Devices, systems and methods for improving conductive communication between external devices and implantable medical devices

Patent metadata

Field	Value
Publication number	US-12427322-B2
Application number	US-202217701132-A
Country	US
Kind code	B2
Filing date	Mar 22, 2022
Priority date	Apr 6, 2020
Publication date	Sep 30, 2025
Grant date	Sep 30, 2025

Abstract

Described herein are external devices, and methods for use therewith, that are configured to communicate with one or more implantable medical devices (IMDs) implanted within a patient using conductive communication, wherein the external device includes or is communicatively coupled to at least three external electrodes that are in contact with the patient. Certain such methods involve the external device identifying, for each IMD, of the plurality of IMDs, which one of the plurality of communication vectors is a preferred communication vector for communicating with the IMD, based on respective indicators of conductive communication quality that are determined for the plurality of communication vectors. Certain embodiments involve determining when there should be a reassessment of which one of the plurality of communication vectors is the preferred communication vector for communicating with an IMD, and in response thereto, identifying an updated preferred communication vector for communicating with the IMD.

First claim

What is claimed is:

1. A method for use by an external device that is configured to communicate with each of a plurality of implantable medical devices (IMDs) implanted within a patient using conductive communication, wherein the external device includes or is communicatively coupled to at least three external electrodes that are in contact with the patient, the method comprising:
determining for each IMD of the plurality of IMDs a respective indicator of conductive communication quality for each communication vector of a plurality of communication vectors that can be used by the external device to communicate with the IMD, wherein each of the plurality of communication vectors comprises a different combination of the at least three external electrodes that are in contact with the patient;
identifying which one of the plurality of communication vectors is a universally preferred communication vector that provides for at least a minimally acceptable level of communication quality between the external device and each of the plurality of IMDs, wherein the identifying is based on the respective indicators of conductive communication quality that are determined for each IMD of the plurality of IMDs using each of the plurality of communication vectors; and
communicating with each of the plurality of IMDs using the universally preferred communication vector, after the universally preferred communication vector is identified.

2. The method of claim 1 , further comprising:
while or after communicating with the plurality of IMDs using the universally preferred communication vector for communicating with the plurality of IMDs, determining whether there should be a reassessment of which one of the plurality of communication vectors is the universally preferred communication vector for communicating with the plurality of IMDs; and
in response to determining that there should be the reassessment, repeating the determining and the identifying steps.

3. The method of claim 2 , wherein the determining that there should be the reassessment occurs in response to at least one of the following:
detecting the indicator of conductive communication quality associated with the universally preferred communication vector for communicating with the plurality of IMDs falling below a corresponding threshold for at least one of the plurality of IMDs;
detecting a loss of conductive communication with at least one of the plurality of IMDs; or
detecting a specified period of time elapsing since the universally preferred communication vector for communicating with the plurality of IMDs was most recently identified.

4. The method of claim 1 , further comprising:
determining that at least one of the indicators of conductive communication quality for communicating with at least one of the plurality of IMDs has fallen below a corresponding threshold; and
providing instructions to a user of the external device to modify at least one of where or how one or more of the at least three external electrodes contact the patient, in response to the determining that the at least one of the indicators of conductive communication quality for communicating with the at least one of the plurality of IMDs has fallen below the corresponding threshold.

5. The method of claim 1 , wherein:
the external device comprises an external programmer; and
at least one of the plurality of IMDs comprises a leadless cardiac pacemaker, an insertable cardiac monitor, or a non-vascular implantable cardioverter defibrillator.

6. The method of claim 1 , wherein the determining the respective indicator of conductive communication quality for each communication vector, of the plurality of communication vectors that can be used to communicate with each of the plurality of IMDs, includes for each communication vector:
determining a plurality of different measures of conductive communication quality and/or surrogates thereof for the communication vector; and
combining the plurality of different measures of conductive communication quality and/or the surrogates thereof to produce the respective indicator of conductive communication quality for the communication vector.

7. The method of claim 6 , wherein the plurality of different measures of conductive communication signal quality and/or the surrogates thereof that are determined for each communication vector, of the plurality of communication vectors that can be used to communicate with each of the plurality of IMDs, are indicative of at least two of the following:
a noise floor associated with the communication vector;
a measure of amplitude of at least a portion of a conductive communication signal received by the external device from one of the plurality of IMDs using the communication vector;
a measure of amplitude of at least a portion of a conductive communication signal received by one of the plurality of IMDs from the external device;
a magnitude of at least a portion of a conductive communication signal received by the external device from one of the plurality of IMDs after rectification and integration thereof;
a magnitude of at least a portion of a conductive communication signal received by one of the plurality of IMDs from the external device after rectification and integration thereof;
a signal-to-noise ratio (SNR) of at least a portion of a conductive communication signal received by the external device from one of the plurality of IMDs;
a SNR of at least a portion of a conductive communication signal received by one of the plurality of IMDs from the external device;
a total energy of at least a portion of a conductive communication signal received by the external device from one of the plurality of IMDs, after rectification and integration thereof;
a total energy of at least a portion of a conductive communication signal received by one of the plurality of IMDs from the external device, after rectification and integration thereof;
a bit-error-rate (BER) associated with at least a portion of a conductive communication signal received by the external device from one of the plurality of IMDs; and
a BER associated with at least a portion of a conductive communication signal received by one of the plurality of IMDs from the external device.

8. The method of claim 1 , wherein when there are multiple different communication vectors that provide at least the minimally acceptable level of communication quality for all the plurality of IMDs, the identifying which one of the plurality of communication vectors is the universally preferred communication vector for communicating with the plurality of IMDs comprises identifying which one of the plurality of communication vectors has a highest sum or average of the indicators of conductive communication quality.

9. The method of claim 1 , further comprising:
determining that only one of the plurality of communication vectors, which can be used to communicate with each of the plurality of IMDs, provides for at least the minimally acceptable level of communication quality between the external device and each of the plurality of IMDs; and
wherein the identifying step includes identifying, as the universally preferred communication vector for communicating with each of the plurality of IMDs, the only one of the plurality of communication vectors that provides for at least the minimally acceptable level of communication quality between the external device and each of the plurality of IMDs.

10. The method of claim 1 , further comprising:
determining for each of the IMDs a respective indicator of conductive communication quality for each communication vector of the plurality of communication vectors;
determining that multiple different communication vectors of the plurali

Assignees

• Pacesetter Inc

Inventors

• Lee Frank
• Tieu Thanh
• Williams Robert
• Bhonsle Suyashree
• Zacharias Jinto
• Fishler Matthew G
• Gurunathan Suresh
• Persson Benjamin T

Classifications

• A61B5/0031

  Implanted circuitry · CPC title

• A61N1/3956

  Implantable devices for applying electric shocks to the heart, e.g. for cardioversion · CPC title

• A61N1/3756 Primary

  Casings with electrodes thereon, e.g. leadless stimulators · CPC title

• A61N1/362

  Heart stimulators (heart defibrillators A61N1/39) · CPC title

• A61B5/6869

  Heart · CPC title