Implantable lead migration monitoring using ECAP
Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to monitor lead position and/or detect lead migration. An example system includes sensing circuitry configured to sense an ECAP signal, and processing circuitry. The processing circuitry controls the sensing circuitry to detect, after delivery of an electrical stimulation pulse, a current ECAP signal, and determines one or more characteristics of the current ECAP signal. The processing circuitry also compares the one or more characteristics of the current ECAP signal to corresponding one or more characteristics of a baseline ECAP signal, and determines, based on the comparison, a migration state of the electrodes delivering the electrical stimulation pulse. Additionally, the processing circuitry outputs, based on the migration state, an alert indicative of migration of the electrodes.
1. A system comprising:
sensing circuitry configured to sense an electrical signal comprising an evoked compound action potential (ECAP) signal; and
processing circuitry configured to:
control the sensing circuitry to detect, after delivery of an electrical stimulation pulse by implanted electrodes, a current electrical signal coprising a current ECAP signal;
compare a first latency of the current ECAP signal to a second latency of a baseline ECAP signal, wherein the first latency and second latency are measures of an interval between a portion of a respective electrical stimulation pulse sensed in a respective electrical signal and a feature of the respective ECAP signal of the respective electrical signal;
determine, based on the comparison of the first latency to the second latency, a migration state of the implanted electrodes that delivered the electrical stimulation pulse, wherein the migration state indicates at least one of a lateral migration state or a longitudinal migration state from a target implant location; and
output, based on the migration state, an alert indicative of migration of the implanted electrodes from the target implant location.
2. The system of claim 1 , wherein the processing circuitry is configured to identify the portion of the respective electrical stimulation pulse as an edge of the respective electrical stimulation pulse, and wherein the processing circuitry is configured to identify the feature of the respective ECAP signal as one of a first peak (P1), a second peak (N1), or a third peak (P2) of the respective ECAP signal.
3. The system of claim 1 , wherein the processing circuitry is configured to determine that the migration state is indicative of lead migration in response to a difference between the first latency of the current ECAP signal and the second latency of the baseline ECAP signal exceeding a threshold value.
4. The system of claim 1 , wherein the processing circuitry is configured to:
store the first latency of the current ECAP signal in memory; and
determine a subsequent migration state based on the first latency of the current ECAP signal stored in the memory.
5. The system of claim 1 , further comprising telemetry circuitry configured to transmit the alert to an external programmer, the alert configured to cause the external programmer to adjust at least one parameter value of a set of therapy parameters to compensate for the migration state of the implanted electrodes from the target implant location.
6. The system of claim 1 , wherein the current ECAP signal is a first current ECAP signal detected by the sensing circuitry using a first combination of the implanted electrodes, and wherein the processing circuitry is configured to control the sensing circuitry to detect, after delivery of a second electrical stimulation pulse, a second current ECAP signal using a second combination of the implanted electrodes.
7. The system of claim 6 , wherein the baseline ECAP signal is a first baseline ECAP signal detected by the sensing circuitry using the first combination of the electrodes, and wherein the processing circuitry is configured to compare a third latency of the second current ECAP signal to a fourth latency of a second baseline ECAP signal detected by the sensing circuitry using the second combination of the implanted electrodes.
8. The system of claim 7 wherein the processing circuitry is configured to set the migration state to indicate lead migration in response to one of: (a) a first difference between the first latency of the first current ECAP signal and the second latency of the first baseline ECAP signal satisfies a threshold value, or (b) a second difference between the third latency of the second current ECAP signal and the fourth latency of the second baseline ECAP signal satisfies the threshold value.
9. The system of claim 1 , wherein the processing circuitry is configured to:
detect a current posture of a patient;
determine that the current posture is equivalent to a target posture detected when the baseline ECAP signal was sensed; and
responsive to determining that the current posture is equivalent to the target posture, control the sensing circuitry to detect the current ECAP signal.
10. The system of claim 1 , wherein the electrical stimulation pulse is generated with a first set of therapy parameters, and wherein the processing circuitry is configured to, based on the migration state, switch the first set of therapy parameters with a second set of therapy parameters to cause a subsequent electrical stimulation pulse to be generated with the second set of therapy parameters.
11. The system of claim 1 , further comprising an implantable medical device comprising the sensing circuitry and the processing circuitry.
12. A method to detect migration of electrodes coupled to an implantable medical device, the method comprising:
sensing, via sensing circuitry, an electrical signal comprising an evoked compound action potential (ECAP) signal; and
controlling, by processing circuitry, the sensing circuitry to detect, after delivery of an electrical stimulation pulse by implanted electrodes, a current an electrical signal coprising a current ECAP signal;
comparing, by the processing circuitry, a first latency of the current ECAP signal to a second latency of a baseline ECAP signal, wherein the first latency and second latency are measures of an interval between a portion of a respective electrical stimulation pulse sensed in a respective electrical signal and a feature of the respective ECAP signal of the respective electrical signal;
determining, by the processing circuitry and based on the comparison of the first latency to the second latency, a migration state of the implanted electrodes that delivered the electrical stimulation pulse, wherein the migration state indicates at least one of a lateral migration state or a longitudinal migration state from a target implant location; and
outputting, by the processing circuitry and based on the migration state, an alert indicative of migration of the implanted electrodes from the target implant location.
13. The method of claim 12 , further comprising identifying the portion of the respective electrical stimulation pulse an an edge of the respective electrical stimulation pulse, and identifying the feature of the respective ECAP signal as one of a first peak (P1), a second peak (N1), or a third peak (P2) of the respective ECAP signal.
14. The method of claim 12 , wherein determining the migration state comprises determining that the migration state is indicative of lead migration in response to a difference between the first latency of the current ECAP signal and the second latency of the baseline ECAP signal exceeding a threshold value.
15. The method of claim 12 , further comprising:
storing the first latency of the current ECAP signal in memory; and
determining a subsequent migration state based on the first latency of the current ECAP signal stored in the memory.
16. The method of claim 12 , further comprising transmitting, by telemetry circuitry, the alert to an external programmer, the alert configured to cause the external programmer to adjust at least one parameter value of a set of therapy parameters to compensate for the migration state of the implanted electrodes from the target implant location.
17. The method of claim 12 , wherein the current ECAP signal is a first current ECAP signal detected by the sensing circuitry using a first combination of the implanted electrodes, and wherein the method further comprises controlling the sensing circuitry to detect, after delivery of a second electrical stimulation pulse, a second current ECAP signal using a second combination of the implanted electrodes.
18. The method of claim 17 , wherein the baseline ECAP signal is a first baseline ECAP signal detected by the sensing circuitry using the first combination of the electrodes, and wherein the method further comprises comparing a third latency of the second current ECAP signal to a fourth latency of a second baseline ECAP signal detected by the sensing circuitry using the second combination of the implanted electrodes.
19. The method of claim 12 , further comprising:
detecting a current posture of a patient;
determining that the current posture is equivalent to a target posture detected when the baseline ECAP signal was sensed; and
responsive to determining that the current posture is equivalent to the target posture, controlling the sensing circuitry to detect the current ECAP signal.
20. A non-transitory computer readable medium comprising instructions that, when executed, cause processing circuitry of an implantable medical device to:
control sensing circuitry to detect, after delivery of an electrical stimulation pulse by implanted electrodes, a current electrical signal comprising a current ECAP signal;
compare a first latency of the current ECAP signal to a second latency of a baseline ECAP signal, wherein the first latency and second latency are measures of an interval between a portion of a respective electrical stimulation pulse sensed in a respective electrical signal and a feature of the respective ECAP signal of the respective electrical signal;
determine, based on the comparison of the first latency to the second latency, a migration state of the implanted electrodes that delivered the electrical stimulation pulse, wherein the migration state indicates at least one of a lateral migration state or a longitudinal migration state from a target implant location; and
output, based on the migration state, an alert indicative of migration of the implanted electrodes from the target implant location.