comprising:

an antenna;

a sensing module configured to receive a cardiac electrogram of the patient via a plurality of electrodes;

a communication receiver module configured to receive and demodulate signals within a predetermined frequency band for radio-frequency (RF) telemetry communication, wherein the communication receiver module is configured to receive from the antenna and demodulate a first RF telemetry signal emitted by an external device outside of the patient, and receive from the plurality of electrodes and demodulate a first tissue conduction communication (TCC) signal emitted by another implantable medical device implanted within the patient, wherein the first RF telemetry signal and the first TCC signal are within the predetermined band for RF telemetry communication;

a switching module comprising one or more switches, wherein the switching module is configured to selectively couple the plurality of electrodes to either the sensing module or the communication receiver module; and

a processor configured to;

determine a heart rate of the patient based on depolarizations sensed by the sensing module in the cardiac electrogram;

determine that the heart rate is greater than a threshold value; and

change the switching module from a first configuration in which the antenna is coupled to the communication receiver module and the plurality of electrodes are decoupled from the communication receiver module to a second configuration in which the antenna is decoupled from the communication receiver module and the plurality of electrodes are coupled to the communication receiver module in response to the determination that the heart rate is greater than the threshold value.

2. The implantable medical device of claim 1, further comprising a communication transmitter module, wherein the switching module is configured to selectively couple either the antenna or the plurality of electrodes to at least one of the communication receiver module or the communication transmitter module,

wherein the communication transmitter module is configured to modulate and transmit signals within the predetermined frequency band for RF telemetry communication, wherein the communication transmitter module is configured to modulate and transmit a second RF telemetry signal to the external device via the antenna, and modulate and transmit a second TCC signal to the other implantable medical device via the plurality of electrodes, wherein the second RF telemetry signal and the second TCC signal are within the predetermined band for RF telemetry communication.

3. The implantable medical device of claim 2, wherein the implantable medical device comprises a leadless pacing device comprising:

a therapeutic signal generator configured to deliver cardiac pacing pulses to a heart of the patient via the plurality of electrodes; and

a housing configured for implantation within the heart of the patient, wherein the housing encloses the antenna, the communication receiver module, the communication transmitter module, the switching module, the sensing module, and the therapeutic signal generator, and wherein the housing comprises or is connected to at least one electrode of the plurality of electrodes, and

wherein the switching module is configured to selectively couple the plurality of electrodes to at least one of;

the sensing module;

the therapeutic signal generator;

the communication receiver module;

or

the communication transmitter module.

4. The implantable medical device of claim 3, wherein the housing encloses the processor, wherein the processor is further configured to receive the demodulated first RF telemetry signal and the demodulated first TCC signal, wherein the first TCC signal is emitted by an extravascular implantable cardioverter defibrillator implanted within the patient and includes a command to deliver at least one of anti-tachycardia pacing (ATP) or post-shock pacing, and wherein the processor is further configured to control the therapeutic signal generator to deliver the at least one of ATP or post-shock pacing via the plurality of electrodes in response to the TCC signal.

5. The implantable medical device of claim 4, wherein the processor is further configured to:

detect a shock delivered by the extravascular implantable cardioverter defibrillator based on cardiac electrogram received by the sensing module; and

change the switching module from the first configuration to the second configuration in response to the detection of the shock.

6. The implantable medical device of claim 1, wherein the processor is further configured to receive the demodulated first RF telemetry signal and the demodulated first TCC signal, wherein the processor is configured to periodically:

change the switching module from the first configuration to the second configuration;

check for the first TCC signal with the switching module in the second configuration; and

return the switching module to the first configuration after checking for the TCC signal.

7. The implantable medical device of claim 1, further comprising a communication transmitter module,

wherein the communication transmitter module is configured to modulate and transmit signals within the predetermined frequency band for RF telemetry communication, wherein the communication transmitter module is configured to modulate and transmit a second RF telemetry signal to the external device via the antenna, and modulate and transmit a second TCC signal to the other implantable medical device via the plurality of electrodes, wherein the second RF telemetry signal and the second TCC signal are within the predetermined band for RF telemetry communication,

wherein the communication transmitter module is further configured to transmit the second TCC signal to a leadless pacing device implanted within the patient, and

wherein the second TCC signal includes a command to deliver at least one of anti-tachycardia pacing (ATP) or post-shock pacing.

8. The implantable medical device of claim 1, wherein the implantable medical device comprises an extravascular implantable cardioverter defibrillator comprising:

a therapeutic signal generator configured to deliver therapeutic shocks to a heart of the patient via the plurality of electrodes; and

a communication transmitter module,

wherein the switching module is configured to selectively couple the plurality of electrodes to at least one of;

the sensing module;

the therapeutic signal generator;

the communication receiver module;

or

the communication transmitter module,

wherein the communication transmitter module is configured to modulate and transmit signals within the predetermined frequency band for RF telemetry communication, wherein the communication transmitter module is configured to modulate and transmit a second RF telemetry signal to the external device via the antenna, and modulate and transmit a second TCC signal to the other implantable medical device via the plurality of electrodes, wherein the second RF telemetry signal and the second TCC signal are within the predetermined band for RF telemetry communication.

9. The implantable medical device of claim 1, further comprising:

a therapeutic signal generator configured to deliver a therapeutic electrical signal to the patient via at least one electrode of the plurality of electrodes; and

a communication transmitter module, wherein the switching module is configured to selectively couple the at least one electrode to either;

the therapeutic signal generator;

the communication receiver module;

or

the communication transmitter module,

wherein the communication transmitter module is configured to modulate and transmit signals within the predetermined frequency band for RF telemetry communication, wherein the communication transmitter module is configured to modulate and transmit a second RF telemetry signal to the external device via the antenna, and modulate and transmit a second TCC signal to the other implantable medical device via the plurality of electrodes, wherein the second RF telemetry signal and the second TCC signal are within the predetermined band for RF telemetry communication.

10. The implantable medical device of claim 1, further comprising an amplifier that amplifies the first TCC signal prior to receipt by the communication receiver module, wherein the amplifier does not amplify the first RF telemetry signal prior to receipt by the communication receiver module.

11. The implantable medical device of claim 1, wherein the predetermined band for RF telemetry communication comprises signals within a range from approximately 150 kilohertz to approximately 200 kilohertz.

12. A method for receiving and demodulating both radio-frequency (RF) telemetry signals and tissue conduction communication (TCC) signals with a common communication receiver module of an implantable medical device, the method comprising:

receiving, by a sensing module of the implantable medical device, a cardiac electrogram of the patient via a plurality of electrodes coupled to the implantable medical device;

receiving, by the communication receiver module, an RF telemetry signal emitted by an external device outside of the patient via an antenna of the implantable medical device, wherein the RF telemetry signal is within a predetermined frequency band for RF telemetry communication;

demodulating, by the communication receiver module, the RF telemetry signal;

receiving, by the communication receiver module, a TCC signal emitted by another implantable medical device implanted within the patient via the plurality of electrodes, wherein the TCC signal is within the predetermined frequency band for RF telemetry communication;

demodulating, by the communication receiver module, the TCC signal;

selectively coupling, by a switching module of the implantable medical device comprising one or more switches, the plurality of electrodes to either the sensing module or the communication receiver module of the implantable medical device;

determining, by a processor of the implantable medical device, a heart rate of the patient based on depolarizations sensed by the sensing module in the cardiac electrogram;

determining, by the processor, that the heart rate is greater than a threshold value; and

changing, by the processor, the switching module from a first configuration in which the antenna is coupled to the communication receiver module and the plurality of electrodes are decoupled from the communication receiver module to a second configuration in which the antenna is decoupled from the communication receiver module and the plurality of electrodes are coupled to the communication receiver module in response to the determination that the heart rate is greater than the threshold value.

13. The method of claim 12, wherein the implantable medical device comprises a leadless pacing device comprising:

a therapeutic signal generator configured to deliver cardiac pacing pulses to a heart of the patient via the plurality of electrodes; and

a housing configured for implantation within the heart of the patient, wherein the housing encloses the antenna, the communication receiver module, the switching module, the sensing module, and the therapeutic signal generator, and wherein the housing comprises or is connected, to the plurality of electrodes,

the method further comprising selectively coupling, with the switching module, the plurality of electrodes to at least one of the communication receiver module, the sensing module, or the therapeutic signal generator.

14. The method of claim 13, wherein the TCC signal is emitted by an extravascular implantable cardioverter defibrillator implanted within the patient and includes a command to deliver at least one of anti-tachycardia pacing (ATP) or post-shock pacing, the method further comprising delivering the at least one of ATP or post-shock pacing via the plurality of electrodes in response to the TCC signal.

15. The method of claim 14, further comprising:

detecting a shock delivered by the extravascular implantable cardioverter defibrillator based on cardiac electrogram received by the sensing module; and

changing the switching module from the first configuration to the second configuration in response to the detection of the shock.

16. The method of claim 12, wherein the implantable medical device comprises a therapeutic signal generator configured to deliver a therapeutic electrical signal to the patient via the plurality of electrodes, the method further comprising selectively coupling, with the switching module, the plurality of electrodes to at least one of the communication receiver module, the sensing module, or the therapeutic signal generator.

17. The method of claim 12, further comprising amplifying, with an amplifier of the implantable medical device, the TCC signal prior to demodulating, by the communication receiver module, the TCC signal, wherein the amplifier does not amplify the RF telemetry signal prior to receipt by the communication module.

18. A method for modulating and transmitting both radio-frequency (RF) telemetry signals and tissue conduction communication (TCC) signals with a common communication transmitter module of an implantable medical device, the method comprising:

receiving, by a sensing module of the implantable medical device, a cardiac electrogram of the patient via a plurality of electrodes;

modulating, by the communication transmitter module, an RF telemetry signal;

transmitting, by the communication transmitter module, the RF telemetry signal to an external device outside of the patient via an antenna of the implantable medical device, wherein the RF telemetry signal is within the predetermined frequency band for RF telemetry communication;

modulating, by the communication transmitter module, a TCC signal;

transmitting, by the communication transmitter module, the TCC signal to another implantable medical device implanted within the patient with the plurality of electrodes coupled to the implantable medical device, wherein the TCC signal is within the predetermined frequency band for RF telemetry communication;

selectively coupling, by a switching module of the implantable medical device comprising one or more switches, the plurality of electrodes to either the sensing module or at least one of a communication receiver module of the implantable medical device or the communication transmitter module;

determining, by a processor of the implantable medical device, a heart rate of the patient based on depolarizations sensed by the sensing module in the cardiac electrogram;

determining, by the processor, that the heart rate is greater than a threshold value; and

changing, by the processor, the switching module from a first configuration in which the antenna is coupled to the communication receiver module and the plurality of electrodes are decoupled from the communication receiver module to a second configuration in which the antenna is decoupled from the communication receiver module and the plurality of electrodes are coupled to the communication receiver module in response to the determination that the heart rate is greater than the threshold value.

19. The method of claim 18, further comprising selectively coupling, with the switching module, the communication transmitter module to either the antenna or the plurality of electrodes.

20. The method of claim 19, wherein the implantable medical device comprises an extravascular implantable cardioverter defibrillator comprising:

a therapeutic signal generator configured to deliver therapeutic shocks to a heart of the patient via the plurality of electrodes,

the method further comprising selectively coupling, with the switching module, the plurality of electrodes to at least one of the communication transmitter module, the sensing module, or the therapeutic signal generator.

21. The method of claim 20, wherein the TCC signal is transmitted to a leadless pacing device implanted within the patient and includes a command to deliver at least one of anti-tachycardia pacing (ATP) or post-shock pacing.

22. The method of claim 18, wherein the implantable medical device further comprises a therapeutic signal generator configured to deliver a therapeutic electrical signal to the patient via the at least one of the plurality of electrodes, the method further comprising selectively coupling, with the switching module, the at least one of the plurality of electrodes to at least one of the communication transmitter module, the sensing module, or the therapeutic signal generator.

23. The method of claim 18, wherein modulating the RF telemetry signal and the TCC signal comprises modulating the RF telemetry signal and the TCC signal using different modulation techniques.

24. The method of claim 18, wherein the TCC signal includes a message, and transmitting the TCC signal comprises transmitting the TCC signal including the message a plurality of times during a cardiac cycle.

25. A system comprising:

an extravascular implantable cardioverter defibrillator comprising;

a first antenna;

a first plurality of electrodes;

a first sensing module configured to receive a first cardiac electrogram of a patient via the first plurality of electrodes;

a first therapeutic signal generator configured to deliver therapeutic shocks to a heart of the patient via the first plurality of electrodes;

a communication transmitter module configured to modulate and transmit signals within a predetermined frequency band for radio-frequency (RF) telemetry communication, wherein the communication transmitter module is configured to modulate and transmit a first RF telemetry signal to an external device via the first antenna, and modulate and transmit a tissue conduction communication (TCC) signal via the first plurality of electrodes, wherein the TCC signal is within the predetermined frequency band for RF telemetry communication; and

a first switching module configured to selectively couple the first plurality of electrodes to at least one of;

the first sensing module;

the first therapeutic signal generator;

or

the communication transmitter module; and

a leadless pacing device comprising;

a second antenna;

a second plurality of electrodes;

a second sensing module configured to receive a second cardiac electrogram of the patient via the second plurality of electrodes;

a second therapeutic signal generator configured to deliver cardiac pacing pulses to a heart of the patient via the second plurality of electrodes;

a communication receiver module configured to receive and demodulate signals within the predetermined frequency band for RF telemetry communication, wherein the communication receiver module is configured to receive from the second antenna and demodulate a second RF telemetry signal emitted by the external device, and receive from the second plurality of electrodes and demodulate the TCC signal emitted by the extravascular implantable cardioverter defibrillator;

a second switching module configured to selectively couple the second plurality of electrodes to at least one of;

the second sensing module;

the second therapeutic signal generator;

or

the communication receiver module; and

a housing configured for implantation within the heart of the patient, wherein the housing encloses the second antenna, the communication receiver module, the second switching module, the second sensing module, and the second therapeutic signal generator, and wherein the housing comprises at least one of the second plurality of electrodes,

wherein the TCC signal includes a command from the extravascular implantable cardioverter defibrillator to the leadless pacing device to deliver at least one of anti-tachycardia pacing (ATP) or post-shock pacing, and

wherein the leadless pacing device further comprises a processor within the housing, wherein the processor is configured to;

determine a heart rate of the patient based on depolarizations sensed by the second sensing module in the second cardiac electrogram;

determine that the heart rate is greater than a threshold value; and

change the second switching module from a first configuration in which the second antenna is coupled to the communication receiver module and the second plurality of electrodes are decoupled from the communication receiver module to a second configuration in which the second antenna is decoupled from the communication receiver module and the second plurality of electrodes are coupled to the communication receiver module in response to the determination that the heart rate is greater than the threshold value.

26. The system of claim 25, wherein the leadless pacing device further comprises a processor within the housing, wherein the processor is configured to:

detect a shock delivered by the extravascular implantable cardioverter defibrillator based on the second cardiac electrogram received by the second sensing module; and

change the second switching module from the first configuration in which the second antenna is coupled to the communication receiver module and the second plurality of electrodes are decoupled from the communication receiver module to the second configuration in which the second antenna is decoupled from the communication receiver module and the second plurality of electrodes are coupled to the communication receiver module in response to the detection of the shock.

27. The system of claim 25,

wherein the communication transmitter module of the extravascular implantable cardioverter defibrillator is configured to send another TCC signal that includes a command to the leadless pacing device to shorten a pacing interval,

wherein the communication receiver module of the leadless pacing device receives the other TCC signal, and the second therapeutic signal generator shortens the pacing interval in response to the command to shorten the pacing interval, and

wherein the first sensing module of the extravascular implantable cardioverter defibrillator detects the shortened pacing interval to confirm receipt of the command.