MULTI-CHAMBER INTRACARDIAC PACING SYSTEM

• US 20160015985A1
• Filed: 03/11/2015
• Published: 01/21/2016
• Est. Priority Date: 07/17/2014
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cho, Yong K., Demmer, Wade M., Eggen, Michael D., Hilpisch, Kathryn, Hess, Michael F., Sheldon, Todd J., Greenhut, Saul E.
• Granted Patent: US 9,981,135 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/36592 controlled by the heart rate variability
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

A medical device system including at least a first implantable medical device and a second implantable medical device is configured to establish by a control module of the first implantable medical device whether the second implantable medical device is present in a patient and self-configure an operating mode of the control module in response to establishing that the second implantable medical device is present.

Claims

1. An implantable medical device system, comprising

a first implantable medical device;

and

a second implantable medical device;

the first implantable medical device comprising a first control module configured to;

control operations of the first implantable medical device according to an operating mode of the first control module;

establish whether the second implantable medical device is present in a patient; and

self-configure the operating mode of the first control module in response to establishing that the second implantable medical device is present.

2. The system of claim 1, wherein the first implantable medical device comprises:

a sensing module coupled to a pair of electrodes, the sensing module comprising a near-field sensing channel configured to produce first sensed event signals in response to events occurring in a first heart chamber and a far-field sensing channel configured to produce second sensed event signals in response to events occurring in a second heart chamber;

the first control module configured to establish whether the second implantable medical device is present in response to the second sensed event signals received from the sensing module far-field sensing channel.

3. The system of claim 2, wherein the far-field sensing channel is configured to sense pacing pulses delivered by the second implantable medical device and produce far-field pacing pulse event signals, the first control module being enabled to establish that the second implantable medical device is present in the patient based on the second sensed event signals comprising sensed far-field pacing pulse event signals.

4. The implantable medical device system of claim 1, wherein

the first implantable medical device is a first intracardiac pacemaker implantable in a first chamber of a patient'"'"'s heart;

the second implantable medical device is a second intracardiac pacemaker implantable in a second chamber of the patient'"'"'s heart; and

the first control module is configured to self-configure the operating mode in one of a plurality of operating modes comprising at least a first mode in response to the second intracardiac pacemaker not being present in the patient and a second mode in response to the second intracardiac pacemaker being present in the patient.

5. The system of claim 4, wherein the first intracardiac pacemaker comprises a pulse generator coupled to a pair of electrodes;

wherein self-configuring the first mode by the first control module comprises selecting a first setting of a pacing pulse output parameter for controlling pacing pulses delivered by the pulse generator via the pair of electrodes,

wherein self-configuring the second mode by the first control module comprises selecting a second setting of the pacing pulse output parameter that is used at least periodically for controlling pacing pulses delivered by the pulse generator, the second setting being different than the first setting.

6. The system of claim 4, wherein the first intracardiac pacemaker comprises:

a sensing module coupled to a pair of electrodes, the sensing module comprising a near-field sensing channel producing first sensed event signals and a far-field sensing channel producing second sensed event signals;

wherein the first control module is configured to determine a need for the second intracardiac pacemaker in response to the second sensed event signals when the first control module is self-configured in the first mode.

7. The system of claim 4, wherein the second intracardiac pacemaker comprises a second control module configured to control operations of the second intracardiac pacemaker according to a second control module operating mode,

the second control module being configured to:

establish whether the first intracardiac pacemaker is present in the patient;

self-configure the second control module operating mode in a second control module first mode in response to the first intracardiac pacemaker not being present in the patient; and

self-configure the second control module operating mode in a second control module second mode in response to the first intracardiac pacemaker being present in the patient'"'"'s heart.

8. The system of claim 7, wherein the second intracardiac pacemaker comprises:

a sensing module coupled to a pair of electrodes and comprising a near-field sensing channel producing first sensed event signals and a far-field sensing channel producing second sensed event signals;

a pacing pulse generator coupled to the pair of electrodes;

wherein the second control module is configured to self-configure the second control module second mode by enabling selectable pacing modes comprising an asynchronous pacing mode and a synchronous pacing mode,

the asynchronous pacing mode being selectably enabled for controlling pacing pulses to the second chamber based on the first sensed event signals received from the near-field sensing channel but not based on the second sensed event signals received from the far-field sensing channel,

the synchronous pacing mode being selectably enabled for controlling pacing pulses delivered to the second chamber in response to the second sensed event signals received from the far-field sensing channel and the first sensed event signals received from the near-field sensing channel.

9. The system of claim 4, wherein the first control module is further configured to self-configure the second mode by enabling tachyarrhythmia detection and a tachyarrhythmia therapy.

10. The system of claim 4, further comprising an extracardiac implantable medical device, wherein the first control module is configured to;

establish whether the extracardiac implantable medical device is present in the patient; and

modify the self-configured operating mode in response to the extracardiac implantable medical device being present.

11. The system of claim 10, wherein the first control module is configured to modify the self-configured operating mode by modifying at least one of a therapy delivery control parameter and a monitoring control parameter in response to establishing the presence of the extracardiac implantable medical device.

12. A method performed by an implantable medical device system, comprising:

establishing by a first control module of a first implantable medical device whether a second implantable medical device is present in a patient; and

self-configuring an operating mode of the first control module in response to establishing that the second implantable medical device is present.

13. The method of claim 12, further comprising:

producing first sensed event signals by a near-field sensing channel of a sensing module of the first implantable medical device in response to events occurring in a first heart chamber;

producing second sensed event signals by a far-field sensing channel of the sensing module in response to events occurring in a second heart chamber; and

establishing whether the second implantable medical device is present in response to the second sensed event signals.

14. The method of claim 13, further comprising:

sensing pacing pulses by the far-field sensing channel that are delivered by the second implantable medical device;

producing sensed far-field pacing pulse event signals in response to sensing the pacing pulses; and

establishing that the second implantable medical device is present in the patient based on the second sensed event signals comprising the sensed far-field pacing pulse event signals.

15. The method of claim 12, wherein the first implantable medical device is a first intracardiac pacemaker and the second implantable medical device is a second intracardiac pacemaker, the method further comprising:

self-configuring the operating mode in one of a plurality of operating modes comprising at least a first mode that is self-configured in response to the second intracardiac pacemaker not being present in the patient and a second mode in response to the second intracardiac pacemaker being present in the patient.

16. The method of claim 15, wherein:

self-configuring the first mode by the first control module comprises selecting a first setting of a pacing pulse output parameter for controlling pacing pulses delivered by the first implantable medical device;

self-configuring the second mode by the first control module comprises selecting a second setting of the pacing pulse output parameter that is used at least periodically for controlling pacing pulses delivered by the first implantable medical device, the second setting different than the first setting.

17. The method of claim 15, further comprising:

producing first sensed event signals by a near-field sensing channel of a sensing module of the first implantable medical device;

producing second sensed event signals by a far-field sensing channel of the sensing module; and

determining a need for the second intracardiac pacemaker in response to the second sensed event signals when the first control module is self-configured in the first mode.

18. The method of claim 15, wherein the second intracardiac pacemaker comprises a second control module configured to control operations of the second intracardiac pacemaker according to a second control module operating mode,

the second control module being configured to:

establishing by a second control module of the second implantable medical device whether the first implantable medical device is present in the patient;

self-configuring an operating mode of the second control module in a second control module first mode in response to the first implantable medical device not being present in the patient; and

self-configuring the second control module operating mode in a second control module second mode in response to the first intracardiac pacemaker being present in the patient'"'"'s heart.

19. The method of claim 18, further comprising

producing first sensed event signals by a near-field sensing channel of a sensing module of the second implantable medical device;

producing second sensed event signals by a far-field sensing channel of the sensing module of the second implantable medical device;

self-configuring the second control module second mode by enabling selectable pacing modes comprising an asynchronous pacing mode and a synchronous pacing mode,

the asynchronous pacing mode selectably enabled for controlling pacing pulses to the second chamber based on the first sensed event signals received from the near-field sensing channel but not based on the second sensed event signals received from the far-field sensing channel,

the synchronous pacing mode selectably enabled for controlling pacing pulses delivered to the second chamber in response to the second sensed event signals received from the far-field sensing channel and the first sensed event signals received from the near-field sensing channel.

20. The method of claim 15, further comprising self-configuring the second mode by enabling tachyarrhythmia detection and a tachyarrhythmia therapy.

21. The method of claim 15, further comprising:

establishing by the first control module whether an extracardiac implantable medical device is present in the patient; and

modifying the self-configured operating mode in response to the extracardiac implantable medical device being present.

22. The method of claim 21, further comprising modifying the self-configured operating mode by modifying at least one of a therapy delivery control parameter and a monitoring control parameter in response to establishing the presence of the extracardiac implantable medical device.

23. A non-transitory, computer-readable storage medium storing a set of instructions that when executed by a control module of a first implantable medical device included in an implantable medical device system cause the system to:

establish whether a second implantable medical device is present in a patient; and

self-configure an operating mode of the control module in response to establishing that the second implantable medical device is present.