| Entries |
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| 20080200961 | SPECTRUM-DRIVEN ARRHYTHMIA TREATMENT METHOD - A method and apparatus for treating an arrhythmia is provided. The method includes the steps of: (a) sensing at least one electrical signal from the patient's heart; (b) calculating a frequency spectrum of each electrical signal; (c) calculating a center frequency for each frequency spectrum; and (d) selecting an electro-therapy for delivery to the patient's heart based on the center frequency. The electro-therapy can be a pre-programmed anti-tachycardia pacing (ATP) therapy, a shock therapy, or no therapy at all. The method is performed through the use of an implantable cardioverter defibrillator (ICD). Also provided is a method of determining the optimal location to deliver the electro-therapy. | 08-21-2008 |
| 20080208275 | DYNAMIC TECHNIQUE FOR FITTING HEART PACERS TO INDIVIDUALS - A method includes mounting pressure sensors in a heart-enclosing device; transmitting the data produced by the sensors during actual operation of the heart-enclosing device worn by a specific individual; receiving the sensor signals for subsequent analysis by a computer; creating a stress map based on the sensor-based data; and creating a virtual heart pacer (model) for optimal support and comfort based on the stress map. | 08-28-2008 |
| 20080215106 | Thoracoscopically implantable diaphragm stimulator - A diaphragm stimulator is provided to treat one or more diseases disorders or conditions where the stimulator is configured to be implanted by way of a thoracoscopic approach to the diaphragm. The stimulator may include sensors positioned within the thorax. The stimulator may also include or be used with a cardiac rhythm management device. | 09-04-2008 |
| 20080215107 | CARDIAC PACING SYSTEM, BLOOD PRESSURE REGULATING SYSTEM, AND CARDIAC DISEASE TREATMENT SYSTEM BY SUBSTITUTING NATIVE BIOLOGICAL REGULATORY FUNCTION - A medical treating system based on biological activities characterized by biological activity sensing means for sensing biological activity information produced by biological activities and outputting a biological activity signal, calculating means for receiving, analyzing, and processing the biological activity signals from the biological activity sensing means, calculating an organism stimulation signal, and outputting the organism stimulation signal, and organism stimulating means for receiving the organism stimulation signal calculated by the calculating means and stimulating an organism according to the organism stimulation signal. A cardiac pacing system based on the treating system, a blood pressure regulating system, and a cardiac disease treating system are also disclosed. | 09-04-2008 |
| 20080215108 | Cardiac rhythm management system for edema - A cardiac rhythm management system detects edema. In response to an episode of detected edema, it initiates or adjusts a cardiac resynchronization therapy and/or a cardiac contractility modulation (CCM) therapy. | 09-04-2008 |
| 20080221635 | IMPLANTABLE CARDIAC RHYTHM MANAGEMENT SYSTEM HAVING MULTIPLE THERAPY MODALITIES - A cardiac rhythm management system for providing a plurality of therapy modalities. For example, the system may include a cardiac resynchronization therapy module for providing cardiac resynchronization therapy and a pacemaker module for providing bradycardia therapy, as well as a selector module coupled to the cardiac resynchronization therapy module and the bradycardia module. The selector module may select an operating mode from among a plurality of operating modes including the cardiac resynchronization therapy module and the pacemaker module. Various manual and automatic methods may be used to select the operating mode. In addition, a reversion management system may be included to assist the cardiac rhythm management system to recover in case of a disruption to the system. | 09-11-2008 |
| 20080234773 | CLOSED-LOOP RESYNCHRONIZATION THERAPY FOR MECHANICAL DYSSYNCHRONY - An apparatus comprises a first impedance sensing circuit, a second sensing circuit, and an impedance-based cardiac dyssynchrony detector. The impedance sensing circuit senses an intracardiac local impedance signal that is indicative of a cardiac local wall motion of a first cardiac region from an implantable first bipolar pair of impedance sensing electrodes. The second sensing circuit is configured to produce a second sensor signal indicative of cardiovascular activity. The impedance-based cardiac dyssynchrony detector is configured for detecting cardiac dyssynchrony using a relationship between the first intracardiac local impedance signal and the second sensor signal. Other apparatuses and methods are disclosed. | 09-25-2008 |
| 20080255628 | 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 independent VVI backup mode, and for switching the pacing therapy to a secondary pacing mode if A-V block events are sustained over multiple cardiac cycles. Other devices and methods are described. | 10-16-2008 |
| 20080269820 | Heart Monitoring Device and a System to Detect Vibrations Concerning the Status of the Heart - An implantable heart monitoring system has a control circuit that operates an implanted vibrator to emit a vibration signal that interacts with tissue in vivo. A vibration sensor detects vibrations after interaction with the tissue, and supplies a detection signal to the control circuit. The control circuit analyzes the vibrations in the detected signal relative to the vibration signal, and derives information concerning at least one mechanical property of the heart therefrom, such as stiffness and/or thickness of at least a part of the heart. | 10-30-2008 |
| 20080269821 | Method and Apparatus For Affecting The Autonomic Nervous System - A method and apparatus for affecting the autonomic nervous system of a subject using stimuli based on separate analysis of the sympathetic and/or parasympathetic branches of the subject's autonomic nervous system. The present invention also relates to a method and apparatus for affecting the autonomic nervous system, wherein stimuli is applied in coordination with cyclical activities of the subjects body such as respiration or cardiac cycle. | 10-30-2008 |
| 20080275518 | METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE - A method and apparatus for determining oversensing of cardiac signals that includes a housing containing electronic circuitry, an electrode coupled to the electronic circuitry to sense cardiac signals, and a processor, positioned within the housing, to determine an oversensing characteristic associated with the cardiac signals sensed over a predetermined sensing window, and to identify oversensing in response to the determined oversensing characteristic. | 11-06-2008 |
| 20080275519 | METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE - A method and apparatus for adjusting a sensing parameter in a medical device that includes a sensing electrode sensing cardiac signals, a processor to determine an adjusting characteristic associated with the cardiac signals sensed over a predetermined sensing window, and a control unit to update the sensing parameter in response to the determined adjusting characteristic. | 11-06-2008 |
| 20080275520 | 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. | 11-06-2008 |
| 20080275521 | Vector Switching in an Implantable Cardiac Stimulus System - The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity. | 11-06-2008 |
| 20080294212 | Trending of systolic murmur intensity for monitoring cardiac disease with implantable device - Described is an implantable device configured to monitor for changes in the intensity and/or duration of a systolic murmur such as mitral regurgitation by means of an acoustic sensor. Such changes may be taken to indicate a change in a patient's heart failure status. Upon detection of a worsening in the patient's heart failure statue, the device may be programmed to alert clinical personnel over a patient management network and/or make appropriate adjustments to pacing therapy. | 11-27-2008 |
| 20080306563 | System and method for cardiovascular treatment or training - The invention provides a system and method for cardiovascular treatment or training of an individual. One or more venous return devices are used to alter the venous return in an individual, and one or more heart rate devices are used to alter the individual's heart rate. A processor activates the venous return devices and the one or more heart rate devices at one or more predetermined levels for one or more predetermined time durations | 12-11-2008 |
| 20080319498 | Apparatus and Method for Detecting Diastolic Heart Failure - In a method and implantable medical apparatus for detecting diastolic heart failure (DHF), and a pacemaker embodying such an apparatus, movement of the valve plane of the heart is measured and analyzed to identify a slowing of the movement of the valve plane as an indication of a DHF state of the heart. A signal indicative of this DHF state is emitted and, in the pacemaker, is used to control the administration of a pacing pulse therapy to the heart. | 12-25-2008 |
| 20090005829 | Measurement of Cardiac Performance Wtih Movement Sensors and Related Methods - Embodiments of the invention are related to implantable devices including movement sensors and related methods for measuring cardiac performance, amongst other things. In an embodiment, the invention includes an implantable electrical stimulation lead. The electrical stimulation lead can include a lead body having a proximal end and a distal end and a sheath defining a central lumen. The lead body can further include an electrical conductor disposed within the central lumen of the sheath. The stimulation lead can further include a stimulation electrode positioned at the distal end of the lead body, the stimulation electrode in electrical communication with the electrical conductor. The electrical stimulation lead can include an flexion sensor coupled to the lead body, the movement sensor configured to generate a signal in response to movement of the lead body. In an embodiment, the invention includes a method of monitoring the condition of a heart failure patient. In an embodiment, the invention includes a method of treating unstable arrhythmia in a patient. Other embodiments are also included herein. | 01-01-2009 |
| 20090018596 | BAROREFLEX ACTIVATION THERAPY DEVICE WITH PACING CARDIAC ELECTRICAL SIGNAL DETECTION CAPABILITY - An exemplary embodiment of the present invention provides systems, devices, and methods for using the same for activating (stimulating) the baroreflex system of a patient using a baroreflex activation system with pacing cardiac electrical signal detection capability. | 01-15-2009 |
| 20090043348 | INTERMITTENT STRESS AUGMENTATION PACING FOR CARDIOPROTECTIVE EFFECT - A device and method for delivering electrical stimulation to the heart in a manner which provides a protective effect is disclosed. The protective effect is produced by configuring a cardiac pacing device to intermittently switch from a normal operating mode to a stress augmentation mode in which the spatial pattern of lo depolarization is varied to thereby subject a particular region or regions of the ventricular myocardium to increased mechanical stress. | 02-12-2009 |
| 20090054944 | Modulation of AV delay to control ventricular interval variability - System and methods provide pacing therapy that modulates the atrioventricular (AV) delay to control ventricular interval variability. A base AV delay is determined as a function of heart rate. For each cardiac cycle, the base AV delay is modulated to reduce beat-to-beat variability of successive ventricular beats. The modulated AV delay compensates for variability of successive atrial beats. For example, modulation of the base AV delay may involve varying the AV delay inversely with a change in atrial interval. | 02-26-2009 |
| 20090076562 | SYSTEM AND METHOD FOR ADJUSTING AV/PV DELAY - A method for adjusting AV/PV delay using a pacing device may include: setting an initial AV/PV delay for the pacing device; setting a threshold for a value related to cardiac function; determining a value based on cardiac function or monitoring a value related to cardiac function; and controlling the AV/PV delay to lengthen the AV/PV delay when the determined/monitored value exceeds the set threshold. The system may include an implantable pacing device; and a processor configured to: set an initial AV/PV delay for the pacing device; set a threshold for a value related to cardiac function; at least one of monitor a value related to cardiac function and determine a value based on cardiac function; and control the AV/PV delay to lengthen the AV/PV delay when the value related to cardiac function or the value based on cardiac function exceeds the set threshold. | 03-19-2009 |
| 20090076563 | METHOD AND APPARATUS FOR TREATING IRREGULAR VENTRICULAR CONTRACTIONS SUCH AS DURING ATRIAL ARRHYTHMIA - A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V-V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable. | 03-19-2009 |
| 20090082823 | Variable shortening of AV delay for treatment of cardiac disease - An implantable pacing device for delivering ventricular pacing may be configured to intermittently and variably reduce the AV delay interval used in an atrial triggered pacing mode in a manner that simulates exercise. The device may be programmed to intermittently switch to and from a variably shortened AV delay mode according to defined entry and exit conditions. | 03-26-2009 |
| 20090082824 | METHOD FOR EXCLUSION OF ECTOPIC EVENTS FROM HEART RATE VARIABILITY METRICS - Heart rate variability metrics are derived from the intervals between successive heart beats, referred to as BB intervals. A method implementable by an implantable cardiac device for excluding BB intervals due to ectopic beats based on a function of preceding BB intervals is presented. It is desirable to remove such BB intervals from a BB interval time series used to calculate a heart rate variability metric. | 03-26-2009 |
| 20090093858 | IMPLANTABLE PULSE GENERATORS AND METHODS FOR SELECTIVE NERVE STIMULATION - An Implantable Pulse Generator (IPG) includes a surgically implantable housing, a battery, a first waveform generator, a second waveform generator, a modulator, and electrodes. The IPG produces a pulse envelope, a carrier waveform, and a modulated waveform. The pulse envelope is a low frequency waveform with specific pulse width, amplitude and shape to selectively stimulate a target nerve or body part. The carrier waveform is a high frequency waveform with properties such as amplitude, frequency and the like chosen so as to overcome tissue impedance and the stimulation threshold of the target nerve. The modulated waveform is the waveform obtained by modulating the carrier waveform by the pulse envelope. | 04-09-2009 |
| 20090093859 | APPARATUS FOR TREATING THE PHYSIOLOGICAL ELECTRIC CONDUCTION OF THE HEART - A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode. The pacemaker further includes a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart. The combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle. | 04-09-2009 |
| 20090099616 | METHOD AND APPARATUS FOR CONCURRENT ATRIO-VENTRICULAR ANTI-TACHYCARDIA PACING - An implantable medical device delivers anti-tachyarrhythmia therapies including anti-tachycardia pacing (ATP). If a detected tachyarrhythmia is classified as a type suitable for treatment using ATP, the implantable medical device selects one of an atrial ATP (A-ATP) mode, a ventricular ATP (V-ATP) mode, and a concurrent atrio-ventricular ATP (concurrent AV-ATP) mode according to the characteristics of the detected tachyarrhythmia. The concurrent ATP mode is an ATP mode during which the atrial pacing pulses and the ventricular pacing pulses are delivered concurrently. In one embodiment, the concurrent AV-ATP mode includes a synchronized atrio-ventricular ATP (synchronized AV-ATP) mode during which atrial and ventricular pacing pulses are delivered synchronously and an independent atrio-ventricular ATP (independent AV-ATP) mode during which atrial and ventricular pacing pulses are delivered concurrently but timed independently. | 04-16-2009 |
| 20090105778 | Cardiac Waveform Template Creation, Maintenance and Use - The present disclosure describes methods and systems for creating, adjusting, and using cardiac waveform morphology templates. The morphology templates include target regions associated with features of cardiac waveforms. The target regions may be adjusted based on relationships between the target regions and features of detected cardiac waveforms associated with the target regions. The templates may be used to analyze cardiac waveforms to classify or monitor various waveform morphologies. Templates may be created or eliminated based on a frequency of use. According to one approach, template creation involves providing target regions defined by one or more characteristics. The target regions are adjusted based on detected cardiac waveform features having similar characteristics. A template may be created using the target regions adjusted by this process. | 04-23-2009 |
| 20090112275 | IMPLANTABLE SYSTEM FOR FLOW MEASUREMENT INCLUDING CHARGE AMPLIFIER - An implantable medical device lead having a flow measurement sensor mounted thereon is provided with a capsule mounted proximate to the sensor. The capsule is used to house electrical circuitry corresponding to the sensor in order to prevent impedance on conductors of the lead, which gradually decreases over chronic periods, from directly affecting signal transmission between the sensor and the electrical circuitry. The electrical circuitry includes a charge amplifier used for processing signals from the sensor. In some cases, the amplifier can be initially calibrated and periodically tuned so as to have consistent functioning with the sensor over chronic periods. | 04-30-2009 |
| 20090112276 | DETERMINATION OF STIMULATION DELAY BETWEEN VENTRICULAR SITES - An earlier intrinsic activation and a later intrinsic activation of a right ventricle and a left ventricle are determined. This information is used for computing a biventricular pacing interval as a function of an interval from a pacing energy delivered to a ventricle corresponding to the later intrinsic activation and a depolarization sensed in a ventricle having earlier intrinsic activation, the depolarization evoked in response to the pacing energy. | 04-30-2009 |
| 20090125076 | SYSTEM FOR NEURAL THERAPY - This document discusses, among other things, a system and method for calculating a neural stimulation energy at an external patient management (EPM) system using received information about a chemical characteristic indicative of a physiological state of a subject. | 05-14-2009 |
| 20090131999 | Hemodynamic status assessment during tachycardia - Systems and methods provide for sensing, during an event of tachycardia, hemodynamic signals concurrently from at least two spatially separated locations within a patient, and quantifying a spatial relationship between the hemodynamic signals. Hemodynamic stability or state of the patient during the tachycardia event is determine based at least in part on the quantified spatial relationship. One or more anti-tachycardia therapies to treat the tachycardia may be selected based at least in part on the determined stability or state of patient hemodynamics, and the selected one or more anti-tachycardia therapies may be delivered to treat the tachycardia. The hemodynamic signals may comprise at least two, or a mixed combination, of cardiac impedance signals, cardiac chamber pressure signals, arterial pressure signals, heart sounds; and acceleration signals. | 05-21-2009 |
| 20090138060 | INTRACARDIAL ELECTRODE LINE AND CARDIAC STIMULATOR - The invention relates to an intracardial implantable electrode line for connection to an implantable medical device, in particular a cardiac pacemaker or cardioverter/defibrillator or the like, which has an acceleration sensor in the area of its distal end, which is implemented to record and differentiate acceleration values in at least two different directions. The invention additionally relates to a cardiac stimulation configuration which also has a cardiac stimulator in addition to such an electrode line. | 05-28-2009 |
| 20090143835 | Method and apparatus for delivering pacing pulses using a coronary stent - An implantable cardiac protection pacing system delivers pacing pulses to protect the heart from injuries associated with ischemia and myocardial infarction. The system includes an implantable pulse generator (PG) that delivers the pacing pulses and a coronary stent electrically connected to the implantable PG to function as a pacing electrode through which the pacing pulses are delivered. In one embodiment, an intravascular lead provides the electrical connection between the coronary stent and the implantable PG to allow the implantable PG to be implanted in the femoral region. In another embodiment, the coronary stent and the implantable PG are integrated into an intravascular pulse generator-stent. | 06-04-2009 |
| 20090149907 | AV DELAY FEATURES - An atrial event and a ventricular event can be received, and an atrioventricular (AV) delay can be provided using information about the atrial and ventricular events. The AV delay can be increased after a first condition is satisfied to allow a heart to regain intrinsic control of ventricular activation, and changed after a second condition is satisfied to allow the heart to remain in intrinsic control of ventricular activation. | 06-11-2009 |
| 20090157136 | MOTION-BASED OPTIMIZATION FOR PLACEMENT OF CARDIAC STIMULATION ELECTRODES - An exemplary method includes use of a multielectrode device that can help position a cardiac stimulation lead to an optimal site in the heart based at least in part on cardiac motion information acquired via the multielectrode device and one or more pairs of current delivery electrodes that establish potential fields (e.g., for use as a coordinate system). An exemplary multielectrode device may be a multielectrode catheter or a multifilar, electrode-bearing guidewire. Various other exemplary methods, devices, systems, etc., are also disclosed. | 06-18-2009 |
| 20090182390 | DELIVERY OF CRT THERAPY DURING AT/AF TERMINATION - In some embodiments, a method for operating a cardiac rhythm management device may include one or more of the following steps: (a) sensing atrial depolarizations through an implanted atrial electrode, (b) administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion, (c) switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode, (d) administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion, (e) analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia, (f) analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia, and (g) sensing ventricular depolarizations of the left and the right ventricle. | 07-16-2009 |
| 20090187227 | Data Manipulation Following Delivery of a Cardiac Stimulus in an Implantable Cardiac Stimulus Device - Methods of cardiac rhythm analysis in an implantable cardiac stimulus device, and devices configured for such methods. In an illustrative embodiment, certain data relating to cardiac event rate or amplitude is modified following delivery of a cardiac stimulus. In another embodiment, cardiac rhythm analysis is performed using one of plural states, with the plural states using different criteria, such as a detection threshold, to detect cardiac events in a sensed signal. Following delivery of a cardiac stimulus, data is manipulated to force the analysis into one of the states, where stimulus is delivered, in the illustrative embodiment, only after a different state is invoked. Implantable devices incorporating operational circuitry for performing such methods are also included in other illustrative embodiments. | 07-23-2009 |
| 20090192560 | CONFIGURABLE INTERMITTENT PACING THERAPY - This document discusses, among other things, an apparatus comprising at least one implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The implantable cardiac depolarization sensing circuit is configured to obtain a sensed depolarization signal from a ventricle and the electrical stimulation circuit is configured to provide pacing electrical stimulation energy to at least one implantable ventricular electrode. The pacing mode controller delivers pacing therapy according to a first pacing mode that is a normal operating mode, and delivers pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode. | 07-30-2009 |
| 20090198298 | METHODS AND SYSTEMS FOR USE IN SELECTING CARDIAC PACING SITES - A method and system for use in selecting a cardiac pacing site includes sensors for tracking wall motion (e.g., sensors coupled to the right and left ventricular heart wall). The wall motion of one or more non-paced cardiac cycles is compared to the wall motion of one or more paced cardiac cycles to determine the effectiveness of one or more pacing sites. For example, image data may be generated to notify the user as to the effectiveness of the one or more pacing sites. | 08-06-2009 |
| 20090198299 | METHOD AND APPARATUS FOR OPTIMIZING VENTRICULAR SYNCHRONY DURING DDD RESYNCHRONIZATION THERAPY USING ADJUSTABLE ATRIO-VENTRICULAR DELAYS - A pacing system for providing optimal hemodynamic cardiac function for parameters such as ventricular synchrony or contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal. | 08-06-2009 |
| 20090204164 | METHOD AND DEVICE FOR LOW-ENERGY TERMINATION OF ATRIAL TACHYARRHYTHMIAS - Methods for treating atrial arrhythmias can involve configuring an implantable arrhythmia treatment device. A device can be configured after implantation when the patient is fully conscious and after any pain suppression medication has worn off. The device is caused to apply a phased unpinning far field therapy to the patient in response to detection of an arrhythmia via a far field configuration of electrodes. An indication of a pain sensation of the patient and the effectiveness of the treatment in response to the therapy can then be received. In response, at least one of a set of therapy parameters is adjusted and the steps are repeated until it is determined that an effective treatment is provide at a pain sensation that is tolerable to the patient. The device is then programmed to automatically treat arrhythmias detected in the patient with the determined set of therapy parameters. | 08-13-2009 |
| 20090216291 | SYSTEM AND METHOD FOR DETECTING ELECTRIC EVENTS IN CHAMBERS OF A HEART - In a system and method for detecting electrical cardiac events, and a heart stimulator embodying such a system, cardiac events are detected in respective chambers of a heart by sensing electrical signals in at least two different chambers of the heart and forming a difference signal from the sensed signals, and using the difference signal to automatically distinguish between events originating from one of the chambers and events originating in another of the chambers. At least one of the sensed signals is sensed in a coronary vein on the left atrium or the left ventricle. | 08-27-2009 |
| 20090222054 | Method and System for Characterizing a Representative Cardiac Beat Using Multiple Templates - The present invention provides a method and system for characterizing one beat of a patient's supraventricular rhythm. A plurality of templates is provided and updated using a plurality of qualified beats. Updating occurs by temporally aligning the shock channel waveforms of the template beats using rate channel fiducial points. The template beats are combined by point-by-point addition of the shock channel waveforms. The resultant updated template characterizes one of the patient's supraventricular conducted cardiac beats. | 09-03-2009 |
| 20090228059 | METHOD AND DEVICE FOR LYMPHATIC SYSTEM MONITORING - A device and method are disclosed for physiological monitoring of the lymphatic system. An implantable device is configured with a lymphatic sensor disposed in a lymphatic vessel for sensing pressure, flow, and/or the concentration of particular markers within the vessel. The device may be further configured to deliver appropriate therapy in accordance with the lymphatic monitoring. | 09-10-2009 |
| 20090248103 | APPARATUS AND METHODS OF OPTIMIZING VENTRICLE-TO-VENTRICULAR PACING DELAY INTERVALS - Provided herewith are methods and apparatus for optimizing ventricle-to-ventricle (V-V) pacing delay intervals based upon ECG-based optimization calculated as a linear function of P-wave duration sensed PR (intrinsic) interval sensed (or paced) QRS duration and heart rate. Since the relationship among these parameters is linear once the coefficients are solved (which can be any value, including null) with reference to a known optimized V-V interval such as from an echocardiographic study, an operating V-V interval value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured more frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker. | 10-01-2009 |
| 20090254139 | IMPLANTABLE MEDICAL DEVICE WITH OPTIMIZATION PROCEDURE - In an implantable medical device and a method for the operation thereof, acoustic energy is sensed in a subject in whom the device is implanted, and signals indicative of heart sounds of the heart of the patient are produced over predetermined periods of a cardiac cycle, during successive cardiac cycles. A signal corresponding to the second heart sound (S | 10-08-2009 |
| 20090254140 | CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION USING PARAMETER ESTIMATION FROM REALTIME ELECTRODE MOTION TRACKING - An exemplary method includes providing at least two-dimensional position information, for at least two points in time, for an electrode located in a cardiac space; determining a local estimator based on the position information; and, based at least in part on the determined local estimator, selecting a configuration for delivering a cardiac pacing therapy or diagnosing a cardiac condition. Exemplary methods for regional estimators and exemplary methods for global estimators are also disclosed along with devices and systems configured to perform various methods. | 10-08-2009 |
| 20090264949 | ELECTROGRAM MORPHOLOGY-BASED CRT OPTIMIZATION - A method and system for determining an optimum atrioventricular delay (AVD) interval and/or ventriculo-ventricular delay (VVD) intervals for delivering ventricular resynchronization pacing in an atrial tracking or atrial sequential pacing mode. Evoked response electrograms recorded at different AVD and VVD intervals are used to determine the extent of paced and intrinsic activation. | 10-22-2009 |
| 20090281588 | DETERMINING ATRIAL TIME PERIODS IN CONJUNCTION WITH REAL-TIME TESTING - Time periods such as PVAB and PVARP are defined based on data acquired during real-time tests. For example, data may be collected during a real-time test that determines a sensing threshold or during a real-time test that determines a capture threshold. Time period information may then be derived based on correlations between the timing of far-field events and/or retrograde conduction derived from the acquired data and the timing of sensed or paced ventricular events. In some cases, the derived time period information may be used to provide timing recommendations for initial programming of an implantable device. | 11-12-2009 |
| 20090287269 | MEDICAL SYSTEM FOR MONITORING AND LOCALIZATION OF ELECTRODE LEADS IN THE HEART - A medical system has an implantable heart stimulator with sensing and stimulating pairs of electrodes, with an electric field through the heart being generated by the respective pairs by the application of alternating voltages at a preset frequency to the respective pairs. A signal receiver receives a signal representing the voltage potential difference between the voltage potential at one of the electrodes in the pair, and a reference electrode. The detected voltage is related to the generated electric field, and the signal receiver generates a potential different signal that is supplied to a control unit to determine parameters therefrom representing cardiac activity. | 11-19-2009 |
| 20090299427 | CORONARY VEIN DIMENSIONAL SENSOR AND FIXATION APPARATUS - A system and method for estimating a hemodynamic performance parameter value of a patient's heart. The system includes a pulse generator and a medical electrical lead implanted partially within a coronary vein of the heart. The lead includes at least one sensor located within the coronary vein configured to generate a signal indicative of at least one dimensional parameter of the coronary vein. Changes in the dimensional parameter during one or more cardiac cycles are measured. The hemodynamic performance parameter is estimated based on the change in the dimensional parameter of the coronary vein. | 12-03-2009 |
| 20090299428 | DETERMINATION OF HEMODYNAMIC INTOLERANCE OF VENTRICULAR PACING - In some examples, this disclosure describes techniques for assessing hemodynamic intolerance of ventricular pacing. A method comprises sensing a parameter indicative of autonomic tone during a first period in which a medical device delivers ventricular pacing to a patient, sensing the parameter indicative of autonomic tone during a second period in which the medical device does not deliver ventricular pacing to the patient, and assessing a level of change in autonomic tone in the patient induced by ventricular pacing based on values of the sensed parameter during the first and second periods. | 12-03-2009 |
| 20090318995 | CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION USING MECHANICAL DYSSYNCHRONY AND SHORTENING PARAMETERS FROM REALTIME ELECTRODE MOTION TRACKING - Therapy optimization includes tracking electrode motion using an electroanatomic mapping system and generating, based on tracked electrode motion, one or more mechanical dyssynchrony metrics to thereby guide a clinician in therapy optimization (e.g., via optimal electrode sites, optimal therapy parameters, etc.). Such a method may include a vector analysis of electrode motion with respect to factors such as times in cardiac cycle, phases of a cardiac cycle, and therapy conditions, e.g., pacing sites, pacing parameters and pacing or no pacing. Differences in position-with-respect-to-time data for electrodes may also be used to provide measurements of mechanical dyssynchrony. | 12-24-2009 |
| 20090326599 | CALIBRATION OF IMPEDANCE MONITORING OF RESPIRATORY VOLUMES USING THORACIC D.C. IMPEDANCE - A system includes an implantable medical device that includes a trans-thoracic impedance measurement circuit providing a trans-thoracic impedance signal of a subject. A controller is coupled to the trans-thoracic impedance circuit. The controller extracts a respiration signal from the trans-thoracic impedance signal, measures a breathing volume of the subject using the amplitude of the respiration signal and a breathing volume calibration factor, computes an adjusted breathing volume calibration factor using a reference baseline value of the trans-thoracic impedance and a measured baseline value of the trans-thoracic impedance, and computes a calibrated breathing volume using the adjusted breathing volume calibration factor. | 12-31-2009 |
| 20100004712 | SYSTEMS AND METHODS FOR USE BY AN IMPLANTABLE MEDICAL DEVICE FOR DETECTING HEART FAILURE BASED ON THE INDEPENDENT INFORMATION CONTENT OF IMMITANCE VECTORS - Techniques are provided for detecting heart failure or other medical conditions within a patient using an implantable medical device, such as pacemaker or implantable cardioverter/defibrillator, or external system. In one example, physiological signals, such as immittance-based signals, are sensed within the patient along a plurality of different vectors, and the amount of independent informational content among the physiological signals of the different vectors is determined. Heart failure is then detected by the implantable device based on a significant increase in the amount of independent informational content among the physiological signals. In response, therapy may be controlled, diagnostic information stored, and/or warning signals generated. In other examples, at least some of these functions are performed by an external system. | 01-07-2010 |
| 20100004713 | Methods and Devices for Accurately Classifying Cardiac Activity - Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In some examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. Several examples emphasize the use of morphology analysis using correlation to static templates and/or inter-event correlation analysis. | 01-07-2010 |
| 20100010554 | METHODS AND DEVICES FOR RESPONDING TO PREMATURE VENTRICULAR CONTRACTIONS WHILE IN AAI(R) MODE - While a cardiac device is in AAI(R) mode, a ventricular channel is monitored for a premature ventricular contraction (PVC). In response to detecting a PVC while the device is in AAI(R) mode, a refractory period is started in an atrial channel to prevent a retrograde atrial event that may occur due to the PVC from resetting an atrial escape interval (AEI). Additionally, during such a relative refractory period in the atrial channel, the atrial channel is monitored for a retrograde atrial event that may occur due to the PVC. If a retrograde atrial event is detected, then the refractory period in the atrial channel is terminated, and an anograde conduction restoration interval (ACRI) is started. The ACRI is a programmed period that specifies how long to wait after a retrograde atrial event is detected before pacing the atrium. | 01-14-2010 |
| 20100010555 | SYSTEM AND METHOD FOR CONTROLLING A HEART STIMULATOR - In a system and method for controlling an implantable stimulator capable of producing pacing pulses to be delivered to cardiac tissue, as well as vagal stimulation pulses to be delivered to vagus nerve sites, upon detection of a premature cardiac event, such as a premature ventricular or atrial contraction, a simulated heart rate turbulence (HRT) procedure is applied if the intrinsic heart rate turbulence is weakened or absent. The simulated HRT includes a first phase in which the heart rate is increased, from the existing level, for a number of heart beats, a second phase in which the heart rate is decreased for a number of heart beats, and an optional third phase in which the heart rate is returned to said existing level. | 01-14-2010 |
| 20100010556 | SYSTEMS AND METHODS FOR DELIVERING VAGAL NERVE STIMULATION - According to various method embodiments, a person is indicated for a therapy to treat a cardiovascular disease, and the therapy is delivered to the person to treat the cardiovascular disease. Delivering the therapy includes delivering a vagal stimulation therapy (VST) to a vagus nerve of the person at a therapeutically-effective intensity for the cardiovascular disease that is below an upper boundary at which upper boundary the VST would lower an intrinsic heart rate during the VST. | 01-14-2010 |
| 20100016915 | MEDICAL DEVICE AND SYSTEM FOR DETERMINING A HEMODYNAMIC PARAMETER USING INTRACARDIAC IMPEDANCE - In implantable medical devices such a pacemaker or cardioverter/defibrillators (ICDs) and systems including such a device and an external programmer a measure of a hemodynamic parameter such as the cardiac output, the stroke volume, or the contractility of a patient is used to trend heart failure or in an AV/VV optimization scheme. The implantable medical device is adapted to measure the cardiac impedance and the cardiac impedance data is used to determine impedance morphology curves, which, in turn, are used to compute a measure of the hemodynamic parameter. | 01-21-2010 |
| 20100016916 | APPARATUS AND METHODS FOR TREATMENT OF ATHEROSCLEROSIS AND INFARCTION - A pacing system delivers cardiac protective pacing therapy (CPPT) to protect the heart from injuries and/or to treat existing injuries. The pacing system receives a set of inputs and delivers optimized cardiac protection pacing tailored for different purposes. The system delivers electrical stimulation to modulate myocardial strain for anti-atherosclerosis therapy and/or to provide therapy for myocardial infarction (MI). In one embodiment, a medical device for treating atherosclerosis is provided. The medical device includes a sensing circuit to receive sensed signals to identify areas of coronary artery disease (CAD) or areas at risk for CAD using the sensed signals. The device also includes a pacemaker circuit adapted to deliver an electrical signal through at least one electrode to a myocardial target adjacent to the identified areas. According to various embodiments, a controller communicates with the sensing circuit and controls the pacemaker circuit to provide intermittent electrical stimulation to the myocardial target to induce periods of stretch on the vessel due to induce myocardial strain changes. The stimulation is targeted to attenuate or prevent atherosclerosis associated with the CAD, according to various embodiments. | 01-21-2010 |
| 20100016917 | CARDIAC PACING USING THE INFERIOR NODAL EXTENSION - A device and method for providing stimulation to an inferior nodal extension of a heart. The method includes providing a lead comprising an electrode, positioning the electrode proximate an inferior nodal extension of a heart, and effecting at least one of activation, deactivation, or modulation of the electrode to provide stimulation to the inferior nodal extension. | 01-21-2010 |
| 20100023080 | IMPLANTABLE MYOCARDIAL ISCHEMIA DETECTION, INDICATION AND ACTION TECHNOLOGY - One embodiment enables detection of MI/I and emerging infarction in an implantable system. A plurality of devices may be used to gather and interpret data from within the heart, from the heart surface, and/or from the thoracic cavity. The apparatus may further alert the patient and/or communicate the condition to an external device or medical caregiver. Additionally, the implanted apparatus may initiate therapy of MI/I and emerging infarction. | 01-28-2010 |
| 20100042172 | SYSTEM AND METHOD FOR ASSESSING ATRIAL ELECTRICAL STABILITY - A method for identifying a susceptibility of a subject to atrial-rhythm disturbances includes a) placing a plurality of sensors on the subject to measure a physiologic signal of the subject, and b) recording the physiologic signal from the sensor. The physiologic signal includes an atrial electrical activity of the subject. The method includes c) determining a beat-to-beat variability in the atrial electrical activity of the subject. The beat-to-beat variability includes alternans of electrocardiographic waveforms of a predetermined number of a sequence of heart beats. The method includes d) determining a susceptibility to atrial-rhythm disturbances of the subject using the beat-to-beat variability in the atrial electrical activity determined in step c), and e) generating a report of the susceptibility to atrial-rhythm disturbances of the subject. | 02-18-2010 |
| 20100049269 | MULTI-ELEMENT ACOUSTIC RECHARGING SYSTEM - An acoustic energy delivery system for delivering acoustic energy to an implantable medical device (“IMD”). The system includes an IMD having a power source and an energy delivery device. The energy delivery device includes a controller and an array of ultrasonic elements electrically coupled to the controller and configured to deliver acoustic energy to the IMD. Methods of delivering acoustic energy to an IMD are also disclosed. | 02-25-2010 |
| 20100057155 | IMPLANTABLE SYSTEMS AND METHOD FOR USE THEREWITH FOR TRACKING CHANGES IN HEMODYNAMICS AND CARDIAC DISEASE - Embodiments of the present invention relate to monitoring a patient's atrial stretch, heart failure (HF) condition, and/or risk of atrial fibrillation (AF), as well as methods for estimating a change in at least one of a patient's left atrial pressure (LAP), pulmonary capillary wedge pressure (PCWP), and right pulmonary artery pressure (RPAP). Embodiments of the present invention also relate to selecting a pacing energy level. Such embodiments involve determining atrial evoked response metrics when a patient's atrium is paced, and monitoring changes in such metrics. | 03-04-2010 |
| 20100057156 | OVERLAPPING PACING AND TACHYARRHYTHMIA DETECTION ZONES - An example implantable medical device (IMD), such as an implantable cardioverter defibrillator, may be configured to store a ventricular tachycardia zone, wherein the ventricular tachycardia zone specifies ventricular depolarization rates indicative of ventricular tachycardia, and to deliver pacing pulses to at least one ventricle of a heart in response to detecting intrinsic atrial depolarizations at rates within the ventricular tachycardia zone. The IMD may further store a maximum ventricular tracking rate that is greater than a lower bound of the ventricular tachycardia zone, and be further configured to deliver the pacing pulses to the at least one ventricle in response to detecting intrinsic atrial depolarizations at rates up to the maximum ventricular rate. In this manner, the IMD may be configured with overlapping pacing and tachyarrhythmia detection zones. In some examples, the IMD dynamically modifies the maximum ventricular tracking rate for ventricular tracking pacing within the ventricular tachycardia zone. | 03-04-2010 |
| 20100063560 | SAFETY PACING IN MULTI-SITE CRM DEVICES - Safety pacing in multi-site cardiac rhythm management (CRM) devices is provided. According to various method embodiments, a first cardiac signal from a first cardiac region and a second cardiac signal from a second cardiac region are sensed. The first cardiac region is paced to maintain at least a minimum cardiac rate, and the second cardiac region is paced to maintain at least the minimum cardiac rate when a pace in the first cardiac region is inhibited. Other aspects and embodiments are provided herein. | 03-11-2010 |
| 20100069987 | MONITORING HF EXACERBATION AND CARDIAC RESYNCHRONIZATION THERAPY PERFORMANCE - An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay parameter and an interventricular delay parameter, measuring an atrio-ventricular conduction delay, measuring an interventricular conduction delay, assessing heart failure and/or cardiac resynchronization therapy performance based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay and determining at least one of an atrio-ventricular delay parameter value and an interventricular delay parameter value based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay. Other exemplary technologies are also disclosed. | 03-18-2010 |
| 20100069988 | 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. | 03-18-2010 |
| 20100076512 | CARDIAC DEVICE INTERFACE TO REDUCE VENTRICULAR PACING - A cardiac interface device helps program an implantable cardiac rhythm or function management device, such as to reduce unnecessary ventricular pacing to avoid contributing to the advancement of heart failure disease progression. An intrinsic conducted AV interval is measured for at least one heart rate, and is predicted or measured for other heart rates. One or more of an age-predicted upper rate limit, a measured sensed AV offset, a PVARP based on measured retrograde conduction time can be used to determine an AV search hysteresis control parameter, and a resulting ventricular interval is graphically displayed relative to the intrinsic conducted AV interval at various heart rates. Confidence intervals or percentage ventricular pacing can also be displayed. Separate graphs for sense and pace initiated AV intervals can be provided. | 03-25-2010 |
| 20100076513 | Multiple Electrode Vectors for Implantable Cardiac Treatment Devices - The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity. | 03-25-2010 |
| 20100082076 | Method and means for connecting and controlling a large number of contacts for electrical cell stimulation in living organisms - An improved electrode for neural stimulation, including deep brain stimulation, cortical stimulation, muscle stimulation and other similar applications. The improvement of our invention over prior art consisting of the possibility of a larger number of electrode pads from where to originate the electrical stimulation, thereby offering the possibility of fine control of the location of the stimulating signal. Our invention discloses a system of address wires which controls switches and demultiplexers to select one of a plurality of wires and one of a plurality of electrode pads from where the electric stimulation starts, and latches that maintain some selected choices after the address buses go on to select other wires and other electrode tips. Our invention also discloses time delay lines which are used to keep the stimulating pulses for a pre-assigned time, after which the stimulating pulses stop until further instruction to start again. | 04-01-2010 |
| 20100087886 | METHOD AND DEVICE FOR PROCESSING CARDIAC SIGNALS - An electromedical implant having a far-field electrocardiogram detection unit connected or connectable to at least two implantable electrodes, at least one electrode of which is to be placed in the right atrium or right ventricle and is designed to record a far-field electrocardiogram via the terminal for the electrode to be placed in the right atrium or the right ventricle and one other electrode. The far-field electrocardiogram detection unit is connected to a far-field electrocardiogram evaluation unit, which is configured to detect signal features of the far-field electrocardiogram associated with an excitation or contraction of the left atrium and/or the left ventricle of the heart in a far-field electrocardiogram recorded by the far-field electrocardiogram detection unit. | 04-08-2010 |
| 20100094369 | Methods and Devices for Accurately Classifying Cardiac Activity - Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In illustrative examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. New methods for organizing the use of morphology and rate analysis in an overall architecture for rhythm classification and cardiac signal analysis are also discussed. | 04-15-2010 |
| 20100100145 | MEASUREMENT OF CARDIAC INFORMATION FOR CRT OPTIMZIATION IN THE PRESENCE OF CONDUCTION DYSFUNCTION OR ATRIAL ARRHYTHMIA - An exemplary method includes delivering a cardiac pacing therapy that includes an atrio-ventricular delay and an interventricular delay, providing a paced propagation delay associated with delivery of a stimulus to a ventricle, delivering a stimulus to the ventricle, sensing an event in the other ventricle caused by the stimulus, determining an interventricular conduction delay value based on the delivering and the sensing, determining a interventricular delay (Δ | 04-22-2010 |
| 20100100146 | MEDICAL DEVICE COMPRISING AN IMPEDANCE MEASUREMENT MEANS TO MEASURE VISCERAL FAT - A medical device having an impedance measurement circuit connected to at least two intracorporeal measurement electrodes arranged to measure the impedance of tissue inside the body of a patient. The impedance measurement circuit is adapted to apply a measurement current/voltage signal to the electrodes to measure and calculate the impedance of the measurement tissue, and to apply the calculated impedance value to a storage unit. The stored impedance values are used, by an analysis unit, to measure the amount of visceral fat of the tissue object inside the body of the patient. | 04-22-2010 |
| 20100100147 | MEDICAL DEVICE FOR DETECTING ISCHEMIA AND A METHOD FOR SUCH A DEVICE - In a method and medical device for detecting an ischemic episode and to determine a location of ischemia in a heart of a patient, an impedance measuring circuit measures the impedances in the tissue between electrodes of at least one electrode configuration according to a predetermined measurement scheme and an ischemia detector evaluates the measured impedance values using at least one reference impedance image of the heart to detect changes in the measured impedances that are consistent with an ischemia and to determine a location of the ischemia to at least one region of the image. | 04-22-2010 |
| 20100106209 | IDENTIFICATION AND REMEDIATION OF OVERSENSED CARDIAC EVENTS USING FAR-FIELD ELECTROGRAMS - In general, the disclosure is directed to techniques for identification and remediation of oversensed cardiac events using far-field electrograms (FFEGMs). Identification of oversensed cardiac events can be used in an ICD to prevent ventricular fibrillation (VF) detection, and thereby avoid delivery of an unnecessary defibrillation shock. Alternatively, or additionally, identification of oversensed cardiac events can be used in an ICD to support delivery of bradycardia pacing during an oversensing condition. In some cases, bradycardia pacing delivered in response to detection of oversensed cardiac events may include pacing pulses from multiple vectors to provide redundancy in the event the oversensing may be due to a lead-related condition. | 04-29-2010 |
| 20100106210 | IMPLANTABLE MEDICAL SYSTEM FOR DETECTING INCIPIENT EDEMA - An implantable medical system for detecting incipient edema has an implantable medical lead including an optical sensor having a light source and a light detector. The medical system further has an edema detection circuit that activates the light source to emit light, the light being directed into lung tissue of a patient and that obtains a light intensity value corresponding to an intensity of light received by the light detector, and that evaluates the light intensity value to detect a consistency with incipient edema. | 04-29-2010 |
| 20100106211 | Automatic Activation of Medical Processes - Systems and methods involve automatic activation, de-activation or modification of therapies or other medical processes based on brain state. A medical system includes a sensor system having one or more sensors configured to sense signals related to the brain state of the patient. A brain state analyzer detects various brain states, including sleep stage and/or brain seizures. A controller uses the brain state detection information to control a medical system configured to perform at least one respiratory or cardiac process. Methods involve sensing signals related to brain state and determining the brain state of a patient based on the sensed signals. At least one respiratory or cardiac medical process is controlled based on the patient's brain state. | 04-29-2010 |
| 20100114227 | Systems and Methds for Use by an Implantable Medical Device for Controlling Vagus Nerve Stimulation Based on Heart Rate Reduction Curves and Thresholds to Mitigate Heart Failure - Systems and techniques are provided for controlling vagus nerve stimulation (VNS) delivered by an implantable medical device for mitigating heart failure in a patient. In one mode, VNS therapy is set to levels just below a heart rate reduction threshold so as to deliver VNS near the highest stimulation levels that can be achieved without reducing patient heart rate. In this manner, a maximum level of heart failure mitigation can be achieved via VNS therapy without incurring the potentially adverse consequences of inducing bradycardia within the patient. In another mode, VNS therapy is instead controlled to deliver VNS above the threshold so as to mitigate heart failure while also selectively reducing heart rate, as may be appropriate in patients susceptible to cardiac ischemia. A controlled heart rate reduction curve may additionally or alternatively be determined for use in achieving target amounts of heart rate reduction. | 05-06-2010 |
| 20100114228 | SYSTEM AND METHOD FOR ACCURATELY DETECTING CARDIAC EVENTS USING RETROSPECTIVE CORRELATION - A system and method enables precise detection of the time of occurrence of a cardiac event of a heart. The method includes the steps of sensing electrical activity of the heart to generate an electrogram signal including the cardiac event, storing the electrogram signal, correlating the electrogram signal with an electrogram template, and identifying the time of occurrence of the cardiac event based upon the correlation. | 05-06-2010 |
| 20100114229 | METHOD AND APPARATUS FOR ASSESSING LEFT VENTRICULAR FUNCTION AND OPTIMIZING CARDIAC PACING INTERVALS BASED ON LEFT VENTRICULAR WALL MOTION - A system and method for monitoring left ventricular (LV) lateral wall motion and for optimizing cardiac pacing intervals based on left ventricular lateral wall motion is provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with a motion sensor electromechanically coupled to the lateral wall of the left ventricle. The device receives and processes wall motion sensor signals to determine a signal characteristic indicative of systolic LV lateral wall motion or acceleration. An automatic pacing interval optimization method evaluates the LV lateral wall motion during varying pacing interval settings, including atrial-ventricular intervals and inter-ventricular intervals and selects the pacing interval setting(s) that correspond to LV lateral wall motion associated with improved cardiac synchrony and hemodynamic performance. | 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 |
| 20100121397 | System and Method for Evaluating Mechanical Cardiac Dyssynchrony Based on Multiple Impedance Vectors Using an Implantable Medical Device - Techniques are provided for evaluating mechanical dyssynchrony within the heart of patient in which a pacemaker, implantable cardioverter-defibrillator (ICD) or other medical device is implanted. In one example, a set of cardiogenic impedance signals are detected along different sensing vectors passing through the heart of the patient, particularly vectors passing through the ventricular myocardium. A measure of mechanical dyssynchrony is detected based on differences, if any, among the cardiogenic impedance signals detected along the different vectors. In particular, differences in peak magnitude delay times, peak velocity delay times, peak magnitudes, and waveform integrals of the cardiogenic impedance signals are quantified and compared to detect abnormally contracting segments, if any, within the heart of the patient. Warnings are generated upon detection of any significant increase in mechanical dyssynchrony. Diagnostic information is recorded for clinical review. Pacing therapies such as cardiac resynchronization therapy (CRT) can be activated or controlled in response to mechanical dyssynchrony to improve the hemodynamic output of the heart. | 05-13-2010 |
| 20100121398 | IMPLANTABLE MEDICAL DEVICE AND METHOD FOR MONITORING VALVE MOVEMENTS OF A HEART - An implantable medical device for monitoring the movements of the valve planes of the heart to determine at least one hemodynamic measure reflecting a mechanical functioning of a heart of a patient, includes an impedance measuring circuit that measures impedance between at least electrode pairs including at least one electrode placed substantially at the level of the valve plane. The measured impedances reflect valve plane movements. A hemodynamic parameter determining circuit determines at least one hemodynamic parameter based on the impedances reflecting the mechanical functioning of the heart. | 05-13-2010 |
| 20100121399 | CLOSED LOOP NEURAL STIMULATION SYNCHRONIZED TO CARDIAC CYCLES - Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein. | 05-13-2010 |
| 20100131026 | METHOD AND APPARATUS FOR USING HEART RATE VARIABILITY AS A SAFETY CHECK IN ELECTRICAL THERAPIES - A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used as a safety check to stop an electrical therapy when it is believed to be potentially harmful to continue the therapy. | 05-27-2010 |
| 20100137932 | METHOD AND APPARATUS FOR OPTIMIZING ELECTRICAL STIMULATION PARAMETERS USING HEART RATE VARIABILITY - A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used to evaluate a plurality of parameter values for selecting an approximately optimal parameter value. | 06-03-2010 |
| 20100145402 | INTELLIGENT CONTROL SYSTEM FOR ADAPTIVE CARDIAC RESYNCHRONIZATION THERAPY DEVICE - An adaptive CRT control system that achieves optimal AV delay and VV pacing intervals associated with temporal patterns of stroke volumes that represent internally the heart conditions is disclosed. The adaptive CRT control system includes: (a) at least two implanted electrodes in patient heart and at least additional one hemodynamic sensor able to indicate the stroke volume heartbeat after heartbeat; (b) an input pre processing stage synchronizer priority classifier that synchronize on the sensed atrial event, classify heart conditions and associate the learned optimal pacing intervals according to prioritized operational modes and learning schemes; (c) a learning module that with the input stage synchronizer priority classifier processes the inputs of the implanted electrodes and hemodynamic sensor and using a reinforcement learning scheme learns to achieve and to associate optimal pacing intervals at each heart condition with temporal patterns of stroke volumes; (d) an algorithmic micro-controller module that supervises the learning module and control a pulse generator module, and (f) a pulse generator that delivers therapeutic stimulation to the patient heart. | 06-10-2010 |
| 20100145403 | SENSING RATE OF CHANGE OF PRESSURE IN THE LEFT VENTRICLE WITH AN IMPLANTED DEVICE - An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing. | 06-10-2010 |
| 20100145404 | T-WAVE ALTERNANS TRAIN SPOTTER - A method and system for detecting T-wave alternans for use in an implanted medical device uses wave transformation of QT intervals to obtain a reliable measure of TWA. In one embodiment, an array provides alternating sign multiplication factors which are applied respectively to n consecutive QT values. Each successive QT value is high pass filtered and moved sequentially through a queue so that each cycle each of the n QT values is multiplied by one of the factors; the products are summed and made absolute to provide an alternans match value. The alternans match is compared with a noise threshold signal, and alternans is declared when the match exceeds the threshold by a predetermined amount. The array is programmable and can be varied, providing a high degree of flexibility to optimize the test for the patient. | 06-10-2010 |
| 20100152804 | SECURE AND EFFICACIOUS THERAPY DELIVERY FOR A PACING ENGINE - The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate. | 06-17-2010 |
| 20100160992 | IMPLANTABLE MEDICAL DEVICE, SYSTEM AND METHOD - In an implantable medical device and method for monitoring a lung deficiency in a patient, a housing containing a control circuit. Is implanted in a patient. The control circuit is configured to analyze one or more signals that represent the breathing of the patient. The control circuit is also configured to monitor a relationship between an expiratory phase and an inspiratory phase of the breathing cycle, or an analogous relationship, and to monitor a change in the lung deficiency by monitoring a change in this relationship. | 06-24-2010 |
| 20100168812 | METHOD AND DEVICE FOR COLLECTING REM SLEEP DATA - In a method and a device for trending and prediction of monitored conditions or diseases, an REM sleep detector is provided to allow data collected during REM sleep to be separated from other data so stable and uniform conditions for data collection are achieved. The REM sleep detector can advantageously be provided inside an implantable medical device. | 07-01-2010 |
| 20100174333 | DUAL CHAMBER PACEMAKER - An implantable medical device and a method for operating such a device to provide cardiac pacing to the heart of a patient for pacing hearts of patients suffering from periodical or intermittent atrio-ventricular blocks, for example, AV block or HIS block. A control circuit operates the device in a DDI-II mode, the DDI-II mode being an operation mode with an atrial inhibited pacing and a DDI-II mode ventricular pacing rate being lower than a predetermined base rate of a pulse circuit of the device, during periods with atrio-ventricular conduction conditions. If a block in atrio-ventricular conduction is detected and at least one first switching criterion is satisfied, the control circuit causes a switching circuit to switch from the DDI-II mode to the DDI mode and, if a block in atrio-ventricular conduction is detected and at least one second switching criterion is satisfied, the control circuit causes the switching circuit to switch from the DDI mode to the DDD mode. The control circuit is adapted to control the switching circuit to switch back to the DDI-II mode at satisfaction of a reinitiating criterion. | 07-08-2010 |
| 20100174334 | SYSTEM AND METHOD FOR PROVIDING IMPROVED ATRIAL PACING BASED ON PHYSIOLOGICAL NEED - An implantable medical device operates according to a ventricular pacing protocol (VPP) that precludes ventricular pacing in any cardiac cycle where a sensed ventricular event has occurred in the preceding cycle. Improved ventricular sensing, detection and classification is provided. | 07-08-2010 |
| 20100179610 | METHODS AND DEVICES FOR MONITORING MYOCARDIAL MECHANICAL STABILITY - Embodiments of the present invention relate to implantable systems, and methods for use therewith, for monitoring myocardial mechanical stability based on a signal that is indicative of mechanical functioning of a patient's heart for a plurality of consecutive beats. Certain embodiments use time domain techniques, while other embodiments use frequency domain techniques, to monitor myocardial mechanical stability. In certain embodiments the patient's heart is paced using a patterned pacing sequence that repeats every N beats. In other embodiments, the patient's heart need not be paced. This abstract is not intended to be a complete description of, or limit the scope of, the invention. | 07-15-2010 |
| 20100179611 | IMPLANTABLE MEDICAL DEVICE WITH ADAPTIVE SIGNAL PROCESSING AND ARTIFACT CANCELLATION - A medical device includes one or more sensors used to acquire a multi-dimensional signal. In one embodiment, principal component analysis is performed on the multi-dimensional signal to produce signal data. The principal component analysis results are used to cancel signal artifact in one embodiment. A medical device controller produces one of a therapy control and a diagnostic output in response to the signal data. | 07-15-2010 |
| 20100198290 | DISTANCE-BASED ANALYSIS OF RETURN CYCLES FOR TACHYCARDIA DISCRIMINATION - A medical device and associated method classify a tachycardia according to a site of origin of the tachycardia. Cardiac signals are sensed and a tachycardia event is detected in response to the sensed cardiac signals. Pacing pulses are delivered and a time interval corresponding to a distance traversed by a depolarization associated with the last one of the pacing pulses from a site of delivery of the plurality of pacing pulses is determined. The tachycardia event is classified according to a site of origin in response to the determined time interval. | 08-05-2010 |
| 20100198291 | FUSION PACING INTERVAL DETERMINATION - Delivery of fusion pacing therapy to a later depolarizing ventricle (V | 08-05-2010 |
| 20100198292 | EVALUATING ELECTRODE CONFIGURATIONS FOR DELIVERING CARDIAC PACING THERAPY - Described techniques include delivering cardiac pacing therapy from a medical device to a chamber of a heart via a first electrode configuration and determining that the delivery of cardiac pacing therapy via the first electrode configuration inadequately captures the chamber. In response to such a determination, the medical device delivers cardiac pacing therapy to the chamber of the heart via a plurality of additional electrode configurations. The techniques further comprise determining a capture characteristic for each of the additional electrode configurations based on the delivery of cardiac pacing therapy to the chamber of the heart via the plurality of other electrode configurations. A new electrode configuration for cardiac pacing may be selected based on the capture characteristics of the various electrode configurations. | 08-05-2010 |
| 20100198293 | PACING THERAPY ADJUSTMENT BASED ON VENTRICULO-ATRIAL DELAY - Techniques for adjusting pacing therapy based on ventriculo-atrial delay are described herein. These techniques may be used to control ventricular filling times during the delivery of pacing therapy. In some examples, a device or system delivers pre-excitation fusion pacing therapy to a ventricular chamber, determines a ventriculo-atrial delay interval for the ventricular chamber for at least one cardiac cycle, and adjusts the pacing therapy delivered by the implantable medical device to compensate for decreased ventricular filling time when the ventriculo-atrial delay interval is less than a threshold. In some examples, the device or system may adjust the pacing therapy by decreasing a pacing rate of the implantable medical device, increasing a pre-excitation interval for pacing of the ventricular chamber, and/or switching from a fusion pacing mode to a biventricular pacing mode. | 08-05-2010 |
| 20100217345 | MICROPHONE FOR REMOTE HEALTH SENSING - A health sensing device is described for placement on a user. The device may include a sensor, a filter, and a transmitter. The sensor is configured to sense one or more factors relating to an indicator of a health related condition or occurrence. The filter is configured to evaluate a signal from the sensor and determine if the indicator has been detected. The transmitter is arranged for initiating a transmission based on a signal from the filter. The sensor can include one or more microphone devices, accelerometers, and/or MEMs devices. A method of monitoring a user for a health related condition is also described. | 08-26-2010 |
| 20100222836 | IMPLANTABLE CARDIAC STIMULATOR, DEVICE AND METHOD FOR MONITORING THE HEART CYCLE IN A HUMAN HEART - In a device for monitoring the heart cycle of a human heart such that coronary flow may be maintained at a desired level, and a heart stimulator including such a device, the monitoring device is connectable to a first sensor adapted to be positioned at a first location of the heart and arranged for sensing cardiac wall movements at the first location, and to a second sensor adapted to be positioned at a second location of the heart and arranged for sensing cardiac wall movements at said second location. Processing circuitry receives output signals from the first and second sensors, which output signals are indicative of myocardial relaxation at said first and second locations. The processing circuitry determines the time of myocardial relaxation at the first and second locations, and provides a diastolic synchronization signal indicative of the synchrony in the time of myocardial relaxation between the first location and the second location. | 09-02-2010 |
| 20100222837 | SYSTEM AND METHOD FOR CONDITIONAL BIVENTRICULAR PACING - An implantable pacing system with single, double and triple chamber pacing capabilities, provided individually or in concert on a conditional or continuous basis depending upon ongoing analyses of atrial rhythm status, atrioventricular conduction status and ventricular rate. A mode is selected to reduce the occurrence of any ventricular pacing in favor of intrinsic atrioventricular and ventricular conduction. If excessively long PR intervals are occurring too frequently or atrioventricular conduction is unreliable or absent, the implantable pulse generator is operated in a conditional triple chamber pacing mode that provides atrial-synchronous biventricular pacing in every cardiac cycle for a period of time as necessary to restore and maintain AV synchrony, while minimizing ventricular asynchrony otherwise associated with monochamber RV pacing as in conventional dual chamber pacing systems. Similarly, biventricular pacing is provided in every cardiac cycle when ventricular rates are undesirably slow during atrial fibrillation, where AV synchronization is excluded. | 09-02-2010 |
| 20100222838 | SYSTEM AND METHOD FOR CONDITIONAL BIVENTRICULAR PACING - An implantable pacing system with single, double and triple chamber pacing capabilities, provided individually or in concert on a conditional or continuous basis depending upon ongoing analyses of atrial rhythm status, atrioventricular conduction status and ventricular rate. A mode is selected to reduce the occurrence of any ventricular pacing in favor of intrinsic atrioventricular and ventricular conduction. If excessively long PR intervals are occurring too frequently or atrioventricular conduction is unreliable or absent, the implantable pulse generator is operated in a conditional triple chamber pacing mode that provides atrial-synchronous biventricular pacing in every cardiac cycle for a period of time as necessary to restore and maintain AV synchrony, while minimizing ventricular asynchrony otherwise associated with monochamber RV pacing as in conventional dual chamber pacing systems. Similarly, biventricular pacing is provided in every cardiac cycle when ventricular rates are undesirably slow during atrial fibrillation, where AV synchronization is excluded. | 09-02-2010 |
| 20100222839 | SYSTEM AND METHOD FOR CONDITIONAL BIVENTRICULAR PACING - A medical device having a plurality of electrodes sensing cardiac signals, and a microprocessor operably coupled to the plurality of electrodes and configured to determine a cumulative atrioventricular interval (AVI) burden in response to the sensed cardiac signals, and to switch operation of the device between a minimal biventricular pacing (MBVP) mode and a conditional triple chamber pacing (CTCP) mode in response to the determined AVI burden. | 09-02-2010 |
| 20100228310 | SYSTEMS AND METHODS FOR AUTONOMIC NERVE MODULATION - According to various embodiments of a method for modulating autonomic neural activity in a body having a spinal cord, a subclavian vein and thoracic lymphatic vessels that include a thoracic duct and a right lymphatic duct, at least one programmed therapy is implemented using an implanted medical device to modulate autonomic neural activity. Implementing the therapy includes increasing or decreasing sympathetic activity in sympathetic nerves branching from a first region of the spinal cord using a first electrode in the thoracic duct, and further includes increasing or decreasing parasympathetic activity in parasympathetic nerves adjacent to the desired thoracic lymphatic vessel or sympathetic activity in sympathetic nerves branching from a second region of the spinal cord using a second electrode in the desired thoracic lymphatic vessel. | 09-09-2010 |
| 20100234912 | FLEXIBLE NEURAL STIMULATION ENGINE - A method for implementing a neural stimulation therapy mode in an implantable medical device (IMD) comprising the acts of mapping respective device states, defined by one or more timer states that include at least one neural event timer or one or more indications of one or more sensed physiologic events, to associated device actions in a stored neural table, storing an event represented as a device status word and a time stamp in a queue in response to an action input, and comparing one or more current timer states or one or more indications of one or more sensed physiologic events to a device state contained in the neural table and, if found to match, causing performance of one or more associated device actions, wherein the device actions include one or more of a neural stimulation energy delivery or a change in one or more timer states. | 09-16-2010 |
| 20100234913 | CLOSED LOOP PROGRAMMING FOR INDIVIDUAL ADJUSTMENT OF ELECTRO-MECHANICAL SYNCHRONY - An implantable therapy system including implantable stimulation and control components. The implantable components operate under a set of variable parameters that can be adjusted for improved performance for an individual patient. The implantable components are adapted to self-evaluate the patients physiologic performance and autonomously adjust an existing set of parameters to improve performance throughout an implantation period without requiring intervention of a clinician, for example with a physicians programmer. The implantable components can compare a patient's exhibited activity to a desired template of that activity to determine when adjustments are indicated. The template can be based on observations of one or more third parties exhibiting normal activity. The implantable components can adjust the operating parameters to improve synchrony of multiple heart chambers and/or to increase a peak contractility. | 09-16-2010 |
| 20100234914 | IMPLANTABLE MEDICAL DEVICE DIAGNOSTIC DATA ACQUISITION AND STORAGE - A method carried out by a therapeutic implantable medical device includes detecting a plurality of physiologic episodes and recording a set of diagnostic data associated with the plurality of physiological episodes. The plurality of physiologic episodes are prioritized based on episode types associated with the physiologic episodes. The diagnostic data is analyzed based on a minimum and maximum number associated with each episode type relating to a minimum and maximum number of sets of diagnostic data to be recorded for the associated episode type. The recorded set of diagnostic data is deleted only if a later recorded set of diagnostic data is associated with a detected physiologic episode having an episode type of a higher priority, and deletion of the set of diagnostic data would not result in fewer sets of diagnostic data than the minimum number specified for the episode type associated with the set of diagnostic data. | 09-16-2010 |
| 20100241185 | STEERABLE EPICARDIAL PACING CATHETER SYSTEM PLACED VIA THE SUBXIPHOID PROCESS - The epicardial pacing system and related method includes an epicardial catheter configured to be disposed in the middle mediastinum of the thorax of a subject for use in electrical pacing of the heart at one or more locations on the epicardial surface. The epicardial pacing catheter may include at least one electrode whereby the electrode is insulated on at least one side to allow pacing of the heart without damage to adjacent anatomical structures. | 09-23-2010 |
| 20100249864 | METHOD AND APPARATUS FOR DETERMINING VARIATION OVER TIME OF A MEDICAL PARAMETER OF A HUMAN BEING - An apparatus for determining variation over time of a medical parameter of a human being obtained from a sensed signal has a sensor implantable in the human being for sensing the signal. A comparator compares at least one characteristic property, derived from the sensed signal obtained for at least one predetermined first level of activity of the human being, with corresponding reference property of a sensed reference signal, obtained for a predetermined reference level of activity of the human being, for determining a relation between the characteristic property of the sensed signal and the reference property. A trend determining unit determines trends in the medical parameter by analyzing the relation between the characteristic property of the sensed signal obtained at different times and the reference property. A corresponding method also function an implant for heart failure diagnostics also function as described. A sensor is then arranged to pick up dynamic mechanical information from the heart of the human being and generate a corresponding signal. A heart stimulator includes such an implant and a control unit arranged to control stimulation of the heart depending on determined trends in the medical parameter. | 09-30-2010 |
| 20100249865 | Systems and Methods for Anemia Detection, Monitoring, and Treatment - Methods and systems for implantably determining a patient's anemia status and treating anemia are described. Blood viscosity is compared one or more thresholds to determine a patient's anemia status. Therapy, in the form of electrical stimulation therapy or administration of a pharmaceutical delivered to the patient's kidneys or hypothalamus is controlled based on the anemia status. | 09-30-2010 |
| 20100249866 | CARDIAC PACING SYSTEM FOR PREVENTION OF VENTRICULAR FIBRILLATION AND VENTRICULAR TACHYCARDIA EPISODE - A cardiac pacing system preventing short-long-short pacing sequences. The system providing pacing pulses where necessary. The system having dynamic event window generation to adapt to changes in heart rate. The event window adaptable to process a number of intervals. The system including provisions for other inputs, such as sensor and morphology detection. The system adaptable for single mode and dual mode applications. The system also applicable to long pause prevention in atrial pacing and ventricular pacing. | 09-30-2010 |
| 20100262204 | Anodal Stimulation Detection and Avoidance - Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse. | 10-14-2010 |
| 20100262205 | STIMULATION DESIGN FOR NEUROMODULATION - The present application relates to a new stimulation design which can be utilized to treat neurological conditions. The stimulation system produces a burst mode stimulation which alters the neuronal activity of the predetermined site, thereby treating the neurological condition or disorder. The burst stimulus comprises a plurality of groups of spike pulses having a maximum inter-spike interval of 100 milliseconds. The burst stimulus is separated by a substantially quiescent period of time between the plurality of groups of spike pulses. This inter-group interval may comprise a minimum of 5 seconds. | 10-14-2010 |
| 20100286738 | INTERMITTENT HIGH-ENERGY CARDIAC STIMULATION FOR THERAPEUTIC EFFECT - A device and method for delivering high-energy electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The high-energy stimulation mimics the effects of exercise and improves symptoms even in patients who are exercise intolerant. The high-energy stimulation may be delivered on an intermittent basis either as pacing pulses in accordance with a programmed pacing mode and with a higher pacing pulse energy than used for conventional pacing or as low energy shock pulses. | 11-11-2010 |
| 20100286739 | Cardiac Rhythm Pacing Rate Selection for Automatic Capture Threshold Testing - Cardiac devices and methods that select pacing rates for automatic threshold tests based on a patient's hemodynamic need. A sensor-indicated pacing rate corresponding to a patient's hemodynamic need is determined. A test pacing rate is selected from either the sensor-indicated rate or another rate. Capture threshold testing is performed using the selected pacing rate. | 11-11-2010 |
| 20100298903 | SELF-DIAGNOSTIC METHOD AND SYSTEM FOR IMPLANTABLE CARDIAC DEVICE - A self-diagnostic system for an implantable cardiac device such as a pacemaker, cardioverter, or resynchronization device which utilizes a subcutaneous ECG channel is described. The subcutaneous ECG channel allows the device to, in real time and independent of the standard pacing and sensing circuitry, verify the presence of pacing spikes, chamber senses, and other device outputs and hence establish and verify device integrity. | 11-25-2010 |
| 20100298904 | IMPLANTABLE HEART STIMULATOR FOR MEASURING DYSSYNCHRONY USING IMPEDANCE - Implantable heart stimulator connectable to an electrode arrangement has a pulse generator adapted to deliver stimulation pulses to a heart of a subject; an impedance measurement unit adapted monitor at least one heart chamber of the heart of the subject to measure the impedance in the at least one monitored heart chamber for generating an impedance signal corresponding to the measured impedance. The impedance signal is applied to a processor where the signal is processed, according to specified criteria, and a fractionation index value is determined represented by the curve length of the impedance signal during a predetermined measurement period. The fractionation index value is a measure of different degrees of mechanical dyssynchrony of the heart. | 11-25-2010 |
| 20100305640 | METHOD, DEVICE, IMPLANTABLE STIMULATOR AND DUAL CHAMBER CARDIAC THERAPY SYSTEM - In a device and method in a dual chamber pacing system operating in an atrial synchronized mode, the cardiac stimulator is connectable to a lead arrangement arranged for sensing atrial electrical and mechanical activity. Upon detection of an atrial arrhythmia based on either of sensed atrial mechanical activity, atrial electrical activity, or a combination thereof, a mode switch from an atrial synchronized ventricle stimulating mode to a non-atrial synchronized mode is triggered. | 12-02-2010 |
| 20100305641 | SYSTEM AND METHOD FOR DETECTING PULMONARY EDEMA BASED ON IMPEDANCE MEASURED USING AN IMPLANTABLE MEDICAL DEVICE DURING A LEAD MATURATION INTERVAL - Techniques are provided for use by implantable medical devices such as cardiac resynchronization therapy (CRT) devices for detecting pulmonary edema based on transthoracic impedance sensed using cardiac pacing/sensing leads, wherein detection can be performed while lead maturation occurs. Briefly, the implantable device determines whether the leads are within an initial post-implant interval following implant during which lead maturation generally occurs. The device then detects pulmonary edema or related medical conditions within the patient based on transthoracic impedance using a set of detection parameters adjusted for use during the post-implant interval. Thus, rather than “blanking” impedance data during lead maturation, the device instead detects and processes impedance during this period to identify possible episodes of pulmonary edema so that appropriate measures can be undertaken, such as delivery of warnings or titration of appropriate medications. | 12-02-2010 |
| 20100305642 | ADAPTIVE EVENT STORAGE IN IMPLANTABLE DEVICE - Monitoring physiological parameter using an implantable physiological monitor in order to detect a condition predictive of a possible future pathological episode and collecting additional physiological data associated with the condition predictive of a possible future pathological episode. Monitoring another physiological parameter in order to detect a condition indicative of the beginning of a present pathological episode and collecting additional pathological data in response to the condition. Determining that the condition predictive of a future episode and the condition indicative of a present episode are associated and, in response thereto, storing all the collected physiological data. | 12-02-2010 |
| 20100305643 | VENTILATION SENSOR RATE RESPONSE NORMALIZATION AND CALCULATION - A cardiac rhythm management (CRM) device can extract ventilation information from thoracic impedance or other information, and adjust a delivery rate of the CRM therapy. A tidal volume of a patient is measured and used to adjust a ventilation rate response factor. The measured tidal volume can optionally be adjusted using a ventilation rate dependent adjustment factor. The ventilation rate response factor can also be adjusted using a maximum voluntary ventilation (MVV), an age predicted maximum heart rate, a resting heart rate, and a resting ventilation determined for the patient. In various examples, a global ventilation sensor rate response factor (for a population) can be programmed into the CRM device, and automatically tailored to be appropriate for a particular patient. | 12-02-2010 |
| 20100305644 | APPARATUS AND METHOD FOR TESTING AND ADJUSTING A BIPOLAR STIMULATION CONFIGURATION - A system and method for measuring the capture threshold of a bipolar lead in order to determine an appropriate value for the stimulus pulse energy to be used with the lead by a cardiac rhythm management device. An appropriate bipolar stimulating configuration can also be determined. The method is particularly useful in testing bipolar leads used to excite the left ventricle such as when delivering cardiac resynchronization therapy. | 12-02-2010 |
| 20100305645 | TACHYARRHYTHMIA DETECTION AND DISCRIMINATION BASED ON CURVATURE PARAMETERS - Estimating a frequency of a sampled cardiac rhythm signal and classifying the rhythm. The received signal is sampled and transformed into a curvature series. A lobe in the curvature series corresponds to a characteristic point in the sampled series. Characteristic points are selected based on a time of a lobe in the curvature series and, in one embodiment, an amplitude of the signal at the time of the lobe. A frequency of the sampled series is estimated by autocorrelating a function of the series of the characteristic points. In one embodiment, the function is a time difference function. The rhythm is classified by plotting the timewise proximity of characteristic points derived from an atrial signal with characteristic points derived from a ventricular signal. Regions of the plot are associated with a particular rhythm and the grouping of the data corresponds to the classification. | 12-02-2010 |
| 20100312301 | SYSTEM AND METHOD FOR MONITORING CARDIOVASCULAR PRESSURE - A method for modulating one or more functions of an implanted medical device is disclosed. The method includes measuring a cardiovascular pressure of a patient; evaluating the cardiovascular pressure based on one or more characteristics of a cardiac cycle of the patient at the time the pressure was measured; and modulating one or more functions of the device based on the pressure. Also disclosed is a method for assessing a cardiovascular pressure of a patient with an implanted medical device that includes detecting one or more characteristics of a cardiac cycle of the patient's heart; detecting the cardiovascular pressure of the patient; classifying the cardiovascular pressure based on one or more characteristics of the cardiac cycle of the patient's heart; and displaying the cardiovascular pressure along with the classification. Also disclosed is a system for collection and display of a cardiovascular pressure of a patient. | 12-09-2010 |
| 20100318146 | Tissue Oxygenation Monitoring in Heart Failure - A medical device for monitoring delivery of a therapy that includes a therapy delivery module to deliver a therapy, a controller to set a therapy delivery control parameter, an optical sensor to produce a signal corresponding to tissue light attenuation, and a processor configured to compute a tissue oxygenation measurement from the optical sensor signal, wherein the controller, the optical sensor, and the processor operate cooperatively to determine a setting of the therapy delivery control parameter corresponding to a maximum tissue oxygenation. | 12-16-2010 |
| 20100318147 | MEDICAL DEVICE FOR STIMULATION OF THE HIS BUNDLE - An implantable medical system for delivering pacing pulses to HIS bundle of a heart of a patient when implanted in said patient includes a medical lead, which is adapted to be attached with a distal end to tissue of said heart, including a at least two electrodes arranged being electrically separated from each other. The implantable medical device connectable to the medical lead includes a pacing circuit adapted to deliver the pacing pulses to said heart via the medical lead, a selection device connected between the pacing circuit and the electrodes adapted to selectively activate at least one of said electrodes, and a processing device adapted to control the selection device to selectively activate at least one of the electrodes to direct the pacing pulses to the HIS bundle. | 12-16-2010 |
| 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 |
| 20100324622 | IMPLANTABLE PULSE GENERATOR AND METHOD HAVING ADJUSTABLE SIGNAL BLANKING - An implantable pulse generator senses a cardiac signal, identifies cardiac events in the cardiac signal, and starts a blanking interval including a repeatable noise window blanking interval in response to each cardiac event. When noise is detected during the repeatable noise window blanking interval, the noise window blanking interval is repeated. In one embodiment, the duration of repeated repeatable noise window blanking intervals is summed and compared to a pacing escape interval. When the sum is greater than the pacing escape interval, asynchronous pacing pulses are delivered until the noise ceases. Alternatively, when the sum is greater than the pacing escape interval, the pace escape interval is repeated. | 12-23-2010 |
| 20100331906 | ANODAL EXCITATION OF TISSUE - A cardiac stimulation device has a plurality of electrodes that deliver therapeutic electrical stimulation to the heart. At least one electrode is designated a cathode that cathodically induces depolarization of the surrounding heart tissue. At least one electrode is designated an anode. The device is configured, through one or more of electrode size, electrode configuration, electrode arrangement, cathode/anode number and pulse delivery circuitry, to induce depolarization of the heart tissue in the area of the at least one anode electrode, thereby resulting in greater depolarization of the heart tissue with reduced power consumption. | 12-30-2010 |
| 20100331907 | HEART TREATMENT DEVICE - Provided is a heart treatment device ( | 12-30-2010 |
| 20100331908 | SUBCARDIAC THRESHOLD VAGAL NERVE STIMULATION - In one embodiment, an implantable stimulation apparatus includes a vagal nerve stimulator configured to generate electrical pulses below a cardiac threshold of a heart, and an electrode coupled to the vagal nerve stimulator which is configured to transmit the electrical pulses below the cardiac threshold, to a vagal nerve so as to inhibit injury resulting from an ischemia and/or reduce injury resulting from an ischemia. In another embodiment, an implantable stimulation apparatus includes a vagal nerve stimulator configured to generate electrical pulses below a cardiac threshold, and includes an electrode, which is coupled to the vagal nerve stimulator and configured transmit electrical pulses to a vagal nerve so as to reduce a defibrillation threshold of the heart. | 12-30-2010 |
| 20100331909 | ANTI-ARRHYTHMIA IMPLANTABLE MEDICAL DEVICE - An implantable medical device has a detector for detecting an arrhythmia event of a subject's heart and generating an arrhythmia signal based on the detected event. An impedance determining unit determines impedance data representative of blood aggregation level of blood present in a cavity, such as heart chamber, of the subject. An anti-arrhythmia unit of the device is arranged for applying electric anti-arrhythmia treatment to at least a portion of the heart. This unit is conditionally operable based on the arrhythmia signal and the impedance data. The risk blood aggregates and clots obstructing blood vessels following anti-arrhythmia treatment is significant reduces by conditioning the treatment based on the aggregation level representing impedance data. | 12-30-2010 |
| 20110004263 | DATA-DRIVEN PATTERN DETECTION OF IMPLANTABLE MEDICAL DEVICE DATA - Detecting patterns in sensed implantable medical device (IMD) data is described. One implementation involves an IMD that includes a data-driven pattern detection network embodied on the IMD to detect a pattern from sensed patient data. The IMD also includes one or more algorithms embodied on the IMD to utilize the pattern to effect patient therapy. | 01-06-2011 |
| 20110022108 | SYSTEM AND METHOD OF AV INTERVAL SELECTION IN AN IMPLANTABLE MEDICAL DEVICE - An implantable medical device provides ventricular pacing capabilities and optimizes AV intervals for multiple purposes. In general, intrinsic conduction is promoted by determining when electromechanical systole (EMS) ends and setting an AV interval accordingly. EMS is determined utilizing various data including QT interval, sensor input, and algorithmic calculations. | 01-27-2011 |
| 20110022109 | WIRELESS ECG IN IMPLANTABLE DEVICES - An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device. | 01-27-2011 |
| 20110029034 | ALGORITHM TO MODULATE ATRIAL-VENTRICULAR DELAY AND RATE RESPONSE BASED ON AUTONOMIC FUNCTION - An implantable medical device and associated method provide atrial pacing and measure an atrial ventricular (AV) delay. An autonomic function index is computed using the AV delay. The autonomic function index may be compiled in a medical report. In some embodiments, the autonomic function index is used to adjust atrial pacing control parameters. | 02-03-2011 |
| 20110040345 | ELECTROMECHANICAL DELAY (EMD) MONITORING DEVICES, SYSTEMS AND METHODS - Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's electromechanical delay (EMD). Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture to the patient's heart. 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. | 02-17-2011 |
| 20110046690 | SYSTEMS AND METHODS TO SYNCHRONIZE COMMANDS SENT TO A MULTI-ELECTRODE LEAD (MEL) WITH A PORTION OF A CARDIAC PACING CYCLE - Embodiments of the present invention concern the timing of sending one or more commands to control circuitry of a multi-electrode lead (MEL). In one embodiment, the one or more commands are sent to control circuitry within the MEL during a predetermined portion of a cardiac pacing cycle to avoid potential problems of prior systems that were not synchronized with the cardiac pacing cycle. In one embodiment, the one or more commands are sent when cardiac tissue is refractory from a cardiac pacing pulse, to prevent the command(s) from potentially undesirably stimulating cardiac tissue. The command sending can occur such that the one or more commands are sent between instances when sensing circuitry of the implantable cardiac stimulation device is being used to obtain one or more signals indicative of cardiac electrical activity, to prevent interference between the one or more commands with the signals indicative of cardiac electrical activity that are sensed. | 02-24-2011 |
| 20110046691 | IMPLANTABLE HEART STIMULATOR DETERMINING LEFT VENTRICULAR SYSTOLIC PRESSURE - An implantable heart stimulator has an impedance measurement a cardiogenic impedance waveform using an impedance configuration arranged to measure myocardial contractility of the heart. The heart stimulator further has a calculating unit that calculates an estimate value being related to at least two impedance values of the waveform, or of an average waveform of several consecutive waveforms, during a predetermined time period of the waveform, or average waveform, the calculated estimate value being an estimate of the left ventricular (LV) systolic pressure. | 02-24-2011 |
| 20110066201 | ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA - A method includes selecting an electrode located in a patient; acquiring position information with respect to time for the electrode where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating a stability metric for the electrode based on the acquired position information with respect to time; and deciding if the selected electrode, as located in the patient, has a stable location for sensing biological electrical activity, for delivering electrical energy or for sensing biological electrical activity and delivering electrical energy. Position information may be acquired during one or both of intrinsic or paced activation of a heart and respective stability indexes calculated for each activation type. | 03-17-2011 |
| 20110066202 | ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA - A method includes selecting an electrode located in a patient wherein the electrode comprises a lead-based electrode; acquiring position information with respect to time for the electrode, during both loaded and unloaded conditions of the lead, where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating a both loaded and unloaded stability metrics for the electrode based on the acquired position information with respect to time; and comparing the unloaded and loaded stability metrics to decide whether the electrode, as located in the patient, comprises a stable location for delivery of therapy. | 03-17-2011 |
| 20110066203 | ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA - A method includes selecting an electrode located in a patient; acquiring position information with respect to time for the electrode, during both acute and chronic states of the electrode, where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating an acute state stability metric and a chronic state stability metric for the electrode based on the acquired position information with respect to time; and comparing the acute state stability metric to the chronic state stability metric to decide whether the electrode, as located in the patient in the chronic state, comprises a stable location for delivery of a therapy. The chronic state stability metric of an electrode may be monitored over time to decide whether stability of the electrode has changed. | 03-17-2011 |
| 20110066204 | METHOD AND APPARATUS FOR POST-SHOCK EVALUATION USING TISSUE OXYGENATION MEASUREMENTS - A method and device for delivering therapy that includes an electrode to sense cardiac signals and to deliver a therapy, a therapy delivery module coupled to the electrode to deliver a therapy via the electrode in response to the sensed cardiac signals, a sensor emitting light and detecting emitted light scattered by a tissue volume adjacent the sensor to generate a corresponding detected light intensity output signal, a control module coupled to the sensor to control light emission of the sensor in response to delivering the therapy; and a controller coupled to the therapy delivery module and the sensor, the controller configured to determine a tissue oxygenation measurement in response to the output signal, and determine whether the delivered therapy was successful in restoring cardiac hemodynamic function in response to the tissue oxygenation measurement. | 03-17-2011 |
| 20110066205 | SYNCHRONISING A HEART RATE PARAMETER OF MULTIPLE USERS - A method of synchronizing a heart rate parameter of multiple users comprises generating a pacing signal ( | 03-17-2011 |
| 20110077706 | AUTOMATIC SELECTION OF PARAMETERS OF AN EXPOSURE MODE OF AN IMPLANTABLE MEDICAL DEVICE - An implantable medical device (IMD) automatically determines at least a portion of the parameters and, in some instances all of the parameters, of an exposure operating mode based on stored information regarding sensed physiological events or therapy provided over a predetermined period of time. The IMD may configure itself to operate in accordance with the automatically determined parameters of the exposure operating mode in response to detecting a disruptive energy field. Alternatively, the IMD may provide the automatically determined parameters of the exposure operating mode to a physician as suggested or recommended parameters for the exposure operating mode. In other instances, the automatically determined parameters may be compared to parameters received manually via telemetry and, if differences exist or occur, a physician or patient may be notified and/or the manual parameters may be overridden by the automatically determined parameters. | 03-31-2011 |
| 20110082512 | Biventricular cardiac stimulator - A biventricular cardiac stimulator has a right-ventricular sensing unit, having or connected to a terminal for a right-ventricular sensing electrode, a left-ventricular sensing unit, having or connected to a terminal for a left-ventricular sensing electrode, and a pacemaker timer, which is connected to the right-ventricular sensing unit and the left-ventricular sensing unit. The cardiac stimulator has a programmable automatic switch, which is effectively connected to the pacemaker timer to switch the pacemaker timer optionally between a primarily right-ventricular control and a primarily left-ventricular control, as well as an evaluation unit, which is effectively connected to the switch and is designed to detect and evaluate at least one stability parameter that is characteristic of the stability of the electrode position of the left-ventricular sensing electrode, whereby the programmable automatic switch is designed to automatically switch the pacemaker timer control as a function of a value of the detected stability parameter. | 04-07-2011 |
| 20110093030 | MANAGING ELECTRICAL STIMULATION THERAPY BASED ON VARIABLE ELECTRODE COMBINATIONS - Various programming techniques are described for medical devices that deliver electrical stimulation therapy that may include mapping between discrete electrical stimulation parameters and a graphical view of the electrical stimulation representing a stimulation zone generated by the parameters. In one example, a method includes receiving, via a programmer for an electrical stimulator, user input that graphically manipulates at least one of size and a shape of a graphical representation of at least one electrical stimulation zone displayed on the programmer, and defining a program to control delivery of electrical stimulation therapy based on the user input. | 04-21-2011 |
| 20110093031 | CARDIAC RESYNCHRONIZATION SYSTEM EMPLOYING MECHANICAL MEASUREMENT OF CARDIAC WALLS - Methods and devices are disclosed for employing mechanical measurements to synchronize contractions of ventricular wall locations. Accelerometers that may be placed within electrode leads are positioned at ventricular wall locations, such as the left ventricle free wall, right ventricle free wall, and the anterior wall/septum wall. The accelerometers produce signals in response to the motion of the ventricular wall locations. A processor may then compare the signals to determine a difference in the synchronization of the ventricular wall location contractions. The difference in synchronization can be determined in various ways such as computing a phase difference and/or amplitude difference between the accelerometer signals. One or more stimulation pulses may be provided per cardiac cycle to resynchronize the contractions as measured by the accelerometers to thereby constantly and automatically optimize the cardiac resynchronization therapy. | 04-21-2011 |
| 20110098767 | SYSTEM FOR AUTOMATICALLY MINIMIZING CARDIAC OXYGEN CONSUMPTION AND CARDIAC DISEASE TREATING SYSTEM USING THE SAME - [PROBLEMS] A system for automatically minimizing cardiac oxygen consumption that is capable of estimating a patient's amount of cardiac oxygen consumption with high accuracy and moreover capable of minimizing the amount of cardiac oxygen consumption and a cardiac disease treating system are provided. | 04-28-2011 |
| 20110106196 | IDENTIFICATION AND TREATMENT OF JUNCTIONAL RHYTHMS - An implantable medical device and associated method provide atrial pacing and measure intervals between atrial pacing pulses and subsequently sensed ventricular events. A decreasing trend in the of intervals indicative of a pre-junctional rhythm is detected. The atrial pacing pulse is delivered at a shortened atrial pacing pulse interval in response to detecting the decreasing trend to reduce the likelihood of a junctional rhythm. | 05-05-2011 |
| 20110106197 | PACEMAKER WITH VAGAL SURGE MONITORING AND RESPONSE - A pacemaker initiates and times a monitoring interval in response to an event such as a therapy delivery to a patient. The monitoring interval is specified to include a duration of an anticipated acute response to the event, such as vagal surge. One or more physiological parameters indicative of the acute response are detected during the monitoring interval for analyzing therapeutic effect of the event. In various embodiments, one or more pacing parameters are adjusted for a response interval specified to include the duration of the anticipated acute response to allow for the analysis and maximization of the therapeutic effect. In various embodiments, the event includes a session of pacing therapy delivered according to an intermittent cardiac stress augmentation pacing protocol, and the therapeutic effect is analyzed to adjust that protocol. | 05-05-2011 |
| 20110106198 | CARDIAC-EVENT PROCESSOR AND HEART TREATMENT DEVICE - Provided is a cardiac-event processor ( | 05-05-2011 |
| 20110106199 | CLOSED LOOP NEURAL STIMULATION SYNCHRONIZED TO CARDIAC CYCLES - Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein. | 05-05-2011 |
| 20110112595 | METHOD AND DEVICE FOR PROCESSING A TIME-DEPENDENT MEASUREMENT SIGNAL - A monitoring device is arranged to receive a time-dependent measurement signal from a pressure sensor in a fluid containing system, which is associated with a first pulse generator and a second pulse generator. The pressure sensor is arranged in the fluid containing system to detect a first pulse originating from the first pulse generator and a second pulse originating from the second pulse generator. The monitoring device is configured to process the measurement signal to remove the first pulse. In this process, the monitoring device receives the measurement signal, obtains a first pulse profile which is a predicted temporal signal profile of the first pulse, and filters the measurement signal in the time-domain, using the first pulse profile, to essentially eliminate the first pulse while retaining the second pulse. The fluid containing system may include an extracorporeal blood flow circuit and a blood circuit of a human patient. | 05-12-2011 |
| 20110118803 | Cardiac Resynchronization Therapy Optimization Using Vector Measurements Obtained From Realtime Electrode Position Tracking - An exemplary method includes selecting a first pair of electrodes to define a first vector and selecting a second pair of electrodes to define a second vector; acquiring position information during one or more cardiac cycles for the first and second pairs of electrodes wherein the acquiring comprises using each of the electrodes for measuring one or more electrical potentials in an electrical localization field established in the patient; and determining a dyssynchrony index by applying a cross-covariance technique to the position information for the first and the second vectors. Another method includes determining a phase shift based on the acquired position information for the first and the second vectors; and determining an interventricular delay based at least in part on the phase shift. | 05-19-2011 |
| 20110125208 | METHODS AND SYSTEMS TO MONITOR CARDIAC CONTRACTILITY - An implanted sensor produces a signal that is indicative of changes in arterial blood volume, such as a photoplethysmography signal or an impedance plethysmography signal. A metric is determined from the signal for each of the plurality of periods. Changes in cardiac contractility are monitored based on changes in the determined metric. | 05-26-2011 |
| 20110125209 | System and Method For Cardiac Resynchronization Therapy With Optimization of Effort-based Rate-Responsive Pacing - An active implantable medical device for cardiac resynchronization therapy with effort based rate-responsive pacing is described. The device calculates a rate-responsive stimulation frequency based on output signal of an effort sensor between a base frequency (f | 05-26-2011 |
| 20110130800 | Microwave Monitoring of Heart Function - Diagnostic apparatus includes a plurality of antennas, which are configured to be disposed at different, respective locations on a thorax of a living body so as to direct radio frequency (RF) electromagnetic waves from different, respective directions toward a heart in the body and to output RF signals responsively to the waves that are scattered from the heart. Processing circuitry is configured to process the RF signals over time so as to provide a multi-dimensional measurement of a movement of the heart. | 06-02-2011 |
| 20110130801 | Pacing Output Configuration Selection for Cardiac Resynchronization Therapy Patients - Cardiac therapy systems include multiple electrodes respectively positionable at multiple left ventricular electrode sites. A pulse generator is coupled to the electrodes and configured to deliver a cardiac resynchronization therapy (CRT). A processor is configured to measure, for each left ventricular electrode site, a timing interval between first and second cardiac signal features associated with left ventricular depolarization. The timing interval is associated with a degree of responsiveness of each left ventricular electrode site to CRT. The processor is configured to determine a pacing output configuration that provides improved patient responsiveness to CRT based on the timing interval measurements and to select at least one left ventricular electrode site from the plurality of left ventricular electrode sites based on the timing interval measurements. The processor may be configured to monitor for a change in hemodynamic status of the patient based on a change in the timing interval. | 06-02-2011 |
| 20110130802 | SYSTEM AND METHOD FOR TESTING NEURAL STIMULATION THRESHOLD - Various system embodiments comprise a neural stimulator, a premature ventricular contraction (PVC) event detector, a heart rate detector, an analyzer, and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to stimulate an autonomic neural target. The analyzer is adapted to, in response to a PVC event signal from the PVC event detector, generate an autonomic balance indicator (ABI) as a function of pre-PVC heart rate data and post-PVC heart rate data. Other aspects and embodiments are provided herein. | 06-02-2011 |
| 20110137365 | TECHNIQUES FOR REDUCING PAIN ASSOCIATED WITH NERVE STIMULATION - Apparatus is provided including an electrode device and a control unit. The electrode device is configured to be coupled to a site of a subject selected from the group consisting of: a vagus nerve, an epicardial fat pad, a pulmonary vein, a carotid artery, a carotid sinus, a coronary sinus, a vena cava vein, a right ventricle, a right atrium, and a jugular vein. The control unit is configured to drive the electrode device to apply to the site a current in at least first and second bursts, the first burst including a plurality of pulses, and the second burst including at least one pulse, and set (a) a pulse repetition interval (PRI) of the first burst to be on average at least 20 ms, (b) an interburst interval between initiation of the first burst and initiation of the second burst to be less than 10 seconds, (c) an interburst gap between a conclusion of the first burst and the initiation of the second burst to have a duration greater than the average PRI, and (d) a burst duration of the first burst to be less than a percentage of the interburst interval between, the percentage being less than 67%. Other embodiments are also described. | 06-09-2011 |
| 20110137366 | CARDIAC RHYTHM MANAGEMENT SYSTEM SELECTING BETWEEN MULTIPLE SAME-CHAMBER ELECTRODES FOR DELIVERING CARDIAC THERAPY - A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction-evoking stimulation therapy is delivered from the selected electrode. | 06-09-2011 |
| 20110137367 | EVALUATING A PATIENT CONDITION USING AUTONOMIC BALANCE INFORMATION IN IMPLANTABLE CARDIAC DEVICES - Systems and methods for evaluating a patient condition using autonomic balance information involve providing an implantable cardiac device that acquires a cardiac waveform from a patient. One or more characteristics associated with autonomic balance of the patient are detected and used to evaluate a patient condition, such as sleep onset, sleep stage, cardiac vulnerability over a predetermined duration, and sleep disordered breathing. Patient activity levels may be sensed and used to evaluate the patient's condition, such as for determining a level of systemic stress. Characteristics associated with the autonomic balance include calculating an LF/HF ratio waveform and/or determining one or more morphological features of the LF/HF ratio waveform. Coordination with a patient-external device may facilitate transmission of information about one or more of the cardiac waveform, the one or more characteristics associated with the autonomic balance, and a marked cardiac waveform. | 06-09-2011 |
| 20110144710 | CARDIAC PACING SYSTEM BY SUBSTITUTING NATIVE BIOLOGICAL REGULATORY FUNCTION - The present invention provides a cardiac pacing system based on biological activities, comprising: a) at least one nerve activity sensing means which senses nerve activity of a cardiac sympathetic nerve and/or a vagal nerve, and outputs a plurality of input nerve activity signals; b) a calculating means which receives the input nerve activity signals, calculates a transfer function by computing a Fourier transform of normal nerve activity signals and a normal heart rate signal from normal cardiovascular system, calculates an impulse response by computing an inverse Fourier transform of the transfer function, calculates a plurality of pacing signals for control of a heart rate using a convolution integral between the input nerve activity signals and the impulse response, and outputs the pacing signals; and c) a pacing means which receives the pacing signals, and stimulates the heart based on the pacing signals such that heart rate is regulated. | 06-16-2011 |
| 20110160787 | OPTIMIZATION OF AV DELAY USING VENTRICULAR PRESSURE SIGNAL - An implantable medical device system including an intraventricular pressure sensor controls an atrioventricular (AV) delay based on the intraventricular pressure signal. An atrial kick pressure waveform corresponding to active contraction of an atrial chamber is detected from the intraventricular pressure signal. In one embodiment, a time interval corresponding to the atrial kick pressure waveform is measured. An AV delay is set in response to the measured time interval. | 06-30-2011 |
| 20110160788 | POSITIVE DISPLACEMENT PUMP SYSTEM AND METHOD - Systems and methods including a motor or electromagnets to control the movement of one or more pistons in a pumping chamber. The pumping chamber may include a pump inlet and a pump outlet in fluid communication with the pumping chamber. Surfaces on a piston or pumping chamber may include hydrodynamic bearing surfaces. | 06-30-2011 |
| 20110160789 | Modulation of AV Delay to Control Ventricular Interval Variability - System and methods provide pacing therapy that modulates the atrioventricular (AV) delay to control ventricular interval variability. A base AV delay is determined as a function of heart rate. For each cardiac cycle, the base AV delay is modulated to reduce beat-to-beat variability of successive ventricular beats. The modulated AV delay compensates for variability of successive atrial beats. For example, modulation of the base AV delay may involve varying the AV delay inversely with a change in atrial interval. | 06-30-2011 |
| 20110178564 | Dynamically Filtered Beat Detection in an Implantable Cardiac Device - Methods and implantable devices that detect cardiac events using dynamic filtering. Illustratively, default filtering is performed except for a predefined period of time following detection of cardiac events, during which post-beat filtering is performed instead. The example post-beat filtering applies a narrower pass-band to the signal than the default filtering in order to attenuate T-waves more greatly than the default filtering during a time period after a detected event that is expected to correspond to occurrence of T-waves. | 07-21-2011 |
| 20110178565 | AUTOMATIC MECHANICAL ALTERNANS DETECTION - This document discusses, among other things, a cardiac mechanical alternans (MA) detector circuit. In an example, the mechanical alternans detector circuit is configured to determine a mechanical alternans (MA) condition. In an example, the MA detector circuit can include a physiologic impedance input configured to receive physiologic information indicative of mechanical alternans. In an example, the MA detector circuit can include an intravascular pressure input configured to receive physiologic information indicative of mechanical alternans. | 07-21-2011 |
| 20110178566 | PACING AND SENSING VECTORS - A method for allowing cardiac signals to be sensed and pacing pulse vectors to be delivered between two or more electrodes. In one embodiment, cardiac signals are sensed and pacing pulse vectors are delivered between at least one of a first left ventricular electrode and a second left ventricular electrode. Alternatively, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrodes and a first supraventricular electrode. In addition, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrode, the first supraventricular electrode and a conductive housing. In an additional embodiment, a first right ventricular electrode is used to sense cardiac signals and provide pacing pulses with different combinations of the first and second left ventricular electrodes, the first supraventricular electrode and the housing. | 07-21-2011 |
| 20110184485 | ADAPTIVE RATE PROGRAMMING CONTROL IN IMPLANTABLE MEDICAL DEVICES USING VENTRICULAR-ARTERIAL COUPLING SURROGATES - Selection of an appropriate rate programming control (RPC) setting in an implantable medical device (IMD), uses analysis of VA coupling surrogate conditions. The VA coupling surrogate conditions are derived from signals such as cardiogenic impedance, blood pressure, and the pulsatile components of PPG. By analyzing a waveform of the measured surrogate condition, the IMD estimates wall stiffness, through the slope of the waveform, and peripheral arterial pressure, through the reflection time between the main wave and reflection wave of the waveform. These values are plotted against each other on a VA coupling coordinate plane. Based on the location and orientation of the resulting VA coupling plot, the IMD selects an appropriate RPC setting. | 07-28-2011 |
| 20110196441 | SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE CARDIAC PACING AND SENSING CONFIGURATIONS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described. | 08-11-2011 |
| 20110196442 | SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE CARDIAC PACING AND SENSING CONFIGURATIONS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described. | 08-11-2011 |
| 20110196443 | APPARATUS AND METHODS FOR AUTOMATIC OPTIMIZATION OF INTERVENTRICULAR AND ATRIO-VENTRICULAR DELAYS IN REAL TIME FOR CARDIAC REYNCHRONIZATION IN AN ACTIVE IMPLANTABLE MEDICAL DEVICE - An active implantable medical device for cardiac resynchronization with automatic and almost in real time optimization of the interventricular and atrio-ventricular delays is disclosed. The active implantable medical device includes a closed-loop for continuously controlling the atrio-ventricular delay AVD and the inter-ventricular delay VVD according to a hemodynamic signal delivered by a hemodynamic sensor. The closed-loop provides controlled modulation ( | 08-11-2011 |
| 20110213435 | OPTIMAL CARDIAC PACING WITH Q LEARNING - A cardiac pacemaker control system constituted of: a means for receiving input from a hemodynamic sensor; an adaptive control system in communication with the means for receiving input from the hemodynamic sensor; and an interface arranged to provide cardiac stimulation responsive to the adaptive control system; the adaptive control system comprising a learning module operative to converge to patient specific cardiac pacing stimulation timing using a machine learning scheme in cooperation with a probabilistic replacement scheme, the probabilistic replacement scheme arranged to replace inputs from the hemodynamic sensor with online calculated values. | 09-01-2011 |
| 20110224750 | DOSING VAGAL NERVE STIMULATION THERAPY IN SYNCHRONIZATION WITH TRANSIENT EFFECTS - The present disclosure is directed to a method of using an implantable medical device. One embodiment of the present disclosure comprises delivering electrical stimulation proximate nerve tissue of a patient during a transient physiological effect period separated by a recovery period. The transient physiological effect period is when electrical stimulation has an increased level of efficacy and the recovery period is when additional electrical stimulation does not provide a beneficial physiological effect to the patient. | 09-15-2011 |
| 20110230927 | METHOD AND SYSTEM FOR DETECTING AND TREATING JUNCTIONAL RHYTHMS - An implantable medical device is provided for detecting transportless ventricular rhythm of a heart lacking atrial transport and comprises a housing, sensors configured to be located proximate to a heart, a sensing module to sense cardiac signals representative of a rhythm originating from the heart and a rhythm detection module. The rhythm detection module determines a change in AV association and identifies a potential ventricular complex with loss of atrial transport (VCLAT) based on the change in AV association. | 09-22-2011 |
| 20110230928 | METHOD AND APPARATUS FOR PACING DURING REVASCULARIZATION - Cardiac protection pacing is applied to prevent or reduce cardiac injury and/or occurrences of arrhythmia associated with an ischemic event including the occlusion of a blood vessel during a revascularization procedure. Pacing pulses are generated from a pacemaker and delivered through one or more pacing electrodes incorporated onto a percutaneous transluminal vascular intervention (PTVI) device used in the revascularization procedure. The pacemaker generates the pacing pulses according to a predetermined cardiac protection pacing sequence before, during, and/or after the ischemic event. | 09-22-2011 |
| 20110230929 | IMPLANTABLE MYOCARDIAL ISCHEMIA DETECTION, INDICATION AND ACTION TECHNOLOGY - One embodiment enables detection of MI/I and emerging infarction in an implantable system. A plurality of devices may be used to gather and interpret data from within the heart, from the heart surface, and/or from the thoracic cavity. The apparatus may further alert the patient and/or communicate the condition to an external device or medical caregiver. Additionally, the implanted apparatus may initiate therapy of MI/I and emerging infarction. | 09-22-2011 |
| 20110251654 | ELECTRODE LEAD - An implantable electrode lead for tissue stimulation adapted to be attached to an implantable tissue stimulator provided with a pulse generator, has at least two stimulation electrodes to apply stimulation pulses to said tissue and arranged close to the distal end of the electrode lead, and at least two electrical conductors to connect said electrodes to said pulse generator. The electrode lead further has a switching unit arranged close to the distal end of the electrode lead and adapted to switch the electrode lead between a local pacing mode and a normal pacing mode, the switching unit being controlled by a mode control signal. Further, a pacing module is arranged close to the distal end of the electrode lead and in relation to the switching unit and being connectable to said at least two stimulation electrodes, the pacing module includes a pulse generating unit to generate stimulating pulses to be applied to the tissue by the stimulation electrodes. When the electrode lead is in the local pacing mode the electrical conductors are disconnected from said stimulation electrodes which instead are connected to the pacing module, and when the electrode lead is in the normal pacing mode the electrical conductors are connected to the stimulation electrodes. | 10-13-2011 |
| 20110295334 | Method and System for Adjusting a Stimulation Rate of an Implantable Medical Device - An implantable medical device includes a lead, a pulse generator, a cardiac signal module, a fusion detection module and a rate modification module. The lead includes electrodes that are configured to be positioned within a heart to sense cardiac signals of the heart. The pulse generator delivers stimulus pulses to the heart through at least one of the electrodes. The cardiac signal module monitors the cardiac signals and directs the pulse generator to deliver one or more of the stimulus pulses to the heart at a stimulation rate based on the cardiac signals. The fusion detection module identifies a presence of fusion-based behavior of the heart that is associated with delivery of the one or more of the stimulus pulses. The rate modification module then adjusts the stimulation rate based on the presence of the fusion-based behavior. | 12-01-2011 |
| 20110307024 | Signal Analysis in Implantable Cardiac Treatment Devices - Methods and devices for cardiac signal analysis in implantable cardiac therapy systems. Several signal processing and/or conditioning methods are shown including R-wave detection embodiments including the use of thresholds related to previous peak amplitudes. Also, some embodiments include sample thresholding to remove extraneous data from sampled signals. Some embodiments include weighting certain samples more heavily than other samples within a sampled cardiac signal for analysis. | 12-15-2011 |
| 20110307025 | 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. | 12-15-2011 |
| 20110313483 | METHODS AND APPARATUS FOR CONTROLLING NEUROSTIMULATION USING EVOKED RESPONSES - A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity. | 12-22-2011 |
| 20110313484 | METHODS AND APPARATUS FOR CONTROLLING NEUROSTIMULATION USING EVOKED PHYSIOLOGIC EVENTS - A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity. | 12-22-2011 |
| 20110319954 | METRICS AND TECHNIQUES FOR OPTIMIZATION OF CARDIAC THERAPIES - An exemplary method includes, based on metrics available as input to a chronic phase optimization algorithm for selecting an optimal electrode configuration for delivery of a cardiac pacing therapy, executing the chronic phase optimization algorithm during an acute phase to select an optimal electrode configuration for delivery of a cardiac pacing therapy; during the acute phase, acquiring position information with respect to time for electrodes implanted in a body; determining one or more acute phase metrics based on the acquired position information; and validating the chronic phase optimization algorithm based at least in part on the one or more acute phase metrics. | 12-29-2011 |
| 20120022608 | 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. | 01-26-2012 |
| 20120029587 | 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. | 02-02-2012 |
| 20120035680 | Systems and Methods for Respiratory-Gated Auricular Vagal Afferent Nerve Stimulation - Neurostimulation is provided to afferent nerve fibers of an auricular vagal nerve of a patient. The neurostimulation is harmonized with the pulmonary activity of the patient. In one implementation, a neurostimulation is gated to a portion of the respiratory cycle. For example, the auricular vagal nerve may be stimulated at the end of exhalation. In another implementation, a stimulation regiment to multiple electrodes are harmonized with pre-selected triggers within the respiratory cycle to achieve selective stimulation and/or bilateral stimulation. | 02-09-2012 |
| 20120041503 | CIRCUIT-BASED DEVICES AND METHODS FOR PULSE CONTROL OF ENDOCARDIAL PACING IN CARDIAC RHYTHM MANAGEMENT - Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart. | 02-16-2012 |
| 20120065696 | Method and System for Characterizing Supraventricular Rhythm during Cardiac Pacing - A method and system for generating a characterization of one beat of a patient's supraventricular rhythm (SVR) involves performing such characterization while the heart is being paced. During SVR characterization, various pacing parameters are modified and the patient's supraventricular rhythm is characterized while the pacing parameters are modified. The SVR characterization process is effective in single and multiple chamber pacing modes. | 03-15-2012 |
| 20120078320 | 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. | 03-29-2012 |
| 20120101541 | DIAGNOSIS AND THERAPY OF BIGEMINY AND FREQUENT PREMATURE CONTRACTIONS - The disclosure describes techniques for diagnosing premature contractions of a patient's heart. This system may differentiate premature atrial contractions (PACs) and premature ventricular contractions (PVCs) from atrial fibrillation by identifying changes in R-wave intervals, i.e., R-R intervals, on a Lorenz plot, measuring a coupling interval between R-waves, and analyzing a morphology of the premature contractions, e.g., the QRS complex. These techniques may also identify when severe premature contractions, or bigeminy, are present. In response to the type of premature contractions detected, the system may alert a user of the premature contractions and/or deliver cardiac pacing at an increased pacing rate to eliminate the abnormal intrinsic contractions. The system may also adjust the pacing rate and pacing rate duration for persistent premature contractions. | 04-26-2012 |
| 20120109242 | ROUTING OF PACING SIGNALS - An apparatus includes a sensing unit and control circuitry. The sensing unit is connected to a channel that delivers Electro-Physiological (EP) signals from a cardiac catheter to an EP recording system and pacing signals from the EP recording system to the catheter. The sensing unit is configured to automatically identify time intervals during which the pacing signals are delivered. The control circuitry is configured to route the EP signals on the channel from the catheter to the EP recording system via an intervening system that is detrimental to the pacing signals, to switch the channel to an alternate path that bypasses the intervening system during the identified time intervals, and to route the pacing signals from the EP recording system to the cardiac catheter over the alternate path. | 05-03-2012 |
| 20120109243 | HEART FAILURE MONITORING AND NOTIFICATION - Techniques for generating a heart failure risk score with detected patient metrics are described. An implantable medical device (IMD) may collect and store patient data regarding therapy use statistics, thoracic impedance, heart rate, patient activity, and other patient metrics. Based on the number of patient metrics exceeding their respective metric thresholds, the IMD may automatically generate a risk score that indicates the likelihood that the patient will suffer from heart failure. The risk score may identify a patient as requiring immediate medical attention to reduce the risk of heart failure. The IMD may push an alert of the heart failure risk score to a clinician, and the clinician may review the patient metric data on an external device. In some examples, a clinician may prioritize patient treatment with a presented list ranking patients with the most severe heart failure risk scores. | 05-03-2012 |
| 20120109244 | PARAMETERS IN MONITORING CARDIAC RESYNCHRONIZATION THERAPY RESPONSE - An exemplary method includes analyzing data from multiple parameters detected by an implantable cardiac device and determining an extent of heart failure (HF) progression. The parameters may include electrical synchrony, mechanical synchrony, and/or electromechanical delay (EMD). A change in a width of the native and/or paced QRS complex may provide a measure of electrical synchrony. Characterization of a delay between local cardiac impedance (CI) and global CI may provide a mechanical dyssynchrony index. A delay between the timing of a peak of the QRS complex and LV contraction (e.g., detected by SVC-CAN impedance) may provide a measure for EMD. Each of the parameters may be analyzed independently or collectively to assess HF progression. Based on the analysis, one or more pacing delays (e.g. AV/PV and/or VV) of the implantable cardiac device may be modified. Other exemplary methods, devices, systems, etc., are also disclosed. | 05-03-2012 |
| 20120116474 | PERFORMANCE ASSESSMENT AND ADAPTATION OF AN ACOUSTIC COMMUNICATION LINK - Systems and methods for adapting the performance of an acoustic communication link with an implantable medical device (IMD) are disclosed. An illustrative method includes initiating an acoustic link with the IMD, measuring an initial performance of the acoustic link, determining whether the initial performance of the acoustic link is adequate, adjusting an operating parameter related to the acoustic link in the event the initial performance of the acoustic link is inadequate, measuring a performance of the acoustic link in response to the adjusted operating parameter, and setting the operating parameter to a prior setting if the measured performance of the acoustic link does not improve in response to the adjusted operating parameter. | 05-10-2012 |
| 20120123493 | Method of Defining Continuous Heart Rate vs AV Delay Values and Sensed to Paced AV Delay Offset in Patients Undergoing Cardiac Resynchronization Therapy - A method of data management for optimizing the patient outcome from the provision of cardiac resynchronization therapy (CRT) is described. A regression equation is constructed using 3 data points on a plot of AV delay vs. HR. The x-axis consist of the three points consist of resting HR, HR at the optimal AV delay value during light exercise, and the upper tracking or paced HR. The y-values associated with the three points consist of the AV delay values computed using an equation for ventricular filling time and the optimally determined AV delay value. Also described is a process for determining the sensed to paced AV delay offset. The combined processes yield 4 (the three constant values in the polynomial regression equation Y=b | 05-17-2012 |
| 20120143275 | NEURAL STIMULATION WITH AVOIDANCE OF INAPPROPRIATE STIMULATION - Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a first monitor and a controller. The pulse generator is adapted to generate a neural stimulation signal for a neural stimulation therapy. The neural stimulation signal has at least one adjustable parameter. The first monitor is adapted to detect an undesired effect. In some embodiments, the undesired effect is myocardial infarction. The controller is adapted to respond to the first monitor and automatically adjust the at least one adjustable parameter of the neural stimulation signal to avoid the undesired effect of the neural stimulation therapy. Other aspects are provided herein. | 06-07-2012 |
| 20120150251 | Implantable Medical Device for Treating Neurological Conditions Including ECG Sensing - An implantable medical device such as an implantable pulse generator that includes EEG sensing for monitoring and treating neurological conditions, and leadless ECG sensing for monitoring cardiac signals. The device includes a connector block with provisions for cardiac leads which may be used/enabled when needed. If significant co-morbid cardiac events are observed in patients via the leadless ECG monitoring, then cardiac leads may be subsequently connected for therapeutic use. | 06-14-2012 |
| 20120158081 | PACEMAKER WITH NO PRODUCTION - Apparatus and methods are provided for use with a heart of a subject, including a set of one or more electrodes. A control unit paces the heart by driving a first electric current via the electrode set into tissue of the subject, in accordance with a first set of parameters. The control unit stimulates nitric oxide production by a portion of the heart by driving a second electric current via the electrode set into the portion of the heart, in accordance with a second set of parameters. Other embodiments are also described. | 06-21-2012 |
| 20120158082 | AORTIC PACING TO CONTROL CARDIAC AFTERLOAD - A chronically implanted medical device, connected to a medical electrical lead that includes a sensor, is used to detect cardiac afterload. Electrical stimulation is delivered proximate aortic arch tissue of a patient in order to reduce a patient's cardiac afterload. Electrical stimulation is terminated after a termination condition is met. | 06-21-2012 |
| 20120158083 | 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. | 06-21-2012 |
| 20120158084 | LEFT VENTRICLE-ONLY AND RIGHT VENTRICULAR SAFETY PACING IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - One way in which cardiac resynchronization therapy may be delivered is to only deliver paces to the left ventricle. If left ventricular pacing is inhibited during a cardiac cycle, it may be desirable to deliver a right ventricular safety pace to prevent asystole. Methods and devices for implementing right ventricular safety pacing in the context of multi-site left ventricular-only pacing are described. | 06-21-2012 |
| 20120158085 | BIVENTRICULAR-TRIGGERED PACING IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - Biventricular-triggered pacing is a pacing mode that can employ in cardiac resynchronization pacing at elevated heart rates. Described herein are methods and devices for implementing biventricular pacing in the context of multi-site left ventricular pacing. | 06-21-2012 |
| 20120158086 | AORTIC PACING TO REDUCE HEART RATE - A chronically implanted medical device, connected to a medical electrical lead that includes a sensor, is used to detect heart rate. Electrical stimulation is delivered proximate aortic arch tissue of a patient in order to reduce a patient's heart rate. Electrical stimulation is terminated after a determination is made that continued electrical stimulation does not provide a beneficial heart rate effect to the patient. | 06-21-2012 |
| 20120165887 | IMPLANTABLE CLOSE-LOOP MICROSTIMULATION DEVICE - An implantable closed-loop micro-stimulation device, comprising: a wireless receiver, a wireless energy conversion and storage interface, a demodulator circuit, a modulator, a main controller, a front end sensor, and a stimulation generator. The wireless energy conversion and storage interface receives AC signal through the wireless receiver, and converts it into DC voltage to charge the battery and provide a stable operation voltage. The demodulator circuit receives a wireless control signal through the wireless receiver, and demodulates it into control data and a control clock, and outputs them to the main controller. When the main controller determines that the control data is correct, the main controller outputs the stimulation parameters to the front end sensor and the stimulation generator based on the control data and the control clock, so that the stimulation generator generates a stimulation pulse signal for applying it onto the stimulation object. | 06-28-2012 |
| 20120191155 | POSTURE SENSOR AUTOMATIC CALIBRATION - A system and method automatically calibrate a posture sensor, such as by detecting a walking state or a posture change. For example, a three-axis accelerometer can be used to detect a patient's activity or posture. This information can be used to automatically calibrate subsequent posture or acceleration data. | 07-26-2012 |
| 20120191156 | Treatment of various ailments - A method of treating a wide variety of heretofore considered unrelated ailments comprises delivering electricity through a circuit in the body. The circuit includes at least four nerves leading from at least two of the patient's extremities to various nerve roots adjacent the spinal column. Electrical energy from an electrical interferential therapy device is delivered through electrodes on the extremities adjacent the nerve endings until symptoms of the diagnosed ailment ameliorates. Sending impulses from the periphery to the central nervous system appears to the help the body manufacture various neuropeptides and other chemicals which control the essential basics of the body's health and well being. | 07-26-2012 |
| 20120197332 | DISABLING AN IMPLANTED MEDICAL DEVICE WITH ANOTHER MEDICAL DEVICE - Various techniques for disabling a first implantable medical device (IMD) by modulation of therapeutic electrical stimulation delivered by a second medical device are described. One example method includes delivering therapeutic electrical stimulation from a more recently implanted second IMD at a higher average rate than the previously implanted first IMD so that only the more recently implanted IMD will administer therapy, and modulating stimulation by the more recently implanted IMD in order to send a disable command to the previously implanted IMD. | 08-02-2012 |
| 20120197333 | SYSTEMS AND METHODS FOR DELIVERING VAGAL NERVE STIMULATION - According to various method embodiments, a person is indicated for a therapy to treat a cardiovascular disease, and the therapy is delivered to the person to treat the cardiovascular disease. Delivering the therapy includes delivering a vagal stimulation therapy (VST) to a vagus nerve of the person at a therapeutically-effective intensity for the cardiovascular disease that is below an upper boundary at which upper boundary the VST would lower an intrinsic heart rate during the VST. | 08-02-2012 |
| 20120203295 | PACING SITE OPTIMIZATION USING PACED INTERVENTRICULAR DELAYS - An apparatus comprises a cardiac signal sensing circuit, a stimulus circuit, and a control circuit. The control circuit includes a pacing site locating circuit that initiates a first electrical stimulus from a first electrode positioned in or near a first ventricle of a heart, determines a first time interval between delivery of the first electrical stimulus and a subsequent cardiac event sensed at a selectable electrode location in or near a second ventricle of the heart, initiates a second electrical stimulus at the selectable electrode location in or near the second ventricle, determines a second time interval between delivery of the second electrical stimulus and a subsequent cardiac event sensed at the first ventricle, calculates a difference between the first and second time intervals, and generates an indication of a preferred pacing site in the second ventricle according to the calculated differences between the first and second time intervals. | 08-09-2012 |
| 20120203296 | Monitoring Physiological Signals During External Electrical Stimulation - Electrodes and circuitry for monitoring and stimulating the exterior of the human body, comprising delivering stimulation pulses to stimulation electrodes applied to the exterior of the body, detecting an electrical potential at monitoring electrodes applied to the exterior of the body, positioning at least a first and second monitoring electrode at locations at which an electrical artifact caused by the electrical stimulation pulses is substantially cancelled in a signal formed from the electrical potentials detected at the first and second monitoring electrodes. | 08-09-2012 |
| 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 |
| 20120221068 | EMERGENCY MODE SWITCHING FOR NON-PACING MODES - An implantable medical device (IMD) may be configured into a sensing only mode in which the IMD does not delivery therapy. For example, the IMD may be configured to operate in a sensing only mode to reduce the undesirable effects that may be caused by external fields, such as those generated by an MRI device. However, there may be instances, such as a change in the patient's condition, in which it may be desirable to transition from the sensing only mode to a pacing mode to provide therapy. In accordance with the techniques described herein, the IMD monitors signals on one or more leads coupled to the medical device while operating in the sensing only mode and transitions to a pacing mode in response to not detecting a minimum number of signals on the one or more leads. | 08-30-2012 |
| 20120239101 | SYSTEM AND METHOD FOR FILTERING NEURAL STIMULATION - Various aspects of the present subject matter provide a filter module. In various embodiments, the filter module comprises an input, an output, a signal path from the input to the output, a filter and a switch. The filter has a transfer response to attenuate a frequency of a neural stimulation signal. The switch is adapted to place the filter in the signal path when the neural stimulation signal is applied and to remove the filter from the signal path when the neural stimulation signal is not applied. Other aspects are provided herein. | 09-20-2012 |
| 20120239102 | IMPLANTABLE MEDICAL DEVICE FOR CARDIAC THERAPY - An implantable medical device, IMD, ( | 09-20-2012 |
| 20120271372 | DETECTING, ASSESSING AND MANAGING A RISK OF DEATH IN EPILEPSY - A method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy is provided. The method includes receiving cardiac data and determining a cardiac index based upon the cardiac data. The method includes determining an increased risk of death associated with epilepsy if the indices are extreme, issuing a warning of the increased risk of death and logging information related to the increased risk of death. Also presented is a second method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy comprising receiving at least one of arousal data, responsiveness data or awareness data and determining an arousal index, a responsiveness index or an awareness index, where the indices are based on arousal data, responsiveness data or awareness data respectively. The second method includes determining an increased risk of death related to epilepsy if indices are extreme values, issuing a warning of the increased risk of death and logging information related to the increased risk of death. A computer readable program storage device is also provided. Also provided is a method for receiving body data, determining a cardiac, an arousal, a responsiveness, or a kinetic index, determining an increased or increasing risk of death over a first time window relating to a patient with epilepsy and issuing a warning and logging relevant information. | 10-25-2012 |
| 20120277816 | ADJUSTING NEIGHBORHOOD WIDTHS OF CANDIDATE HEART BEATS ACCORDING TO PREVIOUS HEART BEAT STATISTICS - Methods and systems for adjusting neighborhood widths of candidate heart beats, including being provided with a plurality of candidate heart beats, the candidate heart beats being associated with neighborhood widths in the time domain, and scaling the neighborhood widths, an amount of scaling being determined according to one or more previous heart rate statistics. | 11-01-2012 |
| 20120283796 | SYSTEM FOR TEMPORARY FIXATION OF AN IMPLANTABLE MEDICAL DEVICE - A medical fixation system for temporary fixation of an implantable medical device such as a short lead pacemaker outside of the heart in a larger blood vessel such as the superior or inferior vena cava. The fixation mechanism or element is temporary in nature in that the fixation holds the implantable medical device in place until the implantable medical device is grown in to the wall of the vessel and the short lead attached to the implantable medical device and implanted in the heart is grown in. The cell tissue surrounding the implantable medical device and the short lead then keeps the implantable medical device in place without the temporary fixation element. | 11-08-2012 |
| 20120290031 | MEDICAL IMPLANTABLE LEAD - The invention relates to a medical implantable lead for monitoring and/or controlling an organ inside a human or animal body. The lead comprises a conducting arrangement having a first conducting coil of at least one electrically conducting wire for connecting a first electrode electrically to a connector to receive and/or transmit electric signals from and to the tissue, respectively. The lead is tapered in a distal portion and has a smaller cross sectional dimension at the distal portion than at the rest of the lead. The first conducting coil is terminated at a termination point on a distance from the distal end. The conducting arrangement has a first end conductor in the form of a non-coiled electric conductor or an eccentrically positioned small diameter coil which connects the first electrode electrically with the coil. | 11-15-2012 |
| 20120296387 | PHRENIC NERVE STIMULATION DETECTION USING HEART SOUNDS - A method of delivering phrenic nerve stimulation in a medical device system that includes detecting an activation event, delivering phrenic nerve stimulation therapy in response to the detected activation event, sensing a heart sound signal, in response to the delivered phrenic nerve stimulation therapy, monitoring a portion of the sensed heart sound signal, the portion defined by a predetermined window ocurring after the delivered phrenic nerve stimulation therapy, and determining whether the delivered phrenic nerve stimulation therapy was successful in response to the monitoring. | 11-22-2012 |
| 20120303082 | Adjusting Cardiac Pacing Response Sensing Intervals - Discrimination between different types of possible cardiac pacing responses may depend on the timing of expected features that are sensed within a temporal framework. The temporal framework may include classification intervals, blanking periods and appropriately timed back up paces. The classification intervals and blanking periods of the temporal framework are intervals of time that have time parameters that include start time, end time, and length. The relationships and timing parameters of the elements of the temporal framework, e.g., blanking periods, classification intervals, delay periods, and backup pacing, should support detection of features used to discriminate between different types of pacing responses. As the system learns the morphology of the particular patient by analyzing the waveform of the pacing response signal, the temporal framework for pacing response determination may be adjusted to accommodate the individual patient. | 11-29-2012 |
| 20120303083 | NOVEL DESMIN PHOSPHORYLATION SITES USEFUL IN DIAGNOSIS AND INTERVENTION OF CARDIAC DISEASE - This invention relates to novel phosphorylation sites in the desmin protein that are associated with the onset of heart failure. The phosphorylation sites, i.e., Ser-27 and Ser-31, can be used as biomarkers for (i) identifying subjects at risk for the development of heart failure, (ii) treating subjects having a higher than normal level of the biomarker, and (iii) monitoring therapy of a subject at risk for the development of heart failure. Also described are antibodies, reagents, and kits for carrying out a method of the present invention. | 11-29-2012 |
| 20120316613 | Antitachycardia Pacing Pulse from a Subcutaneous Defibrillator - Devices and methods for single therapy pulse (STP) therapy for tachyarrythmia are disclosed. The STP therapy can be delivered from a far-field position to allow a “global” capture approach to pacing. Due to the global capture in STP, a series of pulses, which is indicative of conventional anti-tachycardia pacing (ATP) delivered by transvenous systems, becomes unnecessary. One to four pulses at most are needed for STP, and after delivery of the one to four pulses, therapy delivery can be interrupted to determine whether the previously delivered therapy has been successful. | 12-13-2012 |
| 20130030482 | SYSTEM AND METHOD OF ELECTRICAL CURRENT DETECTION IN ELECTROPHYSIOLOGY STUDY - A system in combination with a stimulator system and an electrophysiology recorder system in delivering a stimulator signal to a subject's heart is provided. The electrophysiology recorder system can be generally operable to acquire an electrocardiogram from the subject's heart. The system can include an electrical couple in electrical connection between the simulator system and the electrophysiology recorder. The electrical couple can be configured to communicate the stimulator signal without loading an impedance of the electrophysiology recorder system on the stimulator system. | 01-31-2013 |
| 20130030483 | METHODS FOR PROMOTING INTRINSIC ACTIVATION IN SINGLE CHAMBER IMPLANTABLE CARDIAC PACING SYSTEMS - Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate. | 01-31-2013 |
| 20130030484 | SYSTEM AND METHOD FOR PACING PARAMETER OPTIMIZATION USING HEART SOUNDS - A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings. | 01-31-2013 |
| 20130030485 | CARDIAC RHYTHM MANAGEMENT SYSTEM SELECTING BETWEEN MULTIPLE SAME-CHAMBER ELECTRODES FOR DELIVERING CARDIAC THERAPY - A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction-evoking stimulation therapy is delivered from the selected electrode. | 01-31-2013 |
| 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 |
| 20130110187 | ISCHEMIA DETECTION | 05-02-2013 |
| 20130110188 | METHOD TO ASSESS HEMODYNAMIC PERFORMANCE DURING CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION USING ADMITTANCE WAVEFORMS AND DERIVATIVES | 05-02-2013 |
| 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 |
| 20130131748 | METHOD FOR EFFICIENT DELIVERY OF DUAL SITE PACING - An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses to a first pacing site along a heart chamber and a therapy delivery module for delivering cardiac pacing pulses to a patient's heart via the electrodes. A sensing module measures an activation time at multiple pacing electrode sites along the heart chamber in response to delivering pacing pulses at the first pacing site. A controller is configured to identify a second pacing site from the plurality of pacing electrode sites in response to the activation times measured during pacing at the first site. | 05-23-2013 |
| 20130131749 | METHOD FOR EFFICIENT DELIVERY OF DUAL SITE PACING - An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses. Electrodes positioned at first and second selected pacing sites are used to deliver pacing pulses to a first heart chamber using a bipole comprising the first electrode and the second electrode. A controller is configured to determine if anodal and cathodal capture can be achieved during pacing using the bipole. Responsive to anodal and cathodal capture being achieved, the controller selects a multi-site pacing configuration comprising the bipole for singly pacing the first and second pacing sites | 05-23-2013 |
| 20130138169 | Method and Devices for Performing Cardiac Waveform Appraisal - Implementations of various technologies described herein are directed toward a sensing architecture for use in cardiac rhythm management devices. The sensing architecture may provide a method and means for certifying detected events by the cardiac rhythm management device. Moreover, by exploiting the enhanced capability to accurately identifying only those sensed events that are desirable, and preventing the use of events marked as suspect, the sensing architecture can better discriminate between rhythms appropriate for device therapy and those that are not. | 05-30-2013 |
| 20130158616 | Implantable Device For Evaluating Autonomic Cardiovascular Drive In A Patient Suffering From Chronic Cardiac Dysfunction - An implantable device for evaluating autonomic cardiovascular drive in a patient suffering from chronic cardiac dysfunction is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator also includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. The neurostimulator includes a recordable memory storing a baseline heart rate. The neurostimulator includes an integrated leadless heart rate sensor configured to continually monitor heart rate in light of the baseline heart rate. | 06-20-2013 |
| 20130158617 | Implantable Device For Providing Electrical Stimulation Of Cervical Vagus Nerves For Treatment Of Chronic Cardiac Dysfunction With Bounded Titration - An implantable device for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction with bounded titration is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. The neurostimulator includes an integrated leadless heart rate sensor configured to sense heart rate and alter the triggering in response to the sensed heart rate falling outside a predetermined range. | 06-20-2013 |
| 20130158618 | Computer-Implemented System And Method For Selecting Therapy Profiles Of Electrical Stimulation Of Cervical Vagus Nerves For Treatment Of Chronic Cardiac Dysfunction - A computer-implemented system and method for selecting therapy profiles of electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction is provided. An external programmer includes a plurality of therapy profiles stored in memory. The therapy profiles include different sets of stimulation parameters that cooperatively define alternating cycles of stimuli application and stimuli inhibition for a neurostimulator that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes. A programming wand is configured to provide the set of stimulation parameters chosen by the user to the neurostimulator through wireless telemetry. Finally, an implantable neurostimulator device includes a stimulation therapy lead terminated by helical electrodes and electrically coupled to the neurostimulator. The implantable neurostimulator is configured to therapeutically stimulate the cervical vagus nerve through the helical electrodes by triggering bi-directional action potentials as specified by the selected set of stimulation parameters. | 06-20-2013 |
| 20130158619 | MULTI-VENTRICULAR SITE TIMING OPTIMIZATION USING CARDIOGENIC IMPEDANCE - A method of calculating a timing delay for an implantable medical device based on cardiogenic impedance estimates cardiogenic impedance from a signal between a first electrode and a second electrode positioned in at least one chamber of a heart. The method also determines the timing delay based on the estimated cardiogenic impedance. | 06-20-2013 |
| 20130158620 | METHOD AND SYSTEM FOR STIMULATING A HEART OF A PATIENT - In an implantable medical device and a method for stimulating a heart of a patient, at least one left atrial pressure (LAP) signal over a cardiac cycle is obtained. The A-wave is identified using the LAP signal and a maximum positive rate of change of the A-wave of the LAP signal is determined. The maximum positive rate of change of the A-wave corresponds to the rate which the pressure in the atrium raises as the atria contraction forces more blood into the ventricle during the very last stage of diastole. Further, AV and/or VV delay is adjusted in response to the maximum positive rate of change of the A-wave, wherein a reduction of the maximum positive rate of change of the A-wave indicates an AV and/or VV delay providing an enhanced hemodynamic performance. | 06-20-2013 |
| 20130158621 | ECTOPIC-TRIGGERED PARA-HIS STIMULATION - Ectopic cardiac activity can be detected, such as in the absence of a diagnosed tachyarrhythmia episode. In response to the detected ectopic activity, electrostimulation can be provided to a para-Hisian region, such as to activate natural cardiac contraction mechanisms or to interrupt re-entrant cardiac activity. Subsequent ectopic cardiac activity can be detected, and subsequent electrostimulation can be provided to the para-Hisian region, such as according to one or more adjustable electrostimulation parameters. | 06-20-2013 |
| 20130184775 | LONG TERM VAGAL NERVE STIMULATION FOR THERAPEUTIC AND DIAGNOSTIC TREATMENT - A method of nerve stimulation produces therapeutic effects in an organ not directly innervated by the electrically stimulated nerve. The method includes identifying an electrical stimulation reaction threshold of at least one organ directly innervated by a parasympathetic nerve of a subject, identifying a reaction threshold of at least one tissue that is not directly innervated by the parasympathetic nerve of the subject after the parasympathetic nerve is electrically stimulated, and electrically stimulating the parasympathetic nerve with an electrical stimulation signal that is below the identified reaction threshold for the at least one directly innervated organ, but above a reaction threshold for the at least one tissue or organ that is not directly innervated by the parasympathetic nerve of the subject. | 07-18-2013 |
| 20130190834 | MODIFYING ATRIOVENTRICULAR DELAY BASED ON ACTIVATION TIMES - Methods and/or devices may be configured to monitor ventricular activation times and modify an atrioventricular delay (AV delay) based on the monitored ventricular activation times. Further, the methods and/or devices may determine whether the AV delay should be modified based on the measured activation times before modifying the AV delay. | 07-25-2013 |
| 20130190835 | SYSTEMS AND METHODS FOR DELIVERING VAGAL NERVE STIMULATION - According to various method embodiments, a person is indicated for a therapy to treat a cardiovascular disease, and the therapy is delivered to the person to treat the cardiovascular disease. Delivering the therapy includes delivering a vagal stimulation therapy (VST) to a vagus nerve of the person at a therapeutically-effective intensity for the cardiovascular disease that is below an upper boundary at which upper boundary the VST would lower an intrinsic heart rate during the VST. | 07-25-2013 |
| 20130197597 | TECHNIQUES FOR MITIGATING MOTION ARTIFACTS FROM IMPLANTABLE PHYSIOLOGICAL SENSORS - Disclosed techniques include monitoring a physiological characteristic of a patient with a sensor that is mounted to an inner wall of a thoracic cavity of the patient, and sending a signal based on the monitored physiological characteristic from the sensor to a remote device. | 08-01-2013 |
| 20130218222 | CARDIAC STIMULATOR FOR CARDIAC CONTRACTILITY MODULATION - At least one embodiment of the invention relates to a cardiac stimulator comprising at least one stimulation unit to deliver subthreshold stimulation pulses for a cardiac contractility modulation therapy via at least two stimulation electrode poles, and at least one sensing unit to detect cardiac electrical or mechanical actions. The at least one sensing unit detects signals characteristic of cardiac action and comprises, or is connected to, an evaluation unit that evaluates signals detected by the sensing unit and supplies a corresponding evaluation result signal. The cardiac stimulator further comprises a therapy control unit to control a respective cardiac contractility modulation therapy depending on a respective evaluation result signal. A respective cardiac contractility modulation therapy is activated/deactivated depending on a stimulation success/failure of a suprathreshold stimulation, and/or therapy parameters of a respective cardiac contractility modulation therapy are selected and/or adjusted depending on the respective evaluation result signal. | 08-22-2013 |
| 20130268016 | SYSTEMS AND METHODS FOR CONTROLLING SPINAL CORD STIMULATION TO IMPROVE STIMULATION EFFICACY FOR USE BY IMPLANTABLE MEDICAL DEVICES - Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, SCS treatment is delivered to a patient and nerve impulse firing signals are sensed along the spinal cord following the SCS treatment. The nerve impulse signals are analyzed to determine whether the signals are associated with effective SCS and then the delivery of additional SCS is controlled to improve SCS efficacy. For example, the nerve impulse signals can be analyzed to determine whether the signals are consistent with a positive patient mood associated with pain mitigation and, if not, SCS control parameters are adjusted to improve the efficacy of the SCS in reducing pain. In other examples, heart rate variability (HPV) is also used to control SCS. Still further, adjustments may be made to SCS control parameters to improve antiarrhythmic or sympatholytic effects associated with SCS. Techniques employing baseline/target calibration procedures are also described. | 10-10-2013 |
| 20130289640 | HEART SOUND-BASED PACING VECTOR SELECTION SYSTEM AND METHOD - A system and method for generating a pacing vector selection table senses a heart sound signal generated by a heart sound sensor and representing sounds generated by the heart of the patient. A processor controls the sequential selection of a pacing electrode vectors from electrodes positioned along a heart chamber. Pacing pulses are delivered via the sequentially selected plurality of pacing electrode vectors. The processor receives the heart sound signal, determines a plurality of different pacing responses using the heart sound signal for each of the of pacing electrode vectors, and generates a pacing vector selection table listing the plurality of different pacing responses for each of the plurality of pacing electrode vectors. | 10-31-2013 |
| 20130296959 | METHOD FOR STABILIZATION OF CARDIAC TISSUE CONTRACTIONS USING LIMIT CYCLES - Electrical stimulation to cardiac tissue stabilizes atrial and ventricular arrhythmia when timed to stabilize a limit cycle structure in a Poincare map. Disclosed are methods and apparatus, operational internally or externally, for removing the reentrant effects of heterogeneity present in a diseased heart and returning the heart to an improved metabolic status allowing removal of support. The methods and apparatus disclosed are also useful in the chronic surveillance and maintenance of regularized contractility in an aged or diseased heart. | 11-07-2013 |
| 20130304149 | METHODS FOR IMPROVING HEART FUNCTION - The invention provides methods related to improving heart function. | 11-14-2013 |
| 20140012343 | Pacing Systems for Treating Functional Ventricular Conduction Abnormalities of Intrinsic Origin Incorporating Improved Electrocardiographic Acquisition Apparatus and Methods - Therapeutic implantable cardiac pacing systems incorporating improved electrocardiographic acquisition systems for the purpose of ventricular pacing during wide ORS complexes of intrinsic origin, in order to narrow the QRS complex in patients where QRS narrowing is achievable and improving ventricular function in all patients with wide QRS complexes including those where ORS shortening does not result. These pacing systems are employed to increase coronary artery flow and electrode position is employed to improve ventricular motion in the treatment of functional ventricular abnormalities caused by wide ORS complexes. | 01-09-2014 |
| 20140012344 | LEADLESS CARDIAC STIMULATION SYSTEMS - Various configurations of systems that employ leadless electrodes to provide pacing therapy are provided. In one example, a system that provides multiple sites for pacing of myocardium of a heart includes wireless pacing electrodes that are implantable at sites proximate the myocardium using a percutaneous, transluminal, catheter delivery system. Each of the electrodes contains a source of electrical energy for pacing the myocardium and is adapted to receive electromagnetic energy from a source outside the myocardium. The system also includes a source adapted for placement outside the myocardium and that uses locally measured electrocardiograms to synchronize pacing of the heart by sending electromagnetic commands to the electrodes to pace the myocardium surrounding the electrodes. Also disclosed is various configurations of such systems, wireless electrode assemblies, and delivery catheters for delivering and implanting the electrode assemblies. | 01-09-2014 |
| 20140018873 | SYSTEM AND METHOD FOR IDENTIFYING LEAD DISLODGEMENT - A medical device system and method for detecting cardiac lead dislodgement measures intervals between sensed cardiac events for detecting an event interval pattern including at least one short event interval consecutively followed by a long event interval. Responsive to detecting the event interval pattern, a cardiac signal amplitude associated with a detected short event interval is measured. Dislodgement of the cardiac lead is detected in response to the measured amplitude. | 01-16-2014 |
| 20140018874 | SYSTEMS, DEVICES AND METHODS FOR MONITORING EFFICIENCY OF PACING - Various systems, methods, devices and arrangements are implemented for use in pacing of the heart. One implementation is directed to methods and systems for determining a pacing location in the right ventricle of a heart and near the His bundle. A pacing signal is delivered to the location in the right ventricle. The pacing signal produces a capture of a left ventricle. Properties of the capture are monitored. Results of the monitored capture are used to assess the effectiveness of the delivered pacing signal as a function of heart function. The heart function can be, for example, at least one of a QRS width, fractionation and a timing of electrical stimulation of a late activation site of a left ventricle relative to the QRS. | 01-16-2014 |
| 20140025132 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR MANAGING BRADYCARDIA THROUGH VAGUS NERVE STIMULATION - A method for managing bradycardia through vagus nerve stimulation is provided. An implantable neurostimulator configured to deliver electrical therapeutic stimulation in both afferent and efferent directions of a patient's cervical vagus nerve is provided. An operating mode is stored, which includes parametrically defining a maintenance dose of the electrical therapeutic stimulation tuned to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses. The maintenance dose is delivered via a pulse generator through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead independent of cardiac cycle. The patient's physiology is monitored, and upon sensing a condition indicative of bradycardia, the delivery of the maintenance dose is suspended. A progressively increasing amount of time is spent waiting via a controller and, upon sensing a condition indicative of an absence or termination of the bradycardia, a progressively increasing partial maintenance dose is delivered via the pulse generator. | 01-23-2014 |
| 20140058470 | MULTI-STAGE ATRIAL CARDIOVERSION THERAPY LEADS - Devices and methods of use for treating atrial arrhythmias. A single-pass lead includes a body portion having at least two electrodes configured to be positioned within or adjacent a right atrium of a heart of a patient, and a distal portion having at least two electrodes configured to be positioned within a blood vessel proximate the left atrium. The lead is configured to operated by an implantable therapy generator programmed to deliver a multi-stage therapy by activating various combinations of at least one electrode of the body portion of the lead and at least one electrode of the distal portion of the lead. | 02-27-2014 |
| 20140074177 | METHOD AND APPARATUS TO PERFORM ELECTRODE COMBINATION SELECTION - Approaches for selecting an electrode combination of multi-electrode pacing devices are described. Electrode combination parameters that support cardiac function consistent with a prescribed therapy are evaluated for each of a plurality of electrode combinations. Electrode combination parameters that do not support cardiac function are evaluated for each of the plurality of electrode combinations. An order is determined for the electrode combinations based on the parameter evaluations. An electrode combination is selected based on the order, and therapy is delivered using the selected electrode combination. | 03-13-2014 |
| 20140074178 | CARDIAC RHYTHM MANAGEMENT SYSTEM SELECTING BETWEEN MULTIPLE SAME-CHAMBER ELECTRODES FOR DELIVERING CARDIAC THERAPY - A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction evoking stimulation therapy is delivered from the selected electrode. | 03-13-2014 |
| 20140081344 | CARDIAC WAVEFORM TEMPLATE CREATION, MAINTENANCE AND USE - The present disclosure describes methods, devices, and systems for generating, adjusting, and using cardiac waveform morphology templates. The morphology templates include target regions associated with features of cardiac waveforms. The target regions may be adjusted based on relationships between the target regions and features of detected cardiac waveforms associated with the target regions. The templates may be used to analyze cardiac waveforms to classify or monitor various waveform morphologies. Templates may be created or eliminated, for instance, based on a frequency of use. According to one approach, template creation involves providing target regions defined by one or more characteristics. The target regions are adjusted based on detected cardiac waveform features having similar characteristics. A template may be created using the target regions adjusted by this process. | 03-20-2014 |
| 20140107722 | MECHANISM FOR DETECTING CORONARY ISCHEMIA - A system for detecting myocardial ischemia includes an implantable device having one or more leads connected thereto, at least one electrode on a lead of the device, and a microprocessor in the implantable device. The electrode is configured to stimulate the heart. The at least one sensor is configured to measure a characteristic of blood in a coronary vessel. The microprocessor is programmed to: run a stress test on the heart by stimulating the heart with the electrode; record data obtained from the at least one sensor during the stress test; and determine whether there is myocardial ischemia based upon the recorded data. | 04-17-2014 |
| 20140135865 | Cardiac Stimulation Using Intravascularly-Deliverable Electrode Assemblies - A seed assembly for delivery to an interior of a heart includes an electrical stimulation circuit for delivering an electrical stimulus to cardiac tissue. A first electrode assembly is mechanically and electrically coupled to the seed assembly via a micro lead the first electrode assembly configured to deliver the electrical stimulus generated by the electrical stimulation circuit to the cardiac tissue. The seed assembly and the first electrode assembly are sized and shaped to fit entirely within the heart. | 05-15-2014 |
| 20140155949 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR MANAGING BRADYCARDIA THROUGH VAGUS NERVE STIMULATION - A method for managing bradycardia through vagus nerve stimulation is provided. An implantable neurostimulator configured to deliver electrical therapeutic stimulation in both afferent and efferent directions of a patient's cervical vagus nerve is provided. An operating mode is stored, which includes parametrically defining a maintenance dose of the electrical therapeutic stimulation tuned to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses. The maintenance dose is delivered via a pulse generator through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead independent of cardiac cycle. The patient's physiology is monitored, and upon sensing a condition indicative of bradycardia, the delivery of the maintenance dose is suspended. A progressively increasing amount of time is spent waiting via a controller and, upon sensing a condition indicative of an absence or termination of the bradycardia, a progressively increasing partial maintenance dose is delivered via the pulse generator. | 06-05-2014 |
| 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 |
| 20140180353 | Methods and Systems for Lowering Blood Pressure through Reduction of Ventricle Filling - Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction. | 06-26-2014 |
| 20140180354 | SINGLE-PASS LEFT-SIDED DDD PACING LEAD - A single-pass pacing lead capable of sensing and pacing both the atria and the ventricles is described. In some examples, the single-pass pacing lead is connected to a DDD pacemaker. In some examples, the single-pass pacing lead comprises four electrodes. In some examples, the lead includes three electrodes configured to be positioned in or near an atrium, e.g., the right atrium, and one electrode configured to be positioned in or near a ventricle, e.g., the left ventricle, when the lead is implanted. In other examples, the lead includes two electrodes configured to be positioned in each of the atrium and ventricle when the lead is implanted. In some examples, one of the electrodes, which is configured to be positioned proximate the coronary sinus ostium when the lead is implanted, comprises a helical element for fixation of the lead to tissue. | 06-26-2014 |
| 20140194941 | METHOD AND APPARATUS FOR INTRACHAMBER RESYNCHRONIZATION - Methods, apparatus, and systems are provided to control contraction of the heart. At least one sensing element receives signals indicating electrical activity of sinus rhythm of the heart. Based on the received signals, the progress of contraction of the heart is determined. Based on the progress of contraction, the chamber of the heart may then be stimulated at a plurality of locations. In another embodiment, a plurality of electrodes are implanted in the left ventricle to stimulate at multiple locations in the left ventricle for the purpose of improving hemodynamic performance and increasing cardiac output in a patient who is suffering from congestive heart failure. | 07-10-2014 |
| 20140207205 | CONNECTOR FOR A MEDICAL DEVICE HAVING A RIGID SLEEVE AND A FLEXIBLE SEAL WITH COMPLIMENTARY SURFACE PROFILES - A connector for a multipolar lead has a cavity that contains a stack of alternating annular electrical contact elements and annular isolation elements. The isolation elements comprise an annular rigid sleeve and an annular flexible seal disposed against an annular face in an interior region of the rigid sleeve. The flexible seal extends axially from one lateral side of the rigid sleeve to the other in the interior region of the rigid sleeve. The sleeve and the seal include are immobilized relatively to each other in the axial direction by use of mating surface profiles respectively defined on an inner annular side of the sleeve and on an outer annular side of the flexible seal. | 07-24-2014 |
| 20140236250 | ELECTRICAL MUSCLE CONTROLLER - A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%. | 08-21-2014 |
| 20140243919 | 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. | 08-28-2014 |
| 20140277233 | CLOSED LOOP OPTIMIZATION OF CONTROL PARAMETERS DURING CARDIAC PACING - A system and method control a pacing parameter in a closed-loop manner by determining a value of an EGM-based index corresponding an optimal electrical activation condition of a patient's heart and adjusting a pacing therapy to maintain the EGM-based index value. The closed loop control method performed by the system may establish a relationship between an EGM-based index and multiple settings of a pacing control parameter. Values of the EGM-based index are stored with corresponding setting shifts relative to a previously established optimal setting. A processor of an implantable medical device monitors the EGM-based index during cardiac pacing. Responsive to detecting an EGM-based index value corresponding to a non-optimal setting of the control parameter, the processor determines an adjustment of the control parameter from the stored index values and corresponding setting shifts. | 09-18-2014 |
| 20140277234 | IMPLANTABLE MEDICAL DEVICE AND ASSMEBLY THEREOF - This document describes an apparatus including an implantable medical device having a printed circuit board. The apparatus can include a connector block for a lead terminal of the implantable medical device mounted directly to the printed circuit board. | 09-18-2014 |
| 20140277235 | 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. | 09-18-2014 |
| 20140277236 | PACING AND SENSING VECTORS - A method for allowing cardiac signals to be sensed and pacing pulse vectors to be delivered between two or more electrodes. In one embodiment, cardiac signals are sensed and pacing pulse vectors are delivered between at least one of a first left ventricular electrode and a second left ventricular electrode. Alternatively, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrodes and a first supraventricular electrode. In addition, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrode, the first supraventricular electrode and a conductive housing. In an additional embodiment, a first right ventricular electrode is used to sense cardiac signals and provide pacing pulses with different combinations of the first and second left ventricular electrodes, the first supraventricular electrode and the housing. | 09-18-2014 |
| 20140288611 | ZERO BLOOD FLOW SENSITIVE HEART STIMULATOR - A zero flow responsive heart stimulator contains a zero flow sensors, which generate signals at the moment of the termination of blood inflow in the right atrium and the right ventricle, sensing this the most precisely in the places, where the sinoatrial node and atrioventricular node reside, for the right atrium and the right ventricle, respectively. The stimulator is based on our discovery, that the two nodes are the same sensors in the biological systems, based on the fact that until the filling of the said two chambers continues, the venous blood flow sucks on Bernoulli's principle the Ca and Na cations from the two nodes interstices, preventing the inward currant in their cells, thus delaying the completion of the 0-phase of their depolarization and the action potential, until the blood flow stops. Our discovery proves that the alternating flow/no flow of the blood in the orifice of superior vena cava and the entrance of the right ventricle is the real pacemaker that fires the both nodes, but not the inverse, as generally assumed, approximating the natural pacemaker to a clock mechanism. This, together with the discovered by us arteriovenous, arteriolymphatic and capillary pumps, closes the loop of the autonomous automatic functioning of the cardiovascular system, even completely denervated and in the absence of muscle contractions. It is the first devise, which activates the atrial and the ventricular contractions in a function of the zero-flow of the filling them venous blood, which is the exact imitation of the sinoatrial and atrioventricular firing. | 09-25-2014 |
| 20140330329 | SUBSTERNAL ELECTRICAL STIMULATION SYSTEM - Implantable cardiac pacing systems and methods for providing substernal pacing are described. In one example, a cardiac pacing system includes a pacemaker implanted in a patient and an implantable medical electrical lead. The implantable medical electrical lead includes an elongated lead body having a proximal end and a distal portion, a connector configured to couple to the pacemaker at the proximal end of the elongated lead body, and one or more electrodes along the distal portion of the elongated lead body, wherein the distal portion of the elongated lead body of the lead is implanted substantially within an anterior mediastinum of the patient and the pacemaker is configured to deliver pacing pulses to a heart of the patient. | 11-06-2014 |
| 20140343618 | SAMPLING INTRINSIC AV CONDUCTION TIME - Methods and/or devices for sampling a patient's intrinsic AV conduction time during cardiac therapy that may, e.g., change the AV delays to values based on the AV delays themselves, previously-sampled intrinsic AV conduction times, and/or one or more other parameters directly related to AV delays to provide a time period during which to measure the patient's intrinsic AV conduction time. | 11-20-2014 |
| 20140350625 | SYSTEM AND METHOD FOR STIMULATING THE HEART USING SUB-THRESHOLD BIPHASIC STIMULATION - A rules engine acquires sensor data from sensors applied to the heart and determines whether an electrical waveform should be applied to the heart and, if so, the type of electrical waveform. A multiphase cardiac stimulus generator generates waveforms in response to the rules engine. The electrical waveform is applied to one or more electrodes implanted in or on the heart. | 11-27-2014 |
| 20140350626 | SYSTEM AND METHOD FOR STIMULATING THE HEART VIA STORAGE OF MULTI-WAVEFORMS IN A CARDIAC STIMULATION DEVICE - A rules engine acquires sensor data from sensors applied to the heart and determines whether an electrical waveform should be applied to the heart and, if so, the type of electrical waveform. A multi-phase cardiac stimulus generator generates waveforms in response to the rules engine from waveform data stored in a memory. The electrical waveform is applied to one or more electrodes implanted in or on the heart. | 11-27-2014 |
| 20140350627 | SYSTEM AND METHOD FOR CONDITIONING THE HEART USING SUB-THRESHOLD ANODAL STIMULATION - A rules engine acquires sensor data from sensors applied to the heart and determines whether an electrical waveform should be applied to the heart and, if so, the type of electrical waveform. A multi-phase cardiac stimulus generator generates waveforms in response to the rules engine. The electrical waveform is applied to one or more electrodes implanted in or on the heart. | 11-27-2014 |
| 20140350628 | SYSTEM AND METHOD FOR TRIGGERING CONDITIONING OF THE HEART USING THE INTRINSIC HEARTBEAT - A rules engine acquires sensor data from sensors applied to the heart and detects an intrinsic beat of the heart. The rules engine determines whether an electrical waveform should be applied to the heart and, if so, the type of electrical waveform. | 11-27-2014 |
| 20140350629 | SYSTEM AND METHOD FOR STIMULATING THE HEART IN COMBINATION WITH CARDIAC RHYTHM MANAGEMENT PHARMACEUTICALS - Sensors are applied to the heart and sensor data is supplied to a rules engine. The rules engine applies rules that reflect a CRM pharmaceutical regime of the patient to the sensor data to determine whether an electrical waveform should be applied to the heart. When electrical stimulation is warranted, the drug “awareness” rules are used by the rules engine to instruct a multi-phase cardiac stimulus generator to generate an electrical waveform that improves the performance of the drugs administered to the patient, allow the patient to be administered a lower dose of a particular drug, and/or reduce or eliminate side effects from the drugs. | 11-27-2014 |
| 20150088219 | Apparatus for Artificial Cardiac Stimulation and Method of Using Same - A system for artificial stimulation of the heart of a subject is provided, the system comprising a controller comprising a receiver for receiving signal data, a processor for processing received signal data, and a transmitter for transmitting signal data; a sensing stent for location in the proximal coronary sinus of the subject, the sensing stent electrode comprising a sensing electrode assembly for sensing atrial and/or ventricular signals from the heart of the subject and a transmitting assembly for transmitting signal data to the receiver of the controller; and a stimulation stent for location in a vein of the subject distal of the sensing stent, the stimulation stent comprising a receiver for receiving signal data from the transmitter of the controller and an electrode assembly for providing a stimulating electrical signal to the heart of the subject in response to the data received. | 03-26-2015 |
| 20150134023 | METHOD AND SYSTEM FOR SELECTING LV PACING SITE IN A MULTIPOLAR LV LEAD - A method and system for selecting at least one left ventricular (LV) pacing site for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole LV lead are provided. The method and system include sensing LV activation events at multiple LV sensing sites. The arrival times of the LV activation events for corresponding LV sensing sites are measured. The method and system further include calculating differences between the arrival times for combinations of the LV sensing sites to obtain inter-site arrival delays between the combinations of the LV sensing sites. When at least one of the inter-site arrival delays exceeds a threshold, the method and system include designating the LV sensing site from the corresponding combination that has a later arrival time as a first LV pacing site from which to deliver LV pacing pulses using the implantable medical device. | 05-14-2015 |
| 20150306403 | ENERGY HARVESTING STIMULATOR - A stimulation device that stimulates living tissue includes an energy harvesting circuit that receives an output signal from another device and that powers the stimulation device, immediately or otherwise, using the output signal. The stimulation devices also includes a stimulation circuit that generates a stimulation signal to elicit a predetermined response from the living tissue, and at least one lead that delivers the stimulation signal to the living tissue. | 10-29-2015 |
| 20150314128 | ALTERNANS PREVENTION AND TERMINATION - In a method of preventing the formation of alternans in the heart of a patient, the heart is paced to control the TR interval of each heartbeat. The method may be performed using a heart monitoring and pacing device that includes a processor, memory, an electrocardiogram (ECG) sensing circuit, and a pulse generator. In the method, a heartbeat rate of the heart is detected and comparted to a threshold value stored in the memory. The heart is paced using the pulse generator to force the TR period of a limited number of heartbeats toward a targeted TR period, which is stored in the memory. | 11-05-2015 |
| 20150321005 | HEART STIMULATOR FOR IMPLANTATION IN A HEART VENTRICLE - Embodiments include a heart stimulator that may be implanted in a heart ventricle and that includes a housing. The housing includes fixation elements that passively fix the heart stimulator in a heart ventricle and electrode poles that one or more of deliver stimulation pulses and sense electrical potentials. The housing includes an energy supply unit, a control unit connected to the energy supply unit, and a stimulation pulse generator connected to the control unit and the energy supply unit. A plurality of electrode poles are distributed on a surface of the housing and a switching matrix is connected between the electrode poles and the stimulation pulse generator, wherein the stimulation pulse generator is electrically connected via the switching matrix to different electrode poles depending on a switched state of the switching matrix. | 11-12-2015 |
| 20150352358 | SYSTEMS AND METHODS FOR OPTIMIZING CARDIAC RESYNCHRONIZATION THERAPY (CRT) - Systems and methods for optimizing CRT are disclosed. According to an aspect, a method includes receiving, during at least two time periods of a cardiac cycle, electrical signals communicated by two or more electrodes of a CRT device positioned one or more of on a surface of a body, within a thorax of the body, a heart of the body, a surrounding venous structure of the body, and a surrounding subcutaneous structure of the body. The method also includes calculating, based on the received electrical signals, spacing between the two or more electrodes during the at least two time periods of the cardiac cycle. Further, the method includes controlling output of the CRT device to the electrodes based on the calculated spacing between the two or more electrodes. | 12-10-2015 |
| 20150360025 | METHOD AND APPARATUS FOR ELECTRICAL CURRENT THERAPY OF BIOLOGICAL TISSUE - A method and device for performing electrical current therapy on biological tissue. The device can operate continuously as a bio-energetic thermostat to continuously provide electrical current therapy, or based on sensing parameters and providing electrical current therapy only when the parameters indicate that the electrical current therapy is to be applied. | 12-17-2015 |
| 20150360034 | METHODS FOR PROMOTING INTRINSIC ACTIVATION IN SINGLE CHAMBER IMPLANTABLE CARDIAC PACING SYSTEMS - Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate. | 12-17-2015 |
| 20160008612 | HYBRID SYSTEM FORMING AN ACTIVE IMPLANTABLE MEDICAL DEVICE | 01-14-2016 |
| 20160022998 | APPARATUS AND METHOD FOR THE DETECTION AND TREATMENT OF ATRIAL FIBRILLATION - Embodiments of the invention provide methods for detection and treatment of atrial fibrillation (AF) and related conditions. One embodiment provides a method comprising measuring electrical activity of the heart using electrodes arranged on the heart surface to define an area for detecting aberrant electrical activity (AEA) and then using the measured electrical activity (MEA) to detect foci of AEA causing AF. A pacing signal may then be sent to the foci to prevent AF onset. Atrial wall motion characteristics (WMC) may be sensed using an accelerometer placed on the heart and used with MEA to detect AF. The WMC may be used to monitor effectiveness of the pacing signal in preventing AF and/or returning the heart to normal sinus rhythm (NSR). Also, upon AF detection, a cardioversion signal may be sent to the atria using the electrodes to depolorize an atrial area causing AF and return the heart to NSR. | 01-28-2016 |
| 20160030742 | SYSTEM AND METHOD FOR STIMULATING THE HEART VIA STORAGE OF MULTI-WAVEFORMS IN A CARDIAC STIMULATION DEVICE - A rules engine acquires sensor data from sensors applied to the heart and determines whether an electrical waveform should be applied to the heart and, if so, the type of electrical waveform. A multi-phase cardiac stimulus generator generates waveforms in response to the rules engine from waveform data stored in a memory. The electrical waveform is applied to one or more electrodes implanted in or on the heart. | 02-04-2016 |
| 20160038744 | AUTOMATIC SELECTION OF PARAMETERS OF AN EXPOSURE MODE OF AN IMPLANTABLE MEDICAL DEVICE - An implantable medical device (IMD) automatically determines at least a portion of the parameters and, in some instances all of the parameters, of an exposure operating mode based on stored information regarding sensed physiological events or therapy provided over a predetermined period of time. The IMD may configure itself to operate in accordance with the automatically determined parameters of the exposure operating mode in response to detecting a disruptive energy field. Alternatively, the IMD may provide the automatically determined parameters of the exposure operating mode to a physician as suggested or recommended parameters for the exposure operating mode. In other instances, the automatically determined parameters may be compared to parameters received manually via telemetry and, if differences exist or occur, a physician or patient may be notified and/or the manual parameters may be overridden by the automatically determined parameters. | 02-11-2016 |
| 20160045737 | SYSTEMS AND METHODS FOR CONFIGURATION OF INTERVENTRICULAR INTERVAL - Systems and methods are described herein for assisting a user in identification of interventricular (V-V) delay for cardiac therapy. The systems and methods may monitor electrical activity of a patient using external electrode apparatus to provide electrical heterogeneity information for a plurality of different V-V intervals and may identify a V-V interval based on the electrical heterogeneity information. | 02-18-2016 |
| 20160045738 | SYSTEMS AND METHODS FOR CONFIGURATION OF ATRIOVENTRICULAR INTERVAL - Systems and methods are described herein for assisting a user in identification and/or optimization of an atrioventricular (A-V) interval for use in cardiac therapy. The systems and methods may monitor electrical activity of a patient using external electrode apparatus to provide electrical heterogeneity information for a plurality of different A-V intervals and may identify an A-V interval based on the electrical heterogeneity information. | 02-18-2016 |
| 20160051821 | APPARATUS AND METHODS OF ADJUSTING ATRIOVENTRICULAR PACING DELAY INTERVALS IN A RATE ADAPTIVE PACEMAKER - Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval. One manner described involves dynamically programming an AV interval in cardiac resynchronization therapy (CRT) device having a rate-adaptive AV (RAAV) feature in such a way that not less than a minimum AV interval is maintained. That is, the AV interval is not allowed to be reduced so much that the P-wave is truncated by the QRS complex. In this form of the invention, the AV interval is reduced by one millisecond per one bpm increase in heart rate (and vice versa for reducing heart rate) but maintained at a value calculated from the end of the P-wave (PWend) and the beginning of the QRS complex (QRSbeg) or delivery of a ventricular pacing stimulus or to the end of the end of the QRS complex (QRSend). | 02-25-2016 |
| 20160067486 | FAR-FIELD R-WAVE DETECTION TO CONTROL ATRIAL PACE TIMING IN A DUAL-CHAMBER LEADLESS PACEMAKER - A method for sensing far-field R-waves in a leadless, intracardiac pacemaker implanted in an atrium of a patient's heart may involve sensing an electrical signal generated by the heart with two electrodes and a first sensing channel and/or a second sensing channel of the pacemaker, comparing a first timing marker from the first sensing channel with a second timing marker from the second sensing channel, and either determining that the sensed signal is a P-wave, if the first and second timing markers indicate that the sensed signal was sensed by the first and second sensing channels within a predetermined threshold of time from one another, or determining that the sensed signal is a far-field R-wave, if the sensed signal is sensed by the second sensing channel and not sensed by the first sensing channel. | 03-10-2016 |
| 20160067488 | CARDIAC PACING - A cardiac pacing system that includes an implantable pulse generator and electrical leads that include a lead body portion having a distal end and a proximal end, a connector configured to electrically connect the proximal end of the lead body to the pulse generator, and at least one electrode disposed at the distal end of the lead body for delivering electrical stimulation to a patient's heart, wherein the distal end of the lead body is configured to terminate within the mediastinum of the thoracic cavity of the patient, proximate to the heart. | 03-10-2016 |
| 20160067489 | SYSTEM AND METHODS TO FACILITATE PROVIDING THERAPY TO A PATIENT - A system can include a sensor array comprising a plurality of sensors configured to measure electrical activity across a body surface of a patient and generate electrical data characterizing the measured electrical activity. The plurality of sensors are arranged at predetermined locations for placement over the patient's body to define at least one predetermined zone of the patient's body that maps deterministically to at least one predetermined region of interest of at least one internal anatomical structure of the patient. A control system is configured to analyze the electrical data for the at least one predetermined zone to provide a surrogate estimate of electrical activity at the at least one predetermined region of interest. The control system also is configured to control delivery of a therapy to the patient based on the surrogate estimate of electrical activity at the at least one predetermined region of interest. | 03-10-2016 |
| 20160067490 | DUAL CHAMBER TIMING FOR LEADLESS PACEMAKERS USING INFREQUENT ATRIAL SIGNALS AND VENTRICULAR CONTRACTIONS - A method for adjusting a pacing rate in a dual-chamber, leadless pacemaker implanted in a heart may involve determining, with a leadless atrial pacemaker implanted in an atrium of the heart, that an intrinsic atrial contraction rate of the atrium is faster than a ventricular contraction rate, transmitting a first signal from the atrial pacemaker to a leadless ventricular pacemaker implanted in a ventricle of the heart to increase a ventricular pacing rate of the ventricular pacemaker, receiving the transmitted first signal with the ventricular pacemaker, and increasing the ventricular pacing rate, based on the received first signal. | 03-10-2016 |
| 20160106987 | MULTI-SITE PACING CAPTURE VERIFICATION - Systems and methods for evaluating electrostimulation of a heart are disclosed. A system can comprise an electrostimulation circuit that can deliver multi-site electrostimulation, including pacing at two or more sites of the heart during the same cardiac cycle. The system can comprise a heart sound sensor circuit configured to sense a heart sound (HS) signal during multi-site stimulation. The heart sound sensor circuit can also sense HS signals in response to uni-site stimulation at a specified site capturing at least a portion of the heart. The system can comprise a pacing analyzer circuit that uses the HS signals during the multi-site stimulation and during the uni-site stimulation to determine a capture status indication that indicates whether the multi-site stimulation captures the two or more sites of the heart, and can be one of a full capture indication, a partial capture indication, or a loss of capture indication. | 04-21-2016 |
| 20160114164 | SYSTEMS AND METHODS FOR SELECTIVELY STIMULATING NERVE ROOTS - Various system embodiments comprise an implantable lead, an implantable housing, a neural stimulation circuit in the housing, and a controller in the housing and connected to the neural stimulation circuit. The lead has a proximal end and a distal end. The distal end is adapted to deliver neural stimulation pulses to the ventral nerve root and the dorsal nerve root. The proximal end of the lead is adapted to connect to the housing. The neural stimulation circuit is adapted to generate neural stimulation pulses to stimulate the ventral nerve root or the dorsal nerve root using the implantable lead. The controller is adapted to control the neural stimulation circuit to deliver a neural stimulation treatment. | 04-28-2016 |
| 20160114169 | SENSING AND ATRIAL-SYNCHRONIZED VENTRICULAR PACING IN AN INTRACARDIAC PACEMAKER - An intracardiac pacemaker is configured to receive a cardiac electrical signal developed across a pair of electrodes coupled to the pacemaker and detect a crossing of a first sensing threshold of the cardiac electrical signal. A pacing escape interval timer is set to a first pacing escape interval in response to the cardiac electrical signal crossing the first sensing threshold. The pacing escape interval timer is adjusted if the cardiac electrical signal crosses a second sensing threshold during a time limit. | 04-28-2016 |
| 20160129255 | CARDIAC RHYTHM MANAGEMENT SYSTEM SELECTING BETWEEN MULTIPLE SAME-CHAMBER ELECTRODES FOR DELIVERING CARDIAC THERAPY - A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction-evoking stimulation therapy is delivered from the selected electrode. | 05-12-2016 |
| 20160129262 | MODE SWITCHING BY A VENTRICULAR LEADLESS PACING DEVICE - In some examples, a leadless pacing device (hereinafter, “LPD”) is configured for implantation in a ventricle of a heart of a patient, and is configured to switch between an atrio-ventricular synchronous pacing mode and an asynchronous ventricular pacing mode in response to detection of one or more sensing events, which may be, for example, undersensing events. In some examples, an LPD is configured to switch from a sensing without pacing mode to an atrio-ventricular synchronous pacing mode in response to determining, for a threshold number of cardiac cycles, a ventricular depolarization was not detected within a ventricular event detection window that begins at an atrial activation event. | 05-12-2016 |
| 20160129263 | MODE SWITCHING BY A VENTRICULAR LEADLESS PACING DEVICE - In some examples, a leadless pacing device (hereinafter, “LPD”) is configured for implantation in a ventricle of a heart of a patient, and is configured to switch between an atrio-ventricular synchronous pacing mode and an asynchronous ventricular pacing mode in response to detection of one or more sensing events, which may be, for example, undersensing events. In some examples, an LPD is configured to switch from a sensing without pacing mode to an atrio-ventricular synchronous pacing mode in response to determining, for a threshold number of cardiac cycles, a ventricular depolarization was not detected within a ventricular event detection window that begins at an atrial activation event. | 05-12-2016 |
| 20160136418 | ELECTRICAL MUSCLE CONTROLLER - A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%. | 05-19-2016 |
| 20160136433 | PACING AND SENSING VECTORS - A method for allowing cardiac signals to be sensed and pacing pulse vectors to be delivered between two or more electrodes. In one embodiment, cardiac signals are sensed and pacing pulse vectors are delivered between at least one of a first left ventricular electrode and a second left ventricular electrode. Alternatively, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrodes and a first supraventricular electrode. In addition, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrode, the first supraventricular electrode and a conductive housing. In an additional embodiment, a first right ventricular electrode is used to sense cardiac signals and provide pacing pulses with different combinations of the first and second left ventricular electrodes, the first supraventricular electrode and the housing. | 05-19-2016 |
| 20160144190 | ATRIAL SYNCHRONIZED VENTRICULAR PACING SYSTEM USING INTRACARDIAC PACEMAKER AND EXTRACARDIAC ATRIAL SENSING - An implantable medical device system includes an extracardiac sensing device and an intracardiac pacemaker. The sensing device senses a P-wave attendant to an atrial depolarization of the heart via housing-based electrodes carried by the sensing device when the sensing device is implanted outside the cardiovascular system and sends a trigger signal to the intracardiac pacemaker in response to sensing the P-wave. The intracardiac pacemaker detects the trigger signal and schedules a ventricular pacing pulse in response to the detected trigger signal. | 05-26-2016 |
| 20160151621 | IMPLANTABLE MEDICAL DEVICE WITH STACKED CIRCUIT COMPONENTS | 06-02-2016 |
| 20160151627 | SYSTEM AND METHOD FOR STIMULATING THE HEART USING SUB-THRESHOLD BIPHASIC STIMULATION | 06-02-2016 |
| 20160184590 | CLOSED LOOP OPTIMIZATION OF CONTROL PARAMETERS DURING CARDIAC PACING - A system and method control a pacing parameter in a closed-loop manner by determining a value of an EGM-based index corresponding an optimal electrical activation condition of a patient's heart and adjusting a pacing therapy to maintain the EGM-based index value. The closed loop control method performed by the system may establish a relationship between an EGM-based index and multiple settings of a pacing control parameter. Values of the EGM-based index are stored with corresponding setting shifts relative to a previously established optimal setting. A processor of an implantable medical device monitors the EGM-based index during cardiac pacing. Responsive to detecting an EGM-based index value corresponding to a non-optimal setting of the control parameter, the processor determines an adjustment of the control parameter from the stored index values and corresponding setting shifts. | 06-30-2016 |
| 20160193467 | EPICARDIAL HEART STIMULATOR | 07-07-2016 |
| 20160250478 | PACING CROSSTALK DETECTION | 09-01-2016 |
| 20180021583 | METHODS AND SYSTEMS FOR MANAGING SYNCHRONOUS CONDUCTED COMMUNICATION FOR AN IMPLANTABLE MEDICAL DEVICE | 01-25-2018 |
| 20190143117 | EFFICIENT DELIVERY OF MULTI-SITE PACING | 05-16-2019 |
| 20190143118 | LEADS AND METHODS FOR CARDIAC RESYNCHRONIZATION THERAPY | 05-16-2019 |
