Patent application number | Description | Published |
20080215127 | Medical Electrical Lead Providing Far-Field Signal Attenuation - A bipolar pacing and sensing lead incorporates a range of active surface areas for each of the anode and cathode electrodes, and a range of inter-electrode spacings between the anode and cathode electrodes which, in combination, provide acceptable near-field signal amplitudes and attenuate the amplitudes of unwanted signals, such as far-field R-waves, far-field P-waves, and T-waves. | 09-04-2008 |
20080234769 | SUBCUTANEOUS CARDIAC STIMULATION DEVICE PROVIDING ANTI-TACHYCARDIA PACING THERAPY AND METHOD - An implantable subcutaneous cardiac device includes at least two subcutaneous electrodes adapted for placement external to a heart beneath the skin of a patient. The device further includes an arrhythmia detector that detects a sustained tachyarrhythmia of the heart and a pulse generator that delivers anti-tachycardia pacing pulses to the subcutaneous electrodes in response to detection of a sustained tachyarrhythmia. The pacing pulses preferably have waveforms devoid of any exponential voltage decay and include rounded or substantially constant portions to minimize pain. | 09-25-2008 |
20090018595 | SYSTEMS AND METHODS FOR EMPLOYING MULTIPLE FILTERS TO DETECT T-WAVE OVERSENSING AND TO IMPROVE TACHYARRHYTHMIA DETECTION WITHIN AN IMPLANTABLE MEDICAL DEVICE - Techniques are described for detecting tachyarrhythmia and also for preventing T-wave oversensing using a narrowband bradycardia filter in combination with a narrowband tachycardia filter. In some embodiments, a separate wideband filter is also exploited. In one illustrative example, ventricular tachycardia (VT) is detected by: detecting a preliminary indication of VT using signals filtered by the bradycardia filter and, in response, confirming the detection of VT using signals filtered by the tachycardia filter. That is, the bradycardia filter, traditionally used only to detect bradycardia, is additionally used to provide a preliminary indication of VT. The tachycardia filter is then activated to confirm the detection of VT before therapy is delivered. In this manner, the tachycardia filter need not run continuously, but is instead activated only when there is some indication of possible VT, and hence power is saved. Numerous other exemplary techniques are set forth herein for arrhythmia detection and for T-wave oversensing detection. | 01-15-2009 |
20090036788 | SYSTEMS AND METHODS FOR DETECTION OF VT AND VF FROM REMOTE SENSING ELECTRODES - Methods and systems are provided for performing ventricular arrhythmia monitoring using at least two sensing channels that are each associated with different sensing vectors, for example by different pairs of extracardiac remote sensing electrodes. Myopotential associated with each of the sensing channels in monitored, and a ventricular arrhythmia monitoring mode is selected based thereon (e.g., based on determined myopotential levels). Ventricular arrhythmia monitoring is then performed using the selected monitoring mode. | 02-05-2009 |
20090177104 | System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device - Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia. | 07-09-2009 |
20090177105 | System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device - Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia. | 07-09-2009 |
20090264950 | MEDICAL DEVICES AND SYSTEMS HAVING SEPARATE POWER SOURCES FOR ENABLING DIFFERENT TELEMETRY SYSTEMS - An implantable medical device includes a first, short-range telemetry circuit; a second, long-range telemetry circuit; a first power system that powers the first telemetry circuit; and a second power system that powers the second telemetry circuit. The second power system includes an internal charging system and a rechargeable battery coupled to the internal charging system. The internal charging system may be configured for electromagnetic-inductive or RF-transmission coupling with an external charging system. A controller monitors the energy level of the rechargeable battery and provides an signal indicative of the level. | 10-22-2009 |
20100023083 | METHODS AND DEVICES INVOLVING AUTOMATIC ATRIAL BLANKING - During a period of time comprising a plurality of cardiac cycles, a time relationship between ventricular events and atrial detections is established. Based on the relationship, a post-ventricular atrial refractory period is defined. The period includes an absolute atrial refractory period and a segmented relative atrial refractory period, wherein the segmented relative atrial refractory period includes at least one blanking window during which atrial detections of ventricular events have or are likely to occur. | 01-28-2010 |
20100069768 | USE OF CARDIOHEMIC VIBRATION FOR PACING THERAPIES - An exemplary method includes receiving a signal from an intrathoracic vibration sensor, analyzing the signal for vibration associated with deceleration of blood flow into the left ventricle, based at least in part on the analyzing, deciding whether to call for adjustment to one or more parameters of a bi-ventricular pacing therapy. Other exemplary methods, devices, systems, etc., are also disclosed. | 03-18-2010 |
20100069778 | SYSTEM AND METHOD FOR MONITORING THORACIC FLUID LEVELS BASED ON IMPEDANCE USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (Z | 03-18-2010 |
20100081952 | DETECTING ISCHEMIA USING AN IMPLANTABLE CARDIAC DEVICE BASED ON MORPHOLOGY OF CARDIAC PRESSURE SIGNAL - Methods and systems are presented for using an ICD to detect myocardial ischemia. One such method includes sensing via an implantable cardiac-rhythm-management device (ICRMD) a signal indicative of cardiac pressure; determining via a processor associated with the ICRMD, a derivative signal that is a first derivative of the sensed signal; measuring via the processor, a maximum positive value of the derivative signal; measuring via the processor, a maximum negative value of the derivative signal; and indicating via the processor, an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value. | 04-01-2010 |
20100082087 | IMPLANTABLE LEAD/ELECTRODE DELIVERY MEASUREMENT AND FEEDBACK SYSTEM - A lead implantation system with an introducer, a lead configured to engage with the introducer such that the introducer can convey the lead to a desired internal target location, and at least one sensor. The sensor is adapted to generate an indicator of desired engagement of the system with the desired target tissue location prior to engagement of the lead with the target tissue. Also a method of implanting an implantable patient lead including advancing a lead implantation assembly towards a desired target location along an introduction axis and monitoring at least one indicator of lead implantation assembly position along the lead introduction axis. At least one indicator can be generated by the lead implantation assembly. Advancing of the lead introduction assembly can be halted when the monitoring indicates contact with the desired target tissue. The patient lead can then be advanced towards the target tissue and fixed to the target tissue. | 04-01-2010 |
20100094371 | SYSTEMS AND METHODS FOR PAIRED/COUPLED PACING - A coupled/paired stimulus pulse is delivered to the heart at an inter-pulse interval following one of i) detection of an intrinsic depolarization or ii) delivery of a primary stimulus pulse. Capture resulting from the coupled/paired stimulus pulse is sensed for. In response to capture by a coupled/paired stimulus pulse, the inter-pulse interval is incrementally decreased by a first amount until there is no capture by a coupled/paired stimulus pulse. In response to no capture by a coupled/paired stimulus pulse, the inter-pulse interval is incrementally increased by a second amount greater than the first amount, until capture by a coupled/paired stimulus pulse is detected. Once capture is again detected, paired/coupled pacing is delivered at the inter-pulse interval which resulted in capture for a predetermined period of time or until loss of capture occurs. | 04-15-2010 |
20100113944 | INTERPOLATING LEFT VENTRICULAR PRESSURES - Exemplary techniques and systems for interpolating left ventricular pressures are described. One technique interpolates pressures within the left ventricle from blood pressures gathered without directly sensing blood pressure in the left ventricle. | 05-06-2010 |
20100114235 | HYBRID BATTERY SYSTEM FOR IMPLANTABLE CARDIAC THERAPY DEVICE - A system and method for powering an implantable cardiac therapy device (ICTD) uses a hybrid battery system. In an embodiment, the hybrid battery system includes of a first type of power cell and a second type of power cell. The first power cell is configured to power low voltage, low current background operations of the ICTD. The second power cell is configured to power high voltage, high current cardiac shocking. The second power cell is further configured to be charged by the first power cell via a continuous, non-regulated charging process, thereby reducing the complexity of the charging circuitry. The system is further configured so that when cardiac shocking is in progress, only the secondary power cell powers the shocking capacitor(s) of the ICTD, and the first power cell is electrically isolated from the shocking capacitor(s). This configuration contributes to longer battery life of the hybrid battery system. | 05-06-2010 |
20100114236 | HYBRID BATTERY SYSTEM WITH BIOELECTRIC CELL FOR IMPLANTABLE CARDIAC THERAPY DEVICE - A system and method for powering an implantable cardiac therapy device (ICTD) via a hybrid battery system. The hybrid battery is comprised of a low voltage and low current bioelectric cell, a high voltage and high current rechargeable cell, and a charging means. Via the charging means, the bioelectric cell maintains the rechargeable cell at or near full power. The rechargeable cell is configured to power some or all operations of the ICTD. Some ICTD operations may be powered directly by the bioelectric cell. The rechargeable cell is further configured to be charged via a continuous charging process, reducing the complexity of the charging circuitry. In an embodiment, at least the bioelectric cell is external to the ICTD, enabling easy replacement of this power source. In an embodiment, a consumable anode of the bioelectric cell is external to the ICTD, enabling replacement of the power source by replacing only the anode. | 05-06-2010 |
20100121394 | System and Method for Setting Atrioventricular Pacing Delays Based on Far-Field Atrial Signals - An intrinsic inter-atrial conduction delay is determined by a pacemaker or implantable cardioverter-defibrillator based, at least in part, on far-field atrial events sensed using ventricular pacing/sensing leads. An atrioventricular pacing delay is then set based on the inter-atrial conduction delay. By detecting atrial events using ventricular leads, rather than using atrial leads, a more useful measurement of the intrinsic inter-atrial conduction delay can be obtained. In this regard, since atrial electrodes detect atrial activity locally around the electrodes, a near-field atrial event sensed using an atrial electrode might not properly represent the actual timing of the atrial event across both the right and left atria. Far-field atrial events sensed using ventricular leads thus allow for a more useful measurement of inter-atrial conduction delays for use in setting atrioventricular pacing delays. The delivery of individual V-pulses to the heart of the patient may be timed relative to the ends of individual far-field atrial events. | 05-13-2010 |
20100121395 | System and Method for Setting Atrioventricular Pacing Delays Based on Far-Field Atrial Signals - An intrinsic inter-atrial conduction delay is determined by a pacemaker or implantable cardioverter-defibrillator based, at least in part, on far-field atrial events sensed using ventricular pacing/sensing leads. An atrioventricular pacing delay is then set based on the inter-atrial conduction delay. By detecting atrial events using ventricular leads, rather than using atrial leads, a more useful measurement of the intrinsic inter-atrial conduction delay can be obtained. In this regard, since atrial electrodes detect atrial activity locally around the electrodes, a near-field atrial event sensed using an atrial electrode might not properly represent the actual timing of the atrial event across both the right and left atria. Far-field atrial events sensed using ventricular leads thus allow for a more useful measurement of inter-atrial conduction delays for use in setting atrioventricular pacing delays. The delivery of individual V-pulses to the heart of the patient may be timed relative to the ends of individual far-field atrial events. | 05-13-2010 |
20100121396 | ENHANCED HEMODYNAMICS THROUGH ENERGY-EFFICIENT ANODAL PACING - An implantable device may employ anodal-based cardiac stimulation to improve hemodynamics. Anodal pacing may be provided on a conditional basis (e.g., upon detection of a defined condition). An implantable device may provide anodal pacing or cathodal pacing according to a defined ratio. An implantable device may use automatic capture detection to determine a pacing energy level that provides effective anodal pacing while attempting to minimize the power consumption associated with the anodal pacing. | 05-13-2010 |
20100125305 | USE OF IMPEDANCE TO ASSESS ELECTRODE LOCATIONS - A process for determining whether the location of a stimulation electrode meets a selected heart performance criteria includes providing stimulation to the heart through the electrode and obtaining an impedance measurement during stimulation delivery using an impedance sensing vector formed by electrodes that do not include the stimulation electrode. The impedance measurements are processed, either alone or in combination with an electrogram, also obtained during stimulation, to obtain a measure of hemodynamic performance. | 05-20-2010 |
20100210960 | PACING SCHEMES FOR REVEALING T-WAVE ALTERNANS (TWA) AT LOW TO MODERATE HEART RATES - Implantable systems that can monitor myocardial electrical stability, and methods for use therewith, are provided. Also provided are novel pacing sequences that are used in such monitoring. Such pacing sequences are designed to reveal alternans at low to moderate heart rates. | 08-19-2010 |
20100228330 | LEAD CONFIGURED FOR HISIAN, PARA-HISIAN, RV SEPTUM AND RV OUTFLOW TRACT PACING - Disclosed herein is an implantable medical lead for implantation within a right ventricle of a heart and powered by an implantable pulse generator. The lead includes a lead body having a proximal end configured to couple to the generator, a distal end, an electrode at the distal end, and a distal portion extending proximally from the distal end. When the distal portion is in a non-deflected state, the distal portion biases to assume a configuration including first, second and third generally straight segments and first and second bends. The first segment is proximal of the distal end, the second segment is proximal of the first segment, the third segment is proximal of the second segment, the first bend is between the first and second segments, and the second bend is between the second and third segments. When the distal portion is implanted in the right ventricle, the configuration is at least partially the cause of the electrode being at least one of: positioned against the right ventricle septum; positioned in the outflow tract of the right ventricle; positioned for Hisian pacing; and positioned for para-Hisian pacing. | 09-09-2010 |
20100298670 | ELECTROLYTE MONITORING USING IMPLANTED CARDIAC RHYTHM MANAGEMENT DEVICE - A method for diagnosing an electrolyte level with a cardiac rhythm management device includes recording intra-cardiac electrograms from multiple sites. The method determines the electrolyte level based upon a comparative analysis of intra-cardiac electrograms recorded from at least two of the sites. The electrolyte level can be quantified based upon a general model, or a patient specific model. | 11-25-2010 |
20100318148 | PAC THERAPY - An implantable cardiac device is programmed to detect and classify premature atrial contractions (PACs) and administer responsive pacing therapy. The responsive pacing therapy is in the form of an atrial extrastimulus, which is intended to preempt initiation of a reentrant tachycardia. The atrial extrastimulus is timed to occur late enough after a PAC to ensure atrial capture, but early enough that the resulting atrial depolarization does not conduct through the AV node to the ventricles if the PAC has already done so. If both of these criteria cannot be met, the device may be configured to inhibit the atrial extrastimulus. | 12-16-2010 |
20100331921 | NEUROSTIMULATION DEVICE AND METHODS FOR CONTROLLING SAME - A stimulation device that includes a housing, a neuro lead configured to be coupled to the housing and to be located proximate to a neurostimulation site of interest, a neuro pulse generator, in the housing, configured to generate multi-polar neuro modulation (NM) pulses for delivery by the lead to the neuromodulation site of interest and the neuro pulse generator generating the NM pulses utilizing a waveform, with the frequency components of the ICMD compatible waveform in a range of 0 to 225 Hz having substantially limited NM energy content to avoid interference with sensing operation of the ICMD. A method for managing a neuromodulation (NM) device to avoid interference with an implantable medical device (ICMD) providing an ICMD having electrodes configured based on ICMD sensing parameters that define an ICMD sensing frequency range, providing an NM device having NM electrodes to be located proximate a region of interest, the NM electrodes delivering NM pulses based on NM pulse parameters, setting at least one NM pulse parameter in a manner that limits an amount of NM energy content that propagates beyond an active area surrounding the site of interest within the ICMD sensing frequency range. | 12-30-2010 |
20110004111 | ISCHEMIA DETECTION USING INTRA-CARDIAC SIGNALS - An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave. | 01-06-2011 |
20110009754 | ARTERIAL BLOOD PRESSURE MONITORING DEVICES, SYSTEMS AND METHODS USING CARDIOGENIC IMPEDANCE SIGNAL - Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure. Electrode(s) implanting within and/or on the patient's heart are used to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity. Additionally, a signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from one of the detected features of the CI signal to one of the detected features of the signal indicative of changes in arterial blood volume. Based on at least one of the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values. | 01-13-2011 |
20110009918 | METHOD AND SYSTEM FOR IDENTIFYING A POTENTIAL LEAD FAILURE IN AN IMPLANTABLE MEDICAL DEVICE - A method for detecting potential failures by a lead of an implantable medical device is provided. The method includes sensing a first signal over a first channel between a first combination of electrodes on the lead and sensing a second signal from a second channel between a second combination of electrodes on the lead. The method determines whether at least one of the first and second signals is representative of a potential failure in the lead and identifies a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure. Optionally, when the first and second sensed signals are both representative of the potential failure, the method further includes determining whether the first and second sensed signals are correlated with one another. When the first and second sensed signals are correlated, the method declares an electrode common to both of the first and second combinations to be associated with the failure. | 01-13-2011 |
20110015690 | Neurostimulation and Neurosensing Techniques to Optimize Atrial Anti-Tachycardia Pacing for Prevention of Atrial Tachyarrhythmias - Implantable systems and method for use therewith are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments are for use with an implantable device that includes one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering AATP and one or more electrode for monitoring and/or stimulating atrial vagal fat pads. | 01-20-2011 |
20110060230 | DETERMINATION OF DIASTOLIC HEART FAILURE - An exemplary method includes detecting a change in state of a cardiac valve, detecting elongation of the left ventricle substantially along its major axis, determining a time difference between the change in state of the cardiac valve and the elongation of the left ventricle and, based at least in part on the time difference, deciding whether a diastolic abnormality exists. Other exemplary methods, devices, systems, etc., are also disclosed. | 03-10-2011 |
20110066028 | SYSTEMS AND METHODS FOR REMOTE MONITORING OF IMPLANTABLE MEDICAL DEVICE LEAD TEMPERATURES DURING AN MRI PROCEDURE - Systems and methods are provided for detecting and responding to excessive heating of implantable medical device leads, such as leads used with pacemakers or implantable cardioverter-defibrillators (ICDs), during a magnetic resonance imaging (MRI) procedure. In one example, a critical temperature is determined for the lead that is representative, e.g., of the temperature at which tissue damage might occur or pacing/sensing might be significantly impaired. A temperature threshold is then set based on the critical temperature by subtracting a predetermined safety margin. Lead temperatures are then sensed during the MRI procedure. The lead temperatures are compared against the threshold and suitable warnings are transmitted to an external monitoring system if lead temperatures exceed their thresholds so that the attending personnel can take corrective action. The implantable device may also be programmed to take corrective action, such as automatically changing pacing modes, adjusting pulse magnitudes or sensitivity values, etc. | 03-17-2011 |
20110098546 | ASSESSING MEDICAL CONDITIONS BASED ON VENOUS OXYGEN SATURATION AND HEMATOCRIT INFORMATION - Methods for assessing, diagnosing and treating medical conditions using SvO | 04-28-2011 |
20110125206 | SINGLE CHAMBER IMPLANTABLE MEDICAL DEVICE FOR CONFIRMING ARRHYTHMIA THROUGH RETROSPECTIVE CARDIAC SIGNALS - An implantable medical device is provided that comprises a housing, sensors configured to be located to proximate a heart, and a sensing module to sense cardiac signals originating from the heart over a channel defined by the sensors. The cardiac signals include intrinsic R-wave events and associated intrinsic confirmation events when the heart exhibits normal sinus rhythm. The device further includes memory to store the cardiac signals sensed over a channel, and a detection module. The detection module identifies an R-wave event within the cardiac signals. The detection module captures, in the memory, a segment of the cardiac signals that precedes the R-wave event as a retrospective segment. The detection module determines whether the retrospective segment includes an intrinsic confirmation event that is associated with and occurs before the R-wave event. The detection module declares an arrhythmia based at least in part on the determination of whether the retrospective segment includes the intrinsic confirmation event is absent from the retrospective segment. | 05-26-2011 |
20110137364 | MULTI-SITE PACING FOR ATRIAL TACHYARRHYTHMIAS - Tachyarrhythmia is treated by applying anti-tachycardia pacing through at least one multi-site electrode set located on, in or around the heart. The electrode set is arranged and located such that an electrical activation pattern having a wave-front between substantially flat and concave is generated through a reentrant circuit associated with the tachyarrhythmia. The electrode set may be one of a plurality of predefined, multi-site electrode sets located on, in or around the atria. Alternatively, the electrode set may be formed using at least two selectable electrodes located on, in or around the atria | 06-09-2011 |
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 |
20110152990 | MRI COMPATIBLE LEAD EMPLOYING MULTIPLE MINIATURE INDUCTORS - An implantable medical lead is disclosed herein. The lead includes a first electrode and a first electrical circuit. The first electrode is near a distal portion of the lead. The first electrical circuit extends through the lead to the first electrode and includes at least one conductor and a first band stop filter coupled between the distal end of the conductor and the electrode. The first band stop filter includes a first group of inductors in parallel and a second group of inductors in parallel. The first group is in series with the second group. The first group of inductors may include a self resonant L. The first group of inductors may include a self resonant tank LC. The first group of inductors may include a miniature self resonant L or miniature self resonant tank LC. The first group of inductors may include an integrated circuit of L and C components. | 06-23-2011 |
20110202105 | BIOELECTRIC BATTERY FOR IMPLANTABLE DEVICE APPLICATIONS - A bioelectric battery may be used to power implantable devices. The bioelectric battery may have an anode electrode and a cathode electrode separated by an insulating member comprising a tube having a first end and a second end, wherein said anode is inserted into said first end of said tube and said cathode surrounds said tube such that the tube provides a support for the cathode electrode. The bioelectric battery may also have a membrane surrounding the cathode to reduce tissue encapsulation. Alternatively, an anode electrode, a cathode electrode surrounding the cathode electrode, a permeable membrane surrounding the cathode electrode. An electrolyte is disposed within the permeable membrane and a mesh surrounds the permeable membrane. In an alternative embodiment, a pacemaker housing acts as a cathode electrode for a bioelectric battery and an anode electrode is attached to the housing with an insulative adhesive. | 08-18-2011 |
20110208077 | SYSTEM AND METHOD FOR EXPLOITING ATRIAL EELCTROCARDIAC PARAMETERS IN ASSESSING LEFT ATRIAL PRESSURE USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for assessing left atrial pressure (LAP) based on atrial electrocardiac signal parameters, particularly intra-atrial conduction delay (IACD) and P-wave duration. In one example, a pacemaker or other implantable device senses an intracardiac electrogram (IEGM) or a subcutaneous electrocardiogram (ECG), from which IACD and P-wave duration are derived. The device tracks changes, if any, in the parameters. A significant increase in either IACD or P-wave duration is associated with an increase in LAP. In some examples, conversion factors are calibrated for use with a particular patient to relate IACD and/or P-wave duration values to LAP values to provide an estimate of actual LAP. The conversion factors are pre-calibrated using LAP measurements obtained using a wedge pressure sensor. In other examples, IACD and P-wave duration are instead used to confirm the detection of an elevation in LAP initially made using impedance signals. Other confirmation parameters are described as well. | 08-25-2011 |
20110282226 | CARDIAC ANALYSIS SYSTEM FOR COMPARING CLINICAL AND INDUCED VENTRICULAR TACHYCARDIA EVENTS - A cardiac analysis system is provided that includes an implantable medical device (IMD), at least one sensor, and an external device. The IMD has electrodes positioned proximate to a heart that sense first cardiac signals of the heart and associated with a clinical ventricular tachycardia (VT) event and second cardiac signals associated with an induced VT event. The sensor measures first and second cardiac parameters of the heart associated with the clinical and induced VT events, respectively. The external device is configured to receive the first and second cardiac signals associated with the clinical and the induced VT events and the first and second cardiac parameters associated with the clinical and the induced VT events. The external device compares the first and second cardiac signals and compares the first and second cardiac parameters to determine if the clinical and induced VT events are a common type of VT event. | 11-17-2011 |
20120089032 | METHOD AND SYSTEM FOR DISCRIMINATING AND MONITORING ATRIAL ARRHYTHMIA BASED ON CARDIOGENIC IMPEDANCE - A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An arrhythmia monitoring module is configured to analyze intra-cardiac electrogram (IEGM) signals from the at least one IC electrode to identify a potential atrial arrhythmia. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. The hemodynamic performance (HDP) assessment module is configured to determine a hemodynamic performance based on the ECI measurements. The arrhythmia monitoring module is configured to declare the potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The medical device further provides the HDP assessment module that derives a current ECI waveform from current ECI measurements and compares the current ECI pattern with a prior ECI waveform that is derived from prior ECI measurements. | 04-12-2012 |
20120165892 | SYSTEMS AND METHODS FOR OPTIMIZING AV/VV PACING DELAYS USING COMBINED IEGM/IMPEDANCE-BASED TECHNIQUES FOR USE WITH IMPLANTABLE MEDICAL DEVICES - Systems and methods are provided wherein intracardiac electrogram (IEGM) signals are used to determine a set of preliminary optimized atrioventricular (AV/PV) and interventricular (VV) pacing delays. In one example, the preliminary optimized AV/VV pacing delays are used as a starting point for further optimization based on impedance signals such as impedance signals detected between a superior vena cava (SVC) coil electrode and a device housing electrode, which are influenced by changes in stroke volume within the patient. Ventricular pacing is thereafter delivered using the AV/VV pacing delays optimized via impedance. In another example, parameters derived from IEGM signals are used to limit the scope of an impedance-based optimization search to reduce the number of pacing tests needed during impedance-based optimization. Biventricular and multi-site left ventricular (MSLV) examples are described. | 06-28-2012 |
20120190991 | System and Method for Detecting a Clinically-Significant Pulmonary Fluid Accumulation Using an Implantable Medical Device - Techniques are provided for detecting a clinically-significant pulmonary fluid accumulation within a patient using a pacemaker or other implantable medical device. Briefly, the device detects left atrial pressure (LAP) within the patient and tracks changes in the LAP values over time that are indicative of possible pulmonary fluid accumulation within the patient. The device determines whether the changes in LAP values are sufficiently elevated and prolonged to warrant clinical intervention using, e.g., a predictor model-based technique. If the fluid accumulation is clinically significant, the device then generates warning signals, records diagnostics, controls therapy and/or titrates diuretics. False positive detections of pulmonary edema due to transients in LAP are avoided with this technique. Pulmonary artery pressure (PAP)-based techniques are also described. | 07-26-2012 |
20120197141 | IMPLANTABLE ECHO DOPPLER FLOW SENSOR FOR MONITORING OF HEMODYNAMICS - Systems, devices and methods of monitoring blood flow velocity are disclosed herein. For example, one method of monitoring blood flow velocity includes: locating a blood flow velocity sensor near the ostium in the coronary sinus; and sensing towards a portion of the aorta. A second example method includes: locating a blood flow velocity sensor in a vein; and sensing towards an adjacent artery. A third example method includes: locating a blood flow velocity sensor near the tricuspid valve; and sensing towards a tricuspid valve annulus. A fourth example method includes: locating a blood flow velocity sensor right ventricular outflow tract; and sensing towards a portion of the aorta. A fifth example method includes: locating a blood flow velocity sensor in the great cardiac vein; and sensing towards a left anterior descending artery. A sixth example method includes: locating a blood flow velocity sensor in the right atrial appendage; and sensing towards a portion of the aorta. | 08-02-2012 |
20120197149 | SYSTEM AND METHOD FOR DISTINGUISHING AMONG CARDIAC ISCHEMIA, HYPOGLYCEMIA AND HYPERGLYCEMIA USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia. | 08-02-2012 |
20120215274 | ACCELEROMETER ENHANCED IMPLANTABLE CARDIO-DEVICE - An implantable medical device (“IMD”) processes and analyzes valuable clinical information regarding cardiac performance. A database or correlator is pre-customized to the specific patient, by correlating signals received by a remote accelerometer associated with heart movements with accurate heart sounds recorded from a microphone to provide a more effective and customized basis for estimating heart sound. The information is then used to better control an implantable medical device. | 08-23-2012 |
20120253359 | SYSTEMS AND METHODS FOR LEAD PLACEMENT OPTIMIZATION DURING LEAD IMPLANTATION - Disclosed herein is a method of optimizing the implantation of an implantable medical lead into a patient to optimize electrotherapy administered via the lead. The method includes: inserting the lead into the patient, the lead including a first electrode; providing a second electrode in the patient, wherein the second electrode is not part of the lead; generating an electrical vector between the first electrode and second electrode, the electrical vector being generated as the lead is being implanted; analyzing the electrical vector as the lead is being implanted; and optimizing the implantation of the lead based off of the analysis of the electrical vector to optimize electrotherapy administered via the lead. | 10-04-2012 |
20130012824 | CORONARY VENOUS SYSTEM PRESSURE SENSING - Disclose herein is a method of measuring pressures in a coronary sinus. In one embodiment, the method includes: introducing a distal portion of a lead or tool into the coronary sinus, wherein the distal portion includes first and second pressure sensors and at least one selectably expandable member; expanding the at least one expandable member such that the first and second sensors are isolated from each other within the coronary sinus; and taking pressure measurements with the first and second sensors when isolated from each other. | 01-10-2013 |
20130041274 | SYSTEMS AND METHODS FOR USE BY IMPLANTABLE MEDICAL DEVICES FOR DETECTING AND DISCRIMINATING STROKE AND CARDIAC ISCHEMIA USING ELECTROCARDIAC SIGNALS - Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke. | 02-14-2013 |
20130053714 | SYSTEM AND METHOD FOR DETECTING AND CORRECTING ATRIAL UNDERSENSING - A method for operating an implantable medical device includes delivering a plurality of pacing pulses to an atria of a patient's heart and monitoring intrinsic atrial activity to detect intrinsic atrial contractions between one or more of the plurality of pacing pulses. The method further includes detecting atrial undersensing as a function of the detection of intrinsic atrial contractions. | 02-28-2013 |
20130053912 | SYSTEMS AND METHODS FOR ASSESSING HEART FAILURE AND CONTROLLING CARDIAC RESYNCHRONIZATION THERAPY USING HYBRID IMPEDANCE MEASUREMENT CONFIGURATIONS - Techniques are provided for use with an implantable medical device for detecting and assessing heart failure and for controlling cardiac resynchronization therapy (CRT) based on impedance signals obtained using hybrid impedance configurations. The hybrid configurations exploit right atrial (RA)-based impedance measurement vectors and/or left ventricular (LV)-based impedance measurement vectors. In one example, current is injected between the device case and a ring electrode in the right ventricle (RV) or RA. RA-based impedance values are measured along vectors between the device case and an RA electrode. LV-based impedance values are measured along vectors between the device case and one or more electrodes of the LV. Heart failure and other cardiac conditions are detected and tracked using the measured impedance values. CRT delay parameters are also optimized based impedance. In this manner, multiple hybrid impedance measurement configurations are exploited whereby different vectors are used to inject current and measure impedance. | 02-28-2013 |
20130053913 | Method and System to Adjust Pacing Parameters Based on Systolic Interval Heart Sounds - A method is provided to determine pacing parameters for an implantable medical device (IMD) and collects heart sounds during the cardiac cycles. The method comprises changing a value for a pacing parameter between the cardiac cycles and analyzing a characteristic of interest from the heart sounds. The method comprises setting a desired value for the pacing parameter based on the characteristic of interest from the heart sounds. The system comprises inputs configured to be coupled to at least one lead having electrodes to sense intrinsic events and to deliver pacing pulses over cardiac cycles. The system has a sensor for collecting heart sounds during cardiac cycles and controller to control delivery of pacing pulses based on pacing parameters. The controller changes a value for at least one of the pacing parameters between the cardiac cycles and provides an analysis module to analyze a characteristic of interest from the heart sounds. | 02-28-2013 |
20130085489 | SYSTEM AND METHOD FOR PERFORMING RENAL DENERVATION VERIFICATION - A renal denervation feedback method is described that performs a baseline measurement of renal nerve plexus electrical activity at a renal vessel; denervates at least some tissue proximate the renal vessel after performing the baseline measurement; performs a post-denervation measurement of renal nerve plexus electrical activity at the renal vessel, after the denervating; and assesses denervation of the renal vessel based on a comparison of the baseline measurement and the post-denervation measurement of renal nerve plexus electrical activity at the renal vessel. | 04-04-2013 |
20130103108 | METHOD AND APPARATUS TO INCREASE STROKE VOLUME BY SYNCHRONIZING / MODULATING HEART RATE WITH ACTIVITY RATE - A method of synchronizing a heart rate with an activity rate of a patient includes determining the activity rate of the patient. The method also includes synchronizing a pacing pulse with a phase of the activity rate to improve a cardiac stroke volume of the patient. The synchronizing includes lowering the heart rate during down motion associated with the activity rate and increasing the heart rate during an up motion associated with the activity rate when a stride rate is slower than a target heart rate. | 04-25-2013 |
20130110127 | MULTI-PIECE DUAL-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE AND METHOD OF IMPLANTING SAME | 05-02-2013 |
20130110219 | UNITARY DUAL-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE AND METHOD OF IMPLANTING SAME | 05-02-2013 |
20130116529 | LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH BUILT-IN TELEMETRY SYSTEM - A leadless intra-cardiac medical device is configured to be implanted entirely within a heart of a patient. The device includes an intra-cardiac extension and a housing. The intra-cardiac extension includes a loop body having at least one loop segment retaining at least one coil group that is configured to one or both of receive and transmit radio frequency (RF) energy, wherein the loop body is configured to extend into a first chamber of the heart. The housing is in electrical communication within the loop body, and includes a transceiver, control logic and an energy source. The housing is configured to be securely attached to an interior wall portion of a second chamber of the heart, wherein the transceiver is configured to communicate with an external device through the RF energy. | 05-09-2013 |
20130116738 | SINGLE CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH DUAL-CHAMBER FUNCTIONALITY - A leadless intra-cardiac medical device (LIMD) includes a housing configured to be implanted entirely within a single local chamber of the heart. | 05-09-2013 |
20130116740 | SINGLE-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH DUAL-CHAMBER FUNCTIONALITY AND SHAPED STABILIZATION INTRA-CARDIAC EXTENSION - A leadless intra-cardiac medical device (LIMD) configured to be implanted entirely within a heart of a patient includes a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart. | 05-09-2013 |
20130116741 | DUAL-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH INTRA-CARDIAC EXTENSION - A leadless intra-cardiac medical device includes a housing that is configured to be implanted entirely within a single local chamber of the heart. A first electrode is provided on the housing at a first position such that when the housing is implanted in the local chamber, the first electrode engages the local wall tissue at a local activation site within the conduction network of the local chamber. An intra-cardiac extension is coupled to the housing and configured to extend from the local chamber into an adjacent chamber of the heart. A stabilization arm of the intra-cardiac extension engages the adjacent chamber. A second electrode on the intra-cardiac extension engages distal wall tissue at a distal activation site within the conduction network of the adjacent chamber. | 05-09-2013 |
20130123872 | LEADLESS IMPLANTABLE MEDICAL DEVICE WITH DUAL CHAMBER SENSING FUNCTIONALITY - A leadless implantable medical device (LIMD) is provided with dual chamber sensing functionality, without leads, despite the fact that the entire device is located in one chamber. In one embodiment, the LIMD senses local activity in the right atrium (RA) and local activity in the right ventricle (RV), even though it is entirely located in the RA. The sensing electrodes enable sensing in different chambers of the heart while reducing cross talk interference and thus provide accurate tracking of myocardial contraction in multiple chambers. | 05-16-2013 |
20130138006 | SINGLE CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE HAVING DUAL CHAMBER SENSING WITH SIGNAL DISCRIMINATION - A leadless intra-cardiac medical device (LIMD) includes multiple electrodes that allow for stimulation and sensing of the right ventricle (RV) and sensing of the right atrium (RA), even though it is entirely located in the RV. The LIMD includes a housing having a proximal end configured to engage local tissue in the local chamber and electrodes located at multiple locations along the housing. Sensing circuitry is configured to define a far field (FF) channel between a first combination of the electrodes to sense FF signals occurring in the adjacent chamber. The sensing circuitry is configured to define a near field (NF) channel between a second combination of the electrodes to sense NF signals occurring in the local chamber. A controller is configured to analyze the NF and FF signals to determine whether the NF and FF signals collectively indicate that a validated event of interest occurred in the adjacent chamber. | 05-30-2013 |
20130150913 | METHOD AND SYSTEM FOR IDENTIFYING A POTENTIAL LEAD FAILURE IN AN IMPLANTABLE MEDICAL DEVICE - A method for detecting potential failures by a lead of an implantable medical device is provided. The method includes sensing a first signal over a first channel between a first combination of electrodes on the lead and sensing a second signal from a second channel between a second combination of electrodes on the lead. The method determines whether at least one of the first and second signals is representative of a potential failure in the lead and identifies a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure. Optionally, when the first and second sensed signals are both representative of the potential failure, the method further includes determining whether the first and second sensed signals are correlated with one another. When the first and second sensed signals are correlated, the method declares an electrode common to both of the first and second combinations to be associated with the failure. | 06-13-2013 |
20130165965 | PRESSURE TRANSDUCER EQUIPPED CARDIAC PLUG - Disclosed herein is a pressure sensing left atrial occluding implantable medical device. The implantable medical device includes a cardiac plug and a micro electro-mechanical system (“MEMS”). The cardiac plug includes an expandable lobe and an expandable disc proximal the lobe. The expandable lobe is configured to expand into an anchoring arrangement within the left atrial appendage. The expandable lobe is configured to expand into an occluding arrangement with the left atrial appendage. The MEMS is coupled to the cardiac plug proximal of the disc. The MEMS is configured to sense surrounding fluid pressure. | 06-27-2013 |
20130184801 | LEAD SHAPED FOR STIMULATION AT THE BASE LEFT VENTRICLE - Disclosed herein are a variety of implantable medical leads for coupling to an implantable pulse generator and targeted stimulation of the lateral and posterior basal left ventricular region of a patient heart. As one example, the lead may include a tubular body including proximal section, an intermediate section and a distal section. The intermediate section biases into a generally S-shaped or sinusoidal-shaped configuration when the intermediate section is in a free or non-restricted state. The proximal section proximally extends from the intermediate section to a proximal end configured to electrically couple to the implantable pulse generator. The distal section biases into a generally straight linear shaped configuration when the distal section is in a free or non-restricted state. | 07-18-2013 |
20130193947 | POWER CONVERTER - A high voltage resonant step-up convertor converts a lower voltage signal to a higher voltage signal. The converter may be used, for example, to supply power via electromagnetic coupling to an implantable medical device. In some embodiments, a power converter comprises a driver circuit and a resonant circuit. The resonant circuit generates a high voltage output signal at a selected frequency. The driver circuit is controlled by a low voltage signal and periodically generates a higher frequency signal (e.g., approximately twice the selected frequency) to drive the resonant circuit. In some embodiments, the driver circuit comprises another resonant circuit and a switching circuit. The switching circuit periodically pumps current to the other resonant circuit and isolates the two resonant circuits. The other resonant circuit periodically pumps current to the output resonant circuit. | 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 |
20130231727 | LEAD WITH BIOABSORBABLE METALLIC FIXATION STRUCTURE - In one embodiment, an implantable medical lead includes a lead connector end, a tubular body, at least one electrode and at least one fixation structure. The lead connector end is configured to couple to the implantable pulse generator. The tubular body extends distally from the lead connector end and includes a distal portion distally terminating in a distal end. The at least one electrode is located on the distal portion. The at least one fixation structure is located on the distal portion and includes a bioabsorbable metal. For example, the bioabsorbable metal may be iron, an iron alloy with 35% manganese, or a magnesium alloy. The bioabsorbable metal is configured such that the at least one fixation structure will last long enough at an implantation site so as to secure the distal portion of the tubular body in place via fibrotic tissue. | 09-05-2013 |
20130238056 | RF-POWERED COMMUNICATION FOR IMPLANTABLE DEVICE - A communication circuit of an implantable device is coupled to a power source (e.g., including a battery) upon receipt of a radiofrequency (RF) signal at the implantable device. A circuit that controls whether the communication circuit is to be coupled to the power source obtains its power from the received RF signal. Thus, the implantable device is able to perform RF signal monitoring (e.g., RF “sniffing”) without using battery power. Battery power is then used for subsequent communication operations after it has been determined that the implantable device is receiving RF signals (e.g., from a verified external device). | 09-12-2013 |
20130238085 | SILVER NANOPARTICLE ANTIMICROBIAL COATING FOR LONG-TERM AND SHORT-TERM INFECTION RESISTANCE - Disclosed herein is an implantable medical device including an antimicrobial layer. The antimicrobial layer may include a first distinct size of silver nanoparticles, a second distinct size of silver nanoparticles, and a third distinct size of silver nanoparticles. The antimicrobial layer extends over a surface of the implantable medical device, and, in some instances, the surface of the implantable medical device may serve as a substrate on which the antimicrobial layer is deposited. | 09-12-2013 |
20130253352 | METHOD AND SYSTEM FOR IDENTIFYING A POTENTIAL LEAD FAILURE IN AN IMPLANTABLE MEDICAL DEVICE - A method for detecting potential failures by an implantable medical lead is disclosed. The method includes sensing first, second and third signals between at least first and second combinations of electrodes, on the lead; determining whether at least one of the first, second and third signals is representative of a potential failure in the lead and identifies a failure and the electrode associated with the failure based on which of the first, second and third sensed signals is representative of the potential failure. Optionally, when the first and second sensed signals are both representative of the potential failure, the method further includes determining whether the first and second sensed signals are correlated with one another. When the first and second sensed signals are correlated, the method declares an electrode common to both of the first and second combinations to be associated with the failure. | 09-26-2013 |
20130296661 | SYSTEM AND METHOD FOR IMPLANTING A PHYSIOLOGIC SENSOR ASSEMBLY - An implantable physiologic sensor assembly is configured to be implanted within a patient. The assembly includes a module that houses an internal operative chamber, and a flexible pressure-detecting member connected to the module. The module and the pressure-detecting member are separated before implantation into the patient. At least a first end of the pressure-detecting member is configured to be inserted into an artery of the patient and a second end of the pressure-detecting member is connected to the module. The module is configured to be subcutaneously positioned within the patient. | 11-07-2013 |
20130325081 | LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH DUAL CHAMBER SENSING THROUGH ELECTRICAL AND/OR MECHANICAL SENSING - A leadless intra-cardiac medical device senses cardiac activity from multiple chambers and applies cardiac stimulation to at least one cardiac chamber and/or generates a cardiac diagnostic indication. The leadless device may be implanted in a local cardiac chamber (e.g., the right ventricle) and detect near-field signals from that chamber as well as far-field signals from an adjacent chamber (e.g., the right atrium). | 12-05-2013 |
20130325083 | SYSTEMS AND METHODS FOR CONTROLLING NEUROSTIMULATION BASED ON REGIONAL CARDIAC PERFORMANCE FOR USE BY IMPLANTABLE MEDICAL DEVICES - Techniques are provided for controlling neurostimulation such as spinal cord stimulation (SCS) using a cardiac rhythm management device (CRMD). In various examples described herein, neurostimulation is delivered to a patient while regional cardiac performance of the heart of the patient is assessed by the CRMD. The delivery of further neurostimulation is adjusted or controlled based, at least in part, on the regional cardiac performance, preferably to enhance positive effects on the heart due to the neurostimulation or to mitigate any negative effects. Regional cardiac performance is assessed based on parameters derived from cardiogenic impedance signals detected along various vectors through the heart. | 12-05-2013 |
20130338704 | CARDIAC ACCESS METHODS AND APPARATUS - A chamber or vasculature of a heart may be accessed via the pericardial space of the heart. Initially, the pericardial space may be accessed via a transmyocardial approach or a subxiphoid approach. A lead or other implantable apparatus may thus be routed into the pericardial space, through myocardial tissue and into the chamber or vasculature. The lead or other apparatus may be used to sense activity in or provide therapy to the heart. | 12-19-2013 |
20130345770 | LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH REDUCED NUMBER OF FEED-THRUS - A leadless implantable medical device (LIMD) includes a housing formed from a battery and an end cap. A proximal end of the end cap forms an LIMD proximal end and a distal end of the battery case forms an LIMD distal end. A non-conductive coupler mechanically secures a terminal end of the battery case to a mating end of the end cap, while maintaining the battery case and end cap electrically separated. A first electrode projects from the proximal end of the end cap. An intra-cardiac (IC) device extension projects from the distal end of the battery case. The extension includes a second electrode that is electrically connected to the battery case. The second electrode is located remote from the LIMD distal end. An electronics module is located within an internal cavity of the end cap and communicates with the first and second electrodes. | 12-26-2013 |
20140005605 | USE OF QUORUM SENSING INHIBITORS AND BIOFILM DISPERSING AGENTS FOR CONTROLLING BIOFILM-ASSOCIATED IMPLANTABLE MEDICAL DEVICE RELATED INFECTIONS | 01-02-2014 |
20140018818 | SYSTEM AND METHOD OF IMPLANTING A MEDICAL DEVICE - A system for implanting an implantable medical device (IMD) within a patient may include a main handle assembly having proximal and distal ends, a device-connection control handle connected to the proximal end of the main handle assembly, an introducer connected to the distal end of the main handle assembly, and a connection tool extending from the introducer. The connection tool may include a device-engaging member configured to change at least one of shape or orientation to selectively connect to and disconnect from the IMD. The device-connection control handle may be operatively connected to the device-engaging member and the device-connection control handle may be configured to manipulate the device-engaging member between connected and disconnected states by changing the at least one of the shape or orientation. | 01-16-2014 |
20140039592 | LEAD SHAPED FOR STIMULATION AT THE BASE LEFT VENTRICLE - Disclosed herein are a variety of implantable medical leads for coupling to an implantable pulse generator and targeted stimulation of the lateral and posterior basal left ventricular region of a patient heart. As one example, the lead may include a tubular body including proximal section, an intermediate section and a distal section. The intermediate section biases into a generally S-shaped or sinusoidal-shaped configuration when the intermediate section is in a free or non-restricted state. The proximal section proximally extends from the intermediate section to a proximal end configured to electrically couple to the implantable pulse generator. The distal section biases into a generally straight linear shaped configuration when the distal section is in a free or non-restricted state. | 02-06-2014 |
20140107719 | SYSTEMS AND METHODS FOR POSTEXTRASYSTOLIC POTENTIATION USING ANODIC AND CATHODIC PULSES GENERATED BY AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with implantable medical devices to deliver paired or coupled postextrasystolic potentiation (PESP) pacing using split or bifurcated anodic and cathodic pulses. In a paired pacing example, a single-phase anodic pulse is delivered by the device that has sufficient amplitude to depolarize and contract myocardial tissue. During or just following a subsequent relative refractory period, a single-phase cathodic stimulation pulse is delivered that has sufficient amplitude to depolarize but not contract myocardial tissue, i.e., the cathodic pulse provides for PESP. In a coupled pacing example, the single-phase anodic pulse is delivered during or just following the relative refractory period of a first cardiac cycle; whereas the single-phase cathodic pulse is delivered during or immediately following the relative refractory period of the next consecutive cardiac cycle. | 04-17-2014 |
20140107720 | SYSTEMS AND METHODS FOR PACKED PACING USING BIFURCATED PACING PULSES OF OPPOSING POLARITY GENERATED BY AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with implantable medical devices to deliver packed pacing using split or bifurcated pulses of opposing polarity in different cardiac cycles. In one example, packed single-phase pulses are delivered by the device during a first cardiac cycle that serve to stimulate heart tissue. During the next cardiac cycle, packed single-phase stimulation pulse of opposing polarity are delivered that serve to recharge the pacing capacitors and also serve to stimulate heart tissue. By separating the pulses into separate cardiac cycles, near simultaneous multisite packed stimulation can be achieved within each cardiac cycle while providing for charge balancing and without interfering with sensing. Non-packed pacing with bifurcated pulses is also described. | 04-17-2014 |
20140114387 | CHATTER-FREE ACTIVE FIXATION LEAD - An implantable therapy lead includes a tubular body, an obturator, and a helical anchor electrode. The obturator is displaceably supported on a distal end of the tubular body between a recessed position and an extended position. When the obturator is in the extended position, the extreme distal tip of the tissue penetrating point of the helical anchor electrode contacts an outer surface of the obturator in a manner that prevents the extreme distal tip from being capable of tissue penetration significant enough to allow the helical anchor electrode to be screwed into the heart tissue. When the obturator is in the recessed position, the extreme distal tip no longer contacts the outer surface of the obturator and the extreme distal tip is positioned relative to the outer surface of the obturator so as to allow the extreme distal tip to penetrate the heart tissue. | 04-24-2014 |
20140120240 | SILVER NANOPARTICLE ANTIMICROBIAL COATING FOR LONG-TERM AND SHORT-TERM INFECTION RESISTANCE - Disclosed herein is an implantable medical device including an antimicrobial layer. The antimicrobial layer may include a first distinct size of silver nanoparticles, a second distinct size of silver nanoparticles, and a third distinct size of silver nanoparticles. The antimicrobial layer extends over a surface of the implantable medical device, and, in some instances, the surface of the implantable medical device may serve as a substrate on which the antimicrobial layer is deposited. | 05-01-2014 |
20140172034 | INTRA-CARDIAC IMPLANTABLE MEDICAL DEVICE WITH IC DEVICE EXTENSION FOR LV PACING/SENSING - An assembly is provided for introducing a device within a heart of a patient. The assembly is comprised of a sheath having at least one internal passage. An intra-cardiac implantable medical device (IIMD) is retained within the at least one internal passage, wherein the IIMD is configured to be discharged from a distal end of the sheath. The IIMD has a housing with a first active fixation member configured to anchor the IIMD at a first implant location within a local chamber of the heart. | 06-19-2014 |
20140172060 | METHOD OF IMPLANTING A SINGLE-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH DUAL-CHAMBER FUNCTIONALITY AND SHAPED STABILIZATION INTRA-CARDIAC EXTENSION - A leadless intra-cardiac medical device (LIMD) is configured to be implanted entirely within a heart of a patient. The LIMD comprises a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart. | 06-19-2014 |
20140200644 | BIOELECTRIC BATTERY FOR IMPLANTABLE DEVICE APPLICATIONS - A bioelectric battery may be used to power implantable devices. The bioelectric battery may have an anode electrode and a cathode electrode separated by an insulating member comprising a tube having a first end and a second end, wherein said anode is inserted into said first end of said tube and said cathode surrounds said tube such that the tube provides a support for the cathode electrode. The bioelectric battery may also have a membrane surrounding the cathode to reduce tissue encapsulation. Alternatively, an anode electrode, a cathode electrode surrounding the cathode electrode, a permeable membrane surrounding the cathode electrode. An electrolyte is disposed within the permeable membrane and a mesh surrounds the permeable membrane. In an alternative embodiment, a pacemaker housing acts as a cathode electrode for a bioelectric battery and an anode electrode is attached to the housing with an insulative adhesive. | 07-17-2014 |
20140243917 | METHOD AND SYSTEM FOR IMPROVING IMPEDANCE DATA QUALITY IN THE PRESENCE OF PACING PULSES - An implantable medical device, comprised of at least one lead configured to be located proximate to a heart, the at least one lead including electrodes, at least a portion of the electrodes configured to sense cardiac activity. A therapy module configured to control delivery of pacing pulses in accordance with a therapy timing and based on the cardiac sensed activity sensed. Cardiac impedance (CI) sensor circuitry configured to be coupled to at least a first combination of the electrodes to sense cardiac impedance (CI), the CI sensor circuitry generating an impedance data stream associated with a corresponding CI sensing vector. | 08-28-2014 |
20140276122 | METHOD AND SYSTEM FOR NEUROCARDIAC DIFFERENTIAL ANALYSIS OF ISCHEMIA AND MYOCARDIAL INFARCTION - A method and system for differential analysis of cardiac events are provided that include monitoring cardiac signals from a heart to detect deviations indicative of at least one of ischemia and myocardial infarction (MI). The method and system also monitor physiologic surrogate signals associated with pain to detect chest pain. Additionally, the method and system include characterizing a cardiac event exhibited by the heart based on whether the cardiac event occurs in a presence of at least one of the ischemia, IM, and chest pain. | 09-18-2014 |
20140276125 | METHOD AND SYSTEM FOR CHARACTERIZING CARDIAC FUNCTION BASED ON DYNAMIC IMPEDANCE - A method and system are provided for characterizing cardiac function. The method and system comprise collecting cardiac signals associated with electrical or mechanical behavior of a heart over at least one cardiac cycle; identifying a timing feature of interest (FOI) from the cardiac signals; collecting dynamic impedance (DI) data over at least one cardiac cycle (CC), designated by the timing FOI, along at least one of i) a venous return (VR) vector or ii) a right ventricular function (RVF) vector; and analyzing at least one morphologic characteristic from the DI data based on at least one of i) a VR-DI correlation metric to obtain a VR indicator associated with the CC or ii) a RVF-DI correlation metric to obtain a RVF indicator associated with CC. | 09-18-2014 |
20140277056 | MEDICAL DEVICE AND METHOD FOR ACCESSING SPACE ALONG AN INTERIOR SURFACE OF AN ANATOMIC LAYER - Medical device including a lift tool having a distal end configured to removably engage an anatomic layer. The lift tool includes a shaft lumen that extends longitudinally through the lift tool and through the distal end. The shaft lumen is configured to receive an elongated insert device that is movable through the shaft lumen and through the distal end. The medical device also includes a locking mechanism that is coupled to the lift tool. The locking mechanism includes a locking member that is selectively movable with respect to the insert device between a released position and an engaged position. The locking member engages the insert device when in the engaged position to hold the insert device at a fixed position with respect to the lift tool and permits the insert device to move through the shaft lumen when in the released position. | 09-18-2014 |
20140277226 | EXTERNALLY-SECURED MEDICAL DEVICE - Certain embodiments of the present disclosure provide an externally-secured medical device (ESMD) configured to be securely affixed to skin of a patient. The ESMD may include at least one pad configured to be directly secured to the skin of the patient. The pad(s) may include at least one electrode configured to direct therapeutic energy into the skin of the patient toward an internal organ. An adhesion component is provided on a patient-engaging surface of the at least one pad configured to securely affix the at least one pad in a persistent and enduring manner to the skin of the patient. The at least one pad is directly secured to the skin of the patient through the adhesion component. | 09-18-2014 |
20140277312 | MRI COMPATIBLE IMPLANTABLE LEAD - An implantable lead is provided that comprises a lead body configured to be implanted in a patient, the lead body having a distal end and a proximal end, and a lumen extending between the distal and proximal ends; a connector assembly provided at the proximal end of the lead body, the connector assembly configured to connect to an implantable medical device; an electrode provided along the lead body, the electrode configured to at least one of deliver stimulating pulses and sense electrical activity, the electrode having a length extending between a proximal end and a distal end of the electrode; a conductor cable located within the lead body and extending at least partially along a length of the lead body; and an connection node electrically connecting the cable to the electrode at an intermediate point along the length of the electrode. The connection node is disposed at a position intermediate between the proximal and distal ends of the electrode. | 09-18-2014 |
20140288576 | METHOD OF IMPLANTING A UNITARY DUAL-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE - A method of implanting a leadless intra-cardiac medical device. An introducer assembly is introduced into one of an inferior vena cava or a superior vena cava of a heart and maneuvered into a first chamber of the heart. A housing is pushed out of a sheath of the introducer toward a first implant location within the first chamber, and the housing is anchored to the first implant location. The sheath is moved away from the anchored housing, and an electrode is urged to a distal end of the sheath due to the pushing, anchoring, and moving. The sheath is maneuvered to a second chamber of the heart, and the electrode is forced into a second implant location with the second chamber. The electrode is anchored to the second implant location. The sheath is moved away from the electrode after the anchoring, and the sheath is removed from the heart. | 09-25-2014 |
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 |
20140350623 | SYSTEM AND METHOD FOR CONTROLLING ELECTRICAL STIMULATION BASED ON LOWEST OPERABLE VOLTAGE MULTIPLIER FOR USE WITH IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with implantable devices equipped with programmable voltage multipliers (including voltage dividers.) Candidate pulse widths are determined for selected voltage multipliers and stimulation vectors. Each candidate pulse width corresponds to a lowest pulse energy sufficient to achieve capture within the tissues of the patient (subject to a safety margin) using the selected vector and using the corresponding voltage multiplier. As such, a candidate pulse width represents a preferred or optimal pulse width, at least insofar as energy consumption is concerned. However, depending upon the capabilities of the device, the candidate pulse width might not be achievable. Accordingly, for each programmable vector, the system determines a lowest “operable” voltage multiplier sufficient to generate a pulse at a candidate pulse width subject to the capabilities of the device. The system then determines the corresponding current drain, and the vector achieving the lowest current drain at the lowest operable voltage multiplier is selected for the delivery of stimulation. | 11-27-2014 |
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 |
20150018598 | NEUROSTIMULATION PATCH - A neurostimulation patch is affixed to a patient's skin (e.g., via a medical skin adhesive) and provides stimulation energy for an implanted lead. The patch may be used for SCS trials or other applications where is it desirable to avoid implanting a stimulation device within a patient. Circuitry in the patch generates stimulation signals and couples these signals to the implanted lead. The signals may be coupled to the lead via a direct physical connection or via a wireless connection. In some embodiments, the neurostimulation patch is configured in a manner that enables the patch to be placed immediately above the puncture site where an associated percutaneous lead passes through a patient's skin, thereby protecting the puncture site and facilitating secure routing of the lead. | 01-15-2015 |
20150018838 | FULLY IMPLANTABLE TRIAL NEUROSTIMULATION SYSTEM CONFIGURED FOR MINIMALLY-INTRUSIVE IMPLANT/EXPLANT - A fully implantable trial neurostimulation system for implant within a patient is provided that includes one or more leads equipped to deliver neurostimulation to patient tissues under the control of a trial neurostimulation control device designed as a capsule for removable implant within the patient. The control capsule is provided with minimal components to power and control the delivery of neurostimulation during a trial evaluation period and is shaped and configured to facilitate removal from the patient following completion of the trial period. In some examples, both the lead and the trial control capsule are removed from the patient following the trial period for replacement with a chronic or long-term neurostimulation system (assuming further neurostimulation is warranted.) In other examples, the lead remains within the patient and the trial control capsule is replaced with a long-term neurostimulation controller device. Various minimally-intrusive implantation procedures are also described. | 01-15-2015 |
20150065897 | METHOD AND SYSTEM FOR DETERMINING FLUID STATUS BASED ON A DYNAMIC IMPEDANCE SURROGATE FOR CENTRAL VENOUS PRESSURE - A method and system are provided for determining fluid status with a central venous system of a heart. Dynamic impedance (DI) data and static impedance (SI) data are collected over multiple cardiac cycles (CC) for a persistent time period of interest (POI). The DI and SI data are collected along a central venous (CV) vector that extends through a superior vena cava (SVC). The DI and SI data are analyzed to obtain DI long-term variation (LTV) information and SI LTV information, respectively, and to detect whether the DI LTV information and the SI LTV information include decreasing persistent trends in the DI and SI data. When decreasing persistent trends are detected in the DI and SI data, an overload output is generated to indicate that the heart is experiencing a volume overload state. The DI and SI data represent a surrogate for central venous pressure. | 03-05-2015 |
20150073287 | METHOD AND SYSTEM FOR CHARACTERIZING CHAMBER SPECIFIC FUNCTION - A method and system are provided for characterizing chamber specific function. The method and system comprise collecting cardiac signals associated with asynchronous timing between first and second chambers of the heart; collecting dynamic impedance (DI) data along a chamber-specific function (CSF) vector to form a DI data set, the DI data set collected during a collection window that is temporally aligned based on a timing feature of interest (FOI); repeating the collection operations over multiple cardiac cycles (CC) to obtain an ensemble of DI data sets; and combining the ensemble of DI data sets to form a composite DI data set that is coupled to a chamber functional mechanic of interest (FMOI) associated with the first chamber and decoupled from functional mechanics associated with the second chamber; and analyzing the composite DI data set to obtain a CSF indicator associated with the chamber FMOI of the first chamber. | 03-12-2015 |