Pacing system analyzer having three sensing and pacing channels

Abstract

A pacing system analyzer (PSA) having three or more individually controllable sensing and pacing channels provides for testing and measurement during an operation for implanting a pacemaker having three or more sensing and pacing channels. The PSA allows control and adjustment of pacing parameters including cross-channel pacing parameters relating activities between any two of the three or more channels, such as atrioventricular and interventricular pacing delays. The PSA is also capable of, among other things, displaying real-time cardiac signals, measuring amplitude and slew rate of cardiac depolarizations, and measuring lead impedance for each of the sensing and pacing channels, as well as measuring time intervals between cardiac depolarizations in two different sensing and pacing channels. In one embodiment, the PSA includes individually controllable atrial, right ventricular (RV), and left ventricular (LV) sensing and pacing channels.

1 . A method for operating a pacing system analyzer (PSA), the method comprising:
 sensing cardiac signals including a first cardiac signal indicative of first cardiac events using a first sensing and pacing channel of the PSA, a second cardiac signal indicative of second cardiac events using a second sensing and pacing channel of the PSA, and a third cardiac signal indicative of third cardiac events using a third sensing and pacing channel of the PSA;   controlling delivery of pacing pulses by executing a predetermined pacing algorithm using a plurality of pacing parameters including user-programmable pacing parameters, the delivery of pacing pulses including one or more of delivery of first pacing pulses using the first sensing and pacing channel of the PSA, delivery of second pacing pulses using the second sensing and pacing channel of the PSA, and delivery of third pacing pulses using the third sensing and pacing channel of the PSA; and   measuring a plurality of lead impedance values each associated with one of the first, second, and third sensing and pacing channels, a plurality of event parameters each associated with one of the first, second, and third cardiac events, and a plurality of conduction intervals using the PSA, the conduction intervals each being a time interval between two cardiac events selected from two of the first, second, and third cardiac events.   
   
   
       2 . The method of  claim 1 , further comprising:
 detecting the first, second, and third cardiac events;   producing sense markers each indicative of a detection of one cardiac event of the first, second, and third cardiac events and pace markers each indicative of delivery of one pacing pulse of the first, second, and third pacing pulses;   displaying the first, second, and third cardiac signals in real time using a display screen of the PSA; and   displaying the sense markers and pace markers along with the first, second, and third cardiac signals using the display screen.   
   
   
       3 . The method of  claim 2 , further comprising controlling a plurality of light-emitting diodes (LEDs) mounted on the PSA, the LEDs each corresponding to one of the sense markers and pace markers. 
   
   
       4 . The method of  claim 1 , wherein measuring the plurality of event parameters comprises measuring one or more amplitudes each associated with one of the first cardiac events, the second cardiac events, and the third cardiac events and one or more slew rates each associated with one of the first cardiac events, the second cardiac events, and the third cardiac events. 
   
   
       5 . The method of  claim 3 , wherein measuring the plurality of lead impedance values comprises measuring lead impedance values associated with the first, second, and third sensing and pacing channels concurrently. 
   
   
       6 . The method of  claim 1 , wherein measuring the plurality of conduction intervals comprises two or more of:
 measuring a first conduction interval being a time interval between one of the first cardiac events and one of the second cardiac events;   measuring a second conduction interval being a time interval between one of the first cardiac events and one of the third cardiac events; and   measuring a third conduction interval being a time interval between one of the second cardiac events and one of the third cardiac events.   
   
   
       7 . The method of  claim 6 , furthering comprising receiving the user-programmable pacing parameters including two or more of:
 a first cross-channel pacing delay being a pacing delay interval between the first sensing and pacing channel and the second sensing and pacing channel;   a second cross-channel pacing delay being a pacing delay interval between the first sensing and pacing channel and the third sensing and pacing channel; and   a third cross-channel pacing delay being a pacing delay interval between the second sensing and pacing channel and the third sensing and pacing channel.   
   
   
       8 . The method of  claim 7 , further comprising:
 displaying the first, second, and third cardiac signals in real time using a display screen of the PSA; and   displaying one or more intervals of the first, second, and third conduction intervals using the display screen of the PSA.   
   
   
       9 . The method of  claim 8 , further comprising displaying the plurality of lead impedance values using the display screen of the PSA. 
   
   
       10 . The method of  claim 1 , wherein the first cardiac signal is a first intracardiac electrogram, the second cardiac signal is a second intracardiac electrogram, and the third cardiac signal is a third intracardiac electrogram, and further comprising:
 sensing one or more surface ECG signals; and   displaying the first intracardiac electrogram, the second intracardiac electrogram, and the third intracardiac electrogram, and the one or more surface ECG signals using a display screen of the PSA.   
   
   
       11 . A method for operating a pacing system analyzer (PSA), the method comprising:
 sensing an atrial electrogram indicative of atrial depolarizations using an atrial sensing and pacing channel of the PSA, a right ventricular (RV) electrogram indicative of RV depolarizations using an RV sensing and pacing channel of the PSA, and a left ventricular (LV) electrogram indicative of LV depolarizations using an LV sensing and pacing channel of the PSA;   controlling delivery of pacing pulses using a plurality of pacing parameters including user-programmable pacing parameters, the delivery of pacing pulses including one or more of delivery of atrial pacing pulses using the atrial sensing and pacing channel of the PSA, delivery of RV pacing pulses using the RV sensing and pacing channel of the PSA, and delivery of LV pacing pulses using the LV sensing and pacing channel of the PSA;   measuring a plurality of conduction intervals using the PSA, the conduction intervals each being a time interval between two depolarizations selected from two of the atrial depolarizations, the RV depolarizations, and LV depolarizations; and   displaying the atrial electrogram, the RV electrogram, the LV electrogram, and the measured conduction intervals using a display screen of the PSA.   
   
   
       12 . The method of  claim 10 , wherein measuring the plurality of conduction intervals comprises two or more of:
 measuring a first conduction interval being a time interval between one of the atrial depolarizations and one of the RV depolarizations;   measuring a second conduction interval being a time interval between one of the atrial depolarizations and one of the LV depolarizations;   measuring a third conduction interval being a time interval between one of the RV depolarizations and one of the LV depolarizations.   
   
   
       13 . The method of  claim 12 , wherein controlling the delivery of pacing pulses comprises executing a cardiac resynchronization therapy pacing algorithm. 
   
   
       14 . The method of  claim 13 , further comprising receiving and storing values of the user-programmable pacing parameters including atrioventricular and interventricular pacing delays. 
   
   
       15 . The method of  claim 11 , further comprising measuring a plurality of lead impedance values using the PSA, the lead impedance values each associated with one of the atrial, RV, and LV sensing and pacing channels. 
   
   
       16 . The method of  claim 15 , further comprising measuring a plurality of event parameters using the PSA, the event parameters each associated with one of the atrial depolarizations, the RV depolarizations, and LV depolarizations. 
   
   
       17 . The method of  claim 16 , wherein measuring the plurality of event parameters comprises:
 measuring a plurality of amplitudes each associated with one the atrial depolarizations, the RV depolarizations, and LV depolarizations; and   measuring a plurality of slew rates each associated with one of the atrial depolarizations, the RV depolarizations, and LV depolarizations.   
   
   
       18 . The method of  claim 16 , further comprising displaying one or more of the measured lead impedance values and the measured event parameters using the display screen of the PSA. 
   
   
       19 . The method of  claim 11 , further comprising receiving the user-programmable pacing parameters using a user interface of a computer-based medical device programmer that is electrically connected to the PSA. 
   
   
       20 . The method of  claim 11 , further comprising sensing one or more surface ECG signals, and displaying one or more surface ECG signals using the display screen of the PSA.