US 12,415,082 B2
Systems and methods for using leadless pacemaker to assist non-vascular implantable cardiac defibrillator
Matthew G. Fishler, Scotts Valley, CA (US)
Assigned to Pacesetter, Inc., Sylmar, CA (US)
Filed by Pacesetter, Inc., Sylmar, CA (US)
Filed on Aug. 4, 2022, as Appl. No. 17/880,928.
Prior Publication US 2024/0042220 A1, Feb. 8, 2024
Int. Cl. A61N 1/37 (2006.01); A61N 1/372 (2006.01); A61N 1/375 (2006.01)
CPC A61N 1/3756 (2013.01) [A61N 1/37211 (2013.01); A61N 1/37512 (2017.08)] 14 Claims
OG exemplary drawing
 
1. An implantable system, comprising:
a leadless pacemaker (LP) comprising two or more electrodes and configured to be implanted in or on a cardiac chamber of a heart, the LP configured to use at least two of the two or more electrodes to sense a near-field electrogram (NF-EGM) and to selectively pace the cardiac chamber; and
a non-vascular implantable cardioverter defibrillator (NV-ICD) comprising two or more extracardiac electrodes configured to be implanted external to the heart, the NV-ICD configured to use at least two of the two or more extracardiac electrodes to sense a far-field electrogram (FF-EGM), and the NV-ICD configured to use at least two of the two or more extracardiac electrodes to selectively deliver a defibrillation shock to the heart;
the LP comprising a transmitter configured to selectively send implant-to-implant (i2i) messages to the NV-ICD and a receiver configured to receive i2i messages from the NV ICD; and
the NV-ICD comprising a receiver configured to receive the i2i messages from the LP and a transmitter configured to selectively send i2i messages to the LP;
wherein the NV-ICD is configured to
normally monitor for an arrhythmic episode and perform arrhythmia discrimination based on cardiac activity detected by the NV-ICD itself from the FF-EGM sensed by the NV-ICD, without using cardiac activity information obtained from the LP;
determine itself when the cardiac activity detected by the NV-ICD itself from the FF-EGM is likely being at least one of under-sensed or over-sensed, and in response thereto, send one or more i2i messages to the LP requesting that the LP provide cardiac activity information to the NV-ICD, based upon which the NV-ICD can at least one of monitor for an arrhythmic episode or perform arrhythmia discrimination; and
at least one of monitor for an arrhythmic episode or perform arrhythmia discrimination based on cardiac activity information obtained from the LP via one or more i2i messages received from the LP, following the NV-ICD sending the one or more i2i messages to the LP requesting that the LP provide cardiac activity information to the NV-ICD; and
wherein the LP is configured to
determine cardiac activity information based on sensed cardiac events detected from the NF-EGM and optionally also based on paced cardiac events caused by the LP performing pacing;
monitor for one or more specific pacemaker conditions, wherein one of the one or more specific pacemaker conditions that the LP is configured to monitor for, and in response to which being detected the LP sends one or more i2i messages including the cardiac activity information to the NV-ICD, comprises the LP receiving at least one of the one or more i2i messages from the NV-ICD requesting that the LP provide cardiac activity information to the NV-ICD;
send one or more i2i messages including the cardiac activity information to the NV-ICD in response to receiving at least one of the one or more i2i messages from the NV-ICD requesting that the LP provide cardiac activity information to the NV-ICD; and
not send one or more i2i messages including the cardiac activity information to the NV-ICD when none of the one or more specific pacemaker conditions is detected by the LP.