Patent application number | Description | Published |
20080269813 | METHOD AND APPARATUS FOR SUBCUTANEOUS ECG VECTOR ACCEPTABILITY AND SELECTION - An implantable medical device system and associated method select subcutaneous sensing electrodes for use in monitoring the heart rhythm. A subset of multiple sensing vectors is selected from a number of electrodes positioned at a first subcutaneous location and one electrode positioned at a second subcutaneous location. The subset of sensing vectors includes one vector that includes the electrode positioned at the second location. A signal quality parameter corresponding to each of the sensing vectors of the subset is determined. | 10-30-2008 |
20080275516 | METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE - A method and apparatus of updating a sensing parameter in a medical device that includes sensing cardiac signals, determining intervals in response to the sensed cardiac signals, determining interval patterns associated with the determined intervals, and updating the sensing parameter in response to the determined interval patterns. | 11-06-2008 |
20080275517 | METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE - A method and apparatus for determining oversensing in a medical device that includes sensing cardiac signals, determining an oversensing characteristic associated with cardiac signals sensed during a predetermined sensing window, identifying oversensing in response to the oversensing characteristic, determining, in response to oversensing being identified, an adjusting characteristic associated with cardiac signals sensed during the predetermined sensing window, and updating a sensing parameter in response to the determined adjusting characteristic. | 11-06-2008 |
20080275518 | METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE - A method and apparatus for determining oversensing of cardiac signals that includes a housing containing electronic circuitry, an electrode coupled to the electronic circuitry to sense cardiac signals, and a processor, positioned within the housing, to determine an oversensing characteristic associated with the cardiac signals sensed over a predetermined sensing window, and to identify oversensing in response to the determined oversensing characteristic. | 11-06-2008 |
20080275519 | METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE - A method and apparatus for adjusting a sensing parameter in a medical device that includes a sensing electrode sensing cardiac signals, a processor to determine an adjusting characteristic associated with the cardiac signals sensed over a predetermined sensing window, and a control unit to update the sensing parameter in response to the determined adjusting characteristic. | 11-06-2008 |
20090299432 | IMPEDANCE VARIABILITY ANALYSIS TO IDENTIFY LEAD-RELATED CONDITIONS - In general, the disclosure relates to techniques for calculating mean impedance values and impedance variability values to detect a possible condition with a lead or device-lead pathway or connection. In one example, a device may be configured to determine an impedance value for an electrical path based on a plurality of measured impedance values for the electrical path, wherein the electrical path comprises a plurality of electrodes, and to determine an impedance variability value based on at least one of the plurality of measured impedance values. The device may be further configured to determine a threshold value based on the determined impedance value and the impedance variability value, compare a newly measured impedance value for the electrical path to the threshold value, and indicate a possible condition of the electrical path based on the comparison. | 12-03-2009 |
20100030093 | PERIODIC BEAT DETECTION TO DETECT ARTIFACTS IN A CARDIAC ELECTROGRAM - Techniques for determining whether artifacts are present in a cardiac electrogram are described. According to one example, a medical device senses a cardiac electrogram via electrodes. The medical device determines a derivative, e.g., a second order derivative, the electrogram. The medical device detects beats within the derivative, e.g., by comparing a rectified version of the derivative to one or more thresholds determined based on a maximum of the rectified derivative. The medical device determines whether the beats are periodic, and determines whether artifacts are present in the cardiac electrogram based on the determination of whether the beats are periodic. The medical device may further determine whether tachyarrhythmia is present and/or whether the cardiac rhythm of the patient is treatable based on the determination of whether the beats are periodic. For example, the medical device may determine that an electrogram is not treatable when the beats are periodic. | 02-04-2010 |
20100030292 | DETECTING WORSENING HEART FAILURE BASED ON IMPEDANCE MEASUREMENTS - Techniques for processing impedance data to provide an early warning for heart failure decompensation are described. An example device may be configured to measure intrathoracic impedance values, and increment an index when a determined impedance is less than a reference impedance. The incrementing may be based on the difference between the reference impedances and the determined impedance. In some examples, the amount of incrementing is reduced based on a variability of the impedances, or increased over time so long as the index remains above a threshold, e.g., zero. In some examples, the manner is which the reference impedances are determined changes over time to, for example, address rapid changes in impedance after device or system implantation. In some examples, the index is compared to a threshold to determine whether to provide an alert. In some examples, two thresholds are used to provide hysteresis. | 02-04-2010 |
20100030293 | USING MULTIPLE DIAGNOSTIC PARAMETERS FOR PREDICTING HEART FAILURE EVENTS - Techniques for using multiple physiological parameters to provide an early warning for worsening heart failure are described. A medical device monitors a primary diagnostic parameter that is indicative of worsening heart failure, such as intrathoracic impedance or pressure, and one or more secondary diagnostic parameters. The medical device detects worsening heart failure in the patient based on the primary diagnostic parameter when an index that is changed over time based on the primary diagnostic parameter value is outside a range of values, termed the threshold zone. When the index is within the threshold zone, the medical device detects worsening heart failure in the patient based on the one or more secondary diagnostic parameters. Upon detecting worsening heart failure, the medical device may, for example, provide an alert that enables the patient to seek medical attention before experiencing a heart failure event. | 02-04-2010 |
20100204597 | METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE - A method of detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes, determining rates of change of the sensed cardiac signals, and determining a range of the sensed cardiac signals. The sensed cardiac signals are detected as being associated with the cardiac event in response to the determined rates of change and the determined range. | 08-12-2010 |
20100249627 | Detecting A Condition Of A Patient Using A Probability-Correlation Based Model - Techniques are described for detecting a condition of a patient using a probability-correlation based model that integrates a plurality of parameters associated with the condition. A medical device that operates in accordance with the techniques obtains a plurality of parameters associated with the condition of the patient. The medical device obtains probabilities that the condition of the patient exists based on each single parameter separately and correlations between each of the parameters and the other ones of the parameters. After obtaining the probabilities and correlations associated with each of the parameters, the medical device determines whether the condition of the patient exists based on the determined probabilities and correlations. Such techniques may be particularly effective for use in distinguishing whether a rhythm of a patient is treatable, e.g., VT or VF, or non-treatable, e.g., SVT. | 09-30-2010 |
20100274148 | DISTINGUISHING BETWEEN TREATABLE AND NON-TREATABLE HEART RHYTHMS - Techniques are described for distinguishing between treatable and non-treatable heart rhythms. A medical device that operates in accordance with the techniques analyzes characteristics over several cardiac event intervals to detect initiation of a sudden rate onset. After detection of the initiation of the sudden rate onset, the IMD analyzes a morphology of an EGM associated with a selected cardiac event within the first several beats after the initiation of sudden rate onset. In one example, the IMD analyzes the morphology of the EGM associated with the first cardiac event immediately subsequent to the initiation of the sudden rate onset. If the morphology of the EGM of the selected cardiac event is abnormal compared to template EGM, the rhythm is classified as treatable. Otherwise, the rhythm is classified as non-treatable. | 10-28-2010 |
20110270102 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for discriminating cardiac events includes sensing a cardiac signal spatially located across approximately a full duration of a predetermined sensing window. A match score is determined corresponding to the sensed cardiac signal. A beat feature of multiple beat features across less than the full duration of the sensing window is determined, the beat feature being selected from the multiple beat features in response to the match score. Cardiac event evidence is accumulated in response to the match score and the determined beat feature, and cardiac events are discriminated in response to the accumulated cardiac evidence. | 11-03-2011 |
20110270103 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for discriminating cardiac events includes determining whether a first match score is within a first match zone having a first correlation with a non-treatable cardiac event, a second match zone having a second correlation with the non-treatable cardiac event less than the first correlation with the non-treatable event, a third match zone having a first correlation with a treatable cardiac event, and a fourth match zone having a second correlation with the treatable cardiac event greater than the first correlation with the treatable cardiac event. A determination is made as to whether a second match score and a third match score are within the first match zone, the second match zone, the third match zone and the fourth match zone to generate a first adjusting factor, and cardiac event evidence is accumulated in response to the first adjusting factor for discriminating cardiac events. | 11-03-2011 |
20110270104 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for discriminating cardiac events includes determining whether a cardiac evidence counter is greater than a predetermined detection threshold, determining whether to advance from a current state to a next state in response to the evidence counter being greater than the predetermined detection threshold, determining whether advancing from a previous state to the current state occurred while in one of a low variability mode and a high variability mode during the previous state, and determining whether to advance from the current state to a previous state in response to determining whether advancing from a previous state to the current state occurred while operating in one of a low variability mode and a high variability mode during the previous state. | 11-03-2011 |
20110270106 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for discriminating cardiac events sense cardiac signals that includes determining whether a first match score is within one of a first match zone corresponding to a first cardiac event, and a second match zone corresponding to the first cardiac event, and determining whether a second match score is within one of the first match zone, the second match zone, and a third match zone corresponding to a second cardiac event different from the first cardiac event. One of increasing and decreasing an event counter is performed in response to both the determination of whether the first match score is within one of the first match zone and the second match zone and the determination of whether the second match score is within one of the first match zone, the second match zone, and the third match zone. | 11-03-2011 |
20110270107 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for discriminating cardiac events includes determining whether a first match score is within a first match zone having a first correlation with a non-treatable cardiac event, a second match zone having a second correlation with the non-treatable cardiac event less than the first correlation, a third match zone having a first correlation with a treatable cardiac event, and a fourth match zone having a second correlation with the treatable cardiac event greater than the first correlation with the treatable cardiac event. In response to the first match score being within one of the first and second match zones, a determination is made whether consecutive match scores are within the first match zone and whether a break in the treatable cardiac event has occurred. Cardiac evidence is accumulated in response to determining whether a break has occurred and utilized to discriminate cardiac events. | 11-03-2011 |
20110270108 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for monitoring a patient's heart rhythm sense cardiac events and detect a sudden change in the heart rhythm in response to the sensed cardiac events. Detecting the sudden change includes determining a variability of intervals between the sensed cardiac events and switching between a low variability mode of operation and a high variability mode of operation in response to the variability of intervals. During the low variability mode, detecting the sudden change includes detecting an increase in the rate of cardiac events. During the high variability mode, detecting the sudden change includes detecting a sudden decrease in the variability of the cardiac event intervals. A concerning cardiac rhythm is detected in response to detecting the sudden change. | 11-03-2011 |
20110270109 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method obtaining cardiac event intervals corresponding to a tachycardia interval. Evidence of a rhythm breaking point is obtained in response to sensing a cardiac event having a morphology corresponding to a supraventricular beat. A non-treatable rhythm is detected in response to the plurality of cardiac event intervals and the evidence of the rhythm breaking point. | 11-03-2011 |
20110270110 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for monitoring a patient's heart rhythm sensing a cardiac signal determine whether a cardiac signal is noise corrupted by obtaining cardiac signal pulses and generating a pulse amplitude threshold in response to the plurality of signal pulses. The number of signal sample points exceeding the pulse amplitude threshold in each of the of signal pulses is computed. The cardiac signal is determined to be noise corrupted or non-corrupted in response to the computed number of signal sample points. | 11-03-2011 |
20110270333 | METHOD OF DUAL EGM SENSING AND HEART RATE ESTIMATION IN IMPLANTED CARDIAC DEVICES - A method and apparatus for monitoring a patient's heart rate sense first cardiac events in a heart chamber using a first cardiac electrode pair and sense second cardiac events in the heart chamber using a second cardiac electrode pair. The method includes estimating a first heart rate using the first cardiac events, comparing the first heart rate to a heart rate threshold and estimating a second heart rate using the second cardiac events in response to the first heart rate exceeding the heart rate threshold. | 11-03-2011 |
20110270334 | METHOD OF DUAL EGM SENSING AND HEART RATE ESTIMATION IN IMPLANTED CARDIAC DEVICES - A method and apparatus for monitoring a patient's heart rate sense first cardiac events in a heart chamber using a first cardiac electrode pair and sense second cardiac events in the heart chamber using a second cardiac electrode pair. The method includes estimating a first heart rate using the first cardiac events, comparing the first heart rate to a heart rate threshold and estimating a second heart rate using the second cardiac events in response to the first heart rate exceeding the heart rate threshold, determining whether the second cardiac events are unreliable, and setting the second heart rate equal to the first heart rate in response to the second cardiac events being unreliable. | 11-03-2011 |
20110270335 | METHOD AND APPARATUS FOR DETECTING AND DISCRIMINATING TACHYCARDIA - A medical device and associated method for discriminating cardiac events includes determining whether a cardiac evidence counter is greater than a predetermined detection threshold, advancing from a concerned state to a convinced state in response to the evidence counter being greater than the predetermined detection threshold, determining whether a reduction in the cardiac evidence counter occurs while in the convinced state, determining whether one of a first rate corresponding to the first sensing vector and a second rate corresponding to the second sensing vector is less than a predetermined rate limit, and determining whether to advance from the convinced state to one of a therapy delivery state, the concerned state and the unconcerned state in response to determining whether one of the first rate and the second rate is less than a predetermined rate limit. | 11-03-2011 |
20110301491 | METHOD AND APPARATUS FOR DETECTING CHANGE IN INTRATHORACIC ELECTRICAL IMPEDANCE - A method and apparatus for detection of changes in impedance a patient that includes generating measured impedances, generating an adaptive baseline trend of the measured impedances corresponding to a first time period, generating a short term trend of the measured impedances corresponding to a second time period less than the first time period, determining changes in relative position of the short term trend and the baseline trend, the determined changes in relative position corresponding to determining intersecting of the baseline trend by the short term trend, determining differences between the baseline trend and calculated period average impedances, and accumulating, in response to determining no intersecting of the baseline trend by the short term trend, the determined differences between the baseline trend and the calculated period average impedances. | 12-08-2011 |
20120004566 | SYSTEM AND METHOD FOR ESTABLISHING EPISODE PROFILES OF DETECTED TACHYCARDIA EPISODES - A medical device and associated method sense a cardiac signal and initiate an arrhythmia episode detection process in response to the cardiac signal by enabling an arrhythmia detection counter to be adjusted during the detection process. Data is accumulated relating to cardiac events during the detection process. An arrhythmia episode profile is established using the accumulated data. The accumulated data includes a pattern of the adjustment of the detection counter during the detection process | 01-05-2012 |
20120029373 | PREVENTION OF FALSE ASYSTOLE OR BRADYCARDIA DETECTION - In general, this disclosure is directed to signal processing based methods to reject undersensing in a signal indicative of cardiac activity, e.g., ECG. The undersensing may be due to very small signal amplitudes or due to a sudden increase in single peak amplitude resulting in an increased sensing threshold. The undersensing may result in falsely detecting a cardiac event, e.g., asystole or bradycardia. The techniques of this disclosure monitor the behavior of the signal to determine when a detected asystole is false. | 02-02-2012 |
20120095520 | SEQUENTIAL DISCRIMINATION APPROACH FOR DETECTING TREATABLE CARDIAC RHYTHMS - A system and method for use in a medical device for discriminating cardiac events establishes population-based thresholds corresponding to cardiac signal morphology metrics for discriminating between a first cardiac event and a second cardiac event. A population-based threshold criterion for discriminating cardiac events is established. The population-based threshold criterion is applied to a cardiac signal segment and the segment is classified if the criterion is satisfied. A patient-specific threshold is established in response to the sensed cardiac signal segment not being classified after applying the population-based threshold criterion. The sensed signal segment is classified in response to the patient-specific threshold comparison. | 04-19-2012 |
20120101546 | METHOD AND APPARATUS TO DETERMINE THE RELATIVE ENERGY EXPENDITURE FOR A PLURALITY OF PACING VECTORS - A medical device system determines and displays relative energy expenditure information for programmable parameter values. The system establishes a programmable parameter and multiple values of the parameter to be compared. A module performs a measurements for each of the multiple values and related to energy expenditure of a battery of an implantable medical device when operating according to each of the multiple parameter values. An energy expenditure for each of the values is computed using the measurements, and a graphical user interface is generated for displaying information corresponding to the computed energy expenditure for multiple parameter values. | 04-26-2012 |
20120108990 | METHOD AND APPARATUS FOR REDUCING NOISE IN A MEDICAL DEVICE - A method and apparatus for detecting a cardiac event in a medical device that includes sensing a cardiac signal, detecting a cardiac event in response to the sensed signal, determining whether an interval associated with the cardiac signal is less than an interval threshold, determining a noise metric in response to an interval associated with the cardiac signal being less than the interval threshold, determining whether the noise metric is greater than a noise metric threshold, and determining whether to inhibit detecting in response to determining whether an interval associated with the cardiac signal is less than the interval threshold and determining whether the noise metric is greater than the noise metric threshold. | 05-03-2012 |
20120108991 | ISCHEMIA DETECTION AND CLASSIFICATION - Techniques for detecting ischemia and classifying a type of ischemia are described. Electrograms of cardiac activity may be generated using implanted or external electrodes, e.g., electrodes carried on vascular leads within the heart and a housing electrode. In some examples, ischemia is detected and classified as benign or malignant based on whether a change an electrogram metric is detected, or first detected, in an endocardial electrogram or a non-endocardial electrogram. The relative timing of the change in the electrogram metric and a change in heart rate or patient activity may also be considered. In some examples, the system may create a stress test for detecting ischemia by instructing the patient to exercise or increasing the cardiac pacing rate. | 05-03-2012 |
20120226179 | IMPLANTED MULTICHAMBER CARDIAC DEVICE WITH SELECTIVE USE OF RELIABLE ATRIAL INFORMATION - An implantable medical device acquires a first cardiac signal in a first heart chamber and a second cardiac signal in a second heart chamber. The device determines if the first signal is unreliable. In response to determining the first signal to be unreliable, the device switches from a first cardiac arrhythmia detection mode of operation to a second cardiac arrhythmia detection mode of operation, the first detection mode requiring the use of both the first cardiac signal and the second cardiac signal and the second detection mode requiring the use of the second cardiac signal and not requiring the use of the first cardiac signal. | 09-06-2012 |
20120283587 | ASSESSING INTRA-CARDIAC ACTIVATION PATTERNS AND ELECTRICAL DYSSYNCHRONY - Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient. | 11-08-2012 |
20120284003 | ASSESSING INTRA-CARDIAC ACTIVATION PATTERNS - Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient. | 11-08-2012 |
20130030491 | METHOD FOR DISCRIMINATING ANODAL AND CATHODAL CAPTURE - An implantable device and associated method discriminate between cathodal and anodal capture during electrical stimulation. A control response to a pacing pulse delivered using a candidate cathode electrode and a universal anode and responses to bipolar pacing pulses delivered using candidate bipoles including the candidate cathode are measured. Responsive to the control response meeting a threshold response, the control response is classified as normal and each of the responses for the candidate bipoles are compared to the control response. The responses for the candidate bipoles are each classified based on the comparison. | 01-31-2013 |
20130030492 | METHOD FOR DISCRIMINATING ANODAL AND CATHODAL CAPTURE - An implantable device and associated method detect anodal capture during electrical stimulation. A first pacing pulse is delivered using a first cathode and a first anode. A second pacing pulse is delivered using the first cathode and a second anode. A first response to the first pacing pulse and a second response to the second pacing pulse are measured. Anodal capture of the first pacing pulse at the first anode is detected in response to a first difference between the first response and the second response. | 01-31-2013 |
20130053916 | LEFT-VENTRICULAR PACING SITE SELECTION GUIDED BY ELECTROGRAM MORPHOLOGY ANALYSIS - A medical device and associated method classify candidate pacing electrode sites for delivering pacing pulses to a patient's heart. A first morphology template is established and stored in memory of the device. A processor is configured to determine a cardiac signal morphology in response to delivering pacing pulses at a candidate pacing site in a first heart chamber. The processor compares the determined cardiac signal morphology to the first morphology template. The pacing site in the first heart chamber is classified in response to the comparing of the determined cardiac signal morphology and the first morphology template. | 02-28-2013 |
20130053918 | LEFT-VENTRICULAR PACING SITE SELECTION GUIDED BY ELECTROGRAM MORPHOLOGY ANALYSIS - A medical device system and associated method classify candidate pacing electrode sites for delivering pacing pulses to a patient's heart. A control unit is operatively coupled with a plurality of electrodes for controlling the delivery of the pacing pulses, and a sensing module senses a cardiac signal generated in response to the delivered pacing pulses. A processor is configured to deliver a first pacing pulse at a first timing interval to a first pacing site, determine the cardiac signal sensed in response to the delivered first pacing pulse and determine a first morphology corresponding to the determined sensed cardiac signal, compare the first morphology to a threshold morphology and adjust the first timing interval to a second timing interval different from the first timing interval in response to the comparing, and determine the optimal pacing site in response to the adjusting. | 02-28-2013 |
20130060298 | DETECTION OF EXTRACARDIAC STIMULATION BY A CARDIAC RHYTHM MANAGEMENT DEVICE - A medical device system and associated method for controlling a cardiac rhythm management therapy detect extracardiac stimulation. Cardiac pacing pulses are delivered, and a cardiac electrical signal comprising myocardial depolarization and repolarization signals is acquired. A processor is configured to, responsive to the cardiac electrical signal, detect extracardiac capture due to the cardiac pacing pulse. | 03-07-2013 |
20130110191 | CARDIAC RESYNCHRONIZATION THERAPY LOSS DIAGNOSTICS | 05-02-2013 |
20130110834 | AGGREGATING CARDIAC RESYNCHRONIZATION THERAPY DATA | 05-02-2013 |
20130131748 | METHOD FOR EFFICIENT DELIVERY OF DUAL SITE PACING - An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses to a first pacing site along a heart chamber and a therapy delivery module for delivering cardiac pacing pulses to a patient's heart via the electrodes. A sensing module measures an activation time at multiple pacing electrode sites along the heart chamber in response to delivering pacing pulses at the first pacing site. A controller is configured to identify a second pacing site from the plurality of pacing electrode sites in response to the activation times measured during pacing at the first site. | 05-23-2013 |
20130131749 | METHOD FOR EFFICIENT DELIVERY OF DUAL SITE PACING - An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses. Electrodes positioned at first and second selected pacing sites are used to deliver pacing pulses to a first heart chamber using a bipole comprising the first electrode and the second electrode. A controller is configured to determine if anodal and cathodal capture can be achieved during pacing using the bipole. Responsive to anodal and cathodal capture being achieved, the controller selects a multi-site pacing configuration comprising the bipole for singly pacing the first and second pacing sites | 05-23-2013 |
20130131750 | METHOD AND APPARATUS FOR ADAPTIVE CARDIAC RESYNCHRONIZATION THERAPY EMPLOYING A MULTIPOLAR LEFT VENTRICULAR LEAD - A medical device and associated method control the delivery of a cardiac pacing therapy by selecting first and second pacing sites along a first ventricle of a patient's heart and delivering the pacing therapy by pacing the first ventricle using the first pacing site during the periods of a first ventricular pacing mode and using the second pacing site during periods of a second ventricular pacing mode. In one embodiment, the device determines activation times at multiple sites along a ventricle in response to pacing pulses being delivered to the opposite ventricle. A first pacing site is selected in response to the activation time determination. The device delivers the pacing therapy by pacing the first ventricle using the first pacing site during periods of the first ventricular pacing mode. | 05-23-2013 |
20130131751 | APPARATUS AND METHOD FOR SELECTING A PREFERRED PACING VECTOR IN A CARDIAC RESYNCHRONIZATION DEVICE - A medical device and associated method control the delivery of a cardiac pacing therapy including selecting left ventricular pacing sites for delivering the therapy. The left ventricular pacing sites are selected by delivering pacing pulses to a patient's left ventricle at multiple pacing sites one at a time and determining right ventricular activation times in response to the pacing pulses being delivered at each of the pacing sites. A left ventricular pacing site is selected in response to the determined right ventricular activation times. | 05-23-2013 |
20130165983 | MONITORING ACTIVATION TIMES FOR USE IN DETERMINING PACING EFFECTIVNESS - Methods and/or devices may be configured to track effectiveness of pacing therapy by monitoring activation times over time, e.g., between pacing stimulus and electrical activity resulting from the pacing stimulus. Generally, the methods and/or devices may determine whether the delivered pacing therapy was effective based on the measured activation times. | 06-27-2013 |
20130190834 | MODIFYING ATRIOVENTRICULAR DELAY BASED ON ACTIVATION TIMES - Methods and/or devices may be configured to monitor ventricular activation times and modify an atrioventricular delay (AV delay) based on the monitored ventricular activation times. Further, the methods and/or devices may determine whether the AV delay should be modified based on the measured activation times before modifying the AV delay. | 07-25-2013 |
20130218223 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses. | 08-22-2013 |
20130218224 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses. | 08-22-2013 |
20130218225 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses. | 08-22-2013 |
20130218226 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses. | 08-22-2013 |
20130218227 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses. | 08-22-2013 |
20130237792 | Method and Apparatus for Detecting Change in Intrathoracic Electrical Impedance - A method and apparatus for detection of changes in impedance a patient that includes generating measured impedances, generating an adaptive baseline trend of the measured impedances corresponding to a first time period, generating a short term trend of the measured impedances corresponding to a second time period less than the first time period, determining changes in relative position of the short term trend and the baseline trend, the determined changes in relative position corresponding to determining intersecting of the baseline trend by the short term trend, determining differences between the baseline trend and calculated period average impedances, and accumulating, in response to determining no intersecting of the baseline trend by the short term trend, the determined differences between the baseline trend and the calculated period average impedances. | 09-12-2013 |
20140005740 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DURING BIVENTRICULAR PACING | 01-02-2014 |
20140135867 | CAPTURE THRESHOLD MEASUREMENT FOR SELECTION OF PACING VECTOR - Various techniques for facilitating selection of a pacing vector for pacing a chamber of a heart are described. One example method described includes, for each of a plurality of vectors, delivering a pacing pulse to capture a first heart chamber, determining a first time interval between the pacing pulse and a sensed event in a second heart chamber, determining a capture detection window in response to the determined first time interval, and enabling a capture detection module to iteratively decrease a pacing pulse magnitude delivered in the first heart chamber until an event in the second heart chamber is not sensed during the determined capture detection window. | 05-15-2014 |
20140163632 | EFFECTIVE CAPTURE TEST - The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated. | 06-12-2014 |
20140163633 | EFFECTIVE CAPTURE TEST - The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated. | 06-12-2014 |
20140163634 | EFFECTIVE CAPTURE TEST - The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated. | 06-12-2014 |
20140163635 | EFFECTIVE CAPTURE TEST - The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated. | 06-12-2014 |
20140180355 | EFFECTIVE CAPTURE - The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated. | 06-26-2014 |
20140236252 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DURING FUSION PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a plurality of left ventricular electrodes. Pacing using a first one of the left ventricular electrodes and measuring activation times at other ones of the left and right ventricular electrodes. Pacing using a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing weighted sums of the measured activation times to measure a fusion index and select one of the left ventricular electrodes for delivery of subsequent pacing pulses based on comparing fusion indices during pacing from different LV electrodes. One or more embodiments use the same fusion index to select an optimal A-V delay by comparing fusion indices during pacing with different A-V delays at resting atrial rates as well as rates above the resting rate. | 08-21-2014 |
20140236253 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DURING FUSION PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a plurality of left ventricular electrodes. Pacing using a first one of the left ventricular electrodes and measuring activation times at other ones of the left and right ventricular electrodes. Pacing using a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing weighted sums of the measured activation times to measure a fusion index and select one of the left ventricular electrodes for delivery of subsequent pacing pulses based on comparing fusion indices during pacing from different LV electrodes. One or more embodiments use the same fusion index to select an optimal A-V delay by comparing fusion indices during pacing with different A-V delays at resting atrial rates as well as rates above the resting rate. | 08-21-2014 |
20140277245 | MODULATE PACING RATE TO INCREASE THE PERCENTAGE OF EFFECTIVE VENTRICULAR CAPTURE DURING ATRIAL FIBRILLATION - The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining whether a patient is experiencing atrial fibrillation (AF). If the patient is experiencing AF, the efficacy of CRT is determined. A signal is sensed in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal and a determination is made as to whether the ventricular pacing stimulus evoked a response from the ventricle. | 09-18-2014 |
20140277246 | MODULATE PACING RATE TO INCREASE THE PERCENTAGE OF EFFECTIVE VENTRICULAR CAPTURE DURING ATRIAL FIBRILLATION - The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining whether a patient is experiencing atrial fibrillation (AF). If the patient is experiencing AF, the efficacy of CRT is determined. A signal is sensed in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal and a determination is made as to whether the ventricular pacing stimulus evoked a response from the ventricle. | 09-18-2014 |
20140277247 | REDUCTION OR ELIMINATION OF PACE POLARIZATION EFFECTS - The present disclosure relates to cardiac evoked response detection and, more particularly, reducing polarization effects in order to detect an evoked response following delivery of a stimulation pulse. An implantable medical device (IMD) is configured to deliver a ventricular pacing pulse. A signal is sensed in response to the ventricular pacing stimulus. A window is placed over the sensed signal to obtain a set of data from the signal after a paced event. The set of data extracted from the sensed signal comprises a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. Responsive to processing the extracted data, the window is delayed to avoid polarization effects. A determination is then made as to whether the ventricular pacing stimulus is capturing the paced ventricle in response to determining whether the maximum time is greater than the minimum time. | 09-18-2014 |
20140323894 | STAGED RHYTHM DETECTION SYSTEM AND METHOD - A medical device and associated method for detecting and treating tachyarrhythmias acquires a cardiac signal using electrodes coupled to a sensing module. During an initial detection process, a shockable cardiac rhythm is detected by a processing module configured to compare the cardiac signal to a first set of detection criteria. By analyzing the cardiac signal, the processing module establishes at least one patient-specific detection threshold during the initial detection process. Upon establishing the at least one patient-specific detection threshold, the initial detection process is stopped, and a next detection process is started which includes comparing the cardiac signal to a second set of detection criteria including the at least one patient-specific detection threshold. In some embodiments, user programming of tachyarrhythmia detection parameters is not required. | 10-30-2014 |
20150045849 | CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING - Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses. | 02-12-2015 |