최소 단어 이상 선택하여야 합니다.
최대 10 단어까지만 선택 가능합니다.
다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
NTIS 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
DataON 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Edison 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Kafe 바로가기국가/구분 | United States(US) Patent 등록 |
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국제특허분류(IPC7판) |
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출원번호 | US-0220496 (2008-07-24) |
등록번호 | US-9037239 (2015-05-19) |
발명자 / 주소 |
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출원인 / 주소 |
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대리인 / 주소 |
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인용정보 | 피인용 횟수 : 9 인용 특허 : 448 |
A method and apparatus for selecting an electrode combination in a cardiac pacing device. In some instances, this may include: implanting a plurality of cardiac electrodes supported by one or more leads in a patient; receiving user-determined electrode combination selection criteria from a user; eva
A method and apparatus for selecting an electrode combination in a cardiac pacing device. In some instances, this may include: implanting a plurality of cardiac electrodes supported by one or more leads in a patient; receiving user-determined electrode combination selection criteria from a user; evaluating, for each electrode combination of a plurality of electrode combinations of a plurality of cardiac electrodes, which electrode combination best satisfies the user-determined electrode combination selection criteria; selecting the electrode combination that best satisfies the user-determined electrode combination selection criteria; and programming an implantable pacing circuit to deliver a cardiac pacing therapy to the patient's heart that uses the selected electrode combination.
1. A method comprising: delivering electrical stimulation to a patient's heart using a plurality of cardiac electrodes supported inside the patient by one or more at least partially implanted leads and an evaluation unit having an analyzer circuit that is external of the patient and attached to the
1. A method comprising: delivering electrical stimulation to a patient's heart using a plurality of cardiac electrodes supported inside the patient by one or more at least partially implanted leads and an evaluation unit having an analyzer circuit that is external of the patient and attached to the one or more leads;receiving a user-determined electrode combination selection criteria from a user via the evaluation unit, wherein the user-determined electrode combination selection criteria indicate one or more boundary conditions comprising one or more of a maximum pulse amplitude at which the implantable pacing circuit is programmed to deliver, a minimum pulse amplitude at which the implantable pacing circuit is programmed to deliver, a maximum pulse width at which the implantable pacing circuit is programmed to deliver, a minimum pulse width-at which the implantable pacing circuit is programmed to deliver, and wherein the user-determined electrode combination selection criteria further indicate which electrode combinations of the plurality of cardiac electrodes will be used to deliver electrical stimulation and be evaluated;evaluating, for each electrode combination of a plurality of electrode combinations of the plurality of cardiac electrodes, one or more first parameters and one or more second parameters produced by the electrical stimulation delivered using the electrode combination, the first parameters supportive of cardiac function consistent with a prescribed therapy and the second parameters not supportive of cardiac function consistent with the prescribed therapy;displaying an indicator for each of a plurality of electrode combinations of the plurality of cardiac electrodes on a user interface of the evaluation unit;accepting a selection of one of the plurality of electrode combinations having an indicator displayed on the user interface of the evaluation unit from a user via the user interface of the evaluation unit; andprogramming an implantable pacing circuit to deliver a cardiac pacing therapy that preferentially uses the user-selected electrode combinations relative to other electrode combinations of the plurality of cardiac electrodes. 2. The method of claim 1, wherein: evaluating the first parameters comprises evaluating a capture threshold for each of the plurality of electrode combinations; andevaluating the second parameters comprises evaluating extra-cardiac stimulation. 3. The method of claim 1, further comprising; determining an electrode combination ranking and storing the determined ranking in an electronic memory, the ranking having higher ranked one or more electrode combinations that best satisfy the user-determined electrode combination selection criteria; anddisplaying a measure of the ranking of at least some of the plurality of electrode combinations having the indicator displayed on the user interface of the evaluation unit. 4. The method of claim 1, wherein delivering electrical stimulation to the patient's heart using the plurality of cardiac electrodes and the analyzer circuit comprises delivering electrical stimulation within the boundaries indicated by the user-determined electrode combination selection criteria. 5. The method of claim 1, wherein the user-determined electrode combination selection criteria indicate one or more electrode combinations for which the first parameter is to be directly measured based on the delivery of the electrical stimulation and one or more other electrode combinations for which the first parameter will be estimated and not directly measured. 6. The method of claim 1, further comprising: comparing respective first and second parameters associated with the electrode combinations between the electrode combinations of the plurality of cardiac electrodes;determining a ranking for at least some of the electrode combinations of the plurality of cardiac electrodes, the ranking based, at least in part, on the evaluations of the first and second parameters and the user-determined electrode combination selection criteria; anddetecting a change in condition, wherein programming the implantable pacing circuit to deliver the cardiac pacing therapy further comprises programming the implantable pacing circuit to switch delivery of the cardiac pacing therapy from a first prioritized electrode combination of the ranking to a lower prioritized electrode combination of the ranking in response to the detected change in condition. 7. The method of claim 1, wherein: delivering electrical stimulation using the plurality of cardiac electrodes and the analyzer circuit further comprises delivering electrical stimulation between one or more of the plurality of cardiac electrodes and a catheter electrode, the catheter electrode in the patient at a location identified for implantation of a housing for the implantable pacing circuit;evaluating further comprises evaluating first and second parameters for electrode combinations that use the catheter electrode; andselecting further comprises selecting one or more electrode combinations that use the housing electrode, wherein the selection of the one or more electrode combinations that use the housing electrode is based on the evaluation of the first and second parameters for the electrode combinations that use the catheter electrode and the user-determined electrode combination selection criteria. 8. The method of claim 1, wherein the indicator for each of the plurality of electrode combinations includes a corresponding ranking of the electrode combination. 9. The method of claim 1, further comprising recommending at least one electrode combination of the plurality of cardiac electrodes before accepting the selection of one of the plurality of electrode combinations. 10. A cardiac rhythm management system, comprising: an analyzer device configured to electrically connect to implanted electrodes while the analyzer device is external of a patient, the analyzer device having a user interface;a patient implantable cardiac stimulation device;a plurality of cardiac electrodes provided on one or more patient implantable leads, the one or more leads configured to be coupled to the analyzer device and the patient implantable cardiac stimulation device;evaluation circuitry housed within the analyzer device, the evaluation circuitry configured to receive and accept user-determined electrode combination selection criteria entered by a user via the user interface of the analyzer device and to execute stored program instructions, based at least in part on the user-determined electrode combination selection criteria, to cause the analyzer device to evaluate, for each electrode combination of a plurality of electrode combinations of the plurality of cardiac electrodes, one or more first parameters and one or more second parameters produced by electrical stimulation delivered using at least some of the plurality of electrodes, the first parameters supportive of cardiac function consistent with a prescribed therapy and the second parameters not supportive of cardiac function consistent with the prescribed therapy;an electrode combination processor housed within the analyzer device, the electrode combination processor configured to execute stored program instructions to cause the analyzer device to determine an electrode combination ranking for a plurality of electrode combinations, the ranking having higher ranked one or more electrode combinations that best satisfy the user-determined electrode combination selection criteria, and to display the electrode combination ranking of the plurality of electrode combinations to a user via the user interface of the analyzer device, the electrode combination processor further configured to receive and accept from a user via the user interface one or more user-selected electrode combinations; andprogrammer circuitry configured to execute stored program instructions to cause the programmer circuitry to program the patient implantable cardiac stimulation device to deliver therapy preferentially using the one or more user-selected electrode combinations relative to other electrode combinations of the plurality of cardiac electrodes. 11. The system of claim 10, wherein the one or more first parameters concern a capture threshold, the one or more second parameters concern extra-cardiac stimulation, and the analyzer device is configured such that the one or more electrode combinations that have the lower capture thresholds and do not cause extra cardiac stimulation relative to other electrode combinations are ranked higher by the electrode combination processor. 12. The system of claim 10, wherein the patient implantable cardiac stimulation device includes a processor configured to execute stored program instructions to cause the patient implantable cardiac stimulation device to switch delivery of cardiac pacing therapy from using a first prioritized electrode combination of the ranking to a lower prioritized electrode combination of the ranking in response to a detected change in condition. 13. The system of claim 10, wherein the user-determined electrode combination selection criteria specifying the one or more first parameters and/or the one or more second parameters from a plurality of different parameters upon which the selection of the one or more electrode combinations is to be based. 14. The system of claim 10, wherein execution of the instructions, based at least in part on the user-determined electrode combination selection criteria, cause the analyzer device to deliver electrical stimulation using the plurality of cardiac electrodes to be analyzed by the electrode combination processor using pulse parameter boundaries comprising one or more of a maximum pulse amplitude, a minimum pulse amplitude, a maximum pulse width, a minimum pulse width, and which electrode combinations of the plurality of electrodes will be used for delivery of stimulation and be evaluated by the electrode combination processor. 15. The system of claim 10, wherein the electrode combination processor is further configured to execute stored program instructions to cause the analyzer device to directly measure the first parameter for one or more of the electrode combinations based on the delivery of electrical stimulation and estimate the first parameter for one or more other electrode combinations and not directly measure the first parameter for the one or more other electrode combinations based on the user-determined electrode combination selection criteria. 16. The system of claim 10, wherein the programmer circuitry is housed within the analyzer device. 17. The system of claim 10, further comprising a non-implantable catheter coupled to the analyzer device, the catheter comprising an electrode that is a part of the plurality of electrodes that make up the one or more electrode combinations that the electrode combination processor is configured to evaluate and select the one or more electrode combinations from, wherein the patient implantable cardiac stimulation device comprises a housing electrode, and wherein the analyzer device is programmed such that if an electrode combination that includes the catheter electrode is selected, then the patient implantable cardiac stimulation device is programmed by the programming circuitry to preferentially use the housing electrode for therapy delivery relative to electrode combinations that do not use the housing electrode. 18. A system for selecting an electrode combination, the system comprising: an analyzer device configured to electrically connect to implanted electrodes when the analyzer device is external of a patient;a patient implantable cardiac stimulation device;a plurality of cardiac electrodes provided on one or more leads, the one or more leads configured to be coupled to the analyzer device and the patient implantable cardiac stimulation device;means for receiving and accepting a user-determined electrode combination selection criteria from a user;means for evaluating, for each electrode combination of a plurality of electrode combinations for the plurality of implanted cardiac electrodes, one or more first parameters and one or more second parameters produced by electrical stimulation delivered using the electrode combinations, the first parameters supportive of cardiac function consistent with a prescribed therapy and the second parameters not supportive of cardiac function consistent with the prescribed therapy;means for sensing an extra-cardiac response to the electrical stimulation delivered using each of the electrode combinations of the plurality of electrode combinations, the sensed physiological response indicative of the second parameter not supportive of cardiac function consistent with the prescribed therapy;means for selecting one or more electrode combinations of the plurality of cardiac electrodes based at least in part on the user-determined electrode combination selection criteria received from a user via the means for receiving and accepting the user-determined electrode selection criteria; andmeans for programming the implantable pacing circuit to deliver electrical therapy preferentially using the one or more selected electrode combinations relative to other electrode combinations of the plurality of electrode combinations based on the selection of the one or more electrode combinations. 19. The method of claim 18, wherein the means for selecting one or more electrode combinations of the plurality of cardiac electrodes comprises a user interface for receiving and accepting one or more electrode combination selections from a user. 20. A method comprising: delivering electrical stimulation to a patient's heart using a plurality of cardiac electrodes supported inside the patient by one or more leads with an evaluation unit having an analyzer that is electrically attached to the one or more leads;receiving user-determined electrode combination selection criteria from a user via the evaluation unit, and storing the user-determined electrode combination selection criteria in a memory of the evaluation unit;evaluating, for each electrode combination of a plurality of electrode combinations of the plurality of cardiac electrodes, which electrode combination best satisfies the user-determined electrode combination selection criteria, by delivering electrical stimulation to the patient's heart using each electrode combination of the plurality of electrode combinations;displaying a recommended electrode combination on the user interface of the evaluation unit based, at least in part, on the user-determined electrode combination selection criteria;receiving a user-selected electrode combination that is determined to best satisfy the user-determined electrode combination selection criteria from a user via the evaluation unit; andprogramming an implantable pacing circuit to deliver a cardiac pacing therapy to the patient's heart that uses the user-selected electrode combination. 21. The method of claim 20, wherein the programming step includes programming the implantable pacing circuit to deliver a cardiac pacing therapy to the patient's heart that preferentially uses the selected electrode combination relative to other electrode combinations of the plurality of cardiac electrodes.
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