| Patent application number | Description | Published |
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| 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 |
| 20110245890 | METHOD AND APPARATUS FOR PACING SAFETY MARGIN - An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture. | 10-06-2011 |
| 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 |
| 20120035685 | USER INTERFACE SYSTEM FOR USE WITH MULTIPOLAR PACING LEADS - An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device. | 02-09-2012 |
| 20120130442 | CARDIAC ANODAL ELECTROSTIMULATION DETECTION - Cardiac anodal electrostimulation detection systems and methods are described, such as for distinguishing between cathodal-only capture and at least partially anodal capture (e.g., combined anodal and cathodal capture, or between two anodes of which only one captures nearby cardiac tissue, etc.). | 05-24-2012 |
| 20120303079 | APPARATUS AND METHOD FOR COMBINED CARDIAC FUNCTION MANAGEMENT AND RENAL THERAPIES - A system can coordinate operation of a cardiac function management (CFM) device and a renal device, such as during a vulnerable period in which a patient has an increased risk of tachyarrhythmia. | 11-29-2012 |
| 20120303082 | Adjusting Cardiac Pacing Response Sensing Intervals - Discrimination between different types of possible cardiac pacing responses may depend on the timing of expected features that are sensed within a temporal framework. The temporal framework may include classification intervals, blanking periods and appropriately timed back up paces. The classification intervals and blanking periods of the temporal framework are intervals of time that have time parameters that include start time, end time, and length. The relationships and timing parameters of the elements of the temporal framework, e.g., blanking periods, classification intervals, delay periods, and backup pacing, should support detection of features used to discriminate between different types of pacing responses. As the system learns the morphology of the particular patient by analyzing the waveform of the pacing response signal, the temporal framework for pacing response determination may be adjusted to accommodate the individual patient. | 11-29-2012 |
| 20120310101 | WIDE QRS DETECTOR - A system comprises a cardiac signal sensing circuit and a processor circuit. To detect a QRS duration, the processor circuit determines an isoelectric amplitude value of the cardiac signal segment, identifies a time where the cardiac signal segment amplitude deviates from the first isoelectric amplitude value by a specified threshold deviation value as a Q time, determines an isoelectric value time after the determined maxima and minima times that the cardiac signal segment returns to the same or a different isoelectric amplitude value, identifies a time that follows both the determined maxima and minima times and precedes the isoelectric value time as an S time, wherein the cardiac signal segment amplitude at the identified S time satisfies a specified amplitude change criterion from an isoelectric amplitude value, and determines a time duration of the QRS complex in the cardiac signal segment using the identified Q and S times. | 12-06-2012 |
| 20130018433 | MANAGEMENT OF FUSION BEAT DETECTION DURING CAPTURE THRESHOLD DETERMINATION - An improved technique is described for dealing with the detection of fusion beats when capture verification is performed by a cardiac pacing device such as during a capture threshold determination procedure. Schemes for classifying heart beats may misclassify beats as fusion beats due to feature/m orphology changes in the test electrogram waveform that may occur even when capture is achieved. | 01-17-2013 |
| 20130053914 | METHOD AND APPARATUS FOR ADAPTIVE CONTROL OF NEUROSTIMULATION USING CARDIAC RESTITUTION - A neurostimulation system measures a cardiac parameter at various cardiac intervals and analyzes its restitution, including computing a restitution slope being a rate of change of the restitution parameter with respect to change in the cardiac interval. In various embodiments, the system uses the restitution slope to provide for adaptive control of neurostimulation. In various embodiments, one or more cardiac parameters such as action potential duration (APD), conduction velocity (CV), QT interval (QT), and/or T-wave morphology (TM) parameter are measured and analyzed for restitution of each parameter, which is then used to control the delivery of the neurostimulation. | 02-28-2013 |
| 20130123653 | USING DEVICE BASED ELECTROGRAMS TO IDENTIFY BUNDLE BRANCH BLOCK MORPHOLOGY - A patient QRS duration can be received or determined, such as using one or more patient physiological sensors. A portion of the QRS duration can be determined, such as a right or left ventricular activation time. In an example, the right ventricular activation time can be determined by identifying an onset of a QRS complex and an R-wave peak in the QRS complex. In an example, when the QRS duration exceeds a threshold duration, and the RV activation time does not exceed a second threshold duration, an indication of a cardiac conduction dysfunction can be provided, such as for discriminating between left bundle branch block and right bundle branch block. | 05-16-2013 |
| 20130138174 | AUTOTHRESHOLD WITH SENSING FROM PACING CATHODE - Cardiac electrostimulation energy is delivered to a heart chamber of a subject according to a normal pacing mode using a set of implantable pacing electrodes. When a threshold test for the heart chamber is initiated and a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, cardiac electrostimulation energy is delivered to the subject according to a threshold test mode. The threshold test mode includes sensing a cardiac activity signal from a subject using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and changing the electrostimulation energy and sensing a resulting cardiac activity signal using the set of sensing electrodes to determine the optimum electrostimulation energy for capture of the heart chamber. | 05-30-2013 |
| 20130138175 | HYBRID AUTOTHRESHOLD - An apparatus comprises a control circuit that initiates a normal pacing mode for delivery of electrostimulation energy to the heart chamber. In response to an indication to initiate a threshold test, the control circuit determines an electrode configuration used to deliver the electrostimulation energy in the normal pacing mode, selects a first threshold test mode when a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, wherein a cardiac activity signal is sensed using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and selects a second threshold test mode when a sensing electrode independent from the set of pacing electrodes is available for the heart chamber, wherein the cardiac activity signal is sensed using a set of sensing electrodes that excludes an electrode common to the set of pacing electrodes. | 05-30-2013 |
| 20130172954 | APPARATUSES AND METHODS USING THE ROLE OF VENTRICULAR ELECTRICAL DELAY TO PREDICT LEFT VENTRICULAR REMODELING WITH CARDIAC RESYNCHRONIZATION THERAPY - A system comprises a cardiac signal sensing circuit and a processor circuit. The cardiac signal sensing circuit is configured to sense a cardiac signal segment using a set of electrodes connectable to the cardiac signal sensing circuit. The processor circuit is communicatively coupled to the cardiac signal sensing circuit and includes a peak detector circuit. The peak detector circuit is configured to identify, in the cardiac signal segment, a fiducial indicative of ventricular activation that is local to at least one electrode of the first set of electrodes. The fiducial includes a first large positive or negative peak greater than a specified percentage of a maximum peak of the first cardiac signal segment. The processor circuit is configured to provide an indication of local ventricular activation to at least one of a user or process. | 07-04-2013 |
| 20130190636 | OPTIMIZATION OF LV AND RV LEAD PLACEMENT BASED ON ELECTRICAL DELAYS - A system comprises a cardiac signal sensing and a processing circuit. The cardiac signal sensing circuit senses a first cardiac signal segment that includes a QRS complex and a second cardiac signal segment that includes a fiducial indicative of local ventricular activation. The processor circuit includes a site activation timer circuit configured to determine a time duration between a fiducial of the QRS complex of the first cardiac signal segment and the fiducial of the second cardiac signal segment. The processor circuit is configured to generate, using the determined time duration, an indication of optimality of placement of one or more electrodes for delivering therapy and provide the indication to at least one of a user or process. | 07-25-2013 |
| 20130338727 | SYSTEMS AND METHODS TO REDUCE SYNCOPE RISK DURING NEURAL STIMULATION THERAPY - Some embodiments, by way of example, provide a system, comprising a posture change detector configured to detect a posture transition indicative of an increased risk of syncope, and a neural stimulator configured to deliver a neural stimulation therapy. The neural stimulator may include a syncope avoidance module configured to respond to a detected posture transition by temporarily overriding the neural stimulation therapy to ameliorate the risk of increased syncope. | 12-19-2013 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 20150039044 | SYSTEMS AND METHODS FOR RANKING AND SELECTION OF PACING VECTORS - Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds. | 02-05-2015 |
| 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 |
