Systems and methods for safe delivery of electrical stimulation therapy

Patent metadata

Field	Value
Publication number	US-2016228701-A1
Application number	US-201615015792-A
Country	US
Kind code	A1
Filing date	Feb 4, 2016
Priority date	Feb 6, 2015
Publication date	Aug 11, 2016
Grant date	—

Abstract

Systems and methods for treating arrhythmias are disclosed. In one embodiment an LCP comprises a housing, a plurality of electrodes for sensing electrical signals emanating from outside of the housing, an energy storage module disposed within the housing, and a control module disposed within the housing and operatively coupled to the plurality of electrodes. The control module may be configured to receive electrical signals via two or more of the plurality of electrodes and determine if the received electrical signals are indicative of a command for the LCP to deliver ATP therapy. If the received electrical signals are indicative of a command for the LCP to deliver ATP therapy, the control module may additionally determine whether a triggered ATP therapy mode of the LCP is enabled. If the triggered ATP therapy mode is enabled, the control module may cause the LCP to deliver ATP therapy via the plurality of electrodes.

First claim

What is claimed is:

1 . A leadless cardiac pacemaker (LCP) comprising:
a housing; a plurality of electrodes for sensing electrical signals emanating from outside of the housing; an energy storage module disposed within the housing; a control module disposed within the housing and operatively coupled to the plurality of electrodes, wherein the control module is configured to:
receive electrical signals via two or more of the plurality of electrodes;
determine if the received electrical signals are indicative of a command for the LCP to deliver anti-tachyarrhythmia pacing (ATP) therapy;
if the received electrical signals are indicative of a command for the LCP to deliver anti-tachyarrhythmia pacing (ATP) therapy, determine whether a triggered ATP therapy mode of the LCP is enabled;
if the triggered ATP therapy mode is enabled, deliver ATP therapy via two or more of the plurality of electrodes.

2 . The LCP of claim 1 , wherein if the triggered ATP therapy mode is enabled, the control module is further configured to determine whether to deliver ATP therapy in response to the command, and if it is determined to deliver ATP therapy, deliver ATP therapy via two or more of the plurality of electrodes.

3 . The LCP of claim 2 , wherein the control module is configured to determine to deliver ATP therapy if the triggered ATP therapy mode is enabled.

4 . The LCP of claim 2 , wherein the control module is configured to determine to deliver ATP therapy if a heart rate, determined from the received electrical signals, is above an arrhythmia threshold.

5 . The LCP of claim 2 , wherein the control module is configured to maintain a count of a number of ATP therapy bursts that have been delivered as part of a delivered ATP therapy, and wherein the controller module is further configured to determine to deliver ATP therapy if the number of ATP therapy bursts has not exceeded a ATP therapy burst count threshold.

6 . The LCP of claim 1 , wherein the control module is configured to determine a signal morphology type of a cardiac signal received via two or more of the plurality of electrodes, and wherein the controller module is further configured to determine to deliver ATP therapy if the determined signal morphology type is of a predetermined signal morphology type.

7 . The LCP of claim 6 , wherein the predetermined signal morphology type comprises a Monomorphic Ventricular Tachycardia (MVT).

8 . The LCP of claim 6 , wherein the predetermined signal morphology type comprises a Polymorphic Ventricular Tachycardia (PVT).

9 . The LCP of claim 6 , wherein the predetermined signal morphology type comprises a Supra Ventricular Tachycardia (SVT).

10 . A leadless cardiac pacemaker (LCP) comprising:
a housing; a plurality of electrodes for sensing electrical signals emanating from outside of the housing; an energy storage module disposed within the housing; a control module disposed within the housing and operatively coupled to the plurality of electrodes, wherein the control module is configured to:
receive electrical signals via two or more of the plurality of electrodes;
determine if the received electrical signals are indicative of a command for the LCP to deliver anti-tachyarrhythmia pacing (ATP) therapy;
if the received electrical signals are indicative of a command for the LCP to deliver anti-tachyarrhythmia pacing (ATP) therapy, deliver ATP therapy via two or more of the plurality of electrodes;
maintain a measure related to an amount of ATP therapy delivered as part of the delivered ATP therapy within a predetermined period of time;
continue to allow delivery of ATP therapy if the measure related to the amount of ATP therapy delivered within the predetermined period of time has not exceeded a predetermined ATP therapy threshold; and
stop delivery of ATP therapy if the measure related to the amount of ATP therapy delivered within the predetermined period of time has exceeded the predetermined ATP therapy threshold.

11 . The LCP of claim 10 , wherein the predetermined period of time is between one hour and twenty-four hours.

12 . The LCP of claim 10 , wherein the measure related to the amount of ATP therapy delivered as part of the delivered ATP therapy within the predetermined period of time corresponds to an ATP therapy delivered count that is indicative of a number of times a command is received that results in the LCP delivering ATP therapy within the predetermined period of time.

13 . The LCP of claim 10 , wherein the measure related to the amount of ATP therapy delivered as part of the delivered ATP therapy within the predetermined period of time corresponds to an ATP burst count that is indicative of a number of ATP bursts that are delivered within the predetermined period of time.

14 . The LCP of claim 10 , wherein the received electrical signals comprise a plurality of communication pulses produced by a remote medical device.

15 . The LCP of claim 10 , wherein the received electrical signals comprise a plurality of communication pulses as part of a one-way communication path from a remote medical device.

16 . The LCP of claim 15 , wherein the plurality of communication pulses are free from error checking information for error checking the one-way communication path.

17 . The LCP of claim 10 , wherein after delivering ATP therapy, the LCP is further configured to enter a post shock pacing mode.

18 . A leadless cardiac pacemaker (LCP) comprising:
a housing; a plurality of electrodes for sensing electrical signals emanating from outside of the housing; an energy storage module disposed within the housing; a control module disposed within the housing and operatively coupled to the plurality of electrodes, wherein the control module is configured to:
receive electrical signals via two or more of the plurality of electrodes;
determine if the received electrical signals are indicative of a command for the LCP to deliver anti-tachyarrhythmia pacing (ATP) therapy;
if the received electrical signals are indicative of a command for the LCP to deliver anti-tachyarrhythmia pacing (ATP) therapy:
determine whether a triggered ATP therapy mode of the LCP is enabled;
determine whether a heart rate determined from the received electrical signals is above an arrhythmia threshold; and

if the triggered ATP therapy mode is enabled and the heart rate is above the arrhythmia threshold, deliver ATP therapy via two or more of the plurality of electrodes.

19 . The LCP of claim 18 , wherein the control module maintains a measure related to the amount of ATP therapy delivered within a predetermined period of time, and wherein the control module is configured to determine if the measure related to the amount of ATP therapy delivered within the predetermined period of time exceeds a predetermined ATP therapy threshold, and only delivers ATP therapy via two or more of the plurality of electrodes if the triggered ATP therapy mode is enabled, the heart rate is above the arrhythmia threshold, and the measure related to the amount of ATP therapy delivered within the predetermined period of time does not exceed the predetermined ATP therapy threshold.

20 . The LCP of claim 19 , wherein the predetermined period of time is between one hour and twenty-four hours.

Assignees

• Cardiac Pacemakers Inc

Inventors

• Huelskamp Paul
• Ludwig Jacob M
• Juffer Lance E
• Maile Keith R

Classifications

• A61N1/37217

  characterised by the communication link, e.g. acoustic or tactile · CPC title

• A61N1/3622 Primary

  comprising two or more electrodes co-operating with different heart regions · CPC title

• A61N1/36514 Primary

  controlled by a physiological quantity other than heart potential, e.g. blood pressure (controlled by two or more physical parameters A61N1/36585) · CPC title

• A61N1/3756

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

• A61N1/365

  controlled by a physiological parameter, e.g. heart potential {(evoked response A61N1/371)} · CPC title