Pacemaker catheter utilizing bipolar electrodes spaced in accordance to the length of a heart depolarization signal

Claim 1

A method for enhancing the detection of atrial P-waves using a catheter lead and a cardiac pacemaker in which stimulating pulses are generated for delivery to the heart according to physiological need of the patient determined by signals obtained solely from the detection of naturally occurring P-waves propagating through the artrial myocardial tissue, said method comprising implanting a single catheter lead having a stimulating electrode at the distal end thereof and a pair of sensing electrodes thereon longitudinally spaced apart on opposite sides of the catheter from each other and from said distal end of the lead, by introducing the lead into the right atrial and ventricular chambers of the heart via the patient's vascular system such that both of said sensing electrodes reside unrestrained within the right atrium with the lead substantially parallel to the tissue wall when the distal end of the lead is positioned at the apex of the right ventricle, measuring the approximate separation between adjacent positive and negative peaks of an average P-wave for the recipient and longitudinally spacing the sensing electrodes to approximate the separation between adjacent positive and negative peaks of the naturally occurring average atrial P-wave for the patient in which the lead is implanted, connecting the lead at its proximal end to the pacemaker so that conductors in the lead separately electrically connected to said stimulating electrode and said pair of sensing electrodes are thereby electrically connected to the pulse generator and sense circuitry, respectively, of the pacemaker, and additively combining in the sense circuitry of the pacemaker the respective signals on the separate conductors of the lead connected to each of said sensing electrodes resulting from detection of a P-wave, to enhance said P-wave detection.

Claim 2

A method for enhancing the detection of atrial P-waves using a catheter lead and a cardiac pacemaker in which stimulating pulses are generated for delivery to the heart according to physiological need of the patient determined by signals obtained solely from the detection of naturally occurring P-waves propagating through the artrial myocardial tissue, said method comprising implanting a single catheter lead having a stimulating electrode at the distal end thereof and a pair of sensing electrodes thereon longitudinally spaced apart on opposite sides of the catheter from each other and from said distal end of the lead, by introducing the lead into the right atrial and ventricular chambers of the heart via the patient's vascular system such that both of said sensing electrodes reside unrestrained within the right atrium with the lead substantially parallel to the tissue wall when the distal end of the lead is positioned at the apex of the right ventricle, measuring the approximate separation between adjacent positive and negative peaks of an average P-wave for the recipient and longitudinally spacing the sensing electrodes to approximate the separation between adjacent positive and negative peaks of the naturally occurring average atrial P-wave for the patient in which the lead is implanted, connecting the lead at its proximal end to the pacemaker so that conductors in the lead separately electrically connected to said stimulating electrode and said pair of sensing electrodes are thereby electrically connected to the pulse generator and sense circuitry, respectively, of the pacemaker, and additively combining in the sense circuitry of the pacemaker the respective signals on the separate conductors of the lead connected to each of said sensing electrodes resulting from detection of a P-wave, to enhance said P-wave detection.

Claim 5

A method for sensing cardiac depolarization in a cardiac pacemaker system comprising the steps, arranging an electrode pair of only two electrodes axially on a catheter, operating said electrode pair in a bipolar configuration, determining the cardiac depolarization signal length while the electrode pair is not in contact with cardiac tissue, configuring the electrode pair on the catheter relative to the cardiac depolarization signal wavefront direction to prevent signal cancellation or signal mitigation when the signals sensed from each of the pair of electrodes are electronically processed by the pacemaker system, configuring the electrode pair on opposite sides of the catheter and displaced longitudinally a distance equal to the length of the depolarization signal along the axis of the catheter substantially parallel to the axis of depolarization, such that the combinational features of controlling the electrode dimensions in each of three planes to minimize field averaging in all planes prevents signal cancellation as the depolarization wave passes each electrode.

Claim 6

A method for sensing cardiac depolarization in a cardiac pacemaker system comprising the steps, arranging an electrode pair of only two electrodes axially on a catheter, operating said electrode pair in a bipolar configuration, determining the cardiac depolarization signal length while the electrode pair is not in contact with cardiac tissue, configuring the electrode pair on the catheter relative to the cardiac depolarization signal wavefront direction to prevent signal cancellation or signal mitigation when the signals sensed from each of the pair of electrodes are electronically processed by the pacemaker system, configuring the electrode pair on opposite sides of the catheter and displaced longitudinally a distance equal to the length of the depolarization signal along the axis of the catheter substantially parallel to the axis of depolarization, such that the combinational features of controlling the electrode dimensions in each of three planes to minimize field averaging in all planes prevents signal cancellation as the depolarization wave passes each electrode.