Leadless cardiac pacemaker with multimode communication

• US 10,881,863 B2
• Filed: 11/20/2017
• Issued: 01/05/2021
• Est. Priority Date: 11/21/2016
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Maile, Keith R., Linder, William J., Ludwig, Jacob M.
• Primary Examiner(s): Alter, Alyssa M
• Application Number:
  US15/818,311
• Publication Number:
  US 20180140853A1
• Time in Patent Office: 1,142 Days
• CPC Class Codes: A61N 1/025 Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• 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 1/37223 Circuits for electromagnetic coupling
• CPC Class Codes: A61N 1/37229 Shape or location of the implanted or external antenna
• CPC Class Codes: A61N 1/37512 Pacemakers
• CPC Class Codes: A61N 1/3754 Feedthroughs
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3787 from an external energy source
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

Implantable medical devices such as leadless cardiac pacemakers may be configured to communicate using more than one mode of communication. For example, in some cases, an implantable medical device may be configured to communicate via conducted communication in some circumstances and to communicate via inductive communication in other circumstances. In some cases, the implantable medical device may be configured to switch between communication modes in order to improve communication.

Claims

1. A leadless cardiac pacemaker (LCP) configured to pace a patient'"'"'s heart, the LCP disposable within a chamber of the patient'"'"'s heart, the LCP comprising:

a housing;

a plurality of electrodes secured relative to the housing;

two or more inductive coils secured relative to the housing, wherein each of the two or more inductive coils includes a plurality of windings extending about a central axis, wherein the central axis of one of the two or more inductive coils is not coaxial and not parallel with the central axis of another one of the two or more inductive coils;

a controller disposed within the housing and operably coupled to the plurality of electrodes and the two or more inductive coils, the controller configured to sense cardiac electrical activity of the patient'"'"'s heart via two or more of the electrodes and to generate and deliver pacing pulses via two or more of the electrodes; and

the controller is configured to communicate information between the LCP and one or more remotely located devices using;

conducted communication via two or more of the electrodes; and

inductive communication via one or more of the two or more inductive coils.

2. The LCP of claim 1, wherein the controller is configured to select a particular one of the two or more inductive coils for inductive communication, and to communicate information with one or more remotely located devices using inductive communication via the selected one of the two or more inductive coils, while not using the non-selected ones of the two or more inductive coils for inductive communication.

3. The LCP of claim 1, wherein the controller is configured to select two or more of the inductive coils for inductive communication, and to communicate information with one or more remotely located devices using inductive communication via the selected two or more inductive coils.

4. The LCP of claim 1, wherein at least one of the two or more inductive coils is disposed within the housing.

5. The LCP of claim 1, wherein the controller is configured to:

disable inductive communication to save power;

communicate information with one or more remotely located devices using conducted communication;

detect a predetermined condition, and in response to detecting the predetermined condition, enable inductive communication and communicate information with one or more remotely located devices using inductive communication.

6. The LCP of claim 5, wherein the controller includes a time clock, and the predetermined condition comprises a predetermined time of day.

7. The LCP of claim 5, wherein the LCP further includes a posture sensor for detecting a posture of the patient, and the predetermined condition comprises detection of a predetermined posture of the patient.

8. The LCP of claim 5, wherein the predetermined condition comprises an error in conducted communication with one or more remotely located devices.

9. The LCP of claim 1, wherein the controller is further configured to have a fail-safe in which a user is prevented from having conductive communication and inductive communication disabled at the same time.

10. A leadless cardiac pacemaker (LCP) configured to pace a patient'"'"'s heart, the LCP disposable within a chamber of the patient'"'"'s heart, the LCP comprising:

an elongated housing having a length dimension and a width dimension, wherein the length dimension is longer than the width dimension;

a plurality of electrodes secured relative to the elongated housing;

a plurality of internal components within the elongated housing, the plurality of internal components comprising;

an inductive coil disposed within the elongated housing, the inductive coil comprising a plurality of windings extending about a central aperture, wherein the central aperture of the inductive coil is aligned in the direction of the length dimension of the elongated housing;

a circuit board including circuitry that is operably coupled to the plurality of electrodes and is configured to sense cardiac electrical activity of the patient'"'"'s heart via two or more of the electrodes and to generate and deliver pacing pulses via two or more of the electrodes, the circuitry is further configured to communicate information between the LCP and one or more remotely located devices using;

conducted communication via two or more of the electrodes; and

inductive communication via the inductive coil;

a battery disposed within the elongated housing and operably coupled to the circuitry; and

wherein at least part of one or more of the internal components of the LCP extends into and occupies at least part of the central aperture of the inductive coil.

11. The LCP of claim 10, wherein the inductive coil has a length extending along the length dimension of the elongated housing and a width orthogonal to the length, wherein a ratio of the length of the inductive coil to the width is less than one.

12. The LCP of claim 10, wherein the plurality of internal components within the elongated housing comprises a battery pin extending between a terminal of the battery and circuitry of the circuit board, wherein the battery pin extends through the occupies at least part of the central aperture of the inductive coil.

13. The LCP of claim 10, wherein the plurality of internal components within the elongated housing comprises a feed through pin extending between circuitry of the circuit board and one of the plurality of electrodes, wherein the feed through pin extends through and occupies at least part of the central aperture of the inductive coil.

14. The LCP of claim 10, further comprising a second inductive coil that is disposed within the elongated housing, the second inductive coil comprising a plurality of windings extending about a central aperture, wherein the central aperture of the second inductive coil extends in the direction of the width dimension of the elongated housing.

15. The LCP of claim 14, wherein the central aperture of the second inductive coil extends parallel with the circuit board or perpendicular to the circuit board.

16. The LCP of claim 14, wherein the second inductive coil has a length that extends in the direction of the width dimension of the elongated housing, and a width that is orthogonal to the length, wherein a ratio of the length of the inductive coil to the width is greater than three, and wherein the second inductive coil comprises a ferrite core in the central aperture of the second inductive coil.

17. A leadless cardiac pacemaker (LCP) configured to pace a patient'"'"'s heart, the LCP disposable within a chamber of the patient'"'"'s heart, the LCP comprising:

an elongated housing having a length dimension and a width dimension, wherein the length dimension is longer than the width dimension;

a plurality of electrodes secured relative to the elongated housing;

a circuit board assembly including two or more stacked circuit boards operably coupled together via flexible interconnects, the circuit board assembly disposed within the elongated housing such that each of the two or more stacked circuit boards are orthogonal to the length dimension of the elongated housing;

the circuit board assembly including circuitry that is operably coupled to the plurality of electrodes and is configured to sense cardiac electrical activity of the patient'"'"'s heart via two or more of the electrodes and to generate and deliver pacing pulses via two or more of the electrodes;

an inductive coil disposed within the elongated housing such that the inductive coil extends between a first circuit board and a second circuit board of the plurality of circuit boards; and

the circuitry is configured to communicate information between the LCP and one or more remotely located devices using;

conducted communication via two or more of the electrodes; and

inductive communication via the inductive coil.

18. The LCP of claim 17, further comprising a second inductive coil disposed within the elongated housing such that the second inductive coil extends between two of the plurality of circuit boards of the plurality of circuit boards.

19. The LCP of claim 17, further comprising a second inductive coil disposed within the elongated housing and arranged orthogonal to the inductive coil.

20. The LCP of claim 19, further comprising a third inductive coil disposed within the elongated housing and arranged orthogonal to both the inductive coil and the second inductive coil.