Implantable medical device crosstalk evaluation and mitigation

Patent metadata

Field	Value
Publication number	US-9775987-B2
Application number	US-36279209-A
Country	US
Kind code	B2
Filing date	Jan 30, 2009
Priority date	Oct 31, 2008
Publication date	Oct 3, 2017
Grant date	Oct 3, 2017

Abstract

Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

First claim

The invention claimed is:

1. A method comprising:
determining a noise characteristic of a first electrical signal sensed by a first implantable medical device (IMD) while a second IMD is delivering a second electrical signal to a tissue site within a patient, wherein the first and second IMDs are implanted within the patient;
comparing the noise characteristic of the first electrical signal to a threshold value, wherein comparing the noise characteristic to the threshold value comprises determining whether the noise characteristic is greater than or equal to the threshold value; and
in response to determining the noise characteristic of the first electrical signal is greater than or equal to the threshold value, modifying at least one of a stimulation parameter with which the second IMD generates electrical stimulation that is delivered to the tissue site or a sensing parameter with which the first IMD senses the first electrical signal based on the comparison.

2. The method of claim 1 , wherein the tissue site comprises at least one of a nonmyocardial tissue site or a nonvascular cardiac tissue site.

3. The method of claim 1 , wherein the tissue site comprises at least one of an extravascular tissue site or the tissue site proximate to a nerve of the patient.

4. The method of claim 1 , wherein the first implantable medical device delivers at least one of pacing, cardioversion or defibrillation therapy to a heart of the patient.

5. The method of claim 1 , wherein the second implantable medical device delivers at least one of pacing, cardioversion or defibrillation therapy to the tissue site.

6. The method of claim 1 , wherein determining the noise characteristic of the first electrical signal comprises determining a value indicative of a difference between an amplitude of the first electrical signal and a sensing threshold of the first implantable medical device.

7. The method of claim 1 , wherein determining the noise characteristic of the first electrical signal comprises:
suspending delivery of the second electrical signal by the second implantable medical device (IMD);
sensing a third electrical signal with the first IMD;
activating the delivery of the second electrical signal by the second IMD;
sensing the first electrical signal with the first IMD while second IMD delivers the second electrical signal to the tissue site; and
determining a difference between at least one signal characteristic of the first and third electrical signals.

8. The method of claim 7 , wherein determining the difference between at least one signal characteristic of the first and third electrical signals comprises:
determining a first value indicative of a difference between a first amplitude of the first electrical signal and a sensing threshold of the first implantable medical device (IMD);
determining a second value indicative of a difference between a second amplitude of the third electrical signal and the sensing threshold of the first IMD; and
determining the difference between the first and second values.

9. The method of claim 8 , wherein comparing the noise characteristic of the first electrical signal to the threshold value comprises determining whether the difference between the first and second values is greater than or equal to the threshold value.

10. The method of claim 9 , wherein the threshold value is less than the sensing threshold of the first implantable medical device.

11. The method of claim 10 , wherein the threshold value is about 25 percent (%) to about 50% of the sensing threshold of the first implantable medical device.

12. The method of claim 7 , wherein determining the difference between at least one signal characteristic of the first and third electrical signals comprises determining the difference between at least one signal characteristic of the first and third electrical signals during a quiet segment of a cardiac cycle of a heart of the patient.

13. The method of claim 7 , wherein determining the difference between at least one signal characteristic of the first and third electrical signals comprises determining a difference between one or more frequency band characteristics of the first and third electrical signals.

14. The method of claim 1 , wherein determining the noise characteristic of the first electrical signal comprises determining a first characteristic of the first electrical signal sensed by the first implantable medical device (IMD) at a first time and modifying the at least one of the stimulation parameter or the sensing parameter comprises modifying at least one stimulation parameter, the method further comprising:
delivering a third electrical signal to the tissue site via the second IMD according to the at least one modified stimulation parameter;
determining a second characteristic of a fourth electrical signal sensed by the first IMD at a second time while the second IMD is delivering the third electrical signal; and
determining an electrical noise status based on the second characteristic.

15. The method of claim 14 , wherein modifying the stimulation parameter comprises modifying a first value of a first stimulation parameter and determining the electrical noise status based on the second characteristic comprises comparing the second characteristic to the threshold value, the method further comprising modifying a second value of a second stimulation parameter with which the second implantable medical device generates the electrical stimulation in response to determining the second characteristic is greater than or equal to the threshold value, wherein the first and second stimulation parameters are different.

16. The method of claim 14 , wherein determining the electrical noise status based on the second characteristic comprises comparing the second characteristic to the threshold value, the method further comprising modifying the at least one stimulation parameter in response to determining the second characteristic is greater than or equal to the threshold value.

17. The method of claim 14 , wherein determining the electrical noise status based on the second characteristic comprises comparing the second characteristic to the threshold value, the method further comprising adjusting the delivery of electrical stimulation by the second implantable medical device in response to determining the second characteristic is greater than or equal to the threshold value.

18. The method of claim 17 , wherein adjusting the delivery of electrical stimulation by the second implantable medical device (IMD) comprises suspending the delivery of electrical stimulation by the second IMD.

19. The method of claim 1 , further comprising generating and storing an interference indication in response to determining the noise characteristic is greater than or equal to the threshold value.

20. The method of claim 1 , wherein the stimulation parameter comprises at least one of a current amplitude, a voltage amplitude, a pulse width, a pulse rate, a frequency, a duty cycle or an electrode combination.

21. The method of claim 1 , wherein the sensing parameter comprises at least one of a sensing threshold value, an amplifier gain, a sensing vector, filter characteristic, or a type of physiological parameter of the patient that is sensed by the first implantable medical device.

22. The method of claim 21 , wherein the filter characteristic comprises a type of filter applied by the first implantable medical device to the sensed first electrical signal.

Assignees

• Donofrio William T
• Burnes John E
• Krause Paul G
• Arne Gerald P
• Peichel David J
• Zhou Xiaohong
• Reinke James D
• Davis Timothy
• Medtronic Inc

Inventors

• Donofrio William T
• Burnes John E
• Krause Paul G
• Arne Gerald P
• Peichel David J
• Zhou Xiaohong
• Reinke James D
• Davis Timothy

Classifications

• A61N1/3962

  in combination with another heart therapy · CPC title

• A61N1/36114

  Cardiac control, e.g. by vagal stimulation (stimulating the heart A61N1/362) · CPC title

• A61N1/0551 Primary

  Spinal or peripheral nerve electrodes · CPC title

• A61N1/37282

  characterised by communication with experts in remote locations using a network · CPC title

• A61N1/3621

  for treating or preventing abnormally high heart rate · CPC title