SYSTEMS AND METHODS TO SYNCHRONIZE COMMANDS SENT TO A MULTI-ELECTRODE LEAD (MEL) WITH A PORTION OF A CARDIAC PACING CYCLE

• US 20110046690A1
• Filed: 12/29/2009
• Published: 02/24/2011
• Est. Priority Date: 08/18/2009
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Pixley, April, Clem, Elisabeth M., Hossain, Shohan, Pontiga, Chris, Shelchuk, Anne, Yi, Jianchun, Wu, Yonglian, Iranitalab, Pajhand
• Granted Patent: US 9,233,250 B2
• Time in Patent Office: Days
• US Class Current: 607/17
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/3686 configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/3912 Output circuitry therefor, e.g. switches

Abstract

Embodiments of the present invention concern the timing of sending one or more commands to control circuitry of a multi-electrode lead (MEL). In one embodiment, the one or more commands are sent to control circuitry within the MEL during a predetermined portion of a cardiac pacing cycle to avoid potential problems of prior systems that were not synchronized with the cardiac pacing cycle. In one embodiment, the one or more commands are sent when cardiac tissue is refractory from a cardiac pacing pulse, to prevent the command(s) from potentially undesirably stimulating cardiac tissue. The command sending can occur such that the one or more commands are sent between instances when sensing circuitry of the implantable cardiac stimulation device is being used to obtain one or more signals indicative of cardiac electrical activity, to prevent interference between the one or more commands with the signals indicative of cardiac electrical activity that are sensed.

Claims

1. A method for use by an implantable cardiac stimulation device including

sensing circuitry adapted to selectively obtain, using electrodes selectively connected to the sensing circuitry, one or more signals indicative of cardiac electrical activity,

storage circuitry adapted to store data indicative of at least one of the one or more signals obtained using the sensing circuitry, and

pulse generator circuitry adapted to produce cardiac pacing pulses,

the method for use when sending one or more commands to control circuitry within a multi-electrode lead (MEL) attached to the implantable cardiac stimulation device, the method comprising:

sending the one or more commands, to control circuitry within the MEL, between instances when the sensing circuitry is being used to obtain the one or more signals indicative of cardiac electrical activity.

2. The method of claim 1, wherein

the sensing circuitry is adapted to be selectively connectable, and selectively disconnectable from, the MEL, and

the sending step comprises:

sending the one or more commands, to the control circuitry within the MEL, while the sensing circuitry is disconnected from the MEL, between instances when the sensing circuitry is connected to the MEL and being used to obtain the one or more signals indicative of cardiac electrical activity.

3. The method of claim 2, further comprises, prior to the sending step:

using the switching circuitry of the implantable cardiac stimulation device to disconnect the sensing circuitry from the MEL and connect the pulse generator circuitry to the MEL;

while the sensing circuitry is disconnected from the MEL and the pulse generator circuitry is connected to the MEL, using the pulse generator circuitry to produce a cardiac pacing pulse that includes a primary pace pulse portion followed by an initial charge balancing portion; and

during the initial charge balancing portion of the cardiac pacing pulse disconnecting the pulse generator circuitry from the MEL and connecting the MEL to a controller that is adapted to generate the one or more commands sent during the sending step.

4. The method of claim 1, wherein

cardiac pacing pulses, produced by the pulse generator circuitry, include a primary pace pulse portion followed by an initial charge balancing portion, and

the sending step comprises:

sending the one or more commands, to the control circuitry within the MEL, during a said initial charge balancing portion of a said cardiac pacing pulse.

5. The method of claim 1, wherein the sending step, relative to a cardiac pacing pulse produced by the pulse generator circuitry, begins a predetermined delay after a specified feature of a primary pace pulse portion of the cardiac pacing pulse.

6. The method of claim 1, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode; and

instruct the MEL to enter or exit a low power mode.

7. The method of claim 1, wherein:

a cardiac pacing pulse includes a zero volt primary pace pulse portion; and

the sending of the one or more commands is timed relative to the zero volt primary pace pulse portion.

8. An implantable cardiac stimulation device, comprising:

sensing circuitry adapted to selectively obtain, using electrodes selectively connected to the sensing circuitry, one or more signals indicative of cardiac electrical activity;

storage circuitry adapted to store data indicative of at least one of the one or more signals obtained using the sensing circuitry;

pulse generator circuitry adapted to produce cardiac pacing pulses; and

a controller adapted to send one or more commands, to control circuitry within a multi-electrode lead (MEL) attached to the implantable cardiac stimulation device, between instances when the switching circuitry is causing the sensing circuitry to be connected to the MEL and used to obtain the one or more signals indicative of cardiac electrical activity.

9. The implantable cardiac stimulation device of claim 8, wherein:

the sensing circuitry is adapted to be selectively connectable to, and selectively disconnectable from, the MEL; and

the controller is adapted to send the one or more commands, to control circuitry within the MEL, while the sensing circuitry is disconnected from the MEL, between instances when the sensing circuitry is connected to the MEL and being used to obtain the one or more signals indicative of cardiac electrical activity.

10. The implantable cardiac stimulation device of claim 8, wherein:

cardiac pacing pulses produced by the pulse generator circuitry include a primary pace pulse portion followed by an initial charge balancing portion; and

the controller is adapted to send the one or more commands, to the control circuitry of the MEL, such that the one or more commands begin to be sent after a said initial charge balancing portion begins, and the one or commands are finished being sent prior to the said initial charge balancing portion ending.

11. The implantable cardiac stimulation device of claim 8, wherein:

cardiac pacing pulses, produced by the pulse generator circuitry, include a primary pace pulse portion followed by an initial charge balancing portion; and

the controller is adapted to send the one or more commands, to the control circuitry within the MEL, during a said initial charge balancing portion.

12. The implantable cardiac stimulation device of claim 8, wherein:

the controller is adapted to send the one or more commands, relative to a cardiac pacing pulse produced by the pulse generator circuitry, beginning a predetermined delay after a specified feature of a primary pace pulse portion produced by the pulse generator circuitry.

13. The implantable cardiac stimulation device of claim 8, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode; and

instruct the MEL to enter or exit a low power mode.

14. The implantable cardiac stimulation device of claim 8, wherein the pulse generator circuitry is adapted to produce a zero volt primary pace pulse portion and the controller is adapted to time the sending of the one or more commands relative to the zero volt primary pace pulse portion.

15. A method for use by an implantable cardiac stimulation device, the method for use when sending one or more commands to control circuitry within a multi-electrode lead (MEL) attached to the implantable cardiac stimulation device, the method comprising:

sending the one or more commands, to control circuitry within the MEL, during a predetermined portion of a cardiac pacing cycle such that the one or more commands are sent when cardiac tissue is refractory from a cardiac pacing pulse.

16. The method of claim 15, wherein the sending step is such that the one or more commands are sent between instances when sensing circuitry of the implantable cardiac stimulation device is being used to obtain one or more signals indicative of cardiac electrical activity.

17. The method of claim 15, wherein the cardiac pacing pulse includes a primary pace pulse portion and wherein the sending step begins a predetermined delay after a specified feature of the primary pace pulse portion.

18. The method of claim 15, wherein an initial charge balancing portion of the cardiac pacing pulse occurs after a primary pace pulse portion, and the sending step is performed during the initial charge balancing portion.

19. The method of claim 18, wherein the sending of the one or more commands interrupts charge balancing during the initial charge balancing portion.

20. The method of claim 15, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode; and

instruct the MEL to enter or exit a low power mode.

21. An implantable cardiac stimulation device, comprising:

sensing circuitry adapted to selectively obtain, using electrodes selectively connected to the sensing circuitry, one or more signals indicative of cardiac electrical activity;

storage circuitry adapted to store data indicative of at least one of the one or more signals obtained using the sensing circuitry;

pulse generator circuitry adapted to produce cardiac pacing pulses; and

a controller adapted to send one or more commands, to control circuitry within a multi-electrode lead (MEL) attached to the implantable cardiac stimulation device, during a predetermined portion of a cardiac pacing cycle such that the one or more commands are sent when cardiac tissue is refractory from a said cardiac pacing pulse.

22. The implantable cardiac stimulation device of claim 21, wherein the controller is adapted to send the one or more commands between instances when sensing circuitry of the implantable cardiac stimulation device is being used to obtain one or more signals indicative of cardiac electrical activity.

23. The implantable cardiac stimulation device of claim 21, wherein a said cardiac pacing pulse includes a primary pace pulse portion and wherein the controller is adapted to send the one or more commands beginning a predetermined delay after a specified feature of the primary pace pulse portion.

24. The implantable cardiac stimulation device of claim 21, wherein an initial charge balancing portion of a said cardiac pacing pulse occurs after a primary pace pulse portion of the said cardiac pacing pulse, and wherein the controller is adapted to send the one or more commands to the control circuitry within the MEL during the initial charge balancing portion

25. The implantable cardiac stimulation device of claim 24, wherein the controller is adapted to interrupt charge balancing in the initial charge balancing portion to send the one or more commands.

26. The implantable cardiac stimulation device of claim 21, wherein the one or more commands can be used to do one or more of:

query, change, refresh, or reset to a default, which one or more electrodes, if any, of the MEL is/are configured as an anode and which one or more electrodes of the MEL, if any, is/are configured as a cathode; and

instruct the MEL to enter or exit a low power mode.