Systems and methods for rate responsive pacing with a leadless cardiac pacemaker

• US 9,962,550 B2
• Filed: 06/11/2015
• Issued: 05/08/2018
• Est. Priority Date: 06/12/2014
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kane, Michael J., Stahmann, Jeffrey E., Maile, Keith R.
• Primary Examiner(s): LEVICKY, WILLIAM J
• Application Number:
  US14/736,907
• Publication Number:
  US 20150360036A1
• Time in Patent Office: 1,062 Days
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• 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

Abstract

Systems and methods for providing rate responsive pacing therapy to a heart of a patient. One example method for providing rate responsive pacing therapy includes sensing cardiac electrical data with a leadless cardiac pacemaker (LCP) that is implanted within or proximate the heart. From this location, the LCP may provide pacing therapy to the heart based at least in part on the sensed cardiac electrical data. An implantable medical device located remotely from the heart may sense patient activity, and may wirelessly communicate patient activity data from the implantable medical device to the LCP, sometimes using conducted communication. The LCP may be then determine an adjustment to the provided pacing therapy (e.g. adjust the pacing rate) based at least in part on the received patient activity data signal.

Claims

1. An implantable medical device system for providing adjustable rate pacing therapy to a heart of a patient, the system comprising:

a leadless cardiac pacemaker (LCP) configured to be implantable within or proximate the heart of the patient, wherein the LCP comprises a plurality of electrodes and a controller operably coupled to the plurality of electrodes, wherein the controller of the LCP is configured to;

sense cardiac electrical data using two or more of the plurality of electrodes;

provide pacing therapy to the heart of the patient using two or more of the plurality of electrodes, the pacing therapy based at least in part on the sensed cardiac electrical data;

an implantable cardioverter-defibrillator (ICD) that has a lead with two or more electrodes that are implanted in a location that is spaced from the heart of the patient, wherein the ICD comprises a patient activity sensor and a controller operably coupled to the patient activity sensor, wherein the controller of the ICD is configured to;

sense patient activity using the patient activity sensor, and

wirelessly communicate a patient activity data signal to the LCP using the two or more electrodes; and

wherein the controller of the LCP is configured to determine an adjustment to the provided pacing therapy based at least in part on the received patient activity data signal and to adjust the pacing therapy.

2. The system of claim 1, wherein the pacing therapy comprises a pacing rate, and wherein the adjustment to the provided pacing therapy comprises an adjustment to the pacing rate of the provided pacing therapy.

3. The system of claim 1, wherein the patient activity data signal is wirelessly communicated to the LCP by conducted communication.

4. The system of claim 1, wherein the patient activity sensor comprises an accelerometer.

5. The system of claim 4, wherein the controller of the LCP is further configured to determine the adjustment to the provided pacing therapy based at least in part on both the output of the accelerometer and a respiration rate of the patient that is determined at least in part using the ICD.

6. An implantable medical device system for providing adjustable rate pacing therapy to a heart of a patient, the system comprising:

a leadless cardiac pacemaker (LCP) configured to be implantable within or proximate the heart of the patient, the LCP including an LCP accelerometer, a plurality of electrodes and a controller operably coupled to the LCP accelerometer and the plurality of electrodes;

an implantable cardioverter-defibrillator (ICD) that has a lead with one or more electrodes that are implanted at a location that is spaced from the heart of the patient, wherein the ICD comprises an ICD accelerometer and a controller operably coupled to the one or more electrodes and the ICD accelerometer, and wherein the ICD is wirelessly communicatively coupled to the LCP;

wherein the controller of the ICD is configured to generate patient activity data based at least in part on an output of the ICD accelerometer, and is further configured to wirelessly communicate the patient activity data to the LCP; and

wherein the controller of the LCP is configured to;

provide rate responsive pacing therapy to the heart of the patient; and

adjust the rate of the rate responsive pacing therapy based at least in part on the patient activity data received from the ICD.

7. The implantable medical device system of claim 6, wherein the patient activity data is wirelessly communicated to the LCP by conducted communication using two or more electrodes of the LCP and two or more electrodes of the ICD.

8. The implantable medical device system of claim 6, wherein the patient activity data is wirelessly communicated to the LCP using one or more of an electrical signal, a radiofrequency signal and an acoustic signal.

9. A method for providing rate responsive pacing therapy to a heart of a patient, the method comprising:

sensing cardiac electrical data with a leadless cardiac pacemaker (LCP) implanted within the heart of the patient;

providing pacing therapy to the heart of the patient with the LCP based at least in part on the sensed cardiac electrical data;

sensing patient activity with an implantable cardioverter-defibrillator (ICD) that has a lead with an electrode, wherein the electrode of the lead is implanted at a location that is spaced from the heart of the patient, and the ICD determining a patient activity data signal based upon the patient activity sensed by the ICD;

wirelessly communicating the patient activity data signal from the ICD to the LCP;

the LCP adjusting the pacing therapy provided by the LCP based at least in part on the received patient activity data signal; and

wherein the pacing therapy comprises a pacing rate, and the adjustment to the provided pacing therapy includes an adjustment to the pacing rate.

10. The method of claim 9, wherein the patient activity data signal is wirelessly communicated to the LCP by conducted communication.

11. The method of claim 9, wherein the patient activity data signal comprises one or more of an electrical signal, a radiofrequency signal and an acoustic signal.

12. The method of claim 9, wherein the patient activity data signal is based, at least in part, on an output of an accelerometer of the ICD.

13. The method of claim 12, wherein the LCP adjusts the provided pacing therapy based at least in part on both the output of the accelerometer of the ICD and a respiration rate of the patient that is determined at least in part using the ICD.

14. The method of claim 9, wherein the patient activity data signal comprises accelerometer data.

15. The method of claim 9, wherein the patient activity data signal is based, at least in part, on a respiration signal.

16. The method of claim 15, wherein the respiration signal is based, at least in part, on a measure related to an impedance across at least a portion of a lung of the patient.

17. The method of claim 15, wherein the respiration signal is based, at least in part, on an amplitude of the patient activity data signal received at the LCP, and wherein the LCP adjusts the provided pacing therapy based at least in part on the respiration signal.

18. The method of claim 9, wherein the LCP adjusts the provided pacing therapy based at least in part on a sensed heart rate of the patient.

19. The method of claim 18, wherein sensed heart rate of the patient is sensed by one or more exposed electrodes of the LCP.