Patent application number | Description | Published |
20100152801 | Cardiac Resynchronization Therapy Optimization Using Vector Measurements Obtained from Realtime Electrode Position Tracking - An exemplary method includes selecting multiple electrodes located in a patient; acquiring position information during one or more cardiac cycles for the multiple electrodes where the acquiring includes using each of the electrodes for measuring one or more electrical potentials in an electrical localization field established in the patient; calculating one or more vector metrics based on the acquired position information for one or more vectors, each vector defined by two of the multiple electrodes; and analyzing the one or more vector metrics to assess cardiac performance during the one or more cardiac cycles. Various other methods, devices, systems, etc., are also disclosed. | 06-17-2010 |
20100268059 | THERAPY OPTIMIZATION VIA MULTI-DIMENSIONAL MAPPING - An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient where the cardiac information comprises position information, electrical information and mechanical information; mapping local electrical activation times to anatomic positions to generate an electrical activation time map; mapping local mechanical activation times to anatomic positions to generate a mechanical activation time map; generating an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and rendering at least the electromechanical delay map to a display. Various other methods, devices, systems, etc., are also disclosed. | 10-21-2010 |
20110054559 | PACING, SENSING AND OTHER PARAMETER MAPS BASED ON LOCALIZATION SYSTEM DATA - An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed. | 03-03-2011 |
20110054560 | PACING, SENSING AND OTHER PARAMETER MAPS BASED ON LOCALIZATION SYSTEM DATA - An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed. | 03-03-2011 |
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 |
20110092809 | CARDIAC COORDINATE SYSTEM FOR MOTION ANALYSIS - An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient wherein the cardiac information comprises position information with respect to time for one or more electrodes of the catheter; performing a principal component analysis on at least some of the position information; and selecting at least one component of the principal component analysis to represent an axis of a cardiac coordinate system. Various other methods, devices, systems, etc., are also disclosed. | 04-21-2011 |
20110098770 | SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE LEFT VENTRICULAR PACING BASED ON INTERELECTRODE CONDUCTION DELAYS - 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, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays. | 04-28-2011 |
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 |
20110144510 | METHODS TO IDENTIFY DAMAGED OR SCARRED TISSUE BASED ON POSITION INFORMATION AND PHYSIOLOGICAL INFORMATION - An exemplary system includes one or more processors; memory; and control logic, of one or more modules operable in conjunction with the one or more processors and the memory, to acquire myocardial potential data associated with position information, acquire myocardial electrical activation data associated with position information, acquire myocardial position data with respect to time, generate isopotential contours based on the potential data, generate isochronal contours based on the electrical activation data, generate isomotion contours based on the position data with respect to time, and overlay the generated isopotential contours, isochronal contours and isomotion contours on a display to indicate a region of myocardial damage or myocardial scarring with respect to a map that comprises anatomical markers. Various other methods, devices, systems, etc., are also disclosed. | 06-16-2011 |
20110184274 | ELECTRODE CONFIGURATIONS FOR LEADS OR CATHETERS TO ENHANCE LOCALIZATION USING A LOCALIZATION SYSTEM - An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed. | 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 |
20110213260 | CRT LEAD PLACEMENT BASED ON OPTIMAL BRANCH SELECTION AND OPTIMAL SITE SELECTION - An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a coronary sinus of a patient where the cardiac information includes electrical information and mechanical information; calculating scores based on the cardiac information where each of the scores corresponds to the coronary sinus or a tributary of the coronary sinus; and based on the scores, selecting a tributary of the coronary sinus as an optimal candidate for placement of a left ventricular lead. Accordingly, the selected tributary may be relied on during an implant procedure for the left ventricular lead. Various other methods, devices, systems, etc., are also disclosed. | 09-01-2011 |
20120065527 | Methods and Systems for Monitoring Aterial Stiffness - Implanted systems and methods for monitoring a patient's arterial stiffness are provided. An implanted sensor is used to produce a signal indicative of changes in arterial blood volume for a plurality of beats of the patient's heart. A pulse duration metric is determined for each of a plurality of pulses of the signal, wherein each pulse of the signal corresponds to a beat of the patient's heart. Arterial stiffness is monitored based on the determined pulse duration metric for the plurality of pulses of the signal. This can include monitoring arterial stiffness based on a dispersion of the pulse duration metric and/or an average of the pulse duration metric. | 03-15-2012 |
20120065528 | PRE-EJECTION INTERVAL (PEI) MONITORING DEVICES, SYSTEMS AND METHODS - Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's pre-ejection interval (PEI). A signal indicative of cardiac electrical activity and a signal indicative of changes in arterial blood volume are obtained. One or more predetermined features of the signal indicative of cardiac electrical activity and the signal indicative of changes in arterial blood volume are detected. The patient's PEI is determined by determining an interval between the predetermined feature of the signal indicative of cardiac electrical activity and the predetermined feature of the signal indicative of changes in arterial blood volume. | 03-15-2012 |
20120172867 | SYSTEM AND METHOD FOR TREATING ARRHYTHMIAS IN THE HEART USING INFORMATION OBTAINED FROM HEART WALL MOTION - A system and method for treating an arrhythmia in a heart are provided. The system includes an electronic control unit configured to monitor movement of one or more position sensor over a period of time. The position sensors may, for example, comprise electrodes or coils configured to generate induced voltages and currents in the presence of electromagnetic fields. The positions sensors are in contact with portions of heart tissue and changes in position are representative of motion of that tissue. The electronic control unit is further configured to generate an indicator, responsive to the movements of the sensors over the period of time, of a characteristic of the heart affected by delivery of ablation energy to heart tissue. In this manner, the effectiveness and safety of cardiac tissue ablation for treatment of the arrhythmia can be assessed and a post-ablation therapy regimen determined. | 07-05-2012 |
20120185012 | SYSTEMS AND METHODS FOR SELECTIVELY LIMITING MULTI-SITE VENTRICULAR PACING DELAYS DURING OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY PARAMETERS - Techniques are provided for use with implantable cardiac stimulation devices equipped for multi-site left ventricular (MSLV) cardiac pacing. Briefly, intraventricular and interventricular conduction delays are detected for paced cardiac events. Maximum pacing time delays are determined for use with MSLV pacing where the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation, such as fusion or lack of capture. MSLV pacing delays are then set to values no greater than the maximum pacing delays and cardiac resynchronization therapy (CRT) is delivered using the MSLV pacing delays. In an example where an optimal interventricular pacing delay (VV) is determined in advance using intracardiac electrogram-based or hemodynamic-based optimization techniques, the optimal value for VV can be used as a limiting factor when determining the maximum MSLV pacing time delays. | 07-19-2012 |
20120191154 | System and Method for ATP Treatment Utilizing Multi-Electrode Left Ventricular Lead - An implantable medical device includes a lead configured to be located proximate to the left ventricle (LV) of the heart, the lead including multiple LV electrodes to sense cardiac activity at multiple LV sensing sites. The a detection module to detect an arrhythmia that represents at least one of a tachycardia and fibrillation based at least in part on the cardiac activity sensed at the multiple LV sensing sites. The ATP therapy module to identify at least one of an ATP configuration or an ATP therapy site based on the cardiac sensed activity at the LV sensing sites, the ATP therapy module to control delivery of antitachycardia pacing (ATP) therapy at the ATP therapy site. The ATP therapy module delivers a stimulus to electrodes at one or more of an LV site, right ventricular (RV) site and right atrial (RA) site, the detection module to sense evoked responses at the LV sensing sites, the ATP therapy module to designate the ATP therapy site to include at least the LV sensing site with a shortest activation time relative to the one or more LV site, RV site and RA site where the stimulus is delivered. | 07-26-2012 |
20120215117 | SYSTEMS AND METHODS FOR ESTIMATING CENTRAL ARTERIAL BLOOD PRESSURE OF A PATIENT - In specific embodiments, a method for estimating a patient's central arterial blood pressure (CBP) for use with an implantable system, comprises (a) using an implanted sensor at a first site to obtain a first signal indicative of changes in arterial blood volume at the first site, the first site being along one or more peripheral arterial structures of the patient, (b) using an implanted sensor at a second site to obtain a second signal indicative of changes in arterial blood volume at the second site, the second site being a distance from the first site downstream along an arterial path of the peripheral arterial structure of the patient, and (c) using implanted electrodes to obtain a signal indicative of electrical activity of the patient's heart. The method further comprises (d) determining a time t | 08-23-2012 |
20120215275 | IMPLANTABLE SYSTEMS AND METHODS FOR USE THEREWITH FOR MONITORING AND MODIFYING ARTERIAL BLOOD PRESSURE WITHOUT REQUIRING AN INTRAVASCULAR PRESSURE TRANSDUCER - Embodiments of the present invention are directed to implantable systems, and methods for use therewith, that monitor and modify a patient's arterial blood pressure without requiring an intravascular pressure transducer. In accordance with an embodiment, for each of a plurality of periods of time, there is a determination one or more metrics indicative of pulse arrival time (PAT), each of which are indicative of how long it takes for the left ventricle to generate a pressure pulsation that travels from the patient's aorta to a location remote from the patient's aorta. Based on the one or more metrics indicative of PAT, the patient's arterial blood pressure is estimated. Changes in the arterial blood pressure are monitored over time. Additionally, the patient's arterial blood pressure can be modified by initiating and/or adjusting pacing and/or other therapy based on the estimates of the patient's arterial blood pressure and/or monitored changes therein. | 08-23-2012 |
20130035738 | METHODS AND SYSTEMS FOR DETERMINING PACING PARAMETERS BASED ON REPOLARIZATION INDEX - Methods and systems are provided for determining pacing parameters for an implantable medical device (IMD). The methods and systems provide electrodes in the right atrium (RA), right ventricle (RV) and left ventricle (LV). The methods and systems sense RV cardiac signals and LV cardiac signals at an RV electrode and an LV electrode, respectively, over multiple cardiac cycles, to collect global activation information. The methods and systems identify a T-wave in the LV cardiac signal. The methods and systems calculate a repolarization index based at least in part on a timing of the T-wave identified in the LV cardiac signal. The methods and systems set at least one pacing parameter based on the repolarization index, wherein the at least one pacing parameter that is set represents at least one of an AV delay, an inter-ventricular interval and an intra-ventricular interval. Optionally, the methods and systems may deliver an RV pacing stimulus at the RV electrode such that the LV cardiac signal sensed thereafter includes the RV pacing stimulus followed by a T-wave. The methods and systems determine a waveform metric such as at least one of a QT interval, T-wave duration, and T-wave amplitude, and utilize the waveform metric to determine as the repolarization index. | 02-07-2013 |
20130296962 | CAPTURE VERIFICATION AND PACING ADJUSTMENTS FOR USE WITH MULTISITE LEFT VENTRICULAR PACING - Various embodiments of the present invention are directed to, or are for use with, an implantable system including a lead having multiple electrodes implantable in a patient's left ventricular (LV) chamber. In accordance with an embodiment, the patient's LV chamber is paced at first and second sites within the LV chamber using a programmed LV1-LV2 delay, wherein the LV1-LV2 delay is a programmed delay between when first and second pacing pulses are to be delivered respectively at the first and second sites within the LV chamber. Evoked responses to the first and second pacing pulses are monitored for, and one or more LV pacing parameter is/are adjusted and/or one or more backup pulse is/are delivered based on results of the monitoring. | 11-07-2013 |
20140142406 | GUIDED MYOCARDIAL SUBSTRATE CHARACTERIZATION AND INFARCT SCAR LOCATION - An apparatus and method for quantifying myocardial kinetics by positioning two sensors on a myocardial substrate site so that one sensor is directly opposing the other along a ventricular wall; tracking a relative displacement between the two sensors; and determining whether there is an infarct based on the tracked relative displacement. | 05-22-2014 |
20140276733 | MEDIGUIDE-ENABLED RENAL DENERVATION SYSTEM FOR ENSURING WALL CONTACT AND MAPPING LESION LOCATIONS - An ablation catheter includes an elongated body having a proximal end and a distal end. At least one ablation element is disposed on the body between the proximal end and the distal end and configured to ablate renal tissue to control hypertension. At least one localization sensor is disposed on the body and configured to interact with a magnetic field. The at least one localization sensor aids in determining an appropriate target tissue for ablation. | 09-18-2014 |
20140277278 | CLOSED-LOOP SYSTEMS AND METHODS FOR CONTROLLING NEUROSTIMULATION BASED ON FAR-FIELD CARDIAC SIGNALS SENSED BY A SPINAL CORD STIMULATION DEVICE - Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure. | 09-18-2014 |
20140309543 | DEVICES, SYSTEMS AND METHODS TO PERFORM ARRHYTHMIA DISCRIMINATION BASED ON THE ATRIAL AND VENTRICULAR ACTIVATION TIMES - Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination based on activation times. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in the left atrial (LA) chamber, the right atrial (RA) chamber, and at least one ventricular chamber of a patient's heart. For each of a plurality of cardiac cycles, there is a determination, based on the plurality of obtained IEGMs, of an LA activation time, an RA activation time, and a ventricular activation time. Arrhythmia discrimination is then performed based on the determined activation times. | 10-16-2014 |
20140343649 | METHOD TO ENHANCE ELECTRODE LOCALIZATION OF A LEAD - An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed. | 11-20-2014 |
20140343650 | METHOD TO ENHANCE ELECTRODE LOCALIZATION OF A LEAD - An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed. | 11-20-2014 |
20140343651 | METHOD TO ENHANCE ELECTRODE LOCALIZATION OF A LEAD - An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed. | 11-20-2014 |
20140343652 | METHOD TO ENHANCE ELECTRODE LOCALIZATION OF A LEAD - An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed. | 11-20-2014 |
20150051661 | Method and System for Validating Local Capture in Multisite Pacing Delivery - A method for use with an implantable system including a lead having multiple electrodes implantable proximate to a patient's left ventricular (LV) chamber includes simultaneously delivering pacing pulses over corresponding pacing vectors defined by electrodes proximate to the LV chamber. The method includes recording evoked responses responsive to the pacing pulses that are measured over separate corresponding sensing channels. The method also includes comparing the evoked responses to a template that represents local capture of a local LV tissue region along one or more of the corresponding pacing vectors. The comparison is used to determine whether the pacing pulses achieved local capture along the corresponding pacing vectors. At least one of the pacing pulses or pacing vectors are updated based on the comparison of the evoked responses to the template in order to determine a local capture threshold for the corresponding pacing vectors. | 02-19-2015 |