Patent application number | Description | Published |
20080221636 | METHOD AND APPARATUS FOR CLOSED-LOOP INTERMITTENT CARDIAC STRESS AUGMENTATION PACING - A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing. | 09-11-2008 |
20080234556 | METHOD AND APPARATUS FOR SENSING RESPIRATORY ACTIVITIES USING SENSOR IN LYMPHATIC SYSTEM - A respiratory monitoring system includes an implantable lymphatic sensor configured to be placed in a lymphatic vessel, such as the thoracic duct or a vessel branching from the thoracic duct, near the diaphragm. The implantable lymphatic sensor senses a signal indicative of respiratory activities. Examples of the signal include a diaphragmatic activity signal indicative of movement of the diaphragm and a transthoracic impedance signal indicative of pulmonary volume. In one embodiment, the respiratory monitoring system is incorporated into a cardiac rhythm management system that controls cardiac therapy delivery using the signal sensed by the implantable lymphatic sensor. | 09-25-2008 |
20080234772 | METHOD AND DEVICE FOR MYOCARDIAL STRESS REDISTRIBUTION - Methods and devices are described for delivering electrical stimulation to the heart in a manner that advantageously redistributes myocardial stress during systole for therapeutic purposes in the treatment of, for example, post-MI and HF patients. Pre-excitation pacing may be applied to deliberately de-stress a particular myocardial region that may be expected to undergo deleterious remodeling, such an the area around a myocardial infarct or a hypertrophying region or to deliberately stress a region remote from the pre-excitation pacing site in order to exert a cardioprotective conditioning effect, similar to the beneficial effects of exercise. Pre-excitation pacing may be advantageously combined with inotropic electrical stimulation applied to the stressed region. | 09-25-2008 |
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 |
20080281367 | SYSTEM AND METHOD TO DETERMINE HEMODYNAMIC TOLERABILITY - An implantable medical device detects a tachyarrhythmia of a heart. During the detected tachyarrhythmia, the device determines a local myocardial impedance. Using the local myocardial impedance, the device determines whether there is sufficient perfusion to the heart. The device can then either deliver a less aggressive device therapy in response to the detected tachyarrhythmia when there is sufficient perfusion to the heart, or deliver a more aggressive device therapy in response to the detected tachyarrhythmia when there is insufficient perfusion to the heart. The perfusion information can also be used to alter tachyarrhythmia detection or classification. | 11-13-2008 |
20080294228 | METHOD AND DEVICE FOR CONTROLLED STIMULATION OF LYMPHATIC FLOW - A device and method for controllably augmenting the flow of lymphatic fluid through one or more lymphatic vessels. The device may utilize various means of modulating the flow of lymph, including neural, mechanical and/or chemical stimulation and could be a stand-alone device or be incorporated into any cardiac, neuromodulation and/or drug delivery device. | 11-27-2008 |
20090024194 | SYSTEMS AND METHODS FOR LOCAL VASOACTIVE RESPONSE USING TEMPERATURE MODULATION - Disclosed herein, among other things, is a device for providing a localized vasomodulation of a vessel. According to an embodiment, the device includes a thermal element configured to conduct thermal energy between the thermal element and a desired region of the vessel wall to elicit the localized vasomodulation of the vessel at the desired region. The device also includes a controller operationally connected to the thermal element. The controller is adapted to control the conduction of thermal energy between the thermal element and the desired region of the vessel wall to control the localized vasomodulation of the vessel at the desired region. In various embodiments, a sensor connected to the device provides feedback to the controller. | 01-22-2009 |
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 |
20090082825 | CLOSED-LOOP CONTROL OF INTERMITTENT EXCITATORY CARDIAC STIMULATION FOR THERAPEUTIC EFFECT - A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. In order to provide a consistent hemodynamic response, the high-output pacing is optimized by delivering it using different parameter sets, evaluating the hemodynamic response thereto as reflected by one or more measured physiological variables, and selecting the parameter set with the best hemodynamic response. | 03-26-2009 |
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 |
20090157090 | Cardiac Lead Placement Using Multiple Spatially Distributed Sensors - Systems and methods facilitate placement of a lead in or on a patient's heart. At least one reference sensor is positioned at a right heart location of a patient's heart and a cardiac lead apparatus comprising at least one lead apparatus sensor is advanced to a plurality of left heart locations. Using the reference sensor and the lead apparatus sensor, a distance parameter indicative of a distance between the reference and lead apparatus sensors is measured for each of the plurality of left heart locations. Strain or stress estimates are determined for the plurality of left heart locations derived from the distance parameter measurements. Using the strain or stress estimates, a physician perceivable output is produced indicating suitability of the left heart locations as pacing sites. | 06-18-2009 |
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 |
20090204163 | METHODS OF MONITORING HEMODYNAMIC STATUS FOR RHYTHM DISCRIMINATION WITHIN THE HEART - Systems and methods of performing rhythm discrimination within a patient's body using sensed hemodynamic signals are disclosed. The method can include the steps of receiving an electrical activity signal from an electrode located within or near the heart, detecting an event of the heart based on the received electrical activity signal, sensing one or more mechanical measurements using a sensor located within the body, analyzing a mechanical activity signal received from the sensor, and confirming the type of event based on the mechanical and electrical activity signals. The sensor can comprise a single pressure sensor configured to sense both atrial and ventricular activity within the heart. | 08-13-2009 |
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 |
20090234406 | SYSTEMS, DEVICES AND METHODS FOR MODULATING AUTONOMIC TONE - Various system embodiments comprise means for intermittently delivering a sympathetic stimulus, including means for delivering a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further includes means for delivering neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus. | 09-17-2009 |
20090264716 | HEMODYNAMIC MORPHOLOGICAL ANALYSIS FOR RHYTHM IDENTIFICATION - This document discusses, among other things, an apparatus comprising an implantable hemodynamic sensor circuit that provides a hemodynamic signal representative of mechanical function of a cardiovascular system of a subject and a controller circuit communicatively coupled to the hemodynamic sensor circuit. The controller circuit includes a detection module configured to detect an onset of tachyarrhythmia, a signal analyzer module configured to determine a measure of morphological variability of the hemodynamic signal during the episode of tachyarrhythmia, and a rhythm discrimination module configured to deem whether the tachyarrhythmia episode is indicative of ventricular tachycardia (VT) according to the measure of morphological variability. | 10-22-2009 |
20090270941 | HEMOSTASIS VALVE AND GUIDEWIRE PACING SYSTEM - Systems and methods for temporarily pacing a patient's heart are provided. One system includes a hemostasis valve with an adjustable electrical connection, the adjustable electrical connection having one or more adjustable contacts. The adjustable contacts have a first, radially expanded configuration and a second, radially constricted configuration. In the radially constricted configuration, the adjustable contacts are configured to pierce through a layer of an elongate medical device that is disposed in the hemostasis valve. The elongate medical device has a distal electrode and a conductor extending along a portion of the elongate medical device. The adjustable contacts pierce through a make contact with the conductor, providing an electrical pathway to the distal electrode. Also provided are vascular access systems including a hemostasis valve and a guide catheter, guide wire torquers with adjustable contacts and methods of temporarily pacing a patient's heart. | 10-29-2009 |
20090270960 | SYSTEMS AND METHODS FOR DELIVERING ELECTRIC CURRENT FOR SPINAL CORD STIMULATION - Various system embodiments comprise a lead having a distal end and a proximal end. The distal end includes a plurality of electrodes. The lead is configured to be fed into a dorsal epidural space of a human to a desired region of a spinal column and to be fed laterally to at least partially encircle a spinal cord in the desired region to place at least one stimulation electrode in position to stimulate a dorsal nerve root and at least another stimulation electrode in position to stimulate a ventral nerve root. The desired region may include cervical vertebrae, thoracic vertebrae, or lumbar vertebrae. Some embodiments stimulate the spinal cord in the T1-T5 region. | 10-29-2009 |
20090281591 | SMART DELAY FOR INTERMITTENT STRESS THERAPY - A pacing system delivers cardiac protection pacing to protect the heart from injuries. The pacing system receives a set of inputs and calculates parameters for delivering optimized cardiac protection pacing tailored for different stress levels. The system automatically adjusts heart rate to optimize cardiac protection pacing in a closed-loop system. In one embodiment, a method for delivering pacing pulses for cardiac protection is provided. Intrinsic atrioventricular (AV) intervals are sensed. The intrinsic AV interval and a predetermined equation relating the AV interval to an optimal AV delay are used to provide a maximum positive rate of left ventricular pressure change during systole. An AV delay is calculated using a predetermined percentage of the optimal AV delay to deliver ventricular pacing pulses to provide a desired level of stress for cardiac protective pacing therapy (CPPT) to provide a cardiac conditioning therapy to improve autonomic balance. | 11-12-2009 |
20090299420 | METHOD AND APPARATUS FOR CRYOTHERAPY AND PACING PRECONDITIONING - A method and apparatus are described for delivering myocardial pacing and cryotherapy in conjunction with a coronary revascularization procedure using one catheter/stent system. In one embodiment, a balloon-stent delivery platform incorporates pacing electrode(s) on or near the distal tip for myocardial pacing. | 12-03-2009 |
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 |
20090306486 | SENSING VECTOR CONFIGURATION IN ICD TO ASSIST ARRHYTHMIA DETECTION AND ANNOTATION - An apparatus comprises an implantable cardiac signal sensing circuit, configured to provide a sensed near-field depolarization signal from a ventricle and to provide a sensed a far-field intrinsic atrial signal using a far-field atrial sensing channel, and a controller circuit communicatively coupled to the cardiac signal sensing circuit. The controller circuit includes a P-wave detection module configured to detect an atrial depolarization in the sensed far-field intrinsic atrial signal and a tachyarrhythmia detection module configured to detect an episode of tachyarrhythmia using the sensed near-field depolarization signal and to determine whether the tachyarrhythmia episode is indicative of supraventricular tachycardia (SVT) using the detected atrial depolarization and the sensed near-field depolarization signal. | 12-10-2009 |
20090318749 | METHOD AND APPARATUS FOR PACING AND INTERMITTENT ISCHEMIA - A system delivers multiple enhanced therapies to limit myocardial damage post-revascularization. The system includes a catheter that incorporates features for delivering cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy. In one embodiment, a method for delivering cardiac protection therapies to a heart is provided. One or more catheters are provided having a balloon, at least one pacing electrode and at least one hemodynamic sensor. Cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy are concurrently delivered using the one or more catheters. The pacing and ischemia are adapted to protect the heart from ischemic and reperfusion injuries. The delivery of the CPPT and the intermittent ischemia are controlled using a closed-loop system monitoring a signal sensed by the at least one hemodynamic sensor. | 12-24-2009 |
20090318984 | EXTERNAL PACEMAKER WITH AUTOMATIC CARDIOPROTECTIVE PACING PROTOCOL - A pacing system includes a pacemaker and a pacing protocol module externally attached to the pacemaker. The pacing protocol module stores the pacing protocol. The pacemaker controls delivery of pacing pulses by automatically executing the pacing protocol. In one embodiment, the pacing protocol is a cardioprotective pacing protocol for preventing and/or reducing cardiac injury associated with myocardial infarction (MI) and revascularization procedure. The pacing pulses are generated from the pacemaker and delivered through one or more pacing electrodes incorporated onto one or more percutaneous transluminal vascular intervention (PTVI) devices during the revascularization procedure. | 12-24-2009 |
20090318985 | METHOD AND APPARATUS FOR CONTROLLING ANTI-TACHYARRHYTHMIA THERAPY USING HEMODYNAMIC TOLERABILITY - A cardiac rhythm management system identifies a relationship between one or more hemodynamic parameters sensed from a patient and levels of hemodynamic tolerability of the patient. The identified relationship allows an implantable medical device to control delivery of anti-tachyarrhythmia therapy using the patient's hemodynamic tolerability during a detected tachyarrhythmia episode, in addition to classifying the detected tachyarrhythmia episode by its type and origin. | 12-24-2009 |
20100004706 | PACING SYSTEM CONTROLLER INTEGRATED INTO INDEFLATOR - Systems and methods for temporarily pacing a patient's heart are provided. One system includes a vascular treatment system having a vascular access system and a therapy system. The therapy system includes an indeflator and an elongate medical device and the elongate medical device has an inflatable member and an electrode. The indeflator is adapted to provide pressurized fluid to the inflatable member and electrical signals to the electrode, with its operation manually or automatically controlled. Devices for electrically and fluidly coupling the indeflator and the elongate medical device are also provided. | 01-07-2010 |
20100010551 | METHOD AND APPARATUS FOR TRANSCUTANEOUS CARDIOPROTECTIVE PACING - A transcutaneous cardiac stimulation system delivers pacing pulses according to a cardioprotective pacing protocol. The pacing pulses are delivered through body-surface electrodes attached onto a patient. The cardioprotective pacing protocol specifies pacing parameters selected to augment cardiac stress on the patient's myocardium to a level effecting cardioprotection against ischemic and reperfusion injuries. | 01-14-2010 |
20100016913 | INTERMITTENT PACING THERAPY FOR ANGINA AND DISEASE PREVENTION - 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 each of different purposes. The system delivers electrical stimulation to provide therapy for angina and/or to provide therapy for co-morbidities related to neural imbalance. In one embodiment, a method for treating angina is provided. A signal is sensed indicative of an incidence of angina and an angina region being a myocardial region affected by the angina. The incidence of angina is detected and the angina region is located. A pacing location is selected remote from the angina region, and CPPT is initiated at the pacing location. The CPPT is adapted to create increased stress at the angina region, to promote mass-redistribution and angiogenesis at the angina region to treat the angina. | 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 |
20100042170 | METHOD AND APPARATUS FOR NEURAL STIMULATION VIA THE LYMPHATIC SYSTEM - An implantable neural stimulation system includes an implantable medical device having a neural stimulation circuit and at least one implantable lead configured to allow one or more stimulation electrodes to be placed in one or more lymphatic vessels of a patient, such as the patient's thoracic duct and/or vessels branching from the thoracic duct. Neural stimulation pulses are delivered from the implantable medical device to one or more target regions adjacent to the thoracic duct or the vessels branching from the thoracic duct through the one or more stimulation electrodes. | 02-18-2010 |
20100049270 | TRIGGERED HIGH-OUTPUT PACING THERAPY - A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. The device may be configured to deliver high-output pacing upon detection of cardiac decompensation. | 02-25-2010 |
20100056858 | PACING SYSTEM FOR USE DURING CARDIAC CATHETERIZATION OR SURGERY - Cardioprotective pacing is applied to prevent and/or reduce cardiac injury associated with cardiac catheterization or surgery. Pacing pulses are generated from a pacemaker and delivered through one or more pacing electrodes incorporated onto one or more devices used in the cardiac catheterization or surgery. The pacemaker controls the delivery of the pacing pulses by executing a cardioprotective pacing protocol. In one embodiment, the one or more pacing electrodes are incorporated onto an intravascular ultrasound (IVUS) catheter. In another embodiment, the one or more pacing electrodes are incorporated onto one or more cardiac surgical instruments such as a heart stabilizer and a sternal retractor. | 03-04-2010 |
20100069989 | PRESSURE-DRIVEN INTERMITTENT PACING THERAPY - Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's physiological response to ventricular dyssynchrony to control the duty cycles of intermittent pre-excitation pacing. | 03-18-2010 |
20100076279 | METHOD AND APPARATUS FOR ORGAN SPECIFIC INFLAMMATION MONITORING - An apparatus comprises an implantable sensor and a detection circuit. The implantable sensor provides a physiologic sensor signal and is to be positioned at a lymph node of a subject. The detection circuit detects a change in a physiologic parameter of the lymph node that exceeds a threshold change, and deems that the change in the physiologic parameter indicates a change in inflammation of an organ associated with the lymph node. | 03-25-2010 |
20100087881 | PREFERENTIAL MECHANICAL UNLOADING DURING ANTI-TACHYCARDIA PACING - A pacing device and method for operating same is disclosed in which the point of origin of an arrhythmia is estimated in order to more provide more effective treatment. The origin of an arrhythmia may be estimated by analyzing the timing of electrical events as detected at different electrode sites and/or using different sensing vectors. Anti-tachycardia pacing (ATP) may then be delivered to the most appropriate location. | 04-08-2010 |
20100087887 | TITRATED INTERMITTENT PACING THERAPY - Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's heart rate or exertion level to control the duty cycles of intermittent pre-excitation pacing. | 04-08-2010 |
20100100144 | INTEGRATED CARDIAC RHYTHM MANAGEMENT SYSTEM WITH HEART VALVE - Systems and methods using a heart valve and an implantable medical device, such as for event detection and optimization of cardiac output. The cardiac management system includes a heart valve, having a physiological sensor. The physiological sensor is adapted to measure at least one of an intrinsic electrical cardiac parameter, a hemodynamic parameter or the like. The system further includes an implantable electronics unit, such as a cardiac rhythm management unit, coupled to the physiological sensor of the heart valve to receive physiological information. The electronics unit is adapted to use the received physiological information to control delivery of an electrical output to the subject. | 04-22-2010 |
20100121402 | REVERSE HYSTERESIS AND MODE SWITCHING FOR INTERMITTENT PACING THERAPY - Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described. | 05-13-2010 |
20100210923 | DEPLOYABLE SENSOR PLATFORM ON THE LEAD SYSTEM OF AN IMPLANTABLE DEVICE - Systems and methods for deploying a sensor assembly onto a cardiac lead are disclosed. The sensor assembly can include a resilient cuff having one or more sensor modules for sensing physiological parameters within the body. The resilient cuff may have a substantially cylindrical shape having an inner diameter that is smaller than an outer diameter of the lead body onto which the cuff is deployed such that the cuff is retained on the lead body by frictional forces. The sensor assembly may be deployed in conjunction with a new lead to be implanted within a chamber of the patient's heart or a body vessel, or may be deployed onto an existing, implanted lead implanted within the patient's body. | 08-19-2010 |
20100217346 | METHOD AND APPARATUS FOR GASTROINTESTINAL STIMULATION VIA THE LYMPHATIC SYSTEM - An implantable gastrointestinal (GI) stimulation system includes an implantable medical device and at least one stimulus delivery device configured to be placed in one or more lymphatic vessels of a patient, such as the patient's thoracic duct and/or vessels branching from the thoracic duct. In one embodiment, the implantable medical device includes a GI stimulation circuit to deliver electrical stimulation pulses to one or more target regions adjacent to a lymphatic vessel through the stimulus delivery device. In one embodiment, to control obesity, the electrical stimulation pulses are delivered to the organs and/or nerves of the GI tract to create a sensation of satiety and/or to expedite food movement through the GI tract. | 08-26-2010 |
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 |
20100249860 | EXTERNAL CARDIAC STIMULATION PATCH - An external cardiac stimulation patch integrates a transcutaneous cardiac stimulation device and body-surface electrodes with a skin patch. The skin patch is to be attached onto a patient to provide for electrical contacts between the body-surface electrodes and a patient. The transcutaneous cardiac stimulation device delivers pacing pulses to the heart of the patient through pacing electrodes selected from the body-surface electrodes. | 09-30-2010 |
20100268194 | DEVICE AND METHOD FOR MODULATING RENAL FUNCTION - Renal function may be modulated by an implantable device having one or more leads or catheters disposed near the kidney via the lymphatic system. In one embodiment, lymphatic drainage from the kidney is modulated to increase or decrease tubular reabsorption of salt and water. The renal function modulation therapy may be delivered in an open-loop or closed-loop fashion, with the latter dependent upon a physiological variable such as blood pressure or cardiac output. | 10-21-2010 |
20100292745 | METHOD AND APPARATUS FOR SAFETY CONTROL DURING CARDIAC PACING MODE TRANSITION - A cardiac pacing system introduces a transitional period when pacing mode changes, such as when pacing starts and stops, or when one or more pacing parameter values change substantially. For each pacing parameter that changes substantially when the pacing mode changes, its value is adjusted incrementally over the transitional period to protect the heart from potentially harmful conditions associated with an abrupt change in the value of that pacing parameter. | 11-18-2010 |
20100305635 | SYSTEM AND METHOD FOR RHYTHM IDENTIFICATION AND THERAPY DISCRIMINATION USING HEMODYNAMIC STATUS INFORMATION - A system and method for controlling cardiac ventricular tachyarrhythmias by acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient. A CVP index is derived based on the pressure signal. The onset of a ventricular tachyarrhythmia episode is detected based on a cardiac rates signal. The CVP index and the rate signal are monitored and, responsive to the rate signal indicating a sustained tachycardia episode during the episode monitoring period, anti-tachycardia therapy selectively withheld and the episode monitoring period is extended based on the CVP index. | 12-02-2010 |
20100305648 | METHOD AND APPARATUS FOR SAFE AND EFFICIENT DELIVERY OF CARDIAC STRESS AUGMENTATION PACING - A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac stress augmentation pacing to create or augment regional stress in the heart according to a delivery schedule programmed for a patient. Various events associated with the patient's conditions, activities, and other treatments may render the cardiac stress augmentation pacing risky or ineffective. The system detects such events before and during each cardiac stress augmentation pacing session and modifies the delivery schedule in response to the detection of each event to ensure patient safety and therapy efficiency. | 12-02-2010 |
20110022127 | BLOOD VOLUME REDISTRIBUTION THERAPY FOR HEART FAILURE - A first fluid status indicator of a pulmonary fluid status associated with pulmonary edema and a second fluid status indicator of a non-pulmonary fluid status can be used to provide an alert or to control a therapy for pulmonary edema. Additionally, intermittent cardiac blood volume redistribution therapy can be used to provide cardiac conditioning in heart failure patients. | 01-27-2011 |
20110040344 | MYOCARDIAL INFARCTION TREATMENT SYSTEM WITH ELECTRONIC REPOSITIONING - Methods and devices for treating a blockage in the coronary arterial system are provided. Some blockages in the coronary arterial system restrict the blood flow to a portion of the heart, causing ischemia or infarction. Such blockages may be treated by displacing, removing and/or breaking up the blockage, which allows blood to reperfuse into the infarcted portion of the heart. Before, during, and/or after the reperfusion, cardioprotective pacing is provided to the heart. The devices have multiple electrodes in order to provide multiple locations at which the cardioprotective pacing may be delivered. The devices are adapted to deliver cardioprotective pacing to the heart via the electrode that results in a relatively high level of dyssynchrony of the heart. | 02-17-2011 |
20110071411 | METHOD AND APPARATUS FOR SENSING MECHANICAL ENERGY OF AN IMPLANTABLE LEAD - An apparatus comprises an implantable sensor and a signal analyzer circuit communicatively coupled to the implantable sensor. The implantable sensor is configured for coupling to an implantable lead and the implantable sensor provides an electrical vibration sensor signal representative of mechanical vibration of the implantable lead. The signal analyzer circuit is configured to determine a baseline of the vibration sensor signal, detect a change in the vibration sensor signal from the baseline vibration sensor signal, and provide an indication of the change to a user or process. | 03-24-2011 |
20110087301 | IMPLANTABLE DEVICE WITH HEMODYNAMIC SUPPORT OR RESUSCITATION THERAPY - An apparatus comprises an implantable sensor, a stimulation circuit, and a controller. The implantable sensor is configured to provide a sensor signal representative of hemodynamic function of a subject. The stimulation circuit is configured to provide electrical simulation energy to an implantable electrode. The controller is communicatively coupled to the stimulation circuit and the implantable sensor and includes a hemodynamic monitor module. The hemodynamic monitor module is configured to detect an episode of reduced hemodynamic capacity in a subject using the sensor signal. In response to the detected episode, the controller is configured to initiate delivery of the electrical stimulation energy to artificially induce at least one of deep ventilation or rapid ventilation in the subject. The hemodynamic monitor module is configured to obtain a measure of hemodynamic performance after delivery of the electrical stimulation energy. | 04-14-2011 |
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 |
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 |
20110190840 | SYMPATHETIC STIMULATION FOR IMPROVED MYOCARDIAL RELAXATION - Described are methods and devices for improving diastolic function with electrostimulation in heart failure patients who exhibit relatively normal systolic function. Such patients are characterized by impaired myocardial relaxation during diastole that prevents adequate filling of the ventricles during diastole to thereby reduce cardiac output. An implantable device is described for effecting strategic and periodic stimulation of the sympathetic nervous system to elicit myocardial adrenergic activation for improved myocardial relaxation. | 08-04-2011 |
20110213436 | METHOD AND DEVICE FOR TREATING MYOCARDIAL ISCHEMIA - A method and device for treating myocardial ischemia are described in which the stress experienced by a myocardial region identified as vulnerable to becoming ischemic is varied with pre-excitation pacing. In an unloading mode, pacing is applied in proximity to the vulnerable region to reduce stress and the metabolic demand of the region. In a loading mode, pacing is applied to a region remote from the vulnerable region in order to produce a conditioning effect. | 09-01-2011 |
20110224606 | METHOD AND APPARATUS FOR REMOTE ISCHEMIC CONDITIONING DURING REVASCULARIZATION - Remote ischemic conditioning is applied during a revascularization procedure to prevent and/or reduce myocardial injury associated with myocardial infarction (MI) and the revascularization procedure such as percutaneous transluminal coronary angioplasty (PTCA). A percutaneous transluminal vascular intervention (PTVI) device used for the revascularization procedure, such as an introducer sheath or a guide catheter, includes an adjustable balloon to be positioned at a vascular site remote from the heart. The remote ischemic conditioning is applied by inflating and deflating the adjustable balloon, thereby causing temporary ischemia in the vascular site to activate the patient's intrinsic cardioprotective mechanism. | 09-15-2011 |
20110257523 | FOCUSED ULTRASONIC RENAL DENERVATION - Acoustic energy is delivered to innervated vascular that contributes to renal sympathetic nerve activity, such as innervated tissue of the renal artery and abdominal aorta. Focused acoustic energy is delivered via an intravascular device of sufficient power to ablate innervated renal or aortal tissue. Focused acoustic energy may be delivered via an intravascular or extracorporeal device to image and locate target innervated renal or aortal tissue. Intravascular, extravascular, or transvascular focused ultrasound devices provide for high precision denervation of innervated vascular to terminate renal sympathetic nerve activity. | 10-20-2011 |
20110257641 | PHOTOTHERAPY FOR RENAL DENERVATION - Apparatuses and methods facilitate delivery of optical or photoacoustic energy to innervated vascular that contributes to renal sympathetic nerve activity. The optical energy delivered may be of sufficient power to scan or image innervated renal or aortal tissue. The optical energy delivered may be of sufficient power to ablate innervated renal or aortal tissue, such as by thermal laser ablation or photoacoustic laser ablation. A catheter for intravascular or extravascular deployment supports an optical fiber arrangement comprising a coupling for receiving light from a laser light source. An optics arrangement is supported by the catheter and coupled to the optical fiber arrangement. The optics arrangement includes one or more optical elements arranged to receive the laser light and direct optical energy to target innervated tissue or a water source from which a cavitation bubble may be created and launched for acoustically shocking the target innervated tissue. | 10-20-2011 |
20110264158 | HIS-BUNDLE CAPTURE VERIFICATION AND MONITORING - This document discusses, among other things, a system and method for generating a stimulation energy to provide His-bundle stimulation for a cardiac cycle, receiving electrical information from the heart over at least a portion of the cardiac cycle, determining a characteristic of at least a portion of the received electrical information for the cardiac cycle, and classifying the cardiac cycle using the determined characteristic. | 10-27-2011 |
20110319776 | CARDIAC CONTRACTION DETECTION USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods for cardiac contraction detection using information indicative of lead motion are described. In an example, an implantable medical device can include a receiver circuit configured to be electrically coupled to conductor comprising a portion of an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The device can include a processor circuit configured to determine whether a cardiac mechanical contraction occurred during a specified interval included in the obtained information indicative of the movement of the implantable lead. The processor circuit can be configured to determine information about the cardiac mechanical contraction using the obtained information indicative of the movement of the implantable lead. | 12-29-2011 |
20110319778 | CARDIAC FUNCTION MONITOR USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods to monitor cardiac function using information indicative of lead motion are described. In an example, a system including an implantable medical device can include a receiver circuit configured to be electrically coupled to conductor comprising a portion of an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The system can include a sensing circuit configured to obtain information indicative of cardiac electrical activity. The system can include a processor circuit configured to construct a template representative of a contraction of the heart, where the template can be constructed using the information indicative of the movement of the implantable lead due at least in part to the motion of the heart during the contraction, and using the information indicative of the cardiac electrical activity sensed during the contraction. | 12-29-2011 |
20110319779 | RHYTHM DISCRIMINATION USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods for rhythm discrimination using the motion of an implantable lead are described. In an example, an implantable medical device can include a receiver circuit configured to be electrically coupled to an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The device can include an arrhythmia detection circuit configured to determine an arrhythmia status using the information indicative of the movement of the implantable lead and an arrhythmia classification circuit configured to determine one or more of a location or a type of an arrhythmia, using the information indicative of the movement of the implantable lead, when the arrhythmia status indicates that an arrhythmia is occurring or has occurred. | 12-29-2011 |
20110319782 | CARDIAC MECHANICAL VIBRATION MONITOR USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods to monitor cardiac mechanical vibrations using information indicative of lead motion are described. In an example, a system including an implantable medical device can include an excitation circuit configured to provide a non-tissue stimulating, non-therapeutic electrical excitation signal to a portion of an implantable lead. A receiver circuit can be configured to obtain information indicative of a mechanical vibration of the implantable lead due at least in part to one or more of an impact of at least a portion of the heart to the implantable lead, or friction contact between the implantable lead and cardiac tissue. The system can include a processor circuit configured to determine one or more of a lead mechanical status, or information indicative of valvular activity using the information indicative of the mechanical vibration of the implantable lead. | 12-29-2011 |
20110319955 | REDUCTION OF AV DELAY FOR TREATMENT OF CARDIAC DISEASE - An implantable pacing device for delivering ventricular pacing may be configured to intermittently reduce the AVD interval for beneficial effect in patients with compromised ventricular function (e.g., HF patients and post-MI patients). The AVD interval may be reduced in an AVD reduction mode, by shortening the AVD in an atrial triggered ventricular pacing mode or by switching to a non-atrial triggered ventricular pacing mode (e.g., VVI) and delivering paces at a rate above the intrinsic rate. The physiological effects of AVD reduction may be either positive or negative on cardiac output, depending upon the individual patient. | 12-29-2011 |
20120101542 | TIMING FOR HIS-BUNDLE PACING - An A-H delay can be specified, such as by computing the A-H delay using a measured cardiovascular physiologic parameter. The A-H delay can be used for specifying timing between a paced or sensed atrial contraction and a His-bundle pacing time. | 04-26-2012 |
20120165891 | CLOSED-LOOP CONTROL OF INTERMITTENT EXCITATORY CARDIAC STIMULATION FOR THERAPEUTIC EFFECT - A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. In order to provide a consistent hemodynamic response, the high-output pacing is optimized by delivering it using different parameter sets, evaluating the hemodynamic response thereto as reflected by one or more measured physiological variables, and selecting the parameter set with the best hemodynamic response. | 06-28-2012 |
20120232409 | SYSTEM AND METHOD FOR RENAL ARTERY OCCLUSION DURING RENAL DENERVATION THERAPY - A catheter includes a flexible shaft having a length sufficient to access a patient's renal artery relative to a percutaneous access location. A treatment arrangement is provided at a distal end of the shaft and configured for deployment in the renal artery. The treatment arrangement includes an ablation arrangement configured to deliver renal denervation therapy. An occlusion arrangement is configured for deployment in the renal artery and for altering blood flow through the renal artery during or subsequent to renal denervation therapy delivery. A monitoring unit is configured for monitoring for a change in one or more physiologic parameters influenced by the renal denervation therapy. The monitoring unit is configured to produce data useful in assessing effectiveness of the renal denervation therapy based on the physiologic parameter monitoring. | 09-13-2012 |
20120239106 | HIS CAPTURE VERIFICATION USING ELECTRO-MECHANICAL DELAY - Stimulation energy can be provided to a His-bundle to activate natural cardiac contraction mechanisms. Interval information can be used to describe a cardiac response to His-bundle stimulation, and the interval information can provide cardiac stimulation diagnostic information. For example, interval information can be used to discriminate between intrinsic conduction cardiac contractions and contractions responsive to His-bundle pacing. | 09-20-2012 |
20120277607 | METHOD AND APPARATUS FOR IDENTIFICATION OF ISCHEMIC/INFARCTED REGIONS AND THERAPY OPTIMIZATION - A method and apparatus is described for detecting and localizing areas of myocardial infarction or ischemia. By pacing sites in proximity to the infarcted or ischemic region with appropriately timed pacing pulses, the region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the metabolic demand of the region and the stimulus for remodeling. | 11-01-2012 |
20120296382 | INTEGRATED CARDIAC RHYTHM MANAGEMENT SYSTEM WITH HEART VALVE - Systems and methods using a heart valve and an implantable medical device, such as for event detection and optimization of cardiac output. The cardiac management system includes a heart valve, having a physiological sensor. The physiological sensor is adapted to measure at least one of an intrinsic electrical cardiac parameter, a hemodynamic parameter or the like. The system further includes an implantable electronics unit, such as a cardiac rhythm management unit, coupled to the physiological sensor of the heart valve to receive physiological information. The electronics unit is adapted to use the received physiological information to control delivery of an electrical output to the subject. | 11-22-2012 |
20130123883 | 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. | 05-16-2013 |
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 |
20130165844 | METHODS FOR MODULATING CELL FUNCTION - Methods for modulating nerve function are disclosed. An example method for modulating nerve function may include providing a transgene including a neuron-specific promoter and a gene encoding a light-sensitive protein, delivering the transgene to a body tissue including one or more target neurons, implanting a light source adjacent to the cell bodies of the one or more target neurons, and emitting light from the light source. Light may be exposed to the cell bodies of the one or more target neurons and may cause a conformational change in the light-sensitive protein. | 06-27-2013 |
20130172924 | HEMOSTASIS VALVE AND GUIDEWIRE PACING SYSTEM - Systems and methods for temporarily pacing a patient's heart are provided. One system includes a hemostasis valve with an adjustable electrical connection, the adjustable electrical connection having one or more adjustable contacts. The adjustable contacts have a first, radially expanded configuration and a second, radially constricted configuration. In the radially constricted configuration, the adjustable contacts are configured to pierce through a layer of an elongate medical device that is disposed in the hemostasis valve. The elongate medical device has a distal electrode and a conductor extending along a portion of the elongate medical device. The adjustable contacts pierce through a make contact with the conductor, providing an electrical pathway to the distal electrode. Also provided are vascular access systems including a hemostasis valve and a guide catheter, guide wire torquers with adjustable contacts and methods of temporarily pacing a patient's heart. | 07-04-2013 |
20130237954 | DEVICE AND METHOD FOR MODULATING RENAL FUNCTION - Renal function may be modulated by an implantable device having one or more leads or catheters disposed near the kidney via the lymphatic system. In one embodiment, lymphatic drainage from the kidney is modulated to increase or decrease tubular reabsorption of salt and water. The renal function modulation therapy may be delivered in an open-loop or closed-loop fashion, with the latter dependent upon a physiological variable such as blood pressure or cardiac output. | 09-12-2013 |
20130261685 | COORDINATED HIS-BUNDLE PACING AND HIGH ENERGY THERAPY - A cardiac arrhythmia can be identified, such as a tachycardia or fibrillation episode (atrial or ventricular). In responses to the detected arrhythmia, a coordinated electrostimulation therapy can be provided using at least one of a defibrillation shock therapy, a pre-shock conditioning therapy, or a post-shock conditioning therapy. The pre-shock or post-shock conditioning therapies can include electrostimulation therapies provided to the natural electrical conduction system of the heart between the atrioventricular node and the Purkinje fibers, inclusive, such as at or near a His bundle of a heart. In an example, a defibrillation threshold can be reduced by providing a pre-shock conditioning electrostimulation therapy to the natural electrical conduction system of the heart between the atrioventricular node and the Purkinje fibers, inclusive, such as at or near a His bundle. | 10-03-2013 |
20130268014 | METHOD AND APPARATUS FOR PACING DURING REVASCULARIZATION - A system for use during revascularization includes a catheter having an adjustable balloon for delivery a stent, one or more pacing electrodes for delivering one or more pacing pulses to a patient's heart, and a pacemaker configured to generate the one or more pacing pulses to be delivered to the heart via the one or more pacing electrodes. The one or more pacing pulses are delivered at a rate substantially higher than the patient's intrinsic heart rate without being synchronized to the patient's intrinsic cardiac contractions, and are delivered before, during, or after an ischemic event to prevent or reduce cardiac injury. | 10-10-2013 |
20130289649 | BLOOD VOLUME REDISTRIBUTION THERAPY FOR HEART FAILURE - A first fluid status indicator of a pulmonary fluid status associated with pulmonary edema and a second fluid status indicator of a non-pulmonary fluid status can be used to provide an alert or to control a therapy for pulmonary edema. | 10-31-2013 |
20130296965 | METHOD FOR BLOOD PRESSURE MODULATION USING ELECTRICAL STIMULATION OF THE CORONARY BARORECEPTORS - An apparatus comprises a first stimulation circuit and a control circuit. The stimulation circuit is configured to be electrically coupled to a first electrode assembly that is configured to deliver electrical sub-myocardial activation stimulation to a coronary baroreceptor from a location within a left atrial appendage of a heart. The stimulation circuit is further configured to generate the electrical stimulation for delivery to the coronary baroreceptor via the first electrode assembly. The control circuit is wirelessly or conductively coupled to the first stimulation circuit and is configured to control delivery of the electrical stimulation. | 11-07-2013 |
20130345537 | FAR-FIELD VS LOCAL ACTIVATION DISCRIMINATION ON MULTI-ELECTRODE EGMS USING VECTOR ANALYSIS IN MULTI-DIMENSIONAL SIGNAL SPACE - Electrical activity propagation along an electrode array within a cardiac chamber is reconstructed. Signals are sampled from the electrode array and the signals are plotted in multi-dimensional space with each axis corresponding to a channel in the electrode array. An excursion direction of global activation in the multi-dimensional space is estimated and a change in vectors of the sampled signals over time is determined. Signals with vectors that change over time in the excursion direction are suppressed. | 12-26-2013 |
20130345577 | AUGMENTED SIGNAL VECTOR ANALYSIS TO SUPPRESS GLOBAL ACTIVATION DURING ELECTROPHYSIOLOGY MAPPING - Electrical activity propagation along an electrode array within a cardiac chamber is reconstructed. Signals are sampled from the electrode array including signals from a channel of interest. An N-dimensional signal vector is then constructed using signals from N neighboring channels referenced to the channel of interest. A change in the N-dimensional signal vector over time is then determined and compared to a predetermined threshold to establish whether local activation has occurred on the channel of interest. | 12-26-2013 |
20130345583 | SUPPRESSION OF GLOBAL ACTIVITY DURING MULTI-CHANNEL ELECTROPHYSIOLOGY MAPPING USING A WHITENING FILTER - Electrical activity propagation along an electrode array within a cardiac chamber is reconstructed. Signals from the electrode array are sampled, and the signals are plotted in multi-dimensional space with each axis corresponding to a channel in the electrode array. A covariance matrix of the plotted signals is decomposed to characterize the spread of a data cloud of the signals in the multi-dimensional space. The data cloud is then decorrelated, such as through whitening, to suppress excursions along correlated directions (global activation) and enhance excursions along each axis (local activation). | 12-26-2013 |
20140067036 | HIS BUNDLE LEAD DELIVERY SYSTEM - Various embodiments concern implanting a lead to directly stimulate the bundle of His. Various embodiments can include introducing a curve of an outer guide catheter into the right ventricle, extending a curve of an inner guide catheter from a lumen of the outer guide catheter, extending a fixation element on a distal tip of an anchor wire from a lumen the inner guide catheter, and anchoring the anchor wire to target tissue within the right ventricle, the target tissue along the septal wall and proximate the tricuspid valve and the bundle of His. A distal tip of an implantable lead with a lumen can then be advanced over the anchor wire to the target tissue as the anchor wire guides the distal tip of the lead to the target tissue. | 03-06-2014 |
20140073978 | METHOD AND APPARATUS FOR SENSING AND AVOIDING CARDIAC CONDUCTION SYSTEM DURING VALVE DEPLOYMENT - Various techniques are described for replacement heart valve implantation. In one example, a system includes a specialized conduction system tissue activation potential sensing device, configured for delivery to an intracardiac region, a specialized conduction system tissue activation detector circuit, configured to detect, using the sensing device, a specialized conduction system tissue activation potential, and a processor circuit, configured to use information about the detected specialized conduction system tissue activation potential to generate a heart valve placement indication. | 03-13-2014 |
20140074022 | LOADING TOOLS FOR USE WITH BALLOON CATHETERS - Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a loading tool. The loading tool may include a tubular member that is configured to be disposed about a balloon catheter. The tubular member may include a distal portion and a proximal portion. The tubular member may be configured to shift between a first configuration and a shortened configuration. | 03-13-2014 |
20140107453 | REAL-TIME SIGNAL COMPARISON TO GUIDE ABLATION CATHETER TO THE TARGET LOCATION - A catheter system includes a plurality of mapping electrodes, an electrode movable relative to the plurality of mapping electrodes, and a guidance system coupled to the plurality of mapping electrodes and the ablation electrode. The guidance system is configured to receive signals associated with intrinsic cardiac activity sensed by the plurality of mapping electrodes and the movable electrode, and to correlate in real-time the intrinsic cardiac activity sensed by the movable electrode with the intrinsic cardiac activity sensed by the plurality of mapping electrodes based on the signals received by the plurality of mapping electrodes and movable electrode to determine a location of the movable electrode with respect to the plurality of mapping electrodes. | 04-17-2014 |
20140107724 | METHOD AND APPARATUS FOR SELECTIVE HIS BUNDLE PACING - A cardiac rhythm management system provides for cardiac pacing that is delivered to a target portion of conductive tissue in a heart, such as the His bundle. In various embodiments, the system is configured to verify capture of the target portion and provide for selective pacing of the target portion. In various embodiments, the system is configured to detect responses of the target portion and adjacent myocardial tissue to delivery of pacing pulses and use an outcome of the detection to verify selective capture of the target portion (i.e., without directly exciting the adjacent myocardial tissue. | 04-17-2014 |
20140121718 | SYSTEMS, DEVICES AND METHODS FOR MODULATING AUTONOMIC TONE - Various embodiments intermittently deliver a sympathetic stimulus, including deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further delivers neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus. | 05-01-2014 |
20140172035 | METHOD AND APPARATUS FOR RIGHT VENTRICULAR RESYNCHRONIZATION - An apparatus comprises a cardiac signal sensing circuit and a first implantable electrode pair. At least one electrode of the first implantable electrode pair is configured for placement at a location in a right branch of a His bundle of the subject. The apparatus can include a therapy circuit and a control circuit. The control circuit can include an AH delay calculation circuit configured to calculate an optimal paced AH delay interval. The pacing stimulation location is distal to a location of RV conduction block in a right branch of the His bundle. The control circuit initiates delivery of an electrical stimulation pulse to the stimulation location in the His bundle according to the calculated paced AH delay interval and in response to an intrinsic depolarization event sensed in an atrium of the subject. | 06-19-2014 |
20140180147 | ESTIMATING INTERSPLINE DISTANCES ON MAPPING CATHETERS - A catheter system includes a mapping catheter having a plurality of splines, each of the plurality of splines including a plurality of mapping electrodes. The system further includes a processor operatively coupled to the plurality of mapping electrodes and configured to receive signals sensed by the plurality of mapping electrodes. The processor is further configured to estimate an interspline distance between adjacent splines in the plurality of splines based on the signals sensed by the mapping electrodes on the adjacent splines. | 06-26-2014 |
20140180151 | SUPPRESSION OF GLOBAL ACTIVATION SIGNALS DURING ANATOMICAL MAPPING - A method for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the anatomical structure, identifying at least one of the electrodes not in direct contact with the anatomical structure, and adjusting the activation signals sensed by each of the plurality of electrodes based on the activation signals sensed by the identified at least one of the electrodes not in direct contact with the anatomical structure. | 06-26-2014 |
20140180152 | REAL-TIME FEEDBACK FOR ELECTRODE CONTACT DURING MAPPING - A catheter system includes a mapping catheter including a plurality of mapping electrodes, each mapping electrode configured to sense signals associated with an anatomical structure. The catheter system further includes a processor operatively coupled to the plurality of mapping electrodes and configured to receive the signals sensed by the plurality of mapping electrodes, characterize the signals sensed by the plurality of mapping electrodes based on amplitudes of the sensed signals, and generate an output of a quality of contact of the plurality of mapping electrodes with the anatomical structure based on the signal characterization. | 06-26-2014 |
20140180356 | STIMULATION PATCH WITH PASSIVE ADHESION - System and methods for adhering a patch of stimulation electrode(s) to blood vessels to stimulate a target site on the blood vessel are described. In various embodiments, the system includes an adhesion patch and at least one electrode. The adhesion patch includes a passive adhesion mechanism that may produce an adhesive force sufficiently strong to adhere the adhesion patch to the exterior of the blood vessel and to operationally position the at least one electrode for use in electrically stimulating a target site of the blood vessel. The adhesion patch may also include a release mechanism that is configured for a user to disengage the patch from the exterior of the blood vessel without significant trauma to the blood vessel. After being released, the adhesion patch may be re-adhered to a different target site of the blood vessel and stimulate the different target site. | 06-26-2014 |
20140180357 | STIMULATION PATCH WITH ACTIVE ADHESION - System and methods for adhering a patch of stimulation electrode(s) to blood vessels to stimulate a target site on the blood vessel are described. In one embodiment, the system includes an adhesion patch and at least one electrode. The adhesion patch includes an active adhesion mechanism that may produce an adhesive force sufficiently strong to adhere the adhesion patch to the exterior of the blood vessel and to operationally position the at least one electrode for use in electrically stimulating a target site of the blood vessel. The adhesion patch may also include a release mechanism that is configured for a user to disengage the patch from the exterior of the blood vessel without significant trauma to the blood vessel. After being released, the adhesion patch may be re-adhered to a different target site of the blood vessel and stimulate the different target site. | 06-26-2014 |
20140187989 | ESTIMATING RESTITUTION CURVES IN AN ANATOMICAL MAPPING SYSTEM - A method for mapping an anatomical structure includes sensing activation signals of physiological activity with a plurality of electrodes disposed in or near the anatomical structure, each activation signal having an associated cycle length, estimating an action potential duration and diastolic interval for each cycle length, generating a restitution curve based on the estimated action potential duration and diastolic interval from a preceding cycle length, iteratively optimizing each estimated action potential duration and corresponding diastolic interval to maximize a functional relationship between the estimated action potential duration and estimated diastolic interval from preceding cycle length, and generating an action potential duration restitution curve based on the optimized action potential durations and diastolic intervals. | 07-03-2014 |
20140187991 | ARTIFACT CANCELLATION TO SUPPRESS FAR-FIELD ACTIVATION DURING ELECTROPHYSIOLOGY MAPPING - A method for mapping a cardiac chamber includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the cardiac chamber, the activation signals including a near-field activation signal component and a far-field activation signal component, isolating R-wave events in the activation signals, generating a far-field activation template representative of the far-field activation signal component based on the R-wave events, and filtering the far-field activation template from the activation signals to identify the near-field activation signal components in the activation signals. | 07-03-2014 |
20140188184 | SYSTEMS AND METHODS TO OPTIMIZE PACING FUSION WITH NATIVE ACTIVATION - In an example, a pacing therapy can be optimized using information indicative of an offset duration between an intrinsic first atrioventricular delay of a subject at rest and a second atrioventricular delay specified to enhance a cardiac output of the subject heart when the subject is at rest. Optimizing the therapy can include receiving information about a heart rate of the subject and receiving information about an intrinsic, heart rate dependent atrioventricular delay. In an example, a therapy parameter, such as a therapy atrioventricular delay, can be adjusted using information about the received heart rate of the subject, the heart-rate-dependent third AV delay, or the offset duration. | 07-03-2014 |
20140200457 | RECONSTRUCTION OF CARDIAC ACTIVATION INFORMATION BASED ON ELECTRICAL AND MECHANICAL MEANS - An anatomical mapping system includes a plurality of mapping electrodes, a plurality of mechanical sensors, and a mapping processor associated with the plurality of mapping electrodes and mechanical sensors. The mapping electrodes are configured to detect electrical activation signals of intrinsic physiological activity within an anatomical structure. The mechanical sensors are configured to detect mechanical activity associated with the intrinsic physiological activity. The mapping processor is configured to record the detected activation signals and associate one of the plurality of mapping electrodes and mechanical sensors with each recorded activation signal. The mapping processor is further configured to determine activation times of the intrinsic physiological activity based on a correlation of corresponding electrical activation signals and mechanical activity. | 07-17-2014 |
20140316294 | METHOD AND APPARATUS FOR SUPPRESSING FAR-FIELD SENSING DURING ATRIAL MAPPING - A method and system for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the anatomical structure. Substantially similar activation signals are binned according to a self-correlation algorithm which identifies patterns among the sensed activation signals. A template is generated for each bin and compared to a characteristic template to identify at least one bin which corresponds to a far-field activation signal. | 10-23-2014 |
20140330150 | PERSISTENT DISPLAY OF NEAREST BEAT CHARACTERISTICS DURING REAL-TIME OR PLAY-BACK ELECTROPHYSIOLOGY DATA VISUALIZATION - A system and method for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of electrodes disposed in or near the anatomical structure. A most recent intrinsic event at a selected time is determined based on the sensed activation signals and a persistent display of relevant characteristics is generated based on the sensed activation signals of the most recent intrinsic event. The persistent display is updated upon detection of a subsequent intrinsic event. | 11-06-2014 |
20140336518 | SYSTEM FOR IDENTIFYING ROTOR PROPAGATION VECTORS - A method and system for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of mapping electrodes disposed in or near the anatomical structure. The activation signals are used to determine a dominant frequency for each electrode from which a wavefront vector for each electrode is determined based on a difference between the dominant frequency at a first electrode location and the dominant frequency at neighboring electrodes. An anatomical map is generated based on the determined wavefront vectors. | 11-13-2014 |
20140343388 | Representation and identification of activity patterns during electro-physiology mapping using vector fields - A method and system for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of mapping electrodes disposed in or near the anatomical structure, each of the plurality of mapping electrodes having an electrode location. A vector field map which represents a direction of propagation of the activation signals at each electrode location is generated to identify a signature pattern and a location in the vector field map according to at least one vector field template. A target location of the identified signature pattern is identified according to a corresponding electrode location. | 11-20-2014 |
20140343442 | ENHANCED ACTIVATION ONSET TIME OPTIMIZATION BY SIMILARITY BASED PATTERN MATCHING - An anatomical mapping system and method includes mapping electrodes configured to detect activation signals of cardiac activity. A processing system is configured to record the detected activation signals and generate a vector field for each sensed activation signal during each instance of the physiological activity. The processing system determines an onset time and alternative onset time candidates, identifies an initial vector field template based on a degree of similarity between the initial vector field and a vector field template from a bank of templates, then determines an optimized onset time for each activation signal based on a degree similarity between the onset time candidates and initial vector field template. | 11-20-2014 |
20150065836 | ESTIMATING THE PREVALENCE OF ACTIVATION PATTERNS IN DATA SEGMENTS DURING ELECTROPHYSIOLOGY MAPPING - A system and method for mapping an anatomical structure includes sensing activation signals of physiological activity with a plurality of mapping electrodes disposed in or near the anatomical structure. Patterns among the sensed activation signals are identified based on a similarity measure generated between each unique pair of identified patterns which are classified into groups based on a correlation between the corresponding pairs of similarity measures. A characteristic representation is determined for each group of similarity measures and displayed as a summary plot of the characteristic representations. | 03-05-2015 |