Entries |
Document | Title | Date |
20080221636 | METHOD AND APPARATUS FOR CLOSED-LOOP INTERMITTENT CARDIAC STRESS AUGMENTATION PACING - A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing. | 09-11-2008 |
20080234774 | CLOSED-LOOP CONTROL OF CARDIOPROTECTIVE PRE-EXCITATION PACING - Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of ventricular dyssynchrony or a patient's physiological response to ventricular dyssynchrony to control the delivery of cardioprotective pre-excitation pacing in closed-loop fashion. | 09-25-2008 |
20080249585 | IMPLANTABLE MEDICAL DEVICE AND METHOD FOR LV CORONARY SINUS LEAD IMPLANT SITE OPTIMIZATION - A device is connected to electrode leads which performs intracardiac impedance measurements, conducts a transient pacing protocol, analyses the impedance measurements, and generates an LV lead position quality factor. The transient pacing protocol includes a repeated change (“transitions”) between ventricular intrinsic rhythm and biventricular paced rhythm and may also include a variation of the atrioventricular delay (AVD) and/or the interventricular delay (VVD). The quality factor expresses the degree to which hemodynamic properties have improved due to BiV stimulation for the current LV lead position compared to intrinsic ventricular rhythm. | 10-09-2008 |
20080269822 | Device for Evaluating Positions of an Implantable Medical Device - In a device and method for evaluating positions of a medical lead during an implantation procedure, an IEGM signal and a signal indicative of heart pumping activity are obtained for each of a number of different lead positions, and those signals are stored dependent on the different lead positions. A processor automatically determines a lead position, from among the stored lead positions, that results in most favorable hemodynamics of the heart, based on the IEGM signal and the pumping activity signal. | 10-30-2008 |
20080300643 | Heart failure therapy adjustment based on ventricular pressures - Pacing left and right ventricles of the heart for delivery of heart failure therapy involves measuring right ventricular (RV) pressure and a left ventricular (LV) pressure, and computing a parameter developed from one or both of the RV and LV pressure measurements. The parameter is indicative of a degree of left and right ventricular synchronization. At least one parameter of a heart failure pacing therapy is adjusted based on the parameter to improve synchronization of the right and left ventricles. | 12-04-2008 |
20080306564 | METHOD AND APPARATUS FOR SHORT-TERM HEART RATE VARIABILITY MONITORING AND DIAGNOSTICS - A diagnostic system monitors autonomic using short term heart rate variability (STHRV). Some examples apply a therapy that is adjusted based on wellness indicator. A wellness indicator is a measure of the STHRV produced to indicate a patient's cardiac condition. | 12-11-2008 |
20080306565 | Medical Device - In an implantable medical device and a method and computer-readable medium for operating the medical device to detect a condition of a heart of a patient, activity level of a patient and acoustic energy in a patient are sensed, and acoustic signals are generated that are indicative of heart sounds of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles. A signal corresponding to a first sound is extracted from the sensed acoustic signal of a cardiac cycle. A relation is calculated between a first signal corresponding to the first heart sound in a first activity range, and a second signal corresponding to the first heart sound in a second predetermined activity level range. The calculated relation is compared with at least one reference value to detect the condition or a change of the condition. | 12-11-2008 |
20090036940 | HYPERTENSION DIAGNOSIS AND THERAPY USING PRESSURE SENSOR - An example relates to a method for sensing a pulmonary artery pressure (PAP) and providing a sensed PAP signal, detecting an abnormal blood pressure (BP) condition using information from the sensed PAP signal, delivering a pacing energy to a heart, and automatically altering at least one pacing characteristic in response to the detected abnormal BP condition. The detecting an abnormal BP condition can include detecting various forms of hypertension or hypotension. The automatically altering the at least one pacing characteristic can include automatically altering at least one of a pacing rate, a pacing waveform, an atriventricular (AV) delay, an interventricular (VV) delay, a pacing mode, or a pacing site. The method can also include delivering vagal nerve stimulation and automatically altering the vagal nerve stimulation in response to the detected abnormal BP condition. The detecting the abnormal BP condition can also include using a sensed auxiliary physiological parameter. | 02-05-2009 |
20090082825 | CLOSED-LOOP CONTROL OF INTERMITTENT EXCITATORY CARDIAC STIMULATION FOR THERAPEUTIC EFFECT - A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. In order to provide a consistent hemodynamic response, the high-output pacing is optimized by delivering it using different parameter sets, evaluating the hemodynamic response thereto as reflected by one or more measured physiological variables, and selecting the parameter set with the best hemodynamic response. | 03-26-2009 |
20090099617 | IMPLANTABLE HEART STIMULATOR PROVIDING LONG TERM CARDIAC MONITORING WITH AUTOMATIC NOTIFICATION - An implantable medical device that continuously measures the patient's intracardiac ventricular impedance. Extracts cardiac performance information based on the intracardiac impedance, including amplitude, timing and variability of cardiac contraction function. The device records and analyses trends in the performance information. The device identifies changes, which exceed the selected threshold limits. In the event of an incipient crisis, the device transmits an alert message. | 04-16-2009 |
20090118782 | Complementary Configured Catheter Set for Intracardiac Recording and/or Pacing - A catheter kit can include a pair of catheters, having different and complimentary electrode configurations each configured to provide access to different intraluminal electrophysiological monitoring and/or pacing sites during a procedure. | 05-07-2009 |
20090118783 | Monitoring Right Ventricular Hemodynamic Function During Pacing Optimization - Method and systems related to monitoring right ventricular function during pacing by a cardiac rhythm management device are described. One or more pacing parameters are selected to provide cardiac resynchronization therapy. For example, the one or more pacing parameters may be selected to provide an optimal or improved therapy. The heart is paced using the selected pacing parameters. While pacing with the selected parameters, pressure is sensed via a pressure sensor disposed the pulmonary artery. The sensed pressure is analyzed to determine right ventricular function achieved during the pacing using the selected pacing parameters. A signal, such as an alert signal or control signal, is generated based on the right ventricular function achieved during the pacing. | 05-07-2009 |
20090132000 | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities - A system receives signals indicative of cardiopulmonary conditions sensed by a plurality of sensors and provides for monitoring and automated differential diagnosis of the cardiopulmonary conditions based on the signals. Cardiogenic pulmonary edema is detected based on one or more signals sensed by implantable sensors. If the cardiogenic pulmonary edema is not detected, obstructive pulmonary disease and restrictive pulmonary disease are each detected based on a forced vital capacity (FVC) parameter and a forced expiratory volume (FEV) parameter measured from a respiratory signal sensed by an implantable or non-implantable sensor. In one embodiment, an implantable medical device senses signals indicative of the cardiopulmonary conditions, and an external system detects the cardiopulmonary conditions based on these signals by executing an automatic detection algorithm. | 05-21-2009 |
20090171411 | Method and System for Treating Acute Heart Failure by Neuromodulation - Methods and systems of treating acute heart failure by applying a therapy signal at least one sympathetic cardiopulmonary fiber surrounding the pulmonary trunk that affects heart contractility more than heart rate. Methods and systems also include adjusting the signal to effectuate treatment. | 07-02-2009 |
20090192561 | On-again, off-again physiologic-demand heart pacing - A method of intentional on-again, off-again physiologic-demand heart pacing associated with at least one of (a) an implantable, and (b) an external, controllable/adjustable heart-pacing device having on and off states. The method involves gathering categories of a person's physiologic data, including ECG and heart-sound data, which are (a) relevant to that person's heart's pumping and filling functionalities, and (b) suitable for computing a selected acoustic cardiographic value; and based on such gathering and computing, and using a controlled combination of on and off states in the pacing device, recurrently adjusting the operation of that device, as necessary, so as to maintain a minimum difference between such a computed acoustic cardiographic value and a predetermined, reference acoustic cardiographic value. | 07-30-2009 |
20090204165 | Rest phase heart pacing - A computer method, employable during an at-rest period of a pacemaker patient, for controlling the operation of the pacemaker so as maximally to support the patient's hemodynamic behavior in a context involving inhibiting fluid overload. The method involves (a) collecting simultaneously occurring ECG and heart-sound information, (b) processing the collected information to obtain at least S3 data, and in certain instances also EMAT and/or % LVST data, (c) utilizing such obtained data, and during the at-rest period, applying (a) pacing rate, (b) pacing intensity, (c) atrio-ventricular delay, and (d) inter-ventricular delay control to the pacemaker. Processing involves (a) calculating from the obtained data an actual, real-time, acoustic cardiographic therapy (AC) value which is to be employed in relation to controlling pacemaker activity, and (b) comparing the actual AC value to a pre-established, related, rest-period-associated, reference AC value to detect differences therebetween, with the utilizing and applying steps being implemented so as to minimize such differences. | 08-13-2009 |
20090204166 | IMPLANTABLE CARDIAC STIMULATION DEVICE WITH RESPIRATORY MODULATED THERAPY DELIVERY - A method of providing cardiac stimulation therapy and a device for providing the therapy. A patient's cardiac activity as well as cyclical respiration is monitored. Cardiac stimulation is provided as indicated as therapeutic intervention for a variety of cardiac arrhythmias according to variable timing parameters. One or more of the timing parameters under which cardiac pacing stimulations are provided is varied or modulated with the cyclical variations in respiration. The one or more timing parameters are generally shortened or elongated in concert with the alternating inspiration/exhalation phases of respiration. In certain implementations, the patient's respiration is inferred from cardiac based physiologic signals. The methods and devices for providing cardiac stimulation therapy more accurately emulate natural healthy physiologic activity. | 08-13-2009 |
20090210023 | IMPLANTABLE HEART STIMULATING DEVICE WITH STIMULATION RATE OPTIMIZATION - An implantable heart stimulating device has a stimulation pulse generator that emits stimulation pulses at an adjustable stimulation rate, an activity sensor that emits an activity signal in response to detected activity of the patient, and a physiological parameter sensor that generates a physiological sensor signal in response to a detected physiological parameter. The activity and physiological sensor signals are supplied to a control arrangement that sets the stimulation rate for the stimulation pulse generator by executing a stimulation rate algorithm dependent on those signals. In the stimulation rate algorithm, if the physiological signal indicates an emotional stress on the part of the patient, the stimulation rate is increased to an adjustable emotional stress rate level, and if no increase in the activity signal occurs during a predetermined time period following the stimulation rate increase, the stimulation rate is decreased. | 08-20-2009 |
20090299429 | SENSING INTEGRITY DETERMINATION BASED ON CARDIOVASCULAR PRESSURE - Electrical noise may be discriminated from sensed heart signals based on cardiovascular pressure. A plurality of detected cardiovascular pressure values are respectively associated with a plurality of detected tachyarrhythmia events. In some examples, a variance in the cardiovascular pressure, e.g., above a threshold range, may indicate that the detected tachyarrhythmia events are at least partially attributable to electrical noise. In some examples, stimulation therapy to a heart of a patient may be controlled based on the detection of a tachyarrhythmia episode and a variability in the cardiovascular pressure values that are associated with the tachyarrhythmia episode. In other examples, a sensing integrity indication may be generated upon determining that a tachyarrhythmia episode was associated with a variable cardiovascular pressure. | 12-03-2009 |
20090312814 | CARDIOMECHANICAL ASSESSMENT FOR CARDIAC RESYNCHRONIZATION THERAPY - A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index. | 12-17-2009 |
20090318996 | OPTO-ELECTRICAL COHERENCE DETECTION OF HEMODYNAMICALLY COMPROMISING ARRHYTHMIA - System and methods for assessing sensed signals for determining a reliability measure of their accuracy with respect to a patient's true physiological status. As one example, the signals can include multiple, independently obtained signals, such as an electro-chemically based measure of cardiac activity and a plethysmography based measure of hemodynamic output which typically exhibit different morphologies and varying phase shifts with respect to each other. One manner of assessing the signals is to transform them into the frequency domain, such as via a Fast Fourier Transform (FFT), and evaluate them, such as by a coherence determination, to determine the degree of their mutual agreement. This can be used to assess the reliability of the sensing. Therapy can be delivered under certain observed conditions, such as a condition of hemodynamic insufficiency where anti-tachycardia pacing and/or shocking therapy can be delivered. | 12-24-2009 |
20100023081 | Comprehensive System for Detection of Coronary Syndrome, Cardiac Ischemia and Myocardial Infarction - Heart-monitoring systems, apparatus, and methods adapted to detect CS, CI and/or MI. In one embodiment, a system comprising at least two first-tier sensors capable of measuring and converting into signals at least two aspects related to cardiac function, at least one second-tier sensor that is also a first-tier sensor, at least one signal processor capable of transmitting a first-tier and second-tier trigger signal when coronary syndrome, cardiac ischemia or myocardial infarction has been detected, at least one communication device capable of communicating, at least one control element adapted to produce a first-tier and second-tier trigger signal when at least one first-tier sensor exceeds its threshold signal level, to exclude the signal from the first-tier sensor that exceeded its threshold and lower at least one threshold of the at least one first-tier sensor is provided. | 01-28-2010 |
20100023082 | INDIVIDUALIZED MORPHOLOGY FEATURE EVALUATION AND SELECTION FOR DISCRIMINATION IN IMPLANTABLE MEDICAL DEVICES - An apparatus comprises an implantable sensor, which provides a plurality of physiologic sensor signals of a subject, and a processor. The processor includes a feature module and a detection module. The feature module is configured to identify a feature in the sensor signals and to determine a measure of quality of the feature in the sensor signals. The detection module is configured to perform a morphology analysis of a subsequent portion of at least one of the sensor signals using the feature when the measure of quality of the feature satisfies a quality measure threshold. | 01-28-2010 |
20100030293 | USING MULTIPLE DIAGNOSTIC PARAMETERS FOR PREDICTING HEART FAILURE EVENTS - Techniques for using multiple physiological parameters to provide an early warning for worsening heart failure are described. A medical device monitors a primary diagnostic parameter that is indicative of worsening heart failure, such as intrathoracic impedance or pressure, and one or more secondary diagnostic parameters. The medical device detects worsening heart failure in the patient based on the primary diagnostic parameter when an index that is changed over time based on the primary diagnostic parameter value is outside a range of values, termed the threshold zone. When the index is within the threshold zone, the medical device detects worsening heart failure in the patient based on the one or more secondary diagnostic parameters. Upon detecting worsening heart failure, the medical device may, for example, provide an alert that enables the patient to seek medical attention before experiencing a heart failure event. | 02-04-2010 |
20100042173 | SYSTEM AND METHOD FOR EVALUATING AND OPTIMIZING THE CONTRIBUTION OF PARTICULAR HEART CHAMBERS TO THE OVERALL EFFICACY OF CARDIAC PACING THERAPY - Techniques are provided for evaluating and optimizing the contribution of particular heart chambers to pacing efficacy. Briefly, a pacemaker temporarily alters the mode with which pacing therapy is delivered so as to selectively alter the heart chambers that are paced. The pacemaker detects any transient changes in pacing efficacy following the alteration in pacing mode. The pacemaker then assesses the contribution of particular heart chambers to pacing efficacy based on the alteration in the pacing mode and on any transient changes in the pacing efficacy. Additionally, techniques are provided herein for automatically adjusting pacing parameters to optimize the contribution of particular chambers to pacing efficacy. | 02-18-2010 |
20100069989 | PRESSURE-DRIVEN INTERMITTENT PACING THERAPY - Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's physiological response to ventricular dyssynchrony to control the duty cycles of intermittent pre-excitation pacing. | 03-18-2010 |
20100076514 | FILTERING OF A PHYSIOLOGIC SIGNAL IN A MEDICAL DEVICE - A system and method for filtering a pressure signal in a medical device in which a sensor terminal senses the pressure signal, an electrode terminal receives cardiac electrical signals, a signal filtering system filters the sensed pressure signal in response to a determined heart rate to generate a heart-rate dependent frequency response, and a microprocessor derives a respiration signal in response to the heart rate dependent frequency response, and determines metrics of hemodynamic function in response to the derived respiration signal. | 03-25-2010 |
20100082077 | Method and Apparatus to Optimize Pacing Heart Rate - The present disclosure provides an apparatus and method of optimizing a pacing heart rate. The method can include obtaining a preload-frequency relation and a force-frequency relation from histogram data for a patient condition and determining an optimal pacing heart rate for the patient condition. The optimal pacing heart rate can be substantially between a first heart rate corresponding to a minimum preload condition based on the preload-frequency relation and a second heart rate corresponding to a sustained ionotropic reserve condition based on the force-frequency relation. | 04-01-2010 |
20100106212 | A MEDICAL SYSTEM AND A METHOD FOR DETERMINING SETTINGS OF AN IMPLANTABLE DEVICE (As Amended) - In a medical system and a method for operating such a system, the system includes an implantable medical device of a patient, a programmer device, and an extracorporeal stress equipment adapted to exert a physiological stress on the patient, for automatically determining settings of a sensor for sensing a physiological parameter of the patient or for automatically determining a pacing setting of the device over a broad range of workloads of the equipment. The ingoing units and/or devices of the medical system, i.e. the implantable medical device of the patient, the programmer device, and the extracorporeal stress equipment, communicate bi-directionally with each other and form a closed loop. | 04-29-2010 |
20100114230 | Method and Apparatus to Detect Ischemia With A Pressure Sensor - The present disclosure provides an apparatus and method of detecting ischemia with a pressure sensor. The method can include obtaining a pressure signal and determining a pressure rate of change. The method can also include identifying at least one of impaired relaxation and impaired contractility in order to detect ischemia. | 05-06-2010 |
20100125307 | MULTI-SITE VENTRICULAR PACING THERAPY WITH PARASYMPATHETIC STIMULATION - A method and device for delivering multi-site ventricular pacing therapy in conjunction with parasympathetic stimulation for reducing ventricular wall stress. Such reduction in ventricular wall stress is useful in reversing or preventing the ventricular remodeling which can occur in heart failure patients. | 05-20-2010 |
20100179612 | Non-bioelectric pressure-based sensing for pacemakers and implantable cardioverting defibrillators - Manually and autonomously configured non-bioelectrical-monitoring backup and/or primary pacemaker sensing is provided in the right ventricle and in the right atrium. Non-bioelectrical-monitoring is accomplished via direct, in-chamber metering and analysis of right ventricle and right atrium dynamic intracardiac pressures. A sensor is located on the right ventricular lead, another on the right atrial lead, and both are connected to the pacemaker. Right ventricular and right atrial dynamic intracardiac pressures are monitored and analyzed to indicate the presence or absence of contraction, relaxation and acceptable rhythm. | 07-15-2010 |
20100179613 | Adaptive Therapy for Disordered Breathing - An approach to providing disordered breathing therapy includes detecting disordered breathing and adapting a therapy to mitigate the disordered breathing. The therapy may be adapted to enhance therapy effectiveness, to provide therapy that reduces an impact of the therapy on the patient, or to achieve other therapeutic goals. Cardiac electrical therapy to mitigate the disordered breathing may include various cardiac pacing regimens and/or delivery of non-excitatory electrical stimulation to the heart. | 07-15-2010 |
20100228311 | OPTIMIZATION OF PACEMAKER SETTINGS - The system provides information to facilitate efficient optimization of programmer settings for cardiac pacemakers. It uses simultaneous measurement of a patient's electrocardiogram and peripheral blood pressure waveform in order to calculate, in real-time, a value correlated to the patient's pre-ejection time (PET) and, optionally, ejection duration (ED) for the patient's left ventricle. The peripheral blood pressure waveform is preferably monitored with a wrist mounted tonometer. Data including the electrocardiogram and peripheral blood pressure trace, as well as the surrogate pre-ejection time interval (SPET) for each heart beat and trending is displayed on a computer monitor, thereby allowing a physician or nurse to quickly optimize PET for the patient and adjusting programmer settings for an implanted pacemaker. | 09-09-2010 |
20100286740 | AUTOMATIC NEURAL STIMULATION MODULATION BASED ON MOTION AND PHYSIOLOGICAL ACTIVITY - According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. | 11-11-2010 |
20100305646 | SYSTEMS AND METHODS FOR THE GENERATION AND DISPLAY OF FUSION STATISTICS - In an example, a cardiac rhythm management system includes an implantable physiological data monitor, a processor, a memory, and a display. The implantable physiological data monitor can be configured to monitor a plurality of cardiac responses. The processor can be configured to classify the cardiac response into one of at least three classes including pace-dominant, fusion, and pseudo-fusion. The processor can also be configured to calculate statistical information regarding the classified cardiac responses. In this example, the pace-dominant, fusion, and pseudo-fusion classes correspond to a cardiac response resulting from a corresponding electrostimulation. The memory is configured to store the classified cardiac responses and calculated statistical information for future use by the processor or for display. The display is configured to display the statistical information stored in the memory for diagnostic and device programming purposes. | 12-02-2010 |
20100305647 | Activity Sensor Processing for Phrenic Nerve Activation Detection - An implantable cardiac device includes a sensor for sensing patient activity and detecting phrenic nerve activation. A first filter channel attenuates first frequencies of the sensor signal to produce a first filtered output. A second filter channel attenuates second frequencies of the accelerometer signal to produce a second filtered output. Patient activity is evaluated using the first filtered output and phrenic nerve activation caused by cardiac pacing is detected using the second filtered output. | 12-02-2010 |
20100318149 | Shock Reduction Using Absolute Calibrated Tissue Oxygen Saturation and Total Hemoglobin Volume Fraction - An implantable medical device that includes an optical sensor for providing a signal corresponding to light attenuation by a volume of blood perfused tissue, a control module coupled to the optical sensor controlling the light emitted by the optical sensor, a monitoring module receiving an optical sensor output signal and measuring light attenuation, a tissue electrode for stimulating the volume of blood perfused tissue, a pulse generator coupled to the tissue electrode for delivering electrical stimulation to the volume of blood-perfused tissue, and a processor coupled to the cardiac electrode and the monitoring module and configured to detect an arrhythmia in response to the depolarization signals, compute a tissue oxygenation measurement and control the pulse generator to deliver electrical stimulation to the volume of blood-perfused tissue in response to detecting the arrhythmia, and detect a hemodynamic status of the arrhythmia in response to at least one of a detected rate of tissue oxygenation decline and a detected rate of tissue oxygenation recovery. | 12-16-2010 |
20100318150 | Apparatus And Method For Analyzing Patient Tolerance To A Stimulation Mode Favoring A Spontaneous Atrioventricular Conduction - An implantable cardiac prosthesis device conducting an analysis of a patient tolerance to a pacing mode favoring the spontaneous atrioventricular conduction is disclosed. The device operates in a dual chamber (DDD or biventricular) mode and in a pacing mode favoring the spontaneous atrioventricular conduction such as an AAI mode ( | 12-16-2010 |
20110077707 | DUAL-USE SENSOR FOR RATE RESPONSIVE PACING AND HEART SOUND MONITORING - An implantable medical device includes a dual-use sensor such as a single accelerometer that senses an acceleration signal. A sensor processing circuit processes the acceleration signal to produce an activity level signal and a heart sound signal. The implantable medical device provides for rate responsive pacing in which at least one pacing parameter, such as the pacing interval, is dynamically adjusted based on the physical activity level. The implantable medical device also uses the heart sounds for pacing control purposes or transmits a heart sound signal to an external system for pacing control and/or diagnostic purposes. | 03-31-2011 |
20110087304 | Method of vagal stimulation to treat patients suffering from congestive heart failure - An improved method is presented for evaluating the physiological status of a patient diagnosed with congestive heart failure and treating the patient accordingly to alleviate the congestive heart failure. As part of the method, the thoracic or cardiac impedance and ventilation of the particular patient are derived solely from an input consisting of cardiac signals (EKG) generated by electrical energy of the patient's heart as the heart is undergoing its cardiac cycle with a dynamic impedance obtained by subjecting the EKG to alternately high and low input impedances. The derived thoracic impedance and ventilation are used to control the pattern and rate at which stimulating electrical pulses are applied to the patient's vagus nerve by an implanted stimulator, in a manner to deliver therapy to the patient's heart by adjusting the heart rate to a prescribed target rate for alleviating the congestive heart failure. A change in state of the patient from one of rest to one of physical exercise and vice versa detected from the derived impedance and ventilation is accommodated by modifying the vagal stimulation therapy to adjust the patient's heart rate to a new target rate accordingly, while continuing to deliver the therapy for alleviating the congestive heart failure. A closed loop system is preferably employed for the control and adjustment functions. | 04-14-2011 |
20110098768 | LEFT ATRIAL SENSE OR CAPTURE DETECTION FROM CORONARY SINUS - A method and device to detect and compare changes in atrial rate and morphology can be used to identify left atrial sense and capture, such as from a quadripolar or other lead located in or around the coronary sinus. | 04-28-2011 |
20110106200 | STROKE RISK MONITORING SYSTEM INCLUDING IMPLANTABLE MEDICAL DEVICE - One or more example techniques for monitoring the stroke risk of a patient via a system including an implantable medical device. In some examples, a method including monitoring at least one physiological parameter of a patient via an implantable medical device; determining whether each of a plurality stroke risk factors are present based at least in part on the at least one physiological parameters monitored via the implantable medical device; and generating a stroke risk score based on the stroke risk factors determined to be present, wherein the stroke risk score is reflective of the patient's risk of stroke. | 05-05-2011 |
20110106201 | IMPLANTABLE HEART FAILURE MONITOR - An implantable medical device and associated method monitor a heart failure patient by sensing a signal responsive to oxygen availability in an extravascular volume of skeletal muscle tissue. The signal is used to compute a tissue oxygenation measurement. A change in the tissue oxygenation measurement is detected, and a time interval corresponding to the detected change in muscle tissue oxygenation is computed. The time interval is used for detecting if a heart failure condition is worsening or improving. | 05-05-2011 |
20110144711 | Method and System for Hemodynamic Optimization Using Plethysmography - Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set. | 06-16-2011 |
20110160790 | MEASUREMENT OF CORONARY SINUS PARAMETERS TO OPTIMIZE LEFT VENTRICULAR PERFORMANCE - In some embodiments, an implantable medical device (IMD) system may include one or more of the following elements: (a) an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient's heart, (b) an oxygen signal generated by the oxygen sensor, (c) an IMD coupled to the oxygen sensor, wherein the IMD is configured to output pacing pulses as a function of the oxygen signal, and (d) an atrial and a ventricular pacing lead coupled to the IMD to deliver the pacing pulses to the patient's heart, wherein the IMD generates the pacing pulses as a function of the oxygen signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen signal, wherein the IMD is configured to adjust the pacing pulses to increase oxygen in the blood flow through the coronary sinus. | 06-30-2011 |
20110196444 | METHOD AND APPARATUS TO DELIVER MECHANICALLY FUSED PACING THERAPY - A medical device system and method for delivering mechanically fused left ventricular cardiac stimulation. A sensor monitors left ventricular acceleration while left ventricular cardiac stimulation is provided at an AV interval. The left ventricular acceleration is used to calculate a mechanical response interval and the mechanical response interval is compared to a desired mechanical response interval. The AV interval is adjusted until the mechanical response interval is equal to the desired mechanical response interval. | 08-11-2011 |
20110208260 | Rate Responsive Leadless Cardiac Pacemaker - A leadless cardiac pacemaker comprises a housing, a plurality of electrodes coupled to an outer surface of the housing, and a pulse delivery system hermetically contained within the housing and electrically coupled to the electrode plurality, the pulse delivery system configured for sourcing energy internal to the housing, generating and delivering electrical pulses to the electrode plurality. The pacemaker further comprises an activity sensor hermetically contained within the housing and adapted to sense activity and a processor hermetically contained within the housing and communicatively coupled to the pulse delivery system, the activity sensor, and the electrode plurality, the processor configured to control electrical pulse delivery at least partly based on the sensed activity. | 08-25-2011 |
20110213436 | METHOD AND DEVICE FOR TREATING MYOCARDIAL ISCHEMIA - A method and device for treating myocardial ischemia are described in which the stress experienced by a myocardial region identified as vulnerable to becoming ischemic is varied with pre-excitation pacing. In an unloading mode, pacing is applied in proximity to the vulnerable region to reduce stress and the metabolic demand of the region. In a loading mode, pacing is applied to a region remote from the vulnerable region in order to produce a conditioning effect. | 09-01-2011 |
20110257696 | IMPLANTABLE MEDICAL DEVICE AND METHOD FOR MONITORING SYNCHRONICITY OF THE VENTRICLES OF A HEART - In an implantable medical device and a method for monitoring ventricular synchronicity of a heart, impedance signals are measured that reflect septal wall movements and impedance amplitude peaks in the impedance signal are detected. A synchronicity index indicating a degree of synchronicity is determined based on detected impedance peaks, with at least two impedance peaks detected within a predetermined time window including a cardiac cycle or a part of a cardiac cycle indicating an increased dyssynchronicity in the ventricular contractions. | 10-20-2011 |
20110257697 | IMPLANTABLE MEDICAL DEVICE AND METHOD FOR MONITORING SYNCHRONICITY OF THE VENTRICLES OF A HEART - In an implantable medical device and a method for monitoring ventricular synchronicity of a heart. In particular, impedance signals are measured and an occurrence of a notch is detected in the impedance signal coincident with a period including a change from rapid to slow filling of a ventricle. The notch is indicated by a first positive slope change in a negative slope in a predetermined time window during a diastolic phase of a cardiac cycle. A degree of synchronicity is determined based on the notch feature, wherein a decreasing notch feature indicates an increased degree of synchronicity in the filling phase of the ventricles. | 10-20-2011 |
20110270342 | THERAPY USING PERTURBATION AND EFFECT OF PHYSIOLOGICAL SYSTEMS - Methods for treating a patient and further to devices for performing such treatment, e.g., methods and devices to perturb at least one physiological system and deliver therapy to the patient based on the effects of such perturbation. For example, a method for using an implantable medical device is disclosed that involves delivering electrical stimuli to an efferent nerve associated with the selected organ. Afferent electrical activity is monitored during delivery of electrical stimuli to the efferent nerve, the monitored afferent electrical activity includes an indirect component of a compound action potential (CAP). A status of the selected organ is assessed based upon the indirect component. A determination is made as to whether to deliver therapy to the selected organ in response to assessing the status of the selected organ. | 11-03-2011 |
20110282409 | PROGRAMMING AMBULATORY OPTIMIZATION SYSTEMS AND METHODS FOR CARDIAC RHYTHM MANAGEMENT - A system and method for cardiac rhythm management using a programmable cardiac rhythm management device is described, wherein the method includes storing parameter interaction constraints between different programmable parameters, storing programmable parameters for the device, wherein each programmable parameter has a predefined set of possible values, wherein one programmable parameter is a delay value, and calculating initial seed values for user-set delay range input fields, wherein the seed values do not violate any parameter interaction constraints and maximize the difference between ends of the user-set delay range, wherein the user-set delay range provides the outer limits of a programmed delay value. The method further includes presenting an input screen to the user on a user display device, wherein the input screen comprises user-set delay range input fields containing the initial seed values. The method further includes receiving values from a user for the user-set delay range, collecting patient data including ambulatory patient data, and determining a recommended delay value based on the ambulatory patient data. | 11-17-2011 |
20110288607 | SKIN RESPONSE MONITORING FOR NEURAL AND CARDIAC THERAPIES - An exemplary method includes emitting radiation subcutaneously; sensing at least some of the emitted radiation as reflected cutaneously; detecting an abnormal physiologic condition; and, based at least in part on the sensing, adjusting a stimulation therapy to treat the detected abnormal condition. In such a method, the abnormal condition may be an abnormal cardiac condition, an abnormal neural condition or other condition. Various other methods, devices, systems, etc., are also disclosed. | 11-24-2011 |
20110301660 | HEART FAILURE MANAGEMENT SYSTEM - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 12-08-2011 |
20110319955 | REDUCTION OF AV DELAY FOR TREATMENT OF CARDIAC DISEASE - An implantable pacing device for delivering ventricular pacing may be configured to intermittently reduce the AVD interval for beneficial effect in patients with compromised ventricular function (e.g., HF patients and post-MI patients). The AVD interval may be reduced in an AVD reduction mode, by shortening the AVD in an atrial triggered ventricular pacing mode or by switching to a non-atrial triggered ventricular pacing mode (e.g., VVI) and delivering paces at a rate above the intrinsic rate. The physiological effects of AVD reduction may be either positive or negative on cardiac output, depending upon the individual patient. | 12-29-2011 |
20120004695 | REVERSE PACING-MODE SWITCH - A device comprises a cardiac contraction sensing circuit, a timer circuit, an electrical stimulation circuit, and a controller. The timer circuit provides a time duration of an atrial-atrial interval between successive atrial contractions, a ventricular-ventricular interval between successive ventricular contractions, and an atrial-ventricular (A-V) interval between an atrial contraction and a same cardiac cycle ventricular contraction. The controller includes an event detection module and a pacing module. The event detection module is configured for determining whether A-V block events are sustained over multiple cardiac cycles. The pacing module is configured for providing pacing therapy according to a primary pacing mode that includes AAI(R) mode with non-tracking VVI backup mode, and for switching the pacing therapy to a secondary tracking pacing mode if A-V block events are sustained over multiple cardiac cycles. | 01-05-2012 |
20120010677 | ACQUIRING NERVE ACTIVITY FROM CAROTID BODY AND/OR SINUS - An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed. | 01-12-2012 |
20120010678 | METHOD AND SYSTEM FOR TREATMENT OF NEUROCARDIOGENIC SYNCOPE - A method and apparatus for treating or preventing neurocardiogenic syncope is disclosed. Upon detection of bradycardia or a drop in blood pressure indicating the onset of syncope, electrostimulation pulses are delivered during the heart's refractory period. The pulses are non-excitatory but increase myocardial contractility and thereby increase cardiac output. | 01-12-2012 |
20120041504 | APPARATUS FOR REVERSAL OF MYOCARDIAL REMODELING WITH PRE-EXCITATION - An apparatus for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling. | 02-16-2012 |
20120071943 | SYSTEM AND METHOD FOR THE VISUALIZATION AND OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY - A system and method for optimizing cardiac resynchronization therapy and visualizing cardiac pacing intervals. The system comprises at least one hemodynamic sensor; at least one electrode; a learning module; a micro controller; and at least one graphical interface for showing at least one of a PRV vs. PLV diagram and a responder curve. | 03-22-2012 |
20120123494 | SYSTEM FOR ABATING NEURAL STIMULATION SIDE EFFECTS - Various system embodiments comprise a neural stimulation delivery system adapted to deliver a neural stimulation signal for use in delivering a neural stimulation therapy, a side effect detector, and a controller. The controller is adapted to control the neural stimulation delivery system, receive a signal indicative of detected side effect, determine whether the detected side enact is attributable to delivered neural stimulation therapy, and automatically titrate the neural stimulation therapy to abate the side effect. In various embodiments, the side effect detector includes a cough detector. In various embodiments, the controller is adapted to independently adjusting at least one stimulation parameter for at least one phase in the biphasic waveform as part of a process to titrate the neural stimulation therapy. Other aspects and embodiments are provided herein. | 05-17-2012 |
20120123495 | BAROREFLEX STIMULATION TO TREAT ACUTE MYOCARDIAL INFARCTION - An aspect of the present subject relates to an implantable medical system. An embodiment of the system includes a baroreflex stimulator, a myocardial infarction detector, and a controller. The baroreflex stimulator applies a baroreflex stimulation signal through an electrode. The myocardial infarction detector detects an event indicative of myocardial infarction, The controller is connected to the baroreflex stimulator and to the myocardial infarction detector, and is adapted to apply a baroreflex therapy in response to a detected event indicative of myocardial infarction. Other aspects are provided herein. | 05-17-2012 |
20120130442 | CARDIAC ANODAL ELECTROSTIMULATION DETECTION - Cardiac anodal electrostimulation detection systems and methods are described, such as for distinguishing between cathodal-only capture and at least partially anodal capture (e.g., combined anodal and cathodal capture, or between two anodes of which only one captures nearby cardiac tissue, etc.). | 05-24-2012 |
20120136405 | Method and Apparatus For Maintaining and Monitoring Sleep Quality During Cardiac Pacing - The present invention monitors and interprets physiological signals and spontaneous breathing events to detect the onset of arousal. Once the onset of arousal is determined, the present invention determines adjustments that are needed in the operation of a therapeutic device to avoid or minimize arousals. In one embodiment, the present invention includes one or more sensors which detect a patient's physiological parameters, a controller which monitors and determines the onset of arousal based on the physiological variables received from the sensor, and a therapeutic treatment device which is controlled by the controller. The sensor can be a combination of one or more devices which are able to monitor a physiological parameter that is used by the present invention to determine the onset of arousal or the onset of a sleep disorder. The sensors can be integrated into one unit or may operate independent of the others. | 05-31-2012 |
20120143276 | CARDIOPULMONARY FUNCTIONAL STATUS ASSESSMENT VIA METABOLIC RESPONSE DETECTION BY IMPLANTABLE CARDIAC DEVICE - An implantable cardiac device is configured and programmed to assess a patient's cardiopulmonary function by evaluating the patient's minute ventilation response. Such evaluation may be performed by computing a minute ventilation response slope, defined as the ratio of an incremental change in minute ventilation to an incremental change in measured activity level. The minute ventilation response slope may then be compared with a normal range to assess the patient's functional status. | 06-07-2012 |
20120150252 | Admittance measurement for tuning bi-ventricular pacemakers - An apparatus for treating a heart of a patient includes a first lead and at least a second lead for pacing the heart adapted to be in electrical communication with the heart. The apparatus includes a microcontroller in communication with the first and second leads which triggers the first lead at either different times or the same time from when the microcontroller triggers the second lead. Alternatively, the apparatus includes a microcontroller in communication with the first and second leads that determines heart volume, including stroke volume, end-systolic volume, and calculated values including ejection fraction, from admittance from signals from the first and second leads and uses the admittance as feedback to control heart volume ejected, as measured by stroke volume, calculated values such as ejection fraction, and control end-systolic volume, with respect to the first and second leads. A method for treating the heart of a patient. | 06-14-2012 |
20120150253 | ALGORITHM FOR THE AUTOMATIC DETERMINATION OF OPTIMAL AV AND VV INTERVALS - Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change. | 06-14-2012 |
20120165888 | BAROREFLEX STIMULATION SYNCHRONIZED TO CIRCADIAN RHYTHM - An embodiment of a baroreflex stimulator comprises a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template. According to an embodiment of a method for operating an implantable medical device, comprising a baroreflex stimulation therapy is applied at a stimulation intensity using a baroreflex stimulator in the implantable medical device, and the baroreflex stimulation therapy is modulated based on a circadian rhythm template stored within the implantable medical device. Modulating the baroreflex stimulation therapy includes using the circadian rhythm template to change the stimulation intensity to mimic natural blood pressure fluctuations during the day. | 06-28-2012 |
20120165889 | METHOD AND APPARATUS FOR INSPIRATORY MUSCLE STIMULATION USING IMPLANTABLE DEVICE - An inspiratory muscle stimulation system uses an implantable medical device to deliver stimulation to control diaphragmatic contractions for slower and deeper breathing, thereby conditioning and strengthening inspiratory muscles. In various embodiments, respiratory and/or cardiac performance are monitored for controlling parameters of the stimulation. | 06-28-2012 |
20120185010 | VAGAL STIMULATION - The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions. | 07-19-2012 |
20120185011 | VAGAL STIMULATION - The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions. | 07-19-2012 |
20120221069 | Systems and Methods for Activating and Controlling Impedance-Based Detection Systems of Implantable Medical Devices - Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more. | 08-30-2012 |
20120221070 | MINIMUM VENTRICULAR PACING TO BREAK THE REPETITIVE AR-VS PATTERN - An implantable cardiac pacing device delivering minimum ventricular pacing and an associated method control intervals timed by the device during sensing and pacing. An atrial-only pacing mode is set in response to sensing intrinsic ventricular events in the ventricular chamber. A first post-ventricular atrial refractory period is set following each of a plurality of ventricular events sensed in the ventricular chamber, and atrial events each being sensed during first post-ventricular atrial refractory periods are detected. A second post-ventricular atrial refractory period is set in response to detecting the atrial events each being sensed during the first post-ventricular atrial refractory period. | 08-30-2012 |
20120221071 | METHOD AND SYSTEM FOR ADAPTING PACING SETTINGS OF A CARDIAC STIMULATOR - In an implantable medical device, such as a cardiac stimulator such as a pacemaker, and method for predicting patient responses to physical exertion, the patient response is monitored over time to evaluate disease progression and pacing therapies of cardiac stimulators are adapted based on the predicted patient response. A current cardiac status indicator for the patient is created indicating a response of the patient to an increased physical activity as a primarily heart rate response or as a primarily a stroke volume response. The pacing parameters of the cardiac stimulator can thereafter be adapted depending on the current cardiac status indicator, wherein the adapted pacing parameters include a first pacing setting if the current cardiac status indicator indicates a primarily heart rate response or a second pacing setting if the current cardiac status indicator indicates a primarily stroke volume response. | 08-30-2012 |
20120221072 | EXTRAVASCULAR NEUROMODULATION TO TREAT HEART FAILURE - Treatment of heart failure in a patient by electrically modulating both the sympathetic and parasympathetic autonomic cardiac nerve fibers that innervate the patient's heart at an extravascular site in the pericardial space of the heart. The extravascular site is any suitable single location inside the chest cavity that carries both sympathetic and parasympathetic cardiac nerves such as the cardiac plexus or the pericardial transverse sinus or any two separate extravascular sites with one site carrying predominantly sympathetic cardiac nerves and the other site carrying predominantly parasympathetic cardiac nerves for electrically modulating the balance of autonomic cardiac nerve control. Physiologic inputs from a neuromodulation system's own sensors or from separate implanted or external cardiovascular hemodynamic sensor systems can be used for closed loop control over the balance of sympathetic and parasympathetic cardiac autonomic effects on the patient's cardiac function in real time response to chronic and transient physiologic needs. | 08-30-2012 |
20120226328 | CARDIAC RESYNCHRONIZATION THERAPY PARAMETER OPTIMIZATION - Systems and methods involve determination of CRT parameters using a number of CRT optimization processes. Each CRT optimization process attempts to return recommended parameters. The CRT parameters are determined based on the recommended parameters returned by one or more of the CRT optimization processes. The CRT optimization processes may be sequentially implemented and the CRT parameters may be determined based on the recommended parameters returned by a first CRT optimization process to return recommended parameters. The CRT parameters may be determined based on a combination of the recommended parameters returned. The CRT optimization processes implemented may be selected from available CRT optimization processes based on patient conditions. | 09-06-2012 |
20120232607 | ESTIMATING ACUTE RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY - Systolic timing intervals are measured in response to delivering pacing energy to a pacing site of a patient's heart. An estimate of a patient's acute response to cardiac resynchronization therapy (CRT) for the pacing site is determined using the measured systolic timing intervals. The estimate is compared to a threshold. The threshold preferably distinguishes between acute responsiveness and non-responsiveness to CRT for a patient population. An indication of acute responsiveness to CRT for the pacing site may be produced in response to the comparison. | 09-13-2012 |
20120232608 | CARDIAC STIMULATING DEVICE - An implantable medical device, IMD, comprises atrial and ventricular sensing units for sensing atrial or ventricular electric events. The IMD also comprises atrial and ventricular pulse generators for generating atrial or ventricular pacing pulses. A controller controls the operation of the IMD ( | 09-13-2012 |
20120239103 | INDIVIDUALLY ADAPTED CARDIAC ELECTRO-MECHANICAL SYNCHRONIZATION THERAPY - A method of determining pacing therapy for an individual patient including determining representative electromechanical physiologic characteristics for a plurality of normal patients having a range of anatomical dimensions and developing a plurality of normal templates. Each template indicates the representative electromechanical physiologic characteristics of a group of normal patients having similar anatomical dimensions. The method can include measuring the anatomical dimensions of a dysfunctional patient, matching the dysfunctional patient with a template for normal patients having similar anatomical dimensions as the dysfunctional patient, determining the physiologic characteristics for the dysfunctional patient, determining indicated correction factors corresponding to any differences between the dysfunctional patient's physiologic characteristics and those of the matched template, and adjusting therapy delivery by any indicated correction factors to stimulate the patient in a pattern more closely matched to the physiologic characteristics of the matched template. | 09-20-2012 |
20120253418 | METHODS, APPARATUS, AND SYSTEMS FOR MULTIPLE STIMULATION FROM A SINGLE STIMULATOR - Methods, apparatus, and systems are provided to stimulate multiple sites in a heart. A controller senses electrical activity associated with sinus rhythm of the heart. A signal generator is configured to generate an electrical signal for stimulating the heart. Based on the electrical signal, a distributor circuit then distributes the stimulating signals, such as pacing pulses, to a heart. The distributor circuit may vary the delay time between stimulating signals, inhibit a stimulating signal, trigger application of a stimulating signal, or vary the characteristics, such as the pulse width and amplitude, of a stimulating signal. | 10-04-2012 |
20120259379 | Implantable Cardiac Prosthetic for Resynchronization by Biventricular Pacing Using Reverse Remodeling - Improving cardiac response in terms of pressure, ejected volume, and filling and ejection times by cardiac reverse remodelling, including temporary, occasionally harmful stimulation sequences. An original pacing configuration ( | 10-11-2012 |
20120296388 | PHRENIC NERVE STIMULATION DETECTION USING HEART SOUNDS - A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal. | 11-22-2012 |
20120310295 | SYSTEMS AND METHODS FOR AVOIDING NEURAL STIMULATION HABITUATION - An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter. | 12-06-2012 |
20130013015 | NERVE STIMULATION APPARATUS, NERVE STIMULATION SYSTEM, AND CONTROL METHOD FOR NERVE STIMULATION APPARATUS - A sufficient therapeutic effect is achieved for each of a plurality of pathologies constituting a cardiac failure. Provided is a nerve stimulation apparatus including: a heartbeat detection unit that detects a heartbeat; a nerve electrode that is connected to a nerve controlling a heart; a nerve stimulation unit that outputs an electrical pulse to the nerve electrode; a functional-status detection unit that detects in-vivo information that indicates a functional status of the heart; and a stimulation-timing controller that controls the nerve stimulation unit so as to switch between a synchronous mode in which the electrical pulse is output in synchronization with the heartbeat detected by the heartbeat detection unit and an asynchronous mode in which the electrical pulses are output at constant time intervals, on the basis of the in-vivo information that indicates the functional status of the heart detected by the functional-status detection unit. | 01-10-2013 |
20130013016 | MEDICAL IMPLANT AND METHOD FOR SECURE IMPLANT COMMUNICATION - An implantable medical device includes a telemetry unit wirelessly receiving data signals and control commands; a control unit connected to the telemetry unit; and a comparator unit which compares data signals received via the telemetry unit with data signals generated in or detected by the implantable medical device. Each of the data signals represents specific features, e.g., patient characteristics. The comparator unit generates a release signal if data signals received via the telemetry unit represent one or more features that are similar, according to a specified similarity measure, to one or more features represented by data signals generated in or detected by the implantable medical device. The control unit executes control commands received via the telemetry unit, or receives control commands via the telemetry unit, in response to such a release signal (or, in the absence of the release signal, does not execute or receive control commands). | 01-10-2013 |
20130013017 | APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY - Methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles) and delivering fusion pacing using a decremented value of the intrinsic PR interval. | 01-10-2013 |
20130023946 | Low Power Apparatus and Method to Measure Complex Electrical Admittance or Impedance - An apparatus for measuring complex electrical admittance and/or complex electrical impedance in animal or human patients includes a first electrode and at least a second electrode which are adapted to be disposed in the patient. The apparatus includes a housing adapted to be disposed in the patient. The housing has disposed in it a stimulator in electrical communication with at least the first electrode to stimulate the first electrode with either current or voltage, a sensor in electrical communication with at least the second electrode to sense a response from the second electrode based on the stimulation of the first electrode, and a signal processor in electrical communication with the sensor to determine the complex electrical admittance or impedance of the patient. | 01-24-2013 |
20130030486 | MODIFICATION OF AV CONDUCTION TIME SAMPLING RATE - Methods and/or devices for modifying the sampling rate for measuring a patient's intrinsic AV conduction time during cardiac therapy. For example, the sampling rate for measuring a patient's intrinsic AV conduction time may be modified (e.g., decrease or increased) based on one or more monitored physiological parameters, such as activity level and/or heart rate. | 01-31-2013 |
20130030487 | DEVICES, SYSTEMS AND METHODS TO INCREASE COMPLIANCE WITH A PREDETERMINED VENTRICULAR ELECTRICAL ACTIVATION PATTERN - Described herein are implantable systems and devices, and methods for use therewith, that can be used to increase compliance with a predetermined preferred ventricular electrical activation pattern. Such implantable systems preferably includes a first lead having at least one electrode implantable in a right ventricular (RV) chamber, and a second lead having at least two electrodes implantable in a left ventricular (LV) chamber. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in at least the RV chamber and at at least two separate regions of the LV chamber. The IEGMs can be obtained while the patient's LV chamber is not being paced, or during bi-ventricular (BiV) pacing that includes pacing at only a single site within the LV chamber. An actual ventricular electrical activation pattern is determined based on the plurality of IEGMs. Additionally, there is a determination of whether the actual ventricular electrical activation pattern matches the predetermined preferred ventricular electrical activation pattern. If the actual ventricular electrical activation pattern does not match the predetermined preferred ventricular electrical activation pattern, then multisite LV (MSLV) pacing is delivered to achieve the predetermined preferred ventricular electrical activation pattern. | 01-31-2013 |
20130035736 | SYSTEMS AND METHODS FOR CONTROLLING PAIRED PACING BASED ON PATIENT ACTIVITY FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with implantable medical devices equipped to deliver paired postextrasystolic potentiation (PESP) pacing to control the paired pacing rate based on changes in patient activity. In one example, the current activity level of the patient is detected during paired pacing using an accelerometer. The cardiac output level needed to maintain the current activity level of the patient is determined with reference to pre-stored lookup tables relating activity levels with corresponding minimum necessary cardiac output levels for the particular patient. The minimum paired pacing rate sufficient to achieve the cardiac output level is then determined based, e.g., on stroke volume derived from cardiogenic impedance signals. Paired pacing is then delivered at the minimum paired pacing rate sufficient to achieve the needed cardiac output, thereby assuring that the paired pacing rate is sufficient to meet the current physiological demands of the patient without consuming too much oxygen. | 02-07-2013 |
20130046355 | PRE-EXCITATION PACING FOR TREATMENT OF HYPERTENSION - Described herein are methods and apparatus for treating hypertension with electrical pre-excitation pacing therapy. Electrical pre-excitation of a hypertrophic region advances the timing of the regional contraction and reduces its contribution to the overall contraction. Such pre-excitation pacing therapy may be beneficial to hypertensive patients with an abnormal distribution of ventricular wall stress/strain. | 02-21-2013 |
20130053914 | METHOD AND APPARATUS FOR ADAPTIVE CONTROL OF NEUROSTIMULATION USING CARDIAC RESTITUTION - A neurostimulation system measures a cardiac parameter at various cardiac intervals and analyzes its restitution, including computing a restitution slope being a rate of change of the restitution parameter with respect to change in the cardiac interval. In various embodiments, the system uses the restitution slope to provide for adaptive control of neurostimulation. In various embodiments, one or more cardiac parameters such as action potential duration (APD), conduction velocity (CV), QT interval (QT), and/or T-wave morphology (TM) parameter are measured and analyzed for restitution of each parameter, which is then used to control the delivery of the neurostimulation. | 02-28-2013 |
20130053915 | METHOD AND SYSTEM FOR DETERMINING PACING SETTINGS - Systems and methods for optimizing the stimulation of a heart of a patient are disclosed herein. The method comprises delivering pacing therapy to the patient according to a pacing therapy setting schedule, using specific pacing intervals via specific electrode configurations. Further, sinus rate values are recorded over at least one cardiac cycle at each pacing therapy setting and it is determined whether a sinus rate value satisfies predetermined measurement conditions, wherein sinus rate values are used for trending the sinus rate over time if the measurement conditions are satisfied. The accepted sinus rate values, i.e. values that satisfy the measurement conditions, are trended over time, wherein each trended sinus rate value is created based on recordings from at least one cardiac cycle. A preferred pacing therapy setting is determined to be the pacing therapy setting that provides a lowest sinus rate. | 02-28-2013 |
20130072997 | SYSTEM AND METHOD FOR NEUROMODULATION - A method of treating autonomic imbalance in a patient includes energizing a first therapeutic element disposed in a superior vena cava of the patient to deliver therapy to a parasympathetic nerve fiber (e.g. vagus nerve), and energizing a second therapeutic element disposed within the superior vena cava to deliver therapy to a sympathetic cardiac nerve fiber. A neuromodulation system includes a parasympathetic therapy element adapted for positioning within a blood vessel, a sympathetic therapy element adapted for positioning within the blood vessel; and a stimulator to energize the parasympathetic therapy element to deliver parasympathetic therapy to a parasympathetic nerve fiber disposed external to the blood vessel and energize the sympathetic therapy element within the blood vessel to deliver sympathetic therapy to a sympathetic nerve fiber disposed external to the blood vessel. The therapy decreases the patient's heart rate and elevates or maintains the blood pressure of the patient. | 03-21-2013 |
20130079838 | BAROREFLEX MODULATION TO GRADUALLY CHANGE A PHYSIOLOGICAL PARAMETER - An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein. | 03-28-2013 |
20130090701 | IMPLANTABLE LEAD AND CORONARY VENOUS PRESSURE SENSOR APPARATUS AND METHOD - A cardiac rhythm management system comprises a medical electrical lead, a pressure sensing element, and an implantable pulse generator. The lead is sized to be advanced through the right atrium and coronary sinus into a coronary vein adjacent to the left ventricle. The lead includes an opening intermediate its proximal and distal ends, and a lumen extending longitudinally within the body in communication with the opening. The pressure sensing element is movably disposed in lead lumen and is dimensioned to extend through the opening in the lead, and includes a flexible, elongated conductive member having a distal end, and a pressure transducer coupled to the distal end of the conductive member. The pulse generator is configured to receive cardiac rhythm signals from the electrode and fluid pressure signals from the pressure transducer. | 04-11-2013 |
20130110189 | METHOD AND APPARATUS FOR CARDIAC PROTECTION PACING | 05-02-2013 |
20130123873 | HEART FAILURE MANAGEMENT - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 05-16-2013 |
20130123874 | MONITORING RIGHT VENTRICULAR HEMODYNAMIC FUNCTION DURING PACING OPTIMIZATION - Method and systems related to monitoring right ventricular function during pacing by a cardiac rhythm management device are described. One or more pacing parameters are selected to provide cardiac resynchronization therapy. For example, the one or more pacing parameters may be selected to provide an optimal or improved therapy. The heart is paced using the selected pacing parameters. While pacing with the selected parameters, pressure is sensed via a pressure sensor disposed the pulmonary artery. The sensed pressure is analyzed to determine right ventricular function achieved during the pacing using the selected pacing parameters. A signal, such as an alert signal or control signal, is generated based on the right ventricular function achieved during the pacing. | 05-16-2013 |
20130138170 | MANAGING CROSS THERAPY SENSING IN A MULTIPLE THERAPY IMPLANTABLE DEVICE - An apparatus comprises a cardiac signal sensing circuit configured to sense an electrical cardiac signal from at least one of an atrium or ventricle of a heart of a subject, a therapy circuit configured to provide electrical pacing therapy and electrical autonomic neural modulation therapy to the subject, and a control circuit. The control circuit is configured to initiate delivery of the autonomic modulation neural therapy, and the control circuit includes a signal detection circuit configured to detect delivery of the autonomic neural modulation therapy in the sensed cardiac signal. The control circuit is configured to change, in response to detecting the delivery, a sensitivity of the cardiac signal sensing circuit during delivery of the autonomic neural modulation therapy. | 05-30-2013 |
20130150911 | METHODS AND SYSTEMS FOR IDENTIFYING AND USING HEART RATE VARIABILITY AND HEART RATE VARIATION - A heart rate variability or heart rate variation can be identified using sensed and/or paced heart beats. One or more patient metrics, such as a variability index or a variation index, can correspond to the identified heart rate variability or heart rate variation. The patient metrics can be used to identify a need for a particular therapy, such as a rate-responsive pacing therapy. The patient metrics can be used to identify patients at an elevated risk of death. Methods and systems to identify therapy indications or at-risk patients are provided. In an example, a patient risk profile can be adjusted, such as in response to an identified patient heart rate variability or heart rate variation. In an example, a rate-responsive pacing mode can be used to adjust the patient risk profile. | 06-13-2013 |
20130150912 | METHODS AND SYSTEMS FOR IDENTIFYING AND USING HEART RATE VARIABILITY AND HEART RATE VARIATION - A heart rate variability or heart rate variation can be identified using sensed and/or paced heart beats. One or more patient metrics, such as a variability index or a variation index, can correspond to the identified heart rate variability or heart rate variation. The patient metrics can be used to identify a need for a particular therapy, such as a rate-responsive pacing therapy. The patient metrics can be used to identify patients at an elevated risk of death. Methods and systems to identify therapy indications or at-risk patients are provided. In an example, a patient risk profile can be adjusted, such as in response to an identified patient heart rate variability or heart rate variation. In an example, a rate-responsive pacing mode can be used to adjust the patient risk profile. | 06-13-2013 |
20130165984 | TIMING PACING PULSES IN SINGLE CHAMBER IMPLANTABLE CARDIAC PACEMAKER SYSTEMS - Methods for timing pacing pulses in an implantable single chamber pacemaker create a simulated, or virtual chamber in order to apply dual chamber-type algorithms and modes. For example, a virtual atrium may be constructed based on information provided by the ventricle, that is, the timing of actual intrinsic ventricular events, and the timing of paced ventricular events, both of which may be sensed as ventricular depolarization by electrodes of the implanted system. | 06-27-2013 |
20130172953 | METHODS AND SYSTEMS FOR TREATING ACUTE HEART FAILURE BY NEUROMODULATION - Methods of treating acute heart failure in a patient in need thereof. Methods include inserting a therapy delivery device into a pulmonary artery of the patient and applying a therapy signal to autonomic cardiopulmonary fibers surrounding the pulmonary artery. The therapy signal affects heart contractility more than heart rate. Specifically, the application of the therapy signal increases heart contractility and treats the acute heart failure in the patient. The therapy signal can include electrical or chemical modulation. | 07-04-2013 |
20130184776 | RATE ADAPTIVE CARDIAC PACING SYSTEMS AND METHODS - The invention relates to cardiac rhythm management systems, and more particularly, to rate adaptive cardiac pacing systems and methods. In an embodiment, the invention includes a cardiac rhythm management device. The device can include a pulse generator for generating electrical pulses to be delivered to a heart at a pacing rate, a processor in communication with the pulse generator, and one or more sensors for sensing pulmonary function and cardiac function. The processor can be configured to increase the pacing rate if the pulmonary function is increasing with time and the cardiac function is not decreasing with time, maintain the pacing rate if the pulmonary function is increasing with time and the cardiac function is decreasing with time, and decrease the pacing rate if the respiratory function is decreasing with time. | 07-18-2013 |
20130197598 | PRIORITIZED PROGRAMMING OF MULTI-ELECTRODE PACING LEADS - Various techniques are disclosed for facilitating selection of at least one vector from among a plurality of vectors for pacing a chamber of a heart. In one example, a method includes presenting, by a computing device, a plurality of criteria by which each of the plurality of vectors may be prioritized, selecting at least one criterion from among a plurality of criteria by which each of the plurality of vectors may be prioritized, measuring the at least one selected criterion for each of the plurality of vectors, and automatically prioritizing, by the computing device, the plurality of vectors based on the measurement of the at least one selected criterion. | 08-01-2013 |
20130204312 | SYSTEMS AND METHODS FOR CONTROLLING PACING INDUCED DYSSYNCHRONY TO REDUCE ISCHEMIC INJURY USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use by an implantable medical device for optimizing the amount of ventricular dyssynchrony induced within a patient during protective pacing. In one example, the device analyzes intracardiac electrogram signals to detect an ischemic event within the heart. The device then delivers pacing stimulus in accordance with adjustable pacing parameters to induce ventricular dyssynchrony within the heart and adjusts the pacing parameters within a range of permissible values to achieve a preferred degree of ventricular dyssynchrony within the patient, so long as there is no significant reduction in left ventricular pumping functionality. Preferably, the pacing parameters are adjusted to maximize or otherwise optimize the degree of dyssynchrony induced within the patient. If a significant reduction in LV pumping functionality is detected, the dyssynchrony-inducing pacing is preferably suspended to avoid any deterioration in the condition of the heart. Techniques for detecting early onset of ischemia are also disclosed. | 08-08-2013 |
20130211471 | METHOD AND APPARATUS FOR CONTROLLING AUTONOMIC BALANCE USING NEURAL STIMULATION - A neural stimulation system senses autonomic activities and applies neural stimulation to sympathetic and parasympathetic nerves to control autonomic balance. The neural stimulation system is capable of delivering neural stimulation pulses for sympathetic excitation, sympathetic inhibition, parasympathetic excitation, and parasympathetic inhibition. | 08-15-2013 |
20130211472 | CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION - An implantable medical device, IMD, ( | 08-15-2013 |
20130238045 | METHODS AND SYSTEMS FOR STIMULATING A HEART - The present invention relates generally to methods for implantable medical devices and more particularly to methods for optimizing stimulation of a heart of a patient. The method comprises: determining recommended pacing settings including recommended AV delays and/or recommended W delays based on IEGM data. Further, at least one hemodynamical parameter is determined based on measured at least one hemodynamical signal. Reference pacing settings are determined including reference AV delays and/or reference W delays based on said hemodynamical parameters. An AV delay correction value and a W delay correction value are calculated as a difference between recommended AV and/or VV delays and reference AV and/or W delays, respectively. The correction values are used for updating recommended AV and/or VV delays, respectively. | 09-12-2013 |
20130261687 | SYSTEMS AND METHODS FOR SELECTING PACING VECTORS BASED ON SITE OF LATEST ACTIVATION FOR USE WITH IMPLANTABLE CARDIAC RHYTHM MANAGEMENT DEVICES - Techniques are provided for use with an implantable cardiac stimulation device equipped with a multi-pole left ventricular (LV) lead and a right ventricular (RV) lead for identifying suitable pacing vectors. In one example, RV-LV delay times are measured while using different electrodes of the LV lead as cathodes for sensing. The LV electrode having the longest RV-LV delay time is identified and LV capture thresholds and diaphragmatic stimulation thresholds are measured for pacing vectors that employ that LV electrode as a cathode. Assuming at least one vector employing the selected LV electrode is found to have acceptable thresholds, the vector is selected for use in delivering pacing therapy with the selected LV electrode. If none of the pacing vectors employing the selected LV electrode has acceptable thresholds, another LV electrode is selected and the procedure is repeated. Examples with a multi-pole RV lead are also described. | 10-03-2013 |
20130268017 | HEART-SOUNDS BASED ADAPTIVE CARDIAC RESYNCHRONIZATION THERAPY TIMING PARAMETER OPTIMIZATION SYSTEM - A medical device and associated method for controlling a cardiac pacing therapy sense a first cardiac signal including events corresponding to cardiac electrical events and a second cardiac signal including events corresponding to cardiac hemodynamic events. A processor is enabled to measure a cardiac conduction time interval using the first cardiac signal and control a signal generator to deliver a pacing therapy. A pacing control parameter is adjusted to a plurality of settings during the pacing therapy delivery. A hemodynamic parameter value is measured from the second cardiac signal during application of each of the control parameter settings. The processor identifies an optimal setting from the plurality of settings and solves for a patient-specific equation defining the pacing control parameter as a function of the cardiac conduction time interval. | 10-10-2013 |
20130274821 | AUTOMATIC MODULATION OF PACING TIMING INTERVALS USING BEAT TO BEAT MEASURES - Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals. | 10-17-2013 |
20130282074 | METHOD AND SYSTEM FOR DELIVERING CARDIAC RESYNCHRONIZATION THERAPY WITH VARIABLE ATRIO-VENTRICULAR DELAY - A pacing system computes optimal cardiac resynchronization pacing parameters using intrinsic conduction intervals. In various embodiments, values for atrio-ventricular delay intervals are each computed as a function of an intrinsic atrio-ventricular interval and a parameter reflective of an interventricular conduction delay. Examples of the parameter reflective of the interventricular conduction delay include QRS width and interval between right and left ventricular senses. | 10-24-2013 |
20130289641 | METHOD AND SYSTEM FOR OPTIMIZING CARDIAC PACING SETTINGS - The present invention relates generally to methods and systems for optimizing stimulation of a heart of a patient. Hemodynamical index signals reflecting a mechanical functioning of a heart of a patient are recorded at different hemodynamical states. Corresponding hemodynamical reference signals at corresponding hemodynamical states are recorded. At least one hemodynamical index parameter is extracted from the recorded hemodynamical index signals. The at least one hemodynamical index parameter is a measure of the mechanical functioning of the heart and a hemodynamical index model is created, wherein the hemodynamical index model is based on the at least one hemodynamical index parameter and a comparison between output results from the hemodynamical index model and corresponding hemodynamical reference signals. From this hemodynamical index model, a hemodynamical index can be derived, which then can be used in determining patient customized cardiac pacing settings of the cardiac stimulator. | 10-31-2013 |
20130296960 | ELECTROMECHANICAL DELAY (EMD) MONITORING DEVICES, SYSTEMS AND METHODS - Implantable systems, and methods for use therewith, enable the monitoring of a patient's electromechanical delay (EMD) and arterial blood pressure. Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient's EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal. The value indicative of EMD can be used to more accurately determine metrics indicative of pulse arrival time (PAT), which can be used to estimate arterial blood pressure. | 11-07-2013 |
20130310888 | APPARATUS AND METHOD FOR AUTOMATIC OPTIMIZATION OF ATRIOVENTRICULAR DELAY FOR AN ACTIVE MEDICAL DEVICE - A method for use by an active medical device includes using a stimulation device and an endocardial acceleration sensor to obtain a plurality of hemodynamic parameters associated with at least three atrioventricular delays. The method further includes using the plurality of hemodynamic parameters to find a second derivative associated with the atrioventricular delays. The method further includes using interpolation to estimate an atrioventricular delay which will reduce the second derivative associated with the atrioventricular delays. The method further includes using the estimated atrioventricular delay in a subsequent stimulation. | 11-21-2013 |
20130331902 | IMPLANTABLE CARDIAC DEVICE WITH DYSPNEA MEASUREMENT - Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device. | 12-12-2013 |
20140005739 | METHOD AND SYSTEM TO SELECT A NEUROSTIMULATION SYSTEM CONFIGURATION BASED ON CARDIAC RHYTHM FEEDBACK | 01-02-2014 |
20140012345 | CARDIOPULMONARY FUNCTIONAL STATUS ASSESSMENT VIA METABOLIC RESPONSE DETECTION BY IMPLANTABLE CARDIAC DEVICE - An implantable cardiac device is configured and programmed to assess a patient's cardiopulmonary function by evaluating the patient's minute ventilation response. Such evaluation may be performed by computing a minute ventilation response slope, defined as the ratio of an incremental change in minute ventilation to an incremental change in measured activity level. The minute ventilation response slope may then be compared with a normal range to assess the patient's functional status. | 01-09-2014 |
20140018875 | METHOD AND APPARATUS FOR PACING SAFETY MARGIN - An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture. | 01-16-2014 |
20140031886 | VENTRICULAR PACING TO AUGMENT ATRIAL NATRIURETIC HORMONE PRODUCTION - Intermittent delivery of ventricular pacing pulses synchronized to occur during an atrial diastole time period can be used to provide atrial stretch therapy and augment the production and release of atrial natriuretic hormone. | 01-30-2014 |
20140046395 | AUTONOMOUS INTRACARDIAC IMPLANTABLE MEDICAL DEVICE WITH RELEASEABLE BASE AND FASTENER ELEMENT - An intracorporeal autonomous active medical device having a capsule body and a base. The capsule body includes a body portion and a lid portion, and the capsule body contains therein electronic circuitry containing the active elements of the autonomous medical device, and a power supply. The capsule body also includes a fastening system on an exterior surface of the capsule body that is configured to correspond with a fastening mechanism on the base configured to be anchored to a tissue wall. The fastening mechanism provides selective engagement between the capsule body and the base. | 02-13-2014 |
20140052209 | PHYSIOLOGICAL VIBRATION DETECTION IN AN IMPLANTED MEDICAL DEVICE - An embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy. | 02-20-2014 |
20140067002 | SELECTION OF PACING SITES TO ENHANCE CARDIAC PERFORMANCE - Systems and methods for selection of electrodes and related pacing configuration parameters used to pace a heart chamber are described. A change in the hemodynamic state of a patient is detected. Responsive to the detected change, a distribution of an electrical, mechanical, or electromechanical parameter related to contractile function of a heart chamber with respect to locations of multiple electrodes disposed within the heart chamber is determined. A pacing output configuration, including one or more electrodes of the multiple electrodes, is selected and the heart chamber is paced using the selected pacing output configuration. | 03-06-2014 |
20140094870 | DEVICE FOR ASSESSMENT AND THERAPY OF THE TEMPORAL VENTRICULAR DESYNCHRONIZATION - A device includes a hemodynamic sensor measuring blood flow in the left chambers of a myocardium, at least one motion sensor measuring a displacement of the walls of the left ventricle of the myocardium, a first analysis module determining a time of closure of the aortic valve based on a signal of the hemodynamic sensor, a second analysis module determining a time of peak contraction of the left ventricle based on a signal from the motion sensors, and a third analysis module determining a time between the moment of peak contraction of the left ventricle and the moment of closure of the aortic valve. If the peak of contraction of the left ventricle is after the instant of closure of the aortic valve, the device adjusts the inter-ventricular delay and/or the atrioventricular delay to minimize or cancel the time disparity. | 04-03-2014 |
20140100625 | LEFT VENTRICULAR PACING PROTECTION IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - In a pacing mode where the left ventricle is paced upon expiration of an escape interval that is reset by a right ventricular sense, there is the risk that the left ventricular pace may be delivered in the so-called vulnerable period that occurs after a depolarization and trigger an arrhythmia. To reduce this risk, a left ventricular protective period (LVPP) may be provided. Methods and devices for implementing an LVPP in the context of multi-site left ventricular pacing are described. | 04-10-2014 |
20140100626 | ACTIVITY SENSOR PROCESSING FOR PHRENIC NERVE ACTIVATION DETECTION - An implantable cardiac device includes a sensor for sensing patient activity and detecting phrenic nerve activation. A first filter channel attenuates first frequencies of the sensor signal to produce a first filtered output. A second filter channel attenuates second frequencies of the accelerometer signal to produce a second filtered output. Patient activity is evaluated using the first filtered output and phrenic nerve activation caused by cardiac pacing is detected using the second filtered output. | 04-10-2014 |
20140114370 | HEART FAILURE MANAGEMENT - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 04-24-2014 |
20140121719 | LEADLESS PACEMAKER SYSTEM - A device includes a signal generator module, a processing module, and a housing. The signal generator module is configured to deliver pacing pulses to an atrium. The processing module is configured to detect a ventricular activation event and determine a length of an interval between the ventricular activation event and a previous atrial event that preceded the ventricular activation event. The processing module is further configured to schedule a time at which to deliver a pacing pulse to the atrium based on the length of the interval and control the signal generator module to deliver the pacing pulse at the scheduled time. The housing is configured for implantation within the atrium. The housing encloses the stimulation generator and the processing module. | 05-01-2014 |
20140121720 | LEADLESS PACEMAKER SYSTEM - A device includes a signal generator module, a processing module, and a housing. The signal generator module is configured to deliver pacing pulses to an atrium. The processing module is configured to detect a ventricular activation event and determine a length of an interval between the ventricular activation event and a previous atrial event that preceded the ventricular activation event. The processing module is further configured to schedule a time at which to deliver a pacing pulse to the atrium based on the length of the interval and control the signal generator module to deliver the pacing pulse at the scheduled time. The housing is configured for implantation within the atrium. The housing encloses the stimulation generator and the processing module. | 05-01-2014 |
20140128932 | INTELLIGENT SELF-ORGANIZING ELECTRODE STIMULATION DELIVERY SYSTEM - An electrode stimulation delivery system is described having a unit and a network of wireless remote electrodes configured for implantation within a plurality of spaced apart locations in the tissue, e.g. myocardium, of a patient. The control unit is configured to be positioned at or subcutaneous to the patient's skin, and includes a processor, an antenna configured for delivering RF energy in proximity to the plurality of wireless remote electrodes, and programming executable on the processor for wirelessly communicating to the network of wireless remote electrodes via the delivered RF energy to individually control pacing of the plurality of wireless remote electrodes. Each of the plurality of wireless remote electrodes comprises a metamaterial-based biomimetic harvesting antenna comprising a Van Atta array zero-phase transmission lines to receive the RF energy to power activation of the plurality of wireless remote electrodes. | 05-08-2014 |
20140128933 | METHOD AND APPARATUS FOR PHRENIC STIMULATION DETECTION - Approaches for characterizing a phrenic stimulation threshold, a cardiac capture threshold, a maximum device parameter, and a minimum device parameter are described. A plurality of cardiac pacing pulses can be delivered by using a cardiac pacing device, a pacing parameter of the plurality of cardiac pacing pulses being changed between delivery of at least some of the pulses. One or more sensor signals can be evaluated to detect stimulation of the phrenic nerve by one or more of the plurality of cardiac pacing pluses. The evaluation of the one or more sensor signals and the pacing parameter can be compared to determine if a phrenic stimulation threshold is at least one of higher than a maximum device parameter and lower than a minimum device parameter. | 05-08-2014 |
20140135866 | SYSTEM AND METHODS TO FACILITATE PROVIDING THERAPY TO A PATIENT - A method can include providing ( | 05-15-2014 |
20140142649 | METHODS AND APPARATUS FOR PREDICTING ACUTE RESPONSE TO CARDIAC RESYNCRONIZATION THERAPY AT A GIVEN STIMULATION SITE - Response to cardiac resynchronization therapy is predicted for a given stimulation site so that an atrioventricular delay of an implantable device administering cardiac resynchronization therapy may be set to a proper amount. The first deflection of ventricular depolarization is measured, such as through a surface electrocardiogram or through an intracardiac electrogram measured by a lead positioned in the heart at the stimulation site. The maximum deflection of the ventricular depolarization is then measured by the lead positioned at the stimulation site. The interval of time between the first deflection and the maximum deflection of the ventricular depolarization is compared to a threshold to determine whether the stimulation site is a responder site. If the interval is larger than the threshold, then the site is a responder and the atrioventricular delay of the implantable device may be set to less than the intrinsic atrioventricular delay of the patient. Otherwise, the atrioventricular may be set to approximately equal the intrinsic atrioventricular delay. | 05-22-2014 |
20140142650 | NERVE SIGNAL DIFFERENTIATION IN CARDIAC THERAPY - Methods of nerve signal differentiation, methods of delivering therapy using such nerve signal differentiation, and to systems and devices for performing such methods. Nerve signal differentiation may include locating two electrodes proximate nerve tissue and differentiating between efferent and afferent components of nerve signals monitored using the two electrodes. | 05-22-2014 |
20140142651 | IMPLANTABLE MEDICAL DEVICE WITH VENTRICULAR PACING MANAGEMENT OF ELEVATED HEART RATES - An implantable medical device operates to promote intrinsic ventricular depolarization according to a pacing protocol. When a cardiac rate exceeds a predetermined threshold, the implantable medical device modifies the pacing protocol parameters to promote AV synchrony. | 05-22-2014 |
20140163631 | METHOD AND APPARATUS TO ENSURE CONSISTENT LEFT VENTRICULAR PACING - A method of operating a cardiac therapy system to deliver cardiac resynchronization therapy (CRT) pacing that includes pacing both ventricles or pacing only the left ventricle is described. Delivery of the CRT pacing to one or both ventricles is scheduled for a cardiac cycle. If an intrinsic depolarization of a ventricle is detected during a pacing delay of the ventricle, then the scheduled CRT pacing to the ventricle is inhibited for the cycle. The intrinsic interval of the ventricle, such as the intrinsic atrioventricular interval concluded by the intrinsic depolarization, is measured. During a subsequent cardiac cycle, the pacing delay of the ventricle is decreased to be less than or equal to the measured intrinsic interval. Capture of the ventricle is verified after pacing is delivered during the subsequent cardiac cycle. | 06-12-2014 |
20140172035 | METHOD AND APPARATUS FOR RIGHT VENTRICULAR RESYNCHRONIZATION - An apparatus comprises a cardiac signal sensing circuit and a first implantable electrode pair. At least one electrode of the first implantable electrode pair is configured for placement at a location in a right branch of a His bundle of the subject. The apparatus can include a therapy circuit and a control circuit. The control circuit can include an AH delay calculation circuit configured to calculate an optimal paced AH delay interval. The pacing stimulation location is distal to a location of RV conduction block in a right branch of the His bundle. The control circuit initiates delivery of an electrical stimulation pulse to the stimulation location in the His bundle according to the calculated paced AH delay interval and in response to an intrinsic depolarization event sensed in an atrium of the subject. | 06-19-2014 |
20140172036 | ACTIVE IMPLANTABLE MEDICAL DEVICE TYPE SUCH AS A PACEMAKER WITH CAPTURE TEST BY ANALYSIS OF A VECTOGRAM - A device produces at least two distinct temporal components (V | 06-19-2014 |
20140172037 | ACTIVE IMPLANTABLE MEDICAL DEVICE TYPE SUCH AS A PACEMAKER WITH DETECTION OF ANODAL STIMULATION BY ANALYSIS OF A VECTOGRAM - A device produces at least two distinct temporal components (V | 06-19-2014 |
20140188184 | SYSTEMS AND METHODS TO OPTIMIZE PACING FUSION WITH NATIVE ACTIVATION - In an example, a pacing therapy can be optimized using information indicative of an offset duration between an intrinsic first atrioventricular delay of a subject at rest and a second atrioventricular delay specified to enhance a cardiac output of the subject heart when the subject is at rest. Optimizing the therapy can include receiving information about a heart rate of the subject and receiving information about an intrinsic, heart rate dependent atrioventricular delay. In an example, a therapy parameter, such as a therapy atrioventricular delay, can be adjusted using information about the received heart rate of the subject, the heart-rate-dependent third AV delay, or the offset duration. | 07-03-2014 |
20140207206 | SYSTEM AND METHOD FOR SYSTOLIC INTERVAL ANALYSIS - According to a system or method, information indicative of a cardiac depolarization signal can be obtained. Information indicative of an acoustic signal from an implantable acoustic sensor included as a portion of an implantable therapy device can be obtained. A feature indicative of an R wave can be identified from the information indicative of the cardiac depolarization signal, and a feature indicative of an S2 heart sound can be identified from the information indicative of the acoustic signal. A time interval between an instant corresponding to the feature indicative of the R wave and an instant corresponding to the feature indicative of the S2 heart sound can be determined. Using information about the determined time interval, an adjusted pacing therapy parameter can be provided for use in a pacing therapy to be provided by the implantable therapy device. | 07-24-2014 |
20140249593 | METHOD AND DEVICE FOR COUNTERPULSATION THERAPY - A method of counterpulsation therapy is provided, the method comprising use of a combination of cardiac electrical activity and acoustic signals in such a manner that initially R wave on a cardiogram and then II (aortic) sound are determined, and, after the II sound has been determined, stimulation of muscles by means of electric impulses is initiated. A device for performing the above described method comprises a sensor of the signal of cardiac electrical activity and a sensor of cardiac acoustic signal; a unit for blocking the cardiac electrical activity signal; a unit for blocking the acoustic signal; and a control device coupled with muscle stimulating devices. | 09-04-2014 |
20140277237 | DEVICE BASED OPTIMIZATION OF DEVICE THERAPIES - A system may include an external medical device (e.g., a patch) including one or more physiological sensors configured to sense one or more physiological parameters of a subject when the subject is ambulatory. The external medical device may be configured to communicate information related to the sensed one or more physiological parameters for determining and/or modifying at least one cardiac therapy parameter of an implantable medical device (e.g., pacemaker, implantable cardioverter defibrillators, or cardiac resynchronization therapy device). In some situations, an indication or notification may be generated corresponding to the determined and/modified cardiac therapy parameter. | 09-18-2014 |
20140277238 | SYSTEM AND METHODS FOR IMPROVING DEVICE THERAPY USING HEART SOUNDS - Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can be configured to detect a heart sound signal and generate one or more heart sound metrics, detect a characteristic indicative of cannon waves, and determine a desired value for a device parameter, such as a timing parameter which can be used to control the delivery of CRT pacing to various heart chambers. The desired device parameter value can be determined using the heart sound metrics and the characteristic indicative of the cannon waves. The ambulatory medical device can program stimulation using the desired device parameter value, and deliver the programmed stimulations to one or more target sites to achieve desired therapeutic effects. | 09-18-2014 |
20140277239 | ESTIMATING ELECTROMECHANICAL DELAY TO OPTIMIZE PACING PARAMETERS IN RBBB PATIENTS - Stimulation energy can be provided to stimulate synchronous ventricular contractions. Interval information obtained from a cardiac electrical heart signal and a cardiac mechanical heart signal can be used to determine a right ventricular activation time. The interval information can provide a cardiac stimulation indication. | 09-18-2014 |
20140277240 | SYSTEM AND METHOD FOR CHANGING DEVICE PARAMETERS TO CONTROL CARDIAC HEMODYNAMICS IN A PATIENT - Pacing parameters may be adjusted to increase the cardiac output of a patient's heart while a patient is awake and/or active and the demand placed on the heart may be greatest, and to decrease or hemodynamic efficiency while a patient is at rest so that the heart itself has time to rest before the next period of higher demand for efficiency begins. This may aid in lessening the strain placed on the heart by making the heart work hard when needed such as when the patient is active, and by permitting the heart to “rest” when the patient is relatively inactive. | 09-18-2014 |
20140277241 | COORDINATING MUSCULOSKELETAL AND CARDIOVASCULAR HEMODYNAMICS - The present invention is generally directed to methods, systems, and computer program products for coordinating musculoskeletal and cardiovascular hemodynamics. In some embodiments, a heart pacing signal causes heart contractions to occur with an essentially constant time relationship with respect to rhythmic musculoskeletal activity. In other embodiments, prompts (e.g., audio, graphical, etc.) are provided to a user to assist them in timing of their rhythmic musculoskeletal activity relative to timing of their cardiovascular cycle. In further embodiments, accurately indicating a heart condition during a cardiac stress test is increased. | 09-18-2014 |
20140316480 | IMPLANTABLE DEVICE WITH RESPONSIVE VASCULAR AND CARDIAC CONTROLLERS - Exemplary methods are described for providing responsive vascular control with or without cardiac pacing. An implantable device with responsive vascular and cardiac controllers interprets physiological conditions and responds with an appropriate degree of vascular therapy applied as electrical pulses to a sympathetic nerve. In one implementation, an implantable device is programmed to deliver the vascular therapy in response to low blood pressure or orthostatic hypotension. The device may stimulate the greater splanchnic nerve, to effect therapeutic vasoconstriction. The vascular therapy is dynamically adjusted as the condition improves. In one implementation to benefit impaired physical mobility, vascular therapy comprises vasoconstriction and is timed to coincide with a recurring segment of the cardiac cycle. The vasoconstriction assists circulation and venous return in the lower limbs of inactive and bedridden individuals. In various implementations, cardiac pacing therapy that is synergistic with the vascular therapy may be added to augment treatment. | 10-23-2014 |
20140324115 | VAGAL STIMULATION - The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions. | 10-30-2014 |
20140336719 | METHOD FOR HEMODYNAMIC OPTIMIZATION USING PLETHYSMOGRAPHY - Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set. | 11-13-2014 |
20140350630 | SYSTEM AND METHOD FOR EVALUATING DIASTOLIC FUNCTION BASED ON CARDIOGENIC IMPEDANCE USING AN IMPLANTABLE MEDICAL DEVICE - Diastolic function is monitored within a patient based on dynamic cardiogenic impedance as measured by a pacemaker or other implantable medical device. In one example, the device uses ventricular cardiogenic impedance values to detect E-wave parameters representative of passive filling of the ventricles. Atrial cardiogenic impedance values are used to detect A-wave parameters representative of active filling of the ventricles. Diastolic function is then assessed or evaluated based on the E-wave and A-wave parameters. Various functions of the implantable device are then controlled based on the assessment of diastolic function, such as by adjusting atrioventricular delay parameters to improve diastolic function. In some examples, the detection of E- and A-wave parameters is achieved by aligning impedance signals to atrial activation, and separately to ventricular activation, during asynchronous VOO pacing or while artificially inducing a 2:1 block. | 11-27-2014 |
20140350631 | SENSING VECTOR SELECTION IN A CARDIAC STIMULUS DEVICE WITH POSTURAL ASSESSMENT - Methods, implantable medical devices and systems configured to perform analysis of captured signals from implanted electrodes to identify cardiac arrhythmias. In an illustrative embodiment, signals captured from two or more sensing vectors are analyzed, where the signals are captured with a patient in at least first and second body positions. Analysis is performed to identify primary or default sensing vectors and/or templates for event detection. | 11-27-2014 |
20150032171 | IDENTIFICATION OF HEALTHY VERSUS UNHEALTHY SUBSTRATE FOR PACING FROM A MULTIPOLAR LEAD - A medical device system performs a method for determining presence of scar tissue through an implanted lead having an electrode for cardiac pacing and sensing. A sensing module senses heart activity with the electrode to produce a unipolar electrogram (EGM) waveform. A processor receives the unipolar EGM waveform and extracts two or more features representative of heart activity at the electrode. Scar tissue is identified at the site of the first electrode based upon at least two of the extracted features indicating scar tissue. | 01-29-2015 |
20150032172 | METHOD AND SYSTEM FOR IMPROVED ESTIMATION OF TIME OF LEFT VENTRICULAR PACING WITH RESPECT TO INTRINSIC RIGHT VENTRICULAR ACTIVATION IN CARDIAC RESYNCHRONIZATION THERAPY - A method and system of cardiac pacing is disclosed. A baseline rhythm is determined. The baseline rhythm includes a baseline atrial event and a baseline right ventricular RV event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes. A determination is made as to whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times. A correction factor is applied to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the RV event is disparate from the earliest RV activation time. The processor is configured to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before RV sensing time. | 01-29-2015 |
20150032173 | METHOD AND SYSTEM FOR IMPROVED ESTIMATION OF TIME OF LEFT VENTRICULAR PACING WITH RESPECT TO INTRINSIC RIGHT VENTRICULAR ACTIVATION IN CARDIAC RESYNCHRONIZATION THERAPY - A method and system of cardiac pacing is disclosed. A baseline rhythm is determined. The baseline rhythm includes a baseline atrial event and a baseline right ventricular RV event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes. A determination is made as to whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times. A correction factor is applied to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the RV event is disparate from the earliest RV activation time. The processor is configured to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before RV sensing time. | 01-29-2015 |
20150039044 | SYSTEMS AND METHODS FOR RANKING AND SELECTION OF PACING VECTORS - Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds. | 02-05-2015 |
20150045848 | MEDICAL DEVICE TO PROVIDE BREATHING THERAPY - Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle. | 02-12-2015 |
20150051660 | CARDIAC PACEMAKER AND USES THEREOF - The invention relates to improved cardiac pacemakers and methods of use thereof. In particular the cardiac pacemakers are useful for normalizing heart rates over resting heart rates in order to condition the heart to improve overall cardiac output. | 02-19-2015 |
20150073494 | Pacing Methods, Systems and Computer Program Products for Using Feedback Controlled Timing - Methods, systems and computer program products for cardiac pacing are provided. For pacing using biventricular synchronization in a patient, a first stimulation signal is applied to a first region of a heart of the patient at a first time and a second stimulation signal applied to a second region of the heart of the patient at a second time to provide biventricular synchronization stimulation of the heart. Cardiac function of the patient associated with application of the first and the second stimulation signals is sensed and a timing relationship of the first stimulation signal to the second stimulation signal is adjusted based on the sensed cardiac function. Additionally, a cardiac timing interval, such as the A-V timing interval, may be adjusted by applying stimulation to a heart of the patient utilizing a cardiac timing interval, detecting a change in cardiac function by sensing cardiac function associated with application of the stimulation using the cardiac timing interval and adjusting the cardiac timing interval directly from the detected change in cardiac function. | 03-12-2015 |
20150105835 | METHODS AND APPARATUS FOR DETECTING HEART FAILURE EVENT USING IMPEDANCE VECTOR SWITCHING - Devices and methods for detecting physiological target event such as events indicative of heart failure (HF) decompensation status are described. An ambulatory medical device (AMD) can detect device site maturation such as in a device encapsulation pocket, and classify the maturation status into one of two or more device site maturation states. The AMD can include an electrical impedance analyzer circuit that can measure a first maturation-insensitive impedance vector and a second maturation-sensitive impedance vector. At least one impedance vector can be selected or a composite impedance vector can be generated in accordance with the classified device site maturation state. The AMD can generate an impedance indicator using the selected or composite impedance vector, and detect a target physiologic event indicative of worsening of HF using the impedance indicator. | 04-16-2015 |
20150105836 | LEADLESS PACEMAKER SYSTEM - A device includes a signal generator module, a processing module, and a housing. The signal generator module is configured to deliver pacing pulses to an atrium. The processing module is configured to detect a ventricular activation event and determine a length of an interval between the ventricular activation event and a previous atrial event that preceded the ventricular activation event. The processing module is further configured to schedule a time at which to deliver a pacing pulse to the atrium based on the length of the interval and control the signal generator module to deliver the pacing pulse at the scheduled time. The housing is configured for implantation within the atrium. The housing encloses the stimulation generator and the processing module. | 04-16-2015 |
20150142069 | SYSTEMS AND METHODS FOR LEADLESS CARDIAC RESYNCHRONIZATION THERAPY - Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous device (e.g. subcutaneous implantable (SD)) and a leadless pacing device (LPD) are described. In one or more embodiments, a computer-implemented method includes sensing a first electrical signal from a heart of a patient through a SD. The first signal is stored into memory and serves as a baseline rhythm for a patient. Subsequently, a second signal is sensed from the heart through the SD. A cardiac condition can be detected within the sensed second electrical signal through the SD. A determination is made as to whether cardiac resynchronization therapy (CRT) is appropriate to treat the detected cardiac condition. A determination can then be made as to the timing of pacing pulse delivery to cardiac tissue through a leadless pacing device (LPD). The LPD receives communication from the SD requesting the LPD to deliver CRT to the heart. The SD senses and extracts data from a third electrical signal from the heart of the patient to determine whether the pacing by LPD provided efficacious resynchronization or whether the delivery and timing of the LPD pulse should be modified. | 05-21-2015 |
20150142070 | SYSTEMS AND METHODS FOR LEADLESS CARDIAC RESYNCHRINIZATION THERAPY - Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous device (e.g. subcutaneous implantable (SD)) is described. In one or more other embodiments, SD is implanted into a patient's heart. Electrical signals are then sensed which includes moderately lengthened QRS duration data from the patient's heart. A determination is made as to whether cardiac resynchronization pacing therapy (CRT pacing) is appropriate based upon the moderately lengthened QRS duration in the sensed electrical signals. The CRT pacing pulses are delivered to the heart using electrodes. In one or more embodiments, the SD can switch between fusion pacing and biventricular pacing based upon data (e.g. moderately lengthened QRS, etc.) sensed from the heart. | 05-21-2015 |
20150142071 | SYSTEMS AND METHODS FOR DETERMINING OPTIMAL INTERVENTRICULAR PACING DELAYS BASED ON ELECTROMECHANICAL DELAYS - Techniques are provided for use with implantable medical devices such as pacemakers for optimizing interventricular (VV) pacing delays for use with cardiac resynchronization therapy (CRT). In one example, ventricular electrical depolarization events are detected within a patient in whom the device is implanted. The onset of isovolumic ventricular mechanical contraction is also detected based on cardiomechanical signals detected by the device, such as cardiogenic impedance (Z) signals, S1 heart sounds or left atrial pressure (LAP) signals. Then, an electromechanical time delay (T_QtoVC) between ventricular electrical depolarization and the onset of isovolumic ventricular mechanical contraction is determined. VV pacing delays are set to minimize the time delay to the onset of isovolumic ventricular mechanical contraction. Various techniques for identifying the onset of isovolumic ventricular contraction based on Z, S1 or LAP or other cardiomechanical signals are described. In some examples, CRT nonresponders are specifically identified and/or heart failure progression is tracked. | 05-21-2015 |
20150148859 | ACTIVE IMPLANTABLE MEDICAL DEVICE FOR ATRIAL STIMULATION FOR THE TREATMENT OF HEART FAILURE WITH PRESERVED EJECTION FRACTION - An active implantable medical device includes digital processor circuits configured to sense right and left atrial depolarizations and deliver left atrial stimulation pulses according to a stimulation protocol. The stimulation protocol includes delivering a left atrial stimulation pulse at an inter-atrial coupling interval. The inter-atrial coupling interval is a coupling interval shorter than the sinus rhythm coupling interval, so as to deliver a premature pulse. The protocol further includes delivering a not premature left-atrial stimulation pulse during an immediately subsequent cardiac cycle, at an inter-atrial coupling interval corresponding to the sinus rhythm coupling interval. The protocol also includes assessing the right atrial coupling interval between the right atrial depolarizations and comparing the right atrial coupling interval to the sinus rhythm coupling interval. And finally, modifying an adjustable controlling parameters if necessary according to the result of the comparison. The device has no means for collecting and analyzing the endocardial acceleration. | 05-28-2015 |
20150335894 | COMMUNICATIONS SCHEME FOR DISTRIBUTED LEADLESS IMPLANTABLE MEDICAL DEVICES ENABLING MODE SWITCHING - A distributed leadless implantable system is provided that comprises first and second leadless implantable medical devices (LIMD) configured to be implanted entirely within first and second chambers of the heart. Each of the first and second LIMDs comprises a housing having a proximal end configured to engage local tissue of interest in a local chamber, electrodes located along the housing and cardiac sensing circuitry configured to detect intrinsic and paced cardiac events occurring in a near field associated with the local chamber. | 11-26-2015 |
20150352365 | METHOD AND SYSTEM FOR DETERMINING PACING SETTINGS - Systems and methods for optimizing the stimulation of a heart of a patient are disclosed herein. The method comprises delivering pacing therapy to the patient according to a pacing therapy setting schedule, using specific pacing intervals via specific electrode configurations. Further, sinus rate values are recorded over at least one cardiac cycle at each pacing therapy setting and it is determined whether a sinus rate value satisfies predetermined measurement conditions, wherein sinus rate values are used for trending the sinus rate over time if the measurement conditions are satisfied. The accepted sinus rate values, i.e. values that satisfy the measurement conditions, are trended over time, wherein each trended sinus rate value is created based on recordings from at least one cardiac cycle. A preferred pacing therapy setting is determined to be the pacing therapy setting that provides a lowest sinus rate. | 12-10-2015 |
20150360036 | SYSTEMS AND METHODS FOR RATE RESPONSIVE PACING WITH A LEADLESS CARDIAC PACEMAKER - Systems and methods for providing rate responsive pacing therapy to a heart of a patient. One example method for providing rate responsive pacing therapy includes sensing cardiac electrical data with a leadless cardiac pacemaker (LCP) that is implanted within or proximate the heart. From this location, the LCP may provide pacing therapy to the heart based at least in part on the sensed cardiac electrical data. An implantable medical device located remotely from the heart may sense patient activity, and may wirelessly communicate patient activity data from the implantable medical device to the LCP, sometimes using conducted communication. The LCP may be then determine an adjustment to the provided pacing therapy (e.g. adjust the pacing rate) based at least in part on the received patient activity data signal. | 12-17-2015 |
20160001088 | SYSTEM AND METHOD FOR ANALYZING MEDICAL DEVICE PROGRAMMING PARAMETERS - The technology disclosed herein relates to a system and method for analyzing medical device programming parameters. One aspect of the current technology is a method where an overall performance metric is detected for a cardiac medical device that is outside of a threshold at a first cardiac location in a patient. Processing circuitry identifies a first operating condition and sensing circuitry measures a first sensor response during the first operating condition. An adjustment is proposed to one or more programming parameters of the medical device based on the performance metric, the first operating condition, and the sensor response to the operating condition. | 01-07-2016 |
20160023000 | ATRIAL CONTRACTION DETECTION BY A VENTRICULAR LEADLESS PACING DEVICE FOR ATRIO-SYNCHRONOUS VENTRICULAR PACING - A leadless pacing device (LPD) includes a motion sensor configured to generate a motion signal as a function of heart movement. The LPD is configured to analyze the motion signal within an atrial contraction detection window that begins an atrial contraction detection delay period after activation of the ventricle, and detect a contraction of an atrium of the heart based on the analysis of the motion signal within the atrial contraction detection window. If the LPD does not detect a ventricular depolarization subsequent to the atrial contraction, e.g., with an atrio-ventricular (AV) interval beginning when the atrial contraction was detected, the LPD delivers a ventricular pacing pulse. | 01-28-2016 |
20160030747 | PACING SITE AND CONFIGURATION OPTIMIZATION USING A COMBINATION OF ELECTRICAL AND MECHANICAL INFORMATION - An apparatus comprises a cardiac signal sensing circuit configured to sense a plurality of intrinsic cardiac signals using a plurality of cardiac pacing sites, a heart sound sensing circuit, a stimulus circuit configured to provide an electrical cardiac pacing stimulus to the plurality of pacing sites, and a control circuit electrically coupled to the cardiac signal sensing circuit and the stimulus circuit. The control circuit includes a pacing site locating circuit configured to generate an indication of a preferred pacing site as one of a) a subset of the respective cardiac pacing sites selected using the intrinsic ventricular activation time interval value, from which subset the preferred pacing site is selected using the heart sound characteristic value; or b) a subset of the respective cardiac pacing sites selected using the heart sound characteristic value, from which subset the preferred pacing site is selected using the ventricular activation time interval value. | 02-04-2016 |
20160030751 | SYSTEMS AND METHODS FOR EVALUATING CARDIAC THERAPY - Systems and methods are described herein for assisting a user in evaluation of cardiac therapy. The systems and methods may monitor electrical activity of a patient using external electrode apparatus to provide baseline cardiac information and therapy cardiac information and determine whether the cardiac pacing, or therapy, location is acceptable. If the cardiac pacing, or therapy, location is unacceptable, location information representative of a location that may more effective may be generated based on the therapy cardiac information. | 02-04-2016 |
20160045736 | CARDIAC RESYNCHRONIZATION THERAPY UTILIZING P-WAVE SENSING AND DYNAMIC ANTICIPATIVE LEFT VENTRICULAR PACING - Method for operating a pacemaker comprising the procedures of building a database of a cardiac cycle of a patient suffering from bundle branch block and artificially pacing a ventricle of the patient using the pacemaker according to anticipative atrioventricular (AV) delays in the database which are based on measured P-P intervals in the database. | 02-18-2016 |
20160067487 | SYSTEM AND METHOD FOR DUAL-CHAMBER PACING - A medical device system including an pacemaker implantable in a chamber of a patient's heart is configured to sense near field events from a cardiac electrical signal, establish a lower rate interval to control a rate of delivery of pacing pulses and schedule a first pacing pulse by starting a pacing escape interval set equal to the lower rate interval. The pacemaker withholds the scheduled pacing pulse in response to sensing a near-field event during the pacing escape interval and schedules a next pacing pulse to be delivered at the lower rate interval from a time that the pacing escape interval is scheduled to expire. | 03-10-2016 |
20160067500 | SYSTEM AND METHOD FOR DUAL-CHAMBER PACING - A medical device system including a pacemaker implantable in an atrial chamber of a patient's heart is configured to sense near field atrial events from a cardiac signal received by a sensing module of the pacemaker and to sense far field ventricular events. The pacemaker is configured to establish an atrial lower rate interval to control a rate of delivery of atrial pacing pulses, determine a rate of the far field ventricular events sensed by the sensing module, determine an atrial event rate, compare the rate of the sensed far field ventricular events to the atrial event rate, and adjust the atrial lower rate interval in response to the comparison. | 03-10-2016 |
20160089539 | REFRACTORY AND BLANKING INTERVALS IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - A refractory period for a pacemaker sensing channel refers to a period of time during which the sensing channel is either blind to incoming electrical signals, termed a blanking interval, and/or during which the device is configured to ignore such signals for purposes of sense event detection. Methods and devices for implementing refractory periods in the context of multi-site left ventricular pacing are described. | 03-31-2016 |
20160101290 | SYSTEM AND METHODS FOR IMPROVING DEVICE THERAPY USING MULTIPLE SENSOR METRICS - Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can receive one or more physiologic signals and generate multiple signal metrics from the physiologic signals. The ambulatory medical device can determine a desired value for a device parameter, such as a timing parameter used for controlling the delivery of CRT pacing to various heart chambers, using information fusion of signal metrics that are selected based on one or more of a signal metric sensitivity to perturbations to the device parameter in response to a stimulation, a signal metric variability in response to a stimulation, or a covariability between two or more signal metrics in response to a stimulation. The ambulatory medical device can program a stimulation using the desired device parameter value, and deliver the programmed stimulation to one or more target sites to achieve desired therapeutic effects. | 04-14-2016 |
20160106983 | METHOD AND APPARATUS FOR AMBULATORY OPTIMIZATION OF MULTI-SITE PACING USING HEART SOUNDS - An example of a system for pacing through multiple electrodes in a ventricle includes a sensing circuit to sense cardiac signal(s), a pacing output circuit to deliver pacing pulses, a heart sound sensor to sense a heart sound signal, and a control circuit to control the delivery of the pacing pulses. The control circuit includes a heart sound detector to detect heart sounds using the heart sound signal, an electrical event detector to detect cardiac electrical events using the cardiac signal(s), a measurement module to measure an optimization parameter using the detected heart sounds, an optimization module to perform an optimization procedure using the optimization parameter in response to an optimization command, and an optimization initiator to generate the optimization command. The optimization procedure includes selection of a single electrode or a plurality of electrodes from the multiple electrodes in the ventricle for pacing that ventricle. | 04-21-2016 |
20160106986 | METHOD AND APPARATUS FOR OPTIMIZING MULTI-SITE PACING USING HEART SOUNDS - An example of a system for pacing through multiple electrodes in a ventricle includes a sensing circuit to sense cardiac signal(s), a pacing output circuit to deliver pacing pulses, a heart sound sensor to sense a heart sound signal, and a control circuit to control the delivery of the pacing pulses. The control circuit includes a heart sound detector to detect heart sounds using the heart sound signal, an electrical event detector to detect cardiac electrical events using the cardiac signal(s), a measurement module to measure an optimization parameter using the detected heart sounds, and an optimization module to approximately optimize one or more pacing parameters using the measured optimization parameter. The one or more pacing parameters include an electrode configuration parameter specifying one or more electrodes selected from the multiple electrodes in the ventricle for delivering ventricular pacing pulses to that ventricle. | 04-21-2016 |
20160114168 | SENSING AND ATRIAL-SYNCHRONIZED VENTRICULAR PACING IN AN INTRACARDIAC PACEMAKER - A pacemaker implantable in a chamber of a patient's heart is configured to produce a filtered cardiac electrical signal by filtering a raw cardiac signal by an adjustable filter of a sensing module of the pacemaker. The sensing module is configured to receive the raw cardiac electrical signal comprising R-waves, T-waves and P-waves via electrodes coupled to the sensing module. The pacemaker is further configured to determine if the T-waves are distinct from the P-waves in the filtered cardiac electrical signal and adjust the filter to increase a difference between a feature of the P-waves and a feature of the T-waves in the filtered cardiac signal when the T-waves are not distinct from the P-waves. | 04-28-2016 |
20160129261 | VENTRICULAR LEADLESS PACING DEVICE MODE SWITCHING - In some examples, a leadless pacing device (LPD) is configured to switch from a sensing without pacing mode to ventricular pacing mode in response to determining that no intrinsic ventricular activity was detected within a ventricular event detection window for at least one cardiac cycle, which may be referred to as loss of conduction. The ventricular pacing mode may be selected based on whether atrial oversensing is detected in combination with the loss of conduction. In some examples, an atrio-ventricular synchronous pacing mode is selected in response to detecting loss of conduction and in response to determining that atrial oversensing is not detected. In addition, in some examples, an asynchronous ventricular pacing mode is selected in response to detecting both atrial oversensing and loss of conduction. | 05-12-2016 |
20160144192 | CARDIAC PACING SENSING AND CONTROL - A cardiac pacing system having a pulse generator for generating therapeutic electric pulses, a lead electrically coupled with the pulse generator having an electrode, a first sensor configured to monitor a physiological characteristic of a patient, a second sensor configured to monitor a second physiological characteristic of a patient and a controller. The controller can determine a pacing vector based on variables including a signal received from the second sensor, and cause the pulse generator to deliver the therapeutic electrical pulses according to the determined pacing vector. The controller can also modify pacing characteristics based on variables including a signal received from the second sensor. | 05-26-2016 |
20160166831 | MEDICAL DEVICE TO PROVIDE BREATHING THERAPY | 06-16-2016 |
20160175595 | IMPLANTABLE PULSE GENERATOR SYSTEM FOR VAGAL NERVE STIMULATION | 06-23-2016 |
20160175597 | DEVICE FOR ASSESSMENT AND THERAPY OF TEMPORAL VENTRICULAR DESYNCHRONIZATION | 06-23-2016 |
20160193470 | ACTIVE IMPLANTABLE MEDICAL DEVICE FOR ATRIAL STIMULATION FOR THE TREATMENT OF HEART FAILURE WITH PRESERVED EJECTION FRACTION | 07-07-2016 |
20170232261 | SYSTEM AND METHOD FOR CARDIAC PACING | 08-17-2017 |
20180021581 | METHOD AND SYSTEM FOR UTILIZING AN ATRIAL CONTRACTION TIMING FIDUCIAL IN A LEADLESS CARDIAC PACEMAKER SYSTEM | 01-25-2018 |
20180021582 | METHOD AND SYSTEM FOR DETERMINING A CARDIAC CYCLE PACE TIME IN ACCORDANCE WITH METABOLIC DEMAND IN A LEADLESS CARDIAC PACEMAKER SYSTEM | 01-25-2018 |
20180021584 | LEADLESS CARDIAC PACEMAKER FOR GENERATING CARDIAC PRESSURE VOLUME LOOP | 01-25-2018 |