Systems, methods, and interfaces for identifying effective electrodes

• US 9,931,048 B2
• Filed: 03/27/2014
• Issued: 04/03/2018
• Est. Priority Date: 04/30/2013
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ghosh, Subham, Gillberg, Jeffrey
• Primary Examiner(s): D ABREU, MICHAEL JOSEPH
• Application Number:
  US14/227,962
• Publication Number:
  US 20140323893A1
• Time in Patent Office: 1,468 Days
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

Claims

1. A system for use in cardiac therapy comprising:

electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient;

display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to graphically depict at least a portion of anatomy of the patient'"'"'s heart for use in assisting a user in navigating at least one implantable electrode to a region of the patient'"'"'s heart; and

computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to perform an effectiveness test for each electrode of the plurality of electrodes resulting in an effectiveness value for each electrode representative of the effectiveness of the electrode in providing a valid sensing signal from the tissue of the patient, wherein, to perform the effectiveness test for each electrode, the computing apparatus is further configured to;

monitor a first signal from the patient using a primary electrode being tested,

monitor at least one secondary signal from the patient using at least one neighbor electrode, wherein the at least one neighbor electrode is spatially adjacent to the primary electrode,

store a portion of the first signal being monitored using the primary electrode being tested over a time period,

store a portion of each of the at least one secondary signal being monitored using the at least one neighbor electrode over the time period,

compare the portion of the first signal monitored using the primary electrode being tested to the portion of each of the at least one secondary signal to provide at least one effectiveness value representative of the effectiveness of the same primary electrode being tested in providing a valid sensing signal from the tissue of the patient, and

display, on the graphical user interface, information for use in assisting a user in at least one of assessing a patient'"'"'s cardiac health, evaluating and adjusting cardiac therapy delivered to a patient, and navigating at least one implantable electrode to a region of the patient'"'"'s heart.

2. The system of claim 1, wherein each of the at least one effectiveness value for each primary electrode represent a correlation value between the primary electrode and one neighbor electrode.

3. The system of claim 1, wherein the time period corresponds to ventricular depolarization.

4. The system of claim 1, wherein the time period is less than or equal to 250 milliseconds.

5. The system of claim 1, wherein the at least one neighbor electrode is within 3 centimeters from the primary electrode.

6. The system of claim 1, wherein the effectiveness value comprises a Pearson correlation coefficient.

7. The system of claim 1, wherein the plurality of electrodes comprises surface electrodes positioned in an array.

8. The system of claim 1, wherein the effectiveness value comprises a correlation value, and wherein the computing apparatus is further configured to disable any electrode of the plurality of electrodes having all of their at least one correlation value less than or equal to a selected threshold value.

9. The system of claim 1, wherein the computing apparatus is further configured to perform an additional effectiveness test for each electrode of the plurality of electrodes resulting in at least one additional correlation value for each electrode if more than a selected percentage of the plurality of electrodes had all of their at least one correlation value less than a selected threshold value.

10. The system of claim 1, wherein the computing apparatus is further configured to generate a graphical map comprising the plurality of electrodes spatially distributed and the effectiveness values of the plurality of electrodes.

11. The system of claim 1, wherein information for use in assisting a user in at least one of assessing a patient'"'"'s cardiac health, evaluating and adjusting cardiac therapy delivered to a patient, and navigating at least one implantable electrode to a region of the patient'"'"'s heart comprises at least a portion of the blood vessel anatomy of the patient'"'"'s heart.

12. A method for use in cardiac therapy comprising:

monitoring a first signal from a patient using a primary electrode being tested to determine an effectiveness of the primary electrode in providing a valid sensing signal from tissue of the patient;

monitoring at least one secondary signal from the patient using at least one neighbor electrode, wherein the at least one neighbor electrode is spatially adjacent to the primary electrode;

storing a portion of the first signal being monitored using the primary electrode being tested over a time period;

storing a portion of each of the at least one secondary signal being monitored using the at least one neighbor electrode over the time period;

comparing the portion of the first signal monitored using the primary electrode being tested to the portion of each of the at least one secondary signal to provide at least one effectiveness value representative of the effectiveness of the same primary electrode being tested in providing a valid sensing signal for sensing cardiac signals from the tissue of the patient; and

displaying, on a graphical user interface, information for use in at least one of assessing a patient'"'"'s cardiac health, evaluating and adjusting cardiac therapy delivered to a patient, and assisting a user in navigating at least one implantable electrode to a region of the patient'"'"'s heart.

13. The method of claim 12, wherein each of the at least one effectiveness value for each primary electrode represent a correlation value between the primary electrode and one neighbor electrode.

14. The method of claim 12, wherein the time period corresponds to ventricular depolarization.

15. The method of claim 12, wherein the at least one neighbor electrode is within 3 centimeters from the primary electrode.

16. The method of claim 12, wherein the plurality of electrodes comprises surface electrodes positioned in an array.

17. The method of claim 12, wherein the effectiveness value comprises a correlation value, and wherein the method further comprises disabling any electrode of the plurality of electrodes having all of their at least one correlation value less than or equal to a selected threshold value.

18. The method of claim 12, wherein the method further comprises performing an additional effectiveness test for each electrode of the plurality of electrodes resulting in at least one additional correlation value for each electrode if more than a selected percentage of the plurality of electrodes had all of their at least one correlation value less than a selected threshold value.

19. The method of claim 12, wherein the method further comprises generating a graphical map comprising the plurality of electrodes spatially distributed and the effectiveness values of the plurality of electrodes.

20. A system for use in cardiac therapy comprising:

electrode means for monitoring a first signal from a patient using a primary electrode being tested to determine the effectiveness of the primary electrode in providing a valid sensing signal from tissue of the patient and for monitoring at least one secondary signal from the patient using at least one neighbor electrode, wherein the at least one neighbor electrode is spatially adjacent to the primary electrode;

computing means for storing a portion of the first signal being monitored using the primary electrode being tested over a time period, for storing a portion of each of the at least one secondary signal being monitored using the at least one neighbor electrode over the time period, and for comparing the portion of the first signal monitored using the primary electrode being tested to the portion of each of the at least one secondary signal to provide at least one effectiveness value representative of the effectiveness of the same primary electrode being tested in providing a valid sensing signal from the tissue of the patient; and

display means for displaying, on a graphical user interface, information for use in at least one of assessing a patient'"'"'s cardiac health, evaluating and adjusting cardiac therapy delivered to a patient, and assisting a user in navigating at least one implantable electrode to a region of the patient'"'"'s heart.