Patent application number | Description | Published |
20110098771 | MULTIPLE VECTOR FLUID LOCALIZATION - A differential or relative measurement between an orthogonal measurement vector and another measurement vector can be used to determine the location where fluid accumulation is occurring or the local change in such fluid accumulation. This can help diagnose or treat infection or hematoma or seroma at a pocket of an implanted cardiac rhythm management device, other implanted medical device, or prosthesis. It can also help diagnose or treat pulmonary edema, pneumonia, pulmonary congestion, pericardial effusion, pericarditis, pleural effusion, hemodilution, or another physiological condition. | 04-28-2011 |
20110295084 | INTEGRATING DEVICE-BASED SENSORS AND BEDSIDE BIOMARKER ASSAYS TO DETECT WORSENING HEART FAILURE - Physiological sensor data can be combined with external biomarker assays, such as a bedside assay for B-type natriuretic peptide (BNP), to improve the sensitivity and specificity of heart failure detection. | 12-01-2011 |
20120157798 | PHYSIOLOGIC RESPONSE TO POSTURE - An implantable or other ambulatory medical apparatus comprises a posture sensing circuit, a physiologic sensing circuit that senses a time varying physiologic signal, and a processor circuit. The processor circuit includes a posture calculation circuit and a measurement circuit. The posture calculation circuit determines a posture of the subject using posture data obtained using the posture signal and determines when the posture of the subject is steady state. The measurement circuit derives a physiologic measurement using physiologic data extracted from the physiologic signal during at least one time period when posture is determined to be steady state and provides the physiologic measurement to at least one of a user and a process in association with the determined steady state posture. | 06-21-2012 |
20120157799 | USING DEVICE BASED SENSORS TO CLASSIFY EVENTS AND GENERATE ALERTS - The present subject matter includes apparatus, methods and device-readable media for using impedance and heart sounds to classify events and alerts. An apparatus can include a processor circuit configured to receive a physiological indication, classify the indication, and generate a multi-dimensional heart failure decompensation status indication. A method can include obtaining a physiological indication, classifying the indication and generating a multi-dimensional heart failure decompensation status indication. A device-readable medium can include instructions that, when performed by the device can obtain a physiological indication, classify the indication, and generate a multi-dimensional heart failure decompensation status alert. | 06-21-2012 |
20120157858 | MONITORING PROJECTIONS ALONG PRINCIPAL COMPONENTS OF MULTIPLE SENSORS AS AN INDICATOR OF WORSENING HEART FAILURE - A device can include at least a first physiologic sensor circuit configured to provide a first physiologic signal, a second physiologic sensor circuit configured to provide a second physiologic signal, and a processor circuit. The processor circuit includes a principal component analysis circuit configured to represent data determined from the at least first and second physiologic sensor circuits as at least first and second axes, respectively, in a multidimensional space, determine one or more principal components in the multidimensional space, determine a quantitative attribute of the first and the second physiologic signals using at least one of the determined principal components or a projection of the data along the at least one determined principal component, and provide an indication of heart failure status according to the quantitative attribute to at least one of a user or a process. | 06-21-2012 |
20120157864 | CARDIAC DECOMPENSATION DETECTION USING MULTIPLE SENSORS - Physiological data, such as thoracic impedance data, can be obtained over a first time window to establish a baseline, or can be used to form one or more data clusters. Additional physiological data, such as thoracic impedance test data acquired over a later time window, can be obtained and compared to the baseline or data clusters to determine an indication of worsening heart failure. In an example, a quantitative attribute of one or more data clusters can be monitored and used to provide an indication of worsening heart failure. A posture discrimination metric can be obtained, such as using the physiological data obtained over the first time window. The additional physiological data, such as can be obtained over a second time window, can be compared to the posture discrimination metric to provide a patient posture status. | 06-21-2012 |
20120157874 | POSTURE DETECTION USING THORACIC IMPEDANCE - Physiological data, such as thoracic impedance data, can be obtained over a first time window to establish a baseline, or can be used to form one or more data clusters. Additional physiological data, such as thoracic impedance test data acquired over a later time window, can be obtained and compared to the baseline or data clusters to determine an indication of worsening heart failure. In an example, a quantitative attribute of one or more data clusters can be monitored and used to provide an indication of worsening heart failure. A posture discrimination metric can be obtained, such as using the physiological data obtained over the first time window. The additional physiological data, such as can be obtained over a second time window, can be compared to the posture discrimination metric to provide a patient posture status. | 06-21-2012 |
20120259183 | TRANSIENT SENSOR RESPONSE TO POSTURE AS A MEASURE OF PATIENT STATUS - Patient posture information can be received, such as to indicate a change in patient posture by at least a threshold amount. A transient response signal indicative of a change in a physiological parameter can be received at multiple instances near a change in patient posture. Waveform morphology features can be extracted from a transient response signal and used to provide an indication of a cardiac status, such as a heart failure status. | 10-11-2012 |
20120271177 | SV/CO TRENDING VIA INTRACARDIAC IMPEDANCE - A patient-specific model can show changes in cardiac stroke volume or cardiac output, such as to predict heart failure or to indicate cardiac remodeling. The patient-specific model can be derived from a surrogate indication of a cardiac stroke volume, such as a physical activity level, and features obtained from a thoracic impedance waveform, such as mean or peak-to-peak impedance values. In an example, several models corresponding to different patient physical activity levels can be determined. | 10-25-2012 |
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 |
20130116578 | RISK STRATIFICATION BASED HEART FAILURE DETECTION ALGORITHM - A system comprises a risk analysis module and a worsening heart failure (WHF) detection module. The risk analysis module measures at least one first physiological parameter of a subject using a physiological sensor of an ambulatory medical device, and determines a heart failure (HF) risk score for the subject according to the at least one measured first physiological parameter. The HF risk score indicates susceptibility of the subject to experiencing a HF event. The WHF detection module measures at least one second physiological parameter of the subject using the same or different physiological sensor, and generates an indication of prediction that the subject will experience a WHF event when the at least one second physiological parameter satisfies a WHF detection algorithm. The risk analysis module adjusts generation of the indication by the WHF detection algorithm according to the determined HF risk score. | 05-09-2013 |
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 |
20130165755 | PHYSIOLOGICAL STATUS INDICATOR APPARATUS AND METHOD - A processor circuit can be configured to obtain a first multidimensional vector. The first multidimensional vector can include dimensions corresponding to respective first conductivity characteristics obtained from different implantable electrode configurations associated with a subject. The processor circuit can also be configured to obtain a second multidimensional vector or vector space. The second multidimensional vector or vector space can include dimensions corresponding to respective second conductivity characteristics obtained from such different electrode configurations associated with the same or a different subject. The processor circuit can also provide a physiological status indicator that can be obtained at least in part by performing a vector comparison of the first multidimensional vector to the second multidimensional vector space or vector. | 06-27-2013 |
20130178786 | REMOTE CLOSED-LOOP TITRATION OF DECONGESTIVE THERAPY FOR THE TREATMENT OF ADVANCED HEART FAILURE - An apparatus comprises one or more physiological sensing circuits that generate a sensed physiological signal and at least one of the physiological sensing circuits is implantable, a measurement circuit configured to recurrently measure one or more physiological parameters that indicate a status of heart failure of the subject, a comparison circuit configured to compare the one or more physiological parameter measurements to one or more physiological parameter target values, a therapy circuit configured to control delivery of one or more drugs to treat heart failure, and a control circuit in electrical communication with the comparison circuit and the therapy circuit and configured to recurrently adjust delivery of drug therapy according to the comparison of the measured physiological parameters to the physiological parameter targets. | 07-11-2013 |
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 |
20130237773 | HEART SOUND DETECTION SYSTEMS AND METHODS USING UPDATED HEART SOUND EXPECTATION WINDOW FUNCTIONS - Heart sound detection systems and methods can use updated heart sound expectation window functions to detect heart sounds. In an example, an initial heart sound expectation window function that describes a heart sound timing can be a function of a physiologic variable such as heart rate, intrinsic vs. non-intrinsic beat, respiration rate, index of circadian timing, or posture. The function can include at least one characteristic parameter that describes a value of the heart sound timing at a specified value of the physiologic variable. In an example, information about a patient heart sound can be detected and used to update a characteristic parameter of an initial heart sound expectation window function, and an updated heart sound expectation window function can be provided using the updated characteristic parameter. | 09-12-2013 |
20140031643 | HEART FAILURE PATIENTS STRATIFICATION - A system, apparatus and method are provided to quantify a risk of worsening heart failure for subject using at least one physiological sensor circuit such as, for example, a heart sound sensor, a respiration sensor, a cardiac activity sensor, or other sensor circuit. A central tendency measurement of the at least one physiological sensor can be used to quantify the risk of worsening heart failure of the subject. | 01-30-2014 |
Patent application number | Description | Published |
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 |
20140031641 | INTEGRATING DEVICE-BASED SENSORS AND BEDSIDE BIOMARKER ASSAYS TO DETECT WORSENING HEART FAILURE - Devices and methods for improving the sensitivity and specificity of heart failure (HF) detection are described. The devices and methods can detect a HF status such as using physiological sensor data and external biomarker assays. An apparatus can comprise ambulatory physiological sensors that can provide a first HF status indicator and a second HF status indicator to a user. An external biomarker sensor can provide an amount of a biomarker present, such as an assay for B-type natriuretic peptide (BNP), which provides information about HF status. A processor circuit can switch from a first HF detection mode to a second detection mode such as in response to the information from the biomarker sensor. The first detection mode can detect HF status using the first HF status indicator, and the second detection mode can detect HF status using the second HF status indicator. The second detection mode can have a higher specificity than the first detection mode. | 01-30-2014 |
20140031888 | ELECTRODE DISPLACEMENT DETECTION - Electrode displacement can be detected using a thoracic impedance or conductivity signal. The thoracic impedance or conductivity signal can be filtered to attenuate cardiac contraction (stroke) and respiration components. A fluid status component of the thoracic impedance or conductivity signal can be used to detect a posture-shift related electrode displacement, such as can result from left ventricular/coronary sinus (LV/CS) lead pullback upon a recumbent to upright posture shift. | 01-30-2014 |
20140155762 | METHOD AND APPARATUS FOR DETECTING SUBAUDIBLE CARDIAC VIBRATIONS - A monitoring system senses a physiological signal indicative of mechanical vibrations including audible and/or subaudible frequency ranges and presents information related to the physiological signal to a user. The presented information includes subaudible components of the physiological signal. In various embodiments, the information can be presented as a visual signal representing the mechanical vibrations including the subaudible components, an audial signal representing the mechanical vibrations having a spectrum shifted to an audible frequency range, and/or an audial signal representing the mechanical vibrations having a spectrum compressed into an audible frequency range. An example of the physiological signal can include a heart sound signal indicative of heart sounds including cardiac mechanical vibrations in audible and subaudible frequency ranges. | 06-05-2014 |
20140236026 | METHOD AND APPARATUS FOR MULTI-STATE HEART FAILURE DECOMPENSATION DETECTION - Devices and methods for detecting events indicative of heart failure (HF) decompensation status are described. An ambulatory medical device can determine the present physiologic state as being either a drift state or a stable state, and applies an algorithm to detect HF decompensation event according to the physiologic state. In some embodiments, the ambulatory medical device uses the present physiologic state to estimate one ore more expected future signal characteristics, and to detect HF decompensation event using the one or more expected futures signal characteristics. | 08-21-2014 |
20140236029 | ALGORITHM ADAPTATION TO AN EXTERNAL IMPACT ON THE DATA - Devices and methods for detecting a physiological target event such as events indicative of HF decompensation status are described. An ambulatory medical device is configured to determine the presence and timing of a confounding event, segment a sensed physiological signal into at least two data segments, adjust the physiological signal by removing or lessening the impact of the confounding event on the physiological signal. The adjusted data can be presented to the user, and the ambulatory medical device can detect the target events using the adjusted physiologic signal. In some embodiments, the ambulatory medical device can be configured to detect an event indicative of HF decompensation using a physiological signal and the information of the detected confounding event. | 08-21-2014 |
20140275925 | DETERMINING SYSTOLIC TIME INTERVALS USING HEART SOUNDS - Systems and methods are provided for using information from a subject heart sound signal and information from a subject physiological pulsatile signal to identify subject systolic time intervals. An example system for identifying systolic time intervals includes a heart sound detector circuit, configured to detect a subject heart sound signal using an acoustic signal. The system can include a physiological signal sensing circuit configured to detect a physiological pulsatile signal, including at least one of a pulsatile cervical impedance signal or a pulsatile pulmonary artery pressure signal. A timing circuit can be configured to calculate a systolic time interval between a feature on the heart sound signal and a feature on the pulsatile signal. A subject physiologic diagnostic indication can be provided using information from the timing circuit about the systolic time interval. | 09-18-2014 |
20140276163 | DIAGNOSTIC AND OPTIMIZATION USING EXERCISE RECOVERY DATA - An apparatus, such as a cardiac function management system can detect heart sounds following a sensed transition in physical activity level, such as from an elevated physical activity level to rest. A technique can include systems, methods, machine-readable media, or other techniques that can include identifying a physical activity level transition, receiving a heart sound signal, determining characteristics of the heart sound and subject physiologic activity to provide an indication, such as a heart failure status indication. | 09-18-2014 |
20140276164 | HEART FAILURE MANAGEMENT TO AVOID REHOSPITALIZATION - Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics. Information about relative changes in signal characteristics from multiple sensors can be used to identify particular subject physiologic signals to monitor during subsequent periods. | 09-18-2014 |
20140277235 | SYSTEM AND METHODS FOR IMPROVING DEVICE THERAPY USING MULTIPLE SENSOR METRICS - Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can receive one or more physiologic signals and generate multiple signal metrics from the physiologic signals. The ambulatory medical device can determine a desired value for a device parameter, such as a timing parameter used for controlling the delivery of CRT pacing to various heart chambers, using information fusion of signal metrics that are selected based on one or more of a signal metric sensitivity to perturbations to the device parameter in response to a stimulation, a signal metric variability in response to a stimulation, or a covariability between two or more signal metrics in response to a stimulation. The ambulatory medical device can program a stimulation using the desired device parameter value, and deliver the programmed stimulation to one or more target sites to achieve desired therapeutic effects. | 09-18-2014 |
20140277237 | DEVICE BASED OPTIMIZATION OF DEVICE THERAPIES - A system may include an external medical device (e.g., a patch) including one or more physiological sensors configured to sense one or more physiological parameters of a subject when the subject is ambulatory. The external medical device may be configured to communicate information related to the sensed one or more physiological parameters for determining and/or modifying at least one cardiac therapy parameter of an implantable medical device (e.g., pacemaker, implantable cardioverter defibrillators, or cardiac resynchronization therapy device). In some situations, an indication or notification may be generated corresponding to the determined and/modified cardiac therapy parameter. | 09-18-2014 |
20140277238 | SYSTEM AND METHODS FOR IMPROVING DEVICE THERAPY USING HEART SOUNDS - Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can be configured to detect a heart sound signal and generate one or more heart sound metrics, detect a characteristic indicative of cannon waves, and determine a desired value for a device parameter, such as a timing parameter which can be used to control the delivery of CRT pacing to various heart chambers. The desired device parameter value can be determined using the heart sound metrics and the characteristic indicative of the cannon waves. The ambulatory medical device can program stimulation using the desired device parameter value, and deliver the programmed stimulations to one or more target sites to achieve desired therapeutic effects. | 09-18-2014 |
20140277239 | ESTIMATING ELECTROMECHANICAL DELAY TO OPTIMIZE PACING PARAMETERS IN RBBB PATIENTS - Stimulation energy can be provided to stimulate synchronous ventricular contractions. Interval information obtained from a cardiac electrical heart signal and a cardiac mechanical heart signal can be used to determine a right ventricular activation time. The interval information can provide a cardiac stimulation indication. | 09-18-2014 |
20140277243 | HEART SOUNDS TEMPLATE COMPARISON TO IDENTIFY TRUE PACING MODE - An apparatus may include an implantable therapy circuit that provides bi-ventricular pacing to a subject, a heart sound signal sensing circuit that produces a sensed heart sound signal that is representative of at least one heart sound associated with mechanical cardiac activity, a memory circuit to store one or more heart sound templates of cardiac capture, and a comparison circuit that compares a segment of the sensed heart sound signal to the one or more heart sound templates of cardiac capture to identify ventricles in which cardiac capture was induced by the bi-ventricular pacing. In some situations, an indication of the ventricles in which cardiac capture was induced may be generated according to the comparison. | 09-18-2014 |
20140336637 | SYSTEMS AND METHODS FOR TEMPERATURE MONITORING AND CONTROL DURING AN ABLATION PROCEDURE - A medical system configured for nerve modulation can include an elongate shaft, having a distal end region and a proximal end region is disclosed. Adjacent the distal end region an ablation electrode can be disposed. The system can further include a first optical fiber, having a proximal end and a distal end, extending along an outer surface of the elongate shaft, and in turn a number of (fiber Bragg Grating) FBG sensors therein. The FBG sensors can be positioned adjacent to the ablation electrode. An optical read out mechanism can be optically coupled to the optical fiber to transmit light into the optical fiber and detect light reflected from the FBG sensor. Here, the detected light, reflected from FBG temperature sensors, encodes local temperatures at each of the FBG temperature sensors. | 11-13-2014 |
20140343438 | METHODS AND APPARATUS FOR DETECTING HEART FAILURE EVENT USING PATIENT CHRONIC CONDITIONS - Devices and methods for detecting physiological target event such as events indicative of HF decompensation status are described. A medical device is configured to receive at least a first and a second chronic condition indictors of a patient, receive one or more physiologic signals from the patient, and generate a plurality of signal metrics when the first and the second chronic condition indicators meet their respective criterion. The medical device can detect the target event or condition using one or more patient-specific signal metrics selected from a group including both the first and the second set of the signal metrics. The medical device and the methods can be configured to detect an event indicative of HF decompensation. | 11-20-2014 |
20140343439 | METHODS AND APPARATUS FOR STRATIFYING RISK OF HEART FAILURE DECOMPENSATION - Devices and methods for identifying patient at elevated risk of developing future heart failure (HF) events, such as events indicative of HF decompensation status, are described. The devices and methods can stratify the risk using sensor signals or signal metrics selected in accordance with patient chronic conditions. A medical device can receive a patient status input including at least a first and a second chronic condition indicators, sense one or more physiologic signals from the patient, and generate a plurality of signal metrics from the physiologic signals when the first chronic condition indicator and the second chronic condition indicator meets respective criterion. One or more patient-specific signal metrics can be selected from a group including the signal metrics selected for both the first and the second chronic conditions. A risk stratification algorithm can use the selected one or more patient-specific signal metrics to compute a composite risk index indicative of the probability of the patient later developing an event indicative of worsening of HF. | 11-20-2014 |
20150065819 | MULTIPLE VECTOR FLUID LOCALIZATION - A differential or relative measurement between an orthogonal measurement vector and another measurement vector can be used to determine the location where fluid accumulation is occurring or the local change in such fluid accumulation. This can help diagnose or treat infection or hematoma or seroma at a pocket of an implanted cardiac rhythm management device, other implanted medical device, or prosthesis. It can also help diagnose or treat pulmonary edema, pneumonia, pulmonary congestion, pericardial effusion, pericarditis, pleural effusion, hemodilution, or another physiological condition. | 03-05-2015 |
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 |
20150073203 | HEART FAILURE SYSTEMS AND METHODS - Embodiments of the disclosure include medical device systems and related methods. In an embodiment, the disclosure includes a medical device system. The medical device system can include a cardiac device. The cardiac device can include a processor, a memory, a communications circuit, and one or more sensors. The cardiac device can be configured to engage a sensor mode specific for patients receiving or having implanted ventricular assist devices. The cardiac device can be configured to process data as specified by the sensor mode specific for patients receiving or having implanted ventricular assist devices. In an embodiment, the disclosure includes a method for monitoring heart failure patients. In an embodiment, the disclosure includes a method of controlling devices for heart failure patients. Other embodiments are also included herein. | 03-12-2015 |
20150088026 | METHODS AND APPARATUS FOR DETECTING HEART FAILURE EVENT USING RANK OF THORACIC IMPEDANCE - Devices and methods for detecting physiological target event such as events indicative of HF decompensation status are described. An ambulatory medical device (AMD) can measure bio-impedance, such as thoracic impedance, from a patient. The AMD can receive a specified threshold within a range or a distribution of impedance measurement, or a specified percentile such as less than 50 | 03-26-2015 |
20150105835 | METHODS AND APPARATUS FOR DETECTING HEART FAILURE EVENT USING IMPEDANCE VECTOR SWITCHING - Devices and methods for detecting physiological target event such as events indicative of heart failure (HF) decompensation status are described. An ambulatory medical device (AMD) can detect device site maturation such as in a device encapsulation pocket, and classify the maturation status into one of two or more device site maturation states. The AMD can include an electrical impedance analyzer circuit that can measure a first maturation-insensitive impedance vector and a second maturation-sensitive impedance vector. At least one impedance vector can be selected or a composite impedance vector can be generated in accordance with the classified device site maturation state. The AMD can generate an impedance indicator using the selected or composite impedance vector, and detect a target physiologic event indicative of worsening of HF using the impedance indicator. | 04-16-2015 |
20150119672 | MEDICAL DEVICE FOR HIGH RESOLUTION MAPPING USING LOCALIZED MATCHING - Medical devices and methods for using medical devices are disclosed. An example mapping medical device may include a catheter shaft with a plurality of electrodes. The catheter shaft may be coupled to a processor. The processor may be capable of collecting a first set of signals from a first location, collecting a second set of signals from a second location, characterizing the first set of signals over a first time period, characterizing the second set of signals over a second time period, comparing the first set of signals to the second set of signals and matching a first signal from the first set of signals with a second signal from the second set of signals. | 04-30-2015 |
20150126840 | CARDIAC MAPPING USING LATENCY INTERPOLATION - Medical devices and methods for using medical devices are disclosed. An example mapping medical device may include a catheter shaft with a plurality of electrodes. The plurality of electrodes may include a first pair of electrodes, a second pair of electrodes, a third pair of electrodes and a fourth pair of electrodes. The mapping medical device may further include a processor, wherein the processor may be configured to determine a first latency between the first pair of electrodes, determine a second latency between the second pair of electrodes, determine a third latency between the third pair of electrodes, determine a fourth latency between the fourth pair of electrodes, and determine a target signal by interpolating the first latency, the second latency, the third latency and the fourth latency. | 05-07-2015 |
20150126878 | HEART FAILURE EVENT DETECTION AND RISK STRATIFICATION USING HEART SOUND - Devices and methods for detecting heart failure (HF) events or identifying patient at elevated risk of developing future HF events are described. A medical device can detect contextual condition associated with a patient, such as an environmental context or a physiologic context, sense a heart sound signal, and perform multiple measurements of heart sound features in response to the detected patient contextual condition meeting specified criterion. The contextual condition includes information correlating to or indicative of a change in metabolic demand of a patient. The medical device can use the physiologic signals to calculate one or more signal metrics indicative of diastolic function of the heart such as a trend of the heart sound features. The medical device can use the signal metrics to detect an HF event or to predict the likelihood of the patient later developing an HF event. | 05-07-2015 |
20150126883 | METHODS AND APPARATUS FOR DETECTING HEART FAILURE DECOMPENSATION EVENT AND STRATIFYING THE RISK OF THE SAME - Devices and methods for detecting heart failure (HF) events or identifying patient at elevated risk of developing future HF events, such as events indicative of HF decompensation status, are described. The devices and methods can detect an HF event or predict HF risk using one or more physiologic sensor signals including an electrogram and a heart sound signal. A medical device can use the physiologic signals to calculate one more signal metrics indicative of systolic function of the heart, including relative timing between first and second signal features selected from signal features generated from the electrogram or the heart sound signals. The medical device can detect an HF event using the signal metrics, or use the signal metrics to calculate a composite risk indicator indicative of the likelihood of the patient later developing an event indicative of worsening of HF. | 05-07-2015 |
20150141953 | REMOTE CLOSED-LOOP TITRATION OF DECONGESTIVE THERAPY FOR THE TREATMENT OF ADVANCED HEART FAILURE - An apparatus comprises one or more physiological sensing circuits that generate a sensed physiological signal and at least one of the physiological sensing circuits is implantable, a measurement circuit configured to recurrently measure one or more physiological parameters that indicate a status of heart failure of the subject, a comparison circuit configured to compare the one or more physiological parameter measurements to one or more physiological parameter target values, a therapy circuit configured to control delivery of one or more drugs to treat heart failure, and a control circuit in electrical communication with the comparison circuit and the therapy circuit and configured to recurrently adjust delivery of drug therapy according to the comparison of the measured physiological parameters to the physiological parameter targets. | 05-21-2015 |
20150157221 | METHODS AND APPARATUS FOR PREDICTING HEART FAILURE EVENT - Devices and methods for detecting heart failure (HF) events or identifying patient at elevated risk of developing future HF events, such as events indicative of HF decompensation status, are described. The devices and methods can detect an HF event or predict HF risk using signal transfigurations on different portions of a physiologic signal. A system can comprise a physiologic signal analyzer circuit that can generate a signal trend of a signal feature calculated using one or more physiologic signals obtained from a patient. A signal transformation circuit can dynamically generates first and second transformations, apply the transformations to respective first and second portions of the signal trend, and generate respectively a first and second transformed signal trends. A target physiologic event detector circuit can detect a target physiologic event such as an event of worsening HF using a comparison of the first and second transformed signal trends. | 06-11-2015 |
20150157229 | MEASURING ATRIAL FIBRILLATION BURDEN USING IMPLANTABLE DEVICE BASED SENSORS - An apparatus may include a sensing circuit and an arrhythmia detection circuit. The sensing circuit is configured to generate a sensed physiological signal representative of cardiac activity of a subject. The arrhythmia detection circuit is configured to monitor ventricular depolarization (V-V) intervals using the sensed physiological signal, detect when at least a portion of the V-V intervals satisfies an arrhythmia detection threshold interval, calculate a value of variability of the V-V intervals and calculate a value of variability of a systolic portion of the V-V intervals in response to the detection, and generate an indication of atrial fibrillation (AF) according to a comparison including the value of variability of the V-V intervals and the value of variability of the systolic portion of the V-V intervals and provide the indication to at least one of a user or process. | 06-11-2015 |
20150157234 | PHYSIOLOGIC RESPONSE TO A THERAPY CHANGE USING A VENTRICULAR FILLING CHARACTERISTIC - A system includes a therapy control circuit, a therapy output circuit; and a physiologic interval sensing circuit configured to receive information about subject physiologic intervals. The therapy circuit is configured to determine a change in therapy that is provided by the therapy output circuit, determine that the change in therapy includes a change to a maximum interval of cardiac electrostimulation provided according to the therapy, detecting a change in a ventricular filling characteristic of the subject in response to the change in maximum interval of cardiac electrostimulation, determine an indication of a physiologic response of the subject to the therapy change using information about the change in the ventricular filling characteristic, and update the subject therapy provided by the therapy output circuit when the determined indication of the physiologic response to the therapy change indicates an increased likelihood of worsening health status of the subject. | 06-11-2015 |
20150157260 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE DRUG TITRATION AND MANAGEMENT - A system may include a port, at least one sensing circuit, and at least one processor. The port is configured to receive an indication of dosing of medication to treat a pulmonary condition of a heart failure (HF) subject and the at least one sensing circuit configured to sense at least one physiological signal, wherein the physiological signal includes physiological information of the HF subject. The at least one processor includes a parameter module configured to extract values of at least one physiological parameter indicative of health status of the HF subject, and a trending module configured to trend extracted values of the at least one physiological parameter and detect an effect of the dosing of the medication on the HF subject using the trending of the extracted values of the at least one physiological parameter. | 06-11-2015 |
20150157273 | HEART FAILURE EVENT PREDICTION USING CLASSIFIER FUSION - Systems and methods for detecting a heart failure (HF) event indicative of worsening of HF, or for identifying patient at elevated risk of developing future HF event, are described. The system and methods can detect an HF event or predict HF risk using a multitude of fusion algorithms or classifiers, each employing one or more physiologic sensor signals. A system can comprise two or more partial predictor circuits each can adaptively generate a dynamic computational model (DCM). Each partial predictor circuit can determine a partial risk index indicating a likelihood of the patient developing a precursor physiologic event indicative or correlative of a future HF event. The system can include a prediction fusion circuit that can combine the partial risk indices and generate a composite risk indicator for detecting or predicting a likelihood of the patient developing a future HF event. | 06-11-2015 |
20150196214 | MEDICAL DEVICES FOR MAPPING CARDIAC TISSUE - Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a catheter shaft with a plurality of electrodes coupled thereto and a processor coupled to the catheter shaft. The processor may be capable of collecting a set of signals from the plurality of electrodes, characterizing the set of signals, generating a visual representation of the set of signals and refining the visual representation. | 07-16-2015 |
20150208928 | TRANSIENT SENSOR RESPONSE TO POSTURE AS A MEASURE OF PATIENT STATUS - Patient posture information can be received, such as to indicate a change in patient posture by at least a threshold amount. A transient response signal indicative of a change in a physiological parameter can be received at multiple instances near a change in patient posture. Waveform morphology features can be extracted from a transient response signal and used to provide an indication of a cardiac status, such as a heart failure status. | 07-30-2015 |
20150216433 | IMPEDANCE WAVEFORM MONITORING FOR HEART BEAT CONFIRMATION - Implantable systems and methods directed toward improved accuracy in cardiac signal analysis. An impedance waveform is captured and used to confirm the analysis performed by the system on electrical signals or electrocardiogram. A detected heart beat from the electrocardiogram is either confirmed or identified as a misdetection depending on whether the impedance waveform shows likely correct or incorrect detection. Identified misdetection can then be corrected or otherwise mitigated. | 08-06-2015 |
20150250428 | HEART FAILURE EVENT DETECTION USING MULTI-LEVEL CATEGORICAL FUSION - Systems and methods for detecting a present, or predicting a future, target physiologic event such as worsening heart failure (HF) are described. A system can comprise a patient information receiver circuit, at least two categorical risk analyzer circuits, and a categorical fusion circuit. The patient information receiver circuit receives physiologic signals and generates signal trends. The categorical risk analyzer circuit receives a category-specific input selected from the signal trends according to an associative physiologic condition indicative or correlative of the target event. The categorical risk analyzer circuit produces a signal trend metric indicating relative change in signal strength over time. The categorical risk analyzer circuit calculates a categorical risk index that indicates likelihood of the patient developing or presenting the associative physiologic condition. The categorical fusion circuit uses the categorical risk indices to generate a composite risk indicator indicating likelihood of the patient developing the target physiologic event. | 09-10-2015 |
20150258343 | SYSTEM AND METHOD FOR ALERTING TO UNUSUAL/ATYPICAL PROGRAMMING CHANGES OF A MEDICAL DEVICE - An apparatus comprises a communication circuit configured to communicate information with an ambulatory medical device, a user interface configured to receive a programmable parameter for the ambulatory medical device from a user, a memory to store a distribution of values for the programmable parameter, wherein the distribution is representative of values of the parameter programmed for a patient population, and a processor circuit configured to compare a received value of the programmable parameter to a distribution of programmed values for the programmable parameter and present results of the comparison to the user via a display of the user interface. | 09-17-2015 |
20150282738 | DISCRIMINATION OF APNEA TYPE BY MEDICAL DEVICE - Disclosed herein, among other things, are methods and apparatus related to identification of apnea type. One aspect of the present subject matter provides a method for real-time apnea discrimination. The method includes sensing an impedance-based tidal volume signal to monitor a respiratory cycle of a patient, and detecting a reduction in tidal swing using the sensed impendence to detect an apnea event. When the apnea event is detected, a shape of the sensed signal is compared to a stored signal shape to determine whether the apnea event is primarily an obstructive sleep apnea (OSA) event or primarily a central sleep apnea (CSA) event, in various embodiments. | 10-08-2015 |
20150283383 | METHODS AND APPARATUS FOR APNEA THERAPY STIMULATION - Disclosed herein, among other things, are methods and apparatus related to apnea therapy. One aspect of the present subject matter provides a method for apnea directed therapy. The method includes receiving a signal indicative of a real-time determination of type of an apnea event for a patient during the apnea event, and using the signal to select appropriate therapy to be applied to the patient during the apnea event to treat the apnea event, and to withhold inappropriate therapy. The therapy is applied in a closed loop system, in various embodiments. In various embodiments, the signal includes a determination of whether the apnea event is primarily an obstructive sleep apnea (OSA) event or primarily a central sleep apnea (CSA) event. | 10-08-2015 |
20150327776 | SYSTEM AND METHODS FOR AUTOMATIC DIFFERENTIAL DIAGNOSIS OF WORSENING HEART FAILURE - Devices and methods for differentially diagnosing between worsening heart failure (HF) and other diseases or medical conditions are described. A medical system can receive patient information including one or more physiologic signals, and detect a respective physiologic feature from each of the one or more received physiologic signals. The medical system can include a differential diagnosis circuit that generates one or more signal metrics, receive two or more candidate conditions associated with the change in patient physical or physiological status, and determine a respective diagnostic score for each of the candidate conditions. The diagnostic score can indicate likelihood the change in the patient physical or physiologic status being caused by the corresponding candidate condition. A user interface can be provided to generate a presentation of the detected physiologic features and the diagnostic scores associated with the candidate conditions. | 11-19-2015 |
20150342466 | SYSTEM AND METHODS FOR DETECTING ATRIAL TACHYARRHYTHMIA USING HEMODYNAMIC SENSORS - Systems and methods for detecting atrial tachyarrhythmias such as atrial fibrillation (AF) are disclosed. A medical system can sense a heart rate (HR) output and a hemodynamic status output. An AF detector circuit automatically determines a first detection criterion and a different second detection criterion. The first detection criterion can be more sensitive to the presence of the AF episode than the second detection criterion, and the second detection criterion can be more specific to the AF episode than the first detection criterion. The AF detector circuit detects an AF onset event using the first detection criterion and at least one of the heart rate output or the hemodynamic status output, and detects an AF termination event using the second detection criterion and at least one of the heart rate output or the hemodynamic status output. | 12-03-2015 |
20150342487 | SYSTEMS AND METHODS FOR EVALUATING HEMODYNAMIC RESPONSE TO ATRIAL FIBRILLATION - Systems and methods for assessing hemodynamic status of a patient experiencing atrial tachyarrhythmia such as an atrial fibrillation (AF) episode are disclosed. A system can comprise an atrial tachyarrhythmia detection circuit configured to detect an AF episode, a hemodynamic sensor circuit configured to sense at least one hemodynamic signal, and a hemodynamic status analyzer circuit that can calculate one or more signal metrics using the sensed hemodynamic signal during the AF episode. The hemodynamic status analyzer circuit can categorize the hemodynamic status of the patient into one of two or more categorical hemodynamic status levels which indicate elevated hemodynamic impact of the detected AF episode. A user interface can provide to an end-user a presentation of the categorized hemodynamic status level during AF. | 12-03-2015 |
20150342488 | MEDICAL DEVICES FOR MAPPING CARDIAC TISSUE - Medical devices and methods for making and using medical devices are disclosed. An example method may include a method of identifying an activation time in a cardiac electrical signal. The method may include sensing a cardiac electrical signal, generating an approximation signal based at least in part on one or more parameters of the cardiac electrical signal, identifying a fiducial point on the approximation signal and determining, based at least in part on a timing of the fiducial point in the approximation signal, an activation time in the cardiac electrical signal. | 12-03-2015 |
20150342492 | METHOD AND APPARATUS FOR DETECTING ATRIAL TACHYARRHYTHMIA USING HEART SOUNDS - A cardiac rhythm management system senses a cardiac signal indicative of heartbeats and an acoustic signal indicative of heart sounds and detects atrial tachyarrhythmia based on the sensed cardiac and acoustic signals. In various embodiments, the system senses the cardiac and acoustic signals without using an atrial lead, thus allowing for, for example, monitoring atrial fibrillation burden in a heart failure patient who does not wear an implantable device with an atrial lead. In various embodiments, the system detects heartbeats and heart sounds, measures parameters associated with the detected heartbeats and heart sounds, and detects one or more specified types of atrial tachyarrhythmia using the measured parameters. In various embodiments, the measured parameters are selected from heart rate, heart sound amplitude, cycle length variability, and systolic and diastolic intervals. | 12-03-2015 |
20150342536 | MEDICAL DEVICES FOR MAPPING CARDIAC TISSUE - Medical devices and methods for making and using medical devices are disclosed. A method for removing an artifact of a biological reference signal present in a biological source signal may comprise sensing a biological reference signal with one or more electrodes and sensing a biological source signal, wherein the biological source signal comprises an artifact of the biological reference signal. The method may further comprise determining, based on the biological reference signal, the artifact of the biological reference signal and subtracting the artifact of the biological reference signal from the sensed biological source signal. | 12-03-2015 |
20150342540 | HEART FAILURE EVENT DETECTION AND RISK STRATIFICATION USING HEART RATE TREND - Systems and methods for detecting heart failure (HF) events or identifying patient at elevated risk of developing future HF events such as HF decompensation are described. A medical system can detect a contextual condition associated with a patient, including an environmental context or a physiologic context. The contextual condition includes information indicative or correlative of a change in metabolic demand. The system can include a heart rate (HR) analyzer circuit that extracts a HR feature from a cardiac activity signal, and perform multiple HR feature measurements in response to the detected patient contextual condition meeting a specified criterion. The system can calculate one or more signal metrics including a HR metric using the HR feature measurements. The system can detect an HF event using the signal metrics, or use the signal metrics to calculate a composite risk indicator indicative of the patient's likelihood of developing a future HF event. | 12-03-2015 |
20150343223 | SYSTEM AND METHODS FOR TREATING ATRIAL FIBRILLATION USING HEMODYNAMIC RESPONSES - Systems and methods for treating atrial tachyarrhythmias such as atrial fibrillation (AF) are disclosed. By monitoring a patient's hemodynamic sensor response to a candidate AF therapy, the present systems and methods can be used to determine an individualized AF therapy leading to a desirable hemodynamic outcome. A medical system can include one or more programmable therapy circuits and a hemodynamic sensor circuit. The system includes a therapy selection circuit that automatically programs and sequentially delivers at least a first candidate therapy and a different second candidate therapy. By comparing the values of a hemodynamic parameter in response to or during the first candidate therapy to that in response to or during the second candidate therapy, a desired AF therapy can be determined as the candidate therapy that leads to faster or more significant hemodynamic recovery. | 12-03-2015 |
20150351660 | ABSOLUTE THORACIC IMPEDANCE FOR HEART FAILURE RISK STRATIFICATION - An apparatus may include a sensing circuit configured to generate a sensed physiological signal representative of thoracic impedance of a subject and a controller circuit. The a controller circuit is electrically coupled to the sensing circuit and includes a measurement circuit that determines a measure of absolute thoracic impedance using the sensed physiological signal, and a risk circuit that quantifies a risk of worsening heart failure (WHF) for the subject using a comparison of the determined measure of absolute thoracic impedance to a specified threshold value of absolute thoracic impedance, and generate an indication of risk of WHF of the subject according to the quantifying of the risk. | 12-10-2015 |
20160000380 | SYSTEMS AND METHODS FOR DETECTING MEDICAL TREATMENT - Systems and methods are provided for using stored physiologic information about a subject to detect a previous treatment event. Physiologic information can be sensed from a subject using one or more sensors. Using a detection circuit, a change in the sensed physiologic information, such as a change from reference physiologic information, can be used to identify a candidate previous treatment event. An alert or other information about the candidate treatment event can be provided to a patient or clinician. In an example, a candidate treatment event can include a heart failure or diuresis treatment that is identified using information about a change in one or more of a subject's circadian pattern, a subject's thoracic impedance, or a subject's respiration status. | 01-07-2016 |
20160001088 | SYSTEM AND METHOD FOR ANALYZING MEDICAL DEVICE PROGRAMMING PARAMETERS - The technology disclosed herein relates to a system and method for analyzing medical device programming parameters. One aspect of the current technology is a method where an overall performance metric is detected for a cardiac medical device that is outside of a threshold at a first cardiac location in a patient. Processing circuitry identifies a first operating condition and sensing circuitry measures a first sensor response during the first operating condition. An adjustment is proposed to one or more programming parameters of the medical device based on the performance metric, the first operating condition, and the sensor response to the operating condition. | 01-07-2016 |
20160030747 | PACING SITE AND CONFIGURATION OPTIMIZATION USING A COMBINATION OF ELECTRICAL AND MECHANICAL INFORMATION - An apparatus comprises a cardiac signal sensing circuit configured to sense a plurality of intrinsic cardiac signals using a plurality of cardiac pacing sites, a heart sound sensing circuit, a stimulus circuit configured to provide an electrical cardiac pacing stimulus to the plurality of pacing sites, and a control circuit electrically coupled to the cardiac signal sensing circuit and the stimulus circuit. The control circuit includes a pacing site locating circuit configured to generate an indication of a preferred pacing site as one of a) a subset of the respective cardiac pacing sites selected using the intrinsic ventricular activation time interval value, from which subset the preferred pacing site is selected using the heart sound characteristic value; or b) a subset of the respective cardiac pacing sites selected using the heart sound characteristic value, from which subset the preferred pacing site is selected using the ventricular activation time interval value. | 02-04-2016 |
20160038094 | ACTIVITY LEVEL DETERMINATION FOR RISK STRATIFICATION - In one example, a method of monitoring a sustained activity of a human or animal subject for the purpose of determining a risk group includes detecting a physical activity signal from the subject, determining a magnitude of the detected physical activity signal, initiating a timer in response to determining the magnitude of the physical activity signal exceeding an activity level threshold, triggering storing at least one value associated with the physical activity signal only when the magnitude of the physical activity signal exceeds the activity level threshold and the timer is greater than a duration threshold, and determining, using the processor circuit, an indication of the subject's cardiovascular disease based on the stored value. | 02-11-2016 |
20160081619 | SENSOR GUIDED RESPONSE TO ANTI-ARRHYTHMIC CHANGES - A patient's response to anti-arrhythmic drug changes can be monitored using cardiac activity information, such as using cardiac electromechanical time intervals adjusted for heart rate. A cardiac electromechanical time interval can include an R-S2 interval or an S2-R interval. Tracking changes in cardiac electromechanical time intervals adjusted for heart rate can be used to provide information about a patient, including anti-arrhythmic drug effect information and patient condition information. | 03-24-2016 |
20160095534 | CALIBRATING INTRATHORACIC IMPEDANCE FOR ABSOLUTE LUNG FLUID MEASUREMENT - In one example, a method of estimating lung fluid content includes receiving a first response signal in response to a delivered first test stimulus, the first test stimulus delivered and the first response signal obtained during a first subject state, receiving a first estimate of a fluid content value during the first subject state, receiving a second response signal in response to a delivered second test stimulus, the second test stimulus delivered and the second response signal obtained during a second subject state, receiving a second estimate of the fluid content value during the second subject state, pairing the first response signal and the first estimate of the fluid content value to form a first pair of values and pairing the second response signal and the second estimate of the fluid content value to form a second pair of values, and determining a relationship between the pairs of values. | 04-07-2016 |
20160101290 | SYSTEM AND METHODS FOR IMPROVING DEVICE THERAPY USING MULTIPLE SENSOR METRICS - Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can receive one or more physiologic signals and generate multiple signal metrics from the physiologic signals. The ambulatory medical device can determine a desired value for a device parameter, such as a timing parameter used for controlling the delivery of CRT pacing to various heart chambers, using information fusion of signal metrics that are selected based on one or more of a signal metric sensitivity to perturbations to the device parameter in response to a stimulation, a signal metric variability in response to a stimulation, or a covariability between two or more signal metrics in response to a stimulation. The ambulatory medical device can program a stimulation using the desired device parameter value, and deliver the programmed stimulation to one or more target sites to achieve desired therapeutic effects. | 04-14-2016 |
20160106983 | METHOD AND APPARATUS FOR AMBULATORY OPTIMIZATION OF MULTI-SITE PACING USING HEART SOUNDS - An example of a system for pacing through multiple electrodes in a ventricle includes a sensing circuit to sense cardiac signal(s), a pacing output circuit to deliver pacing pulses, a heart sound sensor to sense a heart sound signal, and a control circuit to control the delivery of the pacing pulses. The control circuit includes a heart sound detector to detect heart sounds using the heart sound signal, an electrical event detector to detect cardiac electrical events using the cardiac signal(s), a measurement module to measure an optimization parameter using the detected heart sounds, an optimization module to perform an optimization procedure using the optimization parameter in response to an optimization command, and an optimization initiator to generate the optimization command. The optimization procedure includes selection of a single electrode or a plurality of electrodes from the multiple electrodes in the ventricle for pacing that ventricle. | 04-21-2016 |
20160106986 | METHOD AND APPARATUS FOR OPTIMIZING MULTI-SITE PACING USING HEART SOUNDS - An example of a system for pacing through multiple electrodes in a ventricle includes a sensing circuit to sense cardiac signal(s), a pacing output circuit to deliver pacing pulses, a heart sound sensor to sense a heart sound signal, and a control circuit to control the delivery of the pacing pulses. The control circuit includes a heart sound detector to detect heart sounds using the heart sound signal, an electrical event detector to detect cardiac electrical events using the cardiac signal(s), a measurement module to measure an optimization parameter using the detected heart sounds, and an optimization module to approximately optimize one or more pacing parameters using the measured optimization parameter. The one or more pacing parameters include an electrode configuration parameter specifying one or more electrodes selected from the multiple electrodes in the ventricle for delivering ventricular pacing pulses to that ventricle. | 04-21-2016 |
20160106987 | MULTI-SITE PACING CAPTURE VERIFICATION - Systems and methods for evaluating electrostimulation of a heart are disclosed. A system can comprise an electrostimulation circuit that can deliver multi-site electrostimulation, including pacing at two or more sites of the heart during the same cardiac cycle. The system can comprise a heart sound sensor circuit configured to sense a heart sound (HS) signal during multi-site stimulation. The heart sound sensor circuit can also sense HS signals in response to uni-site stimulation at a specified site capturing at least a portion of the heart. The system can comprise a pacing analyzer circuit that uses the HS signals during the multi-site stimulation and during the uni-site stimulation to determine a capture status indication that indicates whether the multi-site stimulation captures the two or more sites of the heart, and can be one of a full capture indication, a partial capture indication, or a loss of capture indication. | 04-21-2016 |