Sensing vector selection in a cardiac stimulus device with postural assessment

• US 9,744,366 B2
• Filed: 05/10/2016
• Issued: 08/29/2017
• 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): Johnson, Nicole F
• Application Number:
  US15/150,771
• Publication Number:
  US 20160250488A1
• Time in Patent Office: 476 Days
• Field of Search: 600508-509
• 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 operation of the therapy circuitry and implant communications circuitry, the programmer comprising:

a user interface touchscreen for providing instructions and information to and receiving inputs from a user thereof; and

programmer communication circuitry for communicating with the implantable medical device;

wherein the programmer is configured to perform the following method;

present a plurality of posture states via the touchscreen to a user;

receive 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, direct, via the programmer communication circuitry, the implantable medical device to capture data for the first posture;

receive an indication from the implantable medical device that data capture is complete for the selected posture state; and

provide an indication to the user on the touchscreen in response to receiving an indication from the implantable medical device that data capture is complete for the selected posture state.

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

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

upon receiving the 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 data for the second posture;

receive an indication from the implantable medical device that data capture is complete for the selected second posture state; and

provide an indication to the user on the touchscreen in response to receiving an indication from the implantable medical device that data capture is complete for the selected second posture state.

3. The programmer of claim 1 wherein programmer is further configured to direct the implantable medical device to store a first sensing parameter related to the first posture.

4. The programmer of claim 3 wherein the first sensing parameter is related to a sensing vector for use in sensing patient condition information.

5. The programmer of claim 4 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.

6. The programmer of claim 1 wherein the implantable medical device comprises an accelerometer and the programmer is configured to also direct the implantable medical device to set a first sensing parameter related to an output of the accelerometer using data captured for at least the selected posture state.

7. The programmer of claim 6 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.

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

9. A medical device system comprising:

an implantable medical device comprising therapy circuitry for providing electrical therapy output, a sensor for determining patient body position, and communication circuitry for communicating with an external device; and

a programmer for use with the implantable medical device, the programmer comprising;

a user interface touchscreen for providing instructions and information to and receiving inputs from a user thereof; and

programmer communication circuitry for communicating with the implantable medical device;

wherein the programmer is configured to perform the following method;

present a plurality of posture states via the touchscreen to a user;

receive 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, direct, via the programmer communication circuitry, the implantable medical device to capture data for the first posture;

receive an indication from the implantable medical device that data capture is complete for the selected posture state; and

provide an indication to the user on the touchscreen in response to receiving an indication from the implantable medical device that data capture is complete for the selected posture state.

10. The medical device system of claim 9, wherein the programmer is further configured to:

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

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

receive an indication from the implantable medical device that data capture is complete for the selected second posture state; and

provide an indication to the user on the touchscreen in response to receiving an indication from the implantable medical device that data capture is complete for the selected second posture state.

11. The medical device system of claim 9, wherein the programmer is further configured to direct the implantable medical device to store a first sensing parameter related to the first posture.

12. The medical device system of claim 11, wherein the first sensing parameter is related to a sensing vector for use in sensing patient condition information.

13. The medical device system of claim 12, 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.

14. The medical device system of claim 9, wherein the implantable medical device comprises an accelerometer and the programmer is configured to also direct the implantable medical device to set a first sensing parameter related to an output of the accelerometer using data captured for at least the selected posture state.

15. The medical device system of claim 14, 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.

16. The medical device system of claim 9, wherein the plurality of posture states include at least standing and lying down.

17. A method of operation by 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 operation of the therapy circuitry and implant communications circuitry, the programmer comprising:

a user interface touchscreen for providing instructions and information to and receiving inputs from a user thereof; and

programmer communication circuitry for communicating with the implantable medical device;

wherein the method comprises;

the programmer presenting a plurality of posture states via the touchscreen to a user;

the programmer receiving 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, the programmer directing, via the programmer communication circuitry, the implantable medical device to capture data for the first posture;

the programmer receiving an indication from the implantable medical device that data capture is complete for the selected posture state; and

the programmer providing an indication to the user that data capture is complete for the selected posture state via the touchscreen and in response to receiving an indication from the implantable medical device that data capture is complete for the selected posture state.

18. The method of claim 17 further comprising:

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

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

the programmer receiving an indication from the implantable medical device that data capture is complete for the selected second posture state; and

the programmer providing an indication to the user that data capture is complete for the selected second posture state, on the touchscreen and in response to receiving an indication from the implantable medical device that data capture is complete for the selected second posture state.

19. The method of claim 17 further comprising the programmer directing the implantable medical device to store a first sensing parameter related to the first posture.

20. The method of claim 17 wherein the implantable medical device comprises an accelerometer, and the method further comprises the programmer directing the implantable medical device to set a first sensing parameter related to an output of the accelerometer using data captured for at least the selected posture state.