IMPROVING USABILITY AND SENSING OF SINGLE CHAMBER PACEMAKER
Publication Date: 2010-Jul-29
The IP.com Prior Art Database
An external programmer can receive a user selection indicating a desired single-chamber pacing or sensing mode (e.g., a Brady Mode) for use with an implantable pacemaker. On the programmer, displaying chamber-specific configuration parameters, disallowing or allowing chamber-specific features, and/or using chamber-appropriate markers, in response to the selected single-chamber Brady Mode, can provide a more accurate representation to the user of device and lead function. Clarity can be improved for the user through properly identifying the Brady Mode in many contexts/screens, and such as through better labeling of atrial or ventricular artifacts related to episodes and EGMs.
Implantable medical devices (IMDs), such as pacemakers, can perform a variety of diagnostic or therapeutic functions. In an example, such a medical device can include one or more cardiac function management features, such as to monitor the heart or to provide electrical stimulation to a heart or to the nervous system. In a single chamber pacemaker (e.g., an “SSI” device, using the NBG-style code), a lead, attached to the pacemaker, may be implanted in either the atrium or ventricle. Such a pacemaker or “pulse generator” (PG) can provide pacing therapy to or sensing activity from a single heart chamber, such as via the lead. In traditional SSI pacemakers, the PG is unaware of the chamber-of-implant. This can have undesirable attributes: (1) features that may be appropriate for the ventricle may be misapplied to the atrium (and vice versa); and/or (2) sensing/blanking behavior may be tuned for ventricular use, but sub-optimal for atrial use (or vice versa), among others.
An improved external programmer (“PRM”) user interface can allow a user (e.g., a clinician or other caregiver) to declare the chamber of implant by virtue of a chamber-specific Brady Operating Mode selection (e.g. VVI(R), VOO, AAI(R), AOO, off, etc.). Feature availability can be driven by the declared chamber (e.g., a ventricular rate regularization (VRR) feature can be available in a ventricular mode, but not when an atrial mode is selected, etc.). Sensing and blanking parameters can be automatically configured or range-limited as appropriate for the declared chamber
In an example, the PRM can receive a selection of an SSI lead position using the user-selected Brady Mode, such as to display chamber-specific mode value and data types on various screens. For example, the PRM and PG can make features inappropriate for atrial usage unavailable when the selected Brady Mode indicates an atrial pacing mode. Such behavior can include disallowing VRR, disallowing dynamic refractory periods, disallowing right-ventricular autothreshold testing or commanded pacing threshold testing, and/or changing the configuration of the sensing channel to improve atrial sensing (e.g., decreasing an atrial sensed event threshold or otherwise altering automatic threshold control or automatic gain control (AGC) behavior). Use of traditional ventricular sensing parameters for the atrium has the potential for creating undersensing and/or oversensing of activ...