Sensing vector selection in a cardiac stimulus device with postural assessment

• US 9,357,969 B2
• Filed: 07/29/2015
• Issued: 06/07/2016
• Est. Priority Date: 05/26/2006
• Status: Active Grant

• Current Assignee: Cameron Incorporated (Schlumberger NV)
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: Sanghera, Rick, Allavatam, Venugopal
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US14/812,029
• Publication Number:
  US 20150328470A1
• Time in Patent Office: 314 Days
• Field of Search: 600508-509, 600/522
• US Class Current: 1/1
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• 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 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

Methods, implantable medical devices and systems configured to perform analysis of captured signals from implanted electrodes to identify cardiac arrhythmias. In an illustrative embodiment, signals captured from two or more sensing vectors are analyzed, where the signals are captured with a patient in at least first and second body positions. Analysis is performed to identify primary or default sensing vectors and/or templates for event detection.

Claims

1. A programmer for use with an implantable medical device, the implantable medical device including therapy circuitry for providing electrical therapy output using one or more electrodes disposed on a lead configured for attachment thereto, implant communications circuitry for communicating with the programmer, and operational circuitry for controlling at least the therapy circuitry and communications circuitry, the programmer including a user interface screen for providing instructions and information to a user thereof, an input for taking an input from a user thereof, and programmer communication circuitry for communicating with the implantable medical device, the programmer configured to perform the following method:

present a plurality of posture states via the user interface screen and obtain an input from a user indicating that a patient having the implantable medical device has assumed a first posture of the plurality of posture states;

upon receiving an input from the user indicating that the first posture has been assumed by the patient, directing, via the programmer communication circuitry, the implantable medical device to capture information for the first posture; and

directing the implantable medical device to store a first sensing parameter using at least the captured information for the first posture.

2. The programmer of claim 1 wherein the programmer is further configured to:

obtain an input from the user indicating that the patient has assumed a second posture of the plurality of posture states; and

upon receiving an input from the user indicating that the second posture of the plurality of posture states has been assumed by the patient, directing, via the programmer communication circuitry, the implantable medical device to capture information for the second posture;

wherein the step of directing the implantable medical device to store a first sensing parameter includes using the captured information for the second posture.

3. The programmer of claim 1 wherein the step of directing the implantable medical device to store a first sensing parameter includes receiving and analyzing the captured information for at least the first posture from the implantable medical device.

4. The programmer of claim 1 wherein the step of directing the implantable medical device to store a first sensing parameter includes indicating to the implantable medical device that postural analysis is complete and the implantable medical device may calculate and store the first parameter.

5. The programmer of claim 1 wherein the first sensing parameter is related to a sensing vector for use in sensing patient condition information.

6. The programmer of claim 1 wherein the first sensing parameter defines which of a plurality of cardiac signal sensing vectors the implantable device is to use for sensing patient condition information.

7. The programmer of claim 1 wherein the implantable medical device comprises a position sensor including an accelerometer and the first sensing parameter is used to define one or more output ranges of the accelerometer.

8. The programmer of claim 7 wherein the first sensing parameter defines which of several cardiac signal sensing vectors available to the implantable medical device to use in response to the accelerometer signal.

9. The programmer of claim 1 wherein the plurality of posture states include at least standing and lying down.

10. A medical device system comprising:

an implantable lead having a plurality of electrodes and a connector;

an implantable medical device comprising therapy circuitry for providing electrical therapy output, implant communications circuitry for communicating with the programmer, operational circuitry for controlling at least the therapy circuitry and communications circuitry, and a port for receiving the connector of the lead;

a programmer for use with the implantable medical device, the programmer including a user interface screen for providing instructions and information to a user thereof, an input for taking an input from a user thereof, and programmer communication circuitry for communicating with the implantable medical device;

wherein the programmer and the implantable medical device are configured for cooperative operation as follows;

the programmer is configured to present a plurality of posture states via the user interface screen to a user and obtain an input from the user indicating that a patient having the implantable medical device has assumed a first posture of the plurality of posture states;

the programmer is configured to direct, via the programmer communication circuitry issuing a first communication, the implantable medical device to capture information for the first posture, upon the programmer receiving an input from the user indicating that the first posture has been assumed by the patient;

the implantable medical device is configured to receive the first communication and capture information for the first posture; and

the implantable medical device is configured to store a first sensing parameter using the captured information for the first posture.

11. The system of claim 10 wherein the programmer is further configured to:

obtain an input from the user indicating that the patient has assumed a second posture of the plurality of posture states; and

direct, via the programmer communication circuitry, the implantable medical device to capture information for the second posture upon receiving the input from the user indicating that the second posture of the plurality of posture states has been assumed by the patient;

and further wherein the first sensing parameter is determined using both the captured information for the first posture, and the captured information for the second posture.

12. The system of claim 10 wherein the programmer is configured to receive and analyze the captured information for at least the first posture from the implantable medical device, determine the first sensing parameter, and communicate the first sensing parameter to the implantable medical device.

13. The system of claim 10 wherein the implantable medical device is configured to analyze the captured information for at least the first posture and determine the first sensing parameter therefrom.

14. The system of claim 10 wherein the first sensing parameter is related to a sensing vector for use in sensing patient condition information.

15. The system of claim 14 wherein the first sensing parameter defines which of a plurality of cardiac signal sensing vectors the implantable device is to use for sensing patient condition information.

16. The system of claim 10 wherein the implantable medical device comprises a position sensor having an accelerometer and the first sensing parameter is used to define one or more output ranges of the accelerometer.

17. The system of claim 16 wherein the first sensing parameter defines which of several cardiac signal sensing vectors available to the implantable medical device to use in response to the accelerometer signal.

18. The system of claim 10 wherein the plurality of posture states include at least standing and lying down.

19. A method of operation in an implantable medical device system, the system comprising:

an implantable lead having a plurality of electrodes and a connector;

an implantable medical device comprising therapy circuitry for providing electrical therapy output, implant communications circuitry for communicating with the programmer, operational circuitry for controlling the therapy circuitry, and implant communications circuitry, and a port for receiving the connector of the lead;

a programmer for use with the implantable medical device, the programmer including a user interface screen for providing instructions and information to a user thereof, an input for taking an input from a user thereof, and programmer communication circuitry for communicating with the implantable medical device;

the method comprising;

the programmer presenting at least one posture state via the user interface screen to a user;

the programmer obtaining an input from the user indicating that a patient having the implantable medical device has assumed a first posture of the plurality of posture states;

the programmer directing, via a first communication from the programmer communication circuitry, the implantable medical device to capture information for the first posture upon receiving an input from the user indicating that the first posture has been assumed by the patient;

the implantable medical device capturing information for the first posture upon receiving the first communication from the programmer; and

the implantable medical device storing a first sensing parameter determined by analysis of at least the captured information for the first posture.

20. The method of claim 19 wherein the implantable medical device includes a position sensor which comprises an accelerometer and the first sensing parameter is used to define one or more output ranges of the accelerometer.