IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION

• US 20100114196A1
• Filed: 01/30/2009
• Published: 05/06/2010
• Est. Priority Date: 10/31/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Davis, Timothy, Krause, Paul G., Donofrio, William T., Zhou, Xiaohong, Reinke, James D., Arne, Gerald P., Peichel, David J., Burnes, John E.
• Granted Patent: US 8,452,394 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37258 Alerting the patient
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/39624 Pain reduction therapy

Abstract

Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Claims

1. A method comprising:

delivering electrical stimulation to a tissue site within a patient via an implantable electrical stimulator;

detecting a potential arrhythmia of a heart of the patient;

adjusting the delivery of the electrical stimulation to the tissue site after detecting the potential arrhythmia;

determining whether the potential arrhythmia is detected after adjusting the electrical stimulation to the tissue site; and

modifying at least one stimulation parameter of the electrical stimulator if the potential arrhythmia is not detected after adjusting the electrical stimulation to the tissue site.

2. The method of claim 1, wherein adjusting the delivery of the electrical stimulation to the tissue site comprises suspending the delivery of the electrical stimulation to the tissue site.

3. The method of claim 1, wherein detecting the potential arrhythmia comprises detecting at least one of electrical noise or a true cardiac arrhythmia.

4. The method of claim 1, wherein the tissue site comprises at least one of a nonmyocardial tissue site or a nonvascular cardiac tissue site.

5. The method of claim 1, wherein the tissue site comprises at least one of an extravascular tissue site or the tissue site proximate to a nerve of the patient.

6. The method of claim 1, and further comprising delivering electrical stimulation to the tissue site via the implantable electrical stimulator according to the at least one modified stimulation parameter.

7. The method of claim 1, wherein adjusting the delivery of the electrical stimulation comprises adjusting the delivery of the electrical stimulation at a first time and modifying at least one stimulation parameter of the electrical stimulator comprises modifying a first value of a first stimulation parameter, the method further comprising:

detecting the potential arrhythmia after modifying the first value of the first stimulation parameter;

adjusting the delivery of the electrical stimulation to the tissue site at a second time in response to detecting the potential arrhythmia after modifying the first value of the first stimulation parameter;

determining whether the potential arrhythmia is detected after adjusting the electrical stimulation to the tissue site at the second time; and

modifying a second value of a second stimulation parameter of the electrical stimulator if the potential arrhythmia is not detected after adjusting the electrical stimulation to the tissue site at the second time.

8. The method of claim 1, wherein adjusting the delivery of the electrical stimulation comprises adjusting the delivery of the electrical stimulation at a first time and modifying at least one stimulation parameter of the electrical stimulator comprises modifying a value of a stimulation parameter, the method further comprising:

detecting the potential arrhythmia after modifying the value of the stimulation parameter;

adjusting the delivery of the electrical stimulation to the tissue site at a second time in response to detecting the potential arrhythmia after modifying the value of the stimulation parameter;

determining whether the potential arrhythmia is detected after adjusting the electrical stimulation to the tissue site at the second time; and

further modifying the value of the stimulation parameter of the electrical stimulator if the potential arrhythmia is not detected after adjusting the electrical stimulation to the tissue site at the second time.

9. The method of claim 1, further comprising:

detecting the potential arrhythmia after modifying the at least one stimulation parameter of the electrical stimulator;

adjusting the delivery of the electrical stimulation to the tissue site in response to detecting the potential arrhythmia after modifying the at least one stimulation parameter of the electrical stimulator; and

generating an interference indication upon detecting the potential arrhythmia after modifying the at least one stimulation parameter of the electrical stimulator.

10. The method of claim 9, further comprising transmitting the interference indication to a user via an external device.

11. The method of claim 10, wherein the external device comprises a medical device programmer.

12. The method of claim 9, wherein the interference indication comprises at least one of a visible alert, an audible alert or somatosensory alert.

13. The method of claim 1, and further comprising:

detecting the potential arrhythmia after modifying the at least one stimulation parameter of the electrical stimulator;

determining whether the potential arrhythmia comprises a true arrhythmia; and

delivering therapy to the heart of the patient if the potential arrhythmia comprises a true arrhythmia.

14. The method of claim 13, further comprising:

characterizing a type of the true arrhythmia; and

selecting a treatment based on the type of true arrhythmia, wherein delivering therapy to the heart of the patient comprises delivering therapy to the heart of the patient based on the selected treatment.

15. The method of claim 13, wherein delivering therapy to the heart of the patient comprises delivering therapy to the heart of the patient via an implantable cardiac device that is physically separate from the implantable electrical stimulator.

16. The method of claim 13, wherein delivering therapy to the heart of the patient comprises delivering therapy to the heart of the patient via an implantable cardiac device that is disposed in a common housing with the implantable electrical stimulator.

17. The method of claim 1, wherein detecting the potential arrhythmia comprises detecting the potential arrhythmia with a device that is separate from the electrical stimulator.

18. The method of claim 1, wherein detecting the potential arrhythmia comprises detecting the potential arrhythmia with the electrical stimulator.

19. The method of claim 1, wherein the stimulation parameter comprises at least one of a slew rate, a current amplitude, a voltage amplitude, a pulse width, a pulse rate, a continuous waveform frequency, a duty cycle, an electrode combination, a timing of the delivery of the electrical stimulation relative to a cardiac cycle of the heart of the patient, a waveform shape or a signal envelope of the electrical stimulation signal.

20. The method of claim 1, wherein delivering electrical stimulation to the tissue site via an implantable electrical stimulator comprises delivering electrical stimulation to the tissue site via a subset of electrodes electrically coupled to the implantable electrical stimulator, wherein modifying at least one stimulation parameter of the electrical stimulator after detecting the potential arrhythmia comprises modifying the subset of electrodes to define a guarded cathode arrangement.

21. The method of claim 1, wherein delivering electrical stimulation to the tissue site within a patient via an implantable electrical stimulator comprises delivering electrical stimulation generated in accordance with a first therapy program, wherein modifying the at least one stimulation parameter of the electrical stimulator comprises controlling the implantable electrical stimulator to generate the electrical stimulation according to a second therapy program that is different than the first therapy program.

22. A method comprising:

implanting a first therapy module in a patient, wherein the first therapy module is configured to deliver electrical stimulation to a tissue site within the patient;

implanting a second therapy module in the patient, wherein the second therapy module is configured to deliver at least one of a pacing, cardioversion or defibrillation therapy to a heart of the patient;

implanting a sensing module in the patient, wherein the sensing module is configured to sense a cardiac signal of the heart of the patient; and

implanting a processor in the patient, wherein the processor is configured to detect a potential arrhythmia of the heart based on the cardiac signal, control the first therapy module to adjust the delivery of electrical stimulation to the tissue site after detecting the potential arrhythmia, determine whether the potential arrhythmia is detected after adjusting the electrical stimulation to the tissue site, and modify at least one stimulation parameter of the electrical stimulator if the potential arrhythmia is not detected after adjusting the electrical stimulation to the tissue site.

23. The method of claim 22, wherein implanting the first and second therapy modules comprises separately implanting the first and second therapy modules in the patient.

24. The method of claim 22, wherein implanting the first and second therapy modules comprises implanting a housing substantially enclosing the first and second therapy modules in the patient.

25. A computer-readable medium comprising instructions that cause a programmable processor to:

control an implantable electrical stimulator to deliver electrical stimulation to a tissue site within a patient;

detect a potential arrhythmia of a heart of the patient;

adjust the delivery of the electrical stimulation to the tissue site after detecting the potential arrhythmia;

determine whether the potential arrhythmia is detected after adjusting the electrical stimulation to the tissue site; and

modify at least one stimulation parameter of the electrical stimulator if the potential arrhythmia is not detected after adjusting the electrical stimulation to the tissue site.

26. The computer-readable medium of claim 25, wherein the instructions cause the programmable processor to adjust the delivery of the electrical stimulation to the tissue site by adjusting the delivery of the electrical stimulation to the tissue site.