Patent application number | Description | Published |
20090254140 | CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION USING PARAMETER ESTIMATION FROM REALTIME ELECTRODE MOTION TRACKING - An exemplary method includes providing at least two-dimensional position information, for at least two points in time, for an electrode located in a cardiac space; determining a local estimator based on the position information; and, based at least in part on the determined local estimator, selecting a configuration for delivering a cardiac pacing therapy or diagnosing a cardiac condition. Exemplary methods for regional estimators and exemplary methods for global estimators are also disclosed along with devices and systems configured to perform various methods. | 10-08-2009 |
20090281399 | STANDALONE SYSTEMIC ARTERIAL BLOOD PRESSURE MONITORING DEVICE - Certain embodiments of the present invention are related to an implantable monitoring device to monitor a patient's arterial blood pressure, where the device is configured to be implanted subcutaneously. The device includes subcutaneous (SubQ) electrodes and a plethysmography sensor. Additionally, the device includes an arterial blood pressure monitor configured to determine at least one value indicative of the patient's arterial blood pressure based on at least one detected predetermined feature of a SubQ ECG and at least one detected predetermined feature of a plethysmography signal. Alternative embodiments of the present invention are directed to a non-implantable monitoring device to monitor a patient's arterial blood pressure based on features of a surface ECG and a plethysmography signal obtained from a non-implanted sensor. | 11-12-2009 |
20090306732 | CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION USING ELECTROMECHANICAL DELAY FROM REALTIME ELECTRODE MOTION TRACKING - An exemplary method includes providing a mechanical activation time (MA time) for a myocardial location, the location defined at least in part by an electrode and the mechanical activation time determined at least in part by movement of the electrode; providing an electrical activation time (EA time) for the myocardial location; and determining an electromechanical delay (EMD) for the myocardial location based on the difference between the mechanical activation time (MA time) and the electrical activation time (EA time). | 12-10-2009 |
20090318995 | CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION USING MECHANICAL DYSSYNCHRONY AND SHORTENING PARAMETERS FROM REALTIME ELECTRODE MOTION TRACKING - Therapy optimization includes tracking electrode motion using an electroanatomic mapping system and generating, based on tracked electrode motion, one or more mechanical dyssynchrony metrics to thereby guide a clinician in therapy optimization (e.g., via optimal electrode sites, optimal therapy parameters, etc.). Such a method may include a vector analysis of electrode motion with respect to factors such as times in cardiac cycle, phases of a cardiac cycle, and therapy conditions, e.g., pacing sites, pacing parameters and pacing or no pacing. Differences in position-with-respect-to-time data for electrodes may also be used to provide measurements of mechanical dyssynchrony. | 12-24-2009 |
20100228136 | SYSTEMS AND METHODS FOR MONITORING DP, IVRT, DiFT, DIASTOLIC FUNCTION AND/OR HF - Implantable systems, and methods for use therewith, are provided for monitoring a patient's diastolic function and/or heart failure (HF) condition. A signal indicative of changes in arterial blood volume and a signal indicative of electrical activity of the patient's heart are obtained. Beginnings of diastolic periods can be detected based on a feature of the signal indicative of changes in arterial blood volume. Ends of the diastolic periods can be detected based on a feature of the signal indicative of electrical activity of the patient's heart, or on the signal indicative of changes in arterial blood volume. Diastolic periods (DPs), isovolumic relaxation times (IVRTs) and/or diastolic filling times (DiFTs) can be estimated based on the detected beginnings of the diastolic periods and detected ends of the diastolic periods. The patient's diastolic function and/or HF condition (and/or changes therein) can be monitored based on the estimates of DP, IVRT and/or DiFT. | 09-09-2010 |
20100268059 | THERAPY OPTIMIZATION VIA MULTI-DIMENSIONAL MAPPING - An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient where the cardiac information comprises position information, electrical information and mechanical information; mapping local electrical activation times to anatomic positions to generate an electrical activation time map; mapping local mechanical activation times to anatomic positions to generate a mechanical activation time map; generating an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and rendering at least the electromechanical delay map to a display. Various other methods, devices, systems, etc., are also disclosed. | 10-21-2010 |
20100312128 | SYSTEMS AND METHODS FOR MONITORING BLOOD PARTITIONING AND ORGAN FUNCTION - Methods and systems for monitoring an organ of interest within a patient use one or more sensors to obtain one or more signals indicative of one or more of blood being provided to the organ of interest, blood being received from the organ of interest, and blood present in the organ of interest. Changes in an amount of blood being provided to the organ of interest, an amount of blood being received from the organ of interest, and/or an amount of blood present in the organ of interest are monitored based on changes in the obtained signal(s). Such methods and systems can be used to detect dysfunction of the organ of interest or tumor growth in the organ of interest, but are not limited thereto. | 12-09-2010 |
20110009755 | ARTERIAL BLOOD PRESSURE MONITORING DEVICES, SYSTEMS AND METHODS FOR USE WHILE PACING - Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values. | 01-13-2011 |
20110040345 | ELECTROMECHANICAL DELAY (EMD) MONITORING DEVICES, SYSTEMS AND METHODS - Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's electromechanical delay (EMD). Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture to the patient's heart. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient's EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal. | 02-17-2011 |
20110054559 | PACING, SENSING AND OTHER PARAMETER MAPS BASED ON LOCALIZATION SYSTEM DATA - An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed. | 03-03-2011 |
20110054560 | PACING, SENSING AND OTHER PARAMETER MAPS BASED ON LOCALIZATION SYSTEM DATA - An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed. | 03-03-2011 |
20110066201 | ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA - A method includes selecting an electrode located in a patient; acquiring position information with respect to time for the electrode where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating a stability metric for the electrode based on the acquired position information with respect to time; and deciding if the selected electrode, as located in the patient, has a stable location for sensing biological electrical activity, for delivering electrical energy or for sensing biological electrical activity and delivering electrical energy. Position information may be acquired during one or both of intrinsic or paced activation of a heart and respective stability indexes calculated for each activation type. | 03-17-2011 |
20110066202 | ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA - A method includes selecting an electrode located in a patient wherein the electrode comprises a lead-based electrode; acquiring position information with respect to time for the electrode, during both loaded and unloaded conditions of the lead, where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating a both loaded and unloaded stability metrics for the electrode based on the acquired position information with respect to time; and comparing the unloaded and loaded stability metrics to decide whether the electrode, as located in the patient, comprises a stable location for delivery of therapy. | 03-17-2011 |
20110066203 | ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA - A method includes selecting an electrode located in a patient; acquiring position information with respect to time for the electrode, during both acute and chronic states of the electrode, where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating an acute state stability metric and a chronic state stability metric for the electrode based on the acquired position information with respect to time; and comparing the acute state stability metric to the chronic state stability metric to decide whether the electrode, as located in the patient in the chronic state, comprises a stable location for delivery of a therapy. The chronic state stability metric of an electrode may be monitored over time to decide whether stability of the electrode has changed. | 03-17-2011 |
20110092809 | CARDIAC COORDINATE SYSTEM FOR MOTION ANALYSIS - An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient wherein the cardiac information comprises position information with respect to time for one or more electrodes of the catheter; performing a principal component analysis on at least some of the position information; and selecting at least one component of the principal component analysis to represent an axis of a cardiac coordinate system. Various other methods, devices, systems, etc., are also disclosed. | 04-21-2011 |
20110106233 | INTRAPERICARDIAL LEAD - The intrapericardial lead includes a lead body having a proximal portion and a flexible, pre-curved distal end portion. The distal end portion carries at least one electrode assembly containing an electrode adapted to engage pericardial tissue. The distal end portion further carries a pre-curved flexible wire member having ends attached to spaced apart points along the distal end portion of the lead body, the flexible wire member having a normally expanded state wherein an intermediate portion of the wire member is spaced apart from the distal end portion, and a generally straightened state wherein the wire member and the distal end portion are disposed in a more parallel, adjacent relationship so as to present a small frontal area to facilitate delivery into the pericardial space. The wire member re-expands to its normal state after delivery into the pericardial space to anchor the distal end portion of the lead body relative to the pericardial tissue. | 05-05-2011 |
20110118803 | Cardiac Resynchronization Therapy Optimization Using Vector Measurements Obtained From Realtime Electrode Position Tracking - An exemplary method includes selecting a first pair of electrodes to define a first vector and selecting a second pair of electrodes to define a second vector; acquiring position information during one or more cardiac cycles for the first and second pairs of electrodes wherein the acquiring comprises using each of the electrodes for measuring one or more electrical potentials in an electrical localization field established in the patient; and determining a dyssynchrony index by applying a cross-covariance technique to the position information for the first and the second vectors. Another method includes determining a phase shift based on the acquired position information for the first and the second vectors; and determining an interventricular delay based at least in part on the phase shift. | 05-19-2011 |
20110125208 | METHODS AND SYSTEMS TO MONITOR CARDIAC CONTRACTILITY - An implanted sensor produces a signal that is indicative of changes in arterial blood volume, such as a photoplethysmography signal or an impedance plethysmography signal. A metric is determined from the signal for each of the plurality of periods. Changes in cardiac contractility are monitored based on changes in the determined metric. | 05-26-2011 |
20110137187 | IMPLANTABLE SENSOR FOR MEASURING PHYSIOLOGIC INFORMATION - An implantable sensor is provided that includes a piezopolymer sensor element including a body having a plurality of layers of a piezopolymer, and an attachment device configured to hold the piezopolymer sensor element in direct contact with at least one of a bodily fluid and bodily tissue such that the piezopolymer sensor element is configured to bend in response to motion of the at least one of bodily fluid and bodily tissue. A pair of electrodes is attached to the piezopolymer sensor element and the electrodes are configured to collect an electrical charge that is generated within the piezopolymer sensor element due to the bending of the piezopolymer sensor element. | 06-09-2011 |
20110144510 | METHODS TO IDENTIFY DAMAGED OR SCARRED TISSUE BASED ON POSITION INFORMATION AND PHYSIOLOGICAL INFORMATION - An exemplary system includes one or more processors; memory; and control logic, of one or more modules operable in conjunction with the one or more processors and the memory, to acquire myocardial potential data associated with position information, acquire myocardial electrical activation data associated with position information, acquire myocardial position data with respect to time, generate isopotential contours based on the potential data, generate isochronal contours based on the electrical activation data, generate isomotion contours based on the position data with respect to time, and overlay the generated isopotential contours, isochronal contours and isomotion contours on a display to indicate a region of myocardial damage or myocardial scarring with respect to a map that comprises anatomical markers. Various other methods, devices, systems, etc., are also disclosed. | 06-16-2011 |
20110144711 | Method and System for Hemodynamic Optimization Using Plethysmography - Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set. | 06-16-2011 |
20110184274 | ELECTRODE CONFIGURATIONS FOR LEADS OR CATHETERS TO ENHANCE LOCALIZATION USING A LOCALIZATION SYSTEM - An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed. | 07-28-2011 |
20110213260 | CRT LEAD PLACEMENT BASED ON OPTIMAL BRANCH SELECTION AND OPTIMAL SITE SELECTION - An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a coronary sinus of a patient where the cardiac information includes electrical information and mechanical information; calculating scores based on the cardiac information where each of the scores corresponds to the coronary sinus or a tributary of the coronary sinus; and based on the scores, selecting a tributary of the coronary sinus as an optimal candidate for placement of a left ventricular lead. Accordingly, the selected tributary may be relied on during an implant procedure for the left ventricular lead. Various other methods, devices, systems, etc., are also disclosed. | 09-01-2011 |
20110295137 | CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION USING ELECTROMECHANICAL DELAY FROM REALTIME ELECTRODE MOTION TRACKING - An exemplary method includes providing a mechanical activation time (MA time) for a myocardial location, the location defined at least in part by an electrode and the mechanical activation time determined at least in part by movement of the electrode; providing an electrical activation time (EA time) for the myocardial location; and determining an electromechanical delay (EMD) for the myocardial location based on the difference between the mechanical activation time (MA time) and the electrical activation time (EA time). | 12-01-2011 |
20120046564 | METHODS AND SYSTEMS TO MONITOR AND IDENTIFY TRANSIENT ISCHEMIA - A system and method are provided for monitoring ischemic development. The system and method identify a non-physiologic event and obtain cardiac signals along multiple sensing vectors, wherein at least a portion of the sensing vectors extend to or from electrodes located proximate to the left ventricle. The system and method monitor a segment of interest in the cardiac signals obtained along the multiple sensing vectors to identify deviations in the segment of interest from a baseline. The system and method record at least one of timing or segment shift information associated with the deviations in the segments of interest; and identify at least one of size, direction of development or rate of progression of an ischemia region based on the at least one of timing or segment shift information. | 02-23-2012 |
20120065527 | Methods and Systems for Monitoring Aterial Stiffness - Implanted systems and methods for monitoring a patient's arterial stiffness are provided. An implanted sensor is used to produce a signal indicative of changes in arterial blood volume for a plurality of beats of the patient's heart. A pulse duration metric is determined for each of a plurality of pulses of the signal, wherein each pulse of the signal corresponds to a beat of the patient's heart. Arterial stiffness is monitored based on the determined pulse duration metric for the plurality of pulses of the signal. This can include monitoring arterial stiffness based on a dispersion of the pulse duration metric and/or an average of the pulse duration metric. | 03-15-2012 |
20120065528 | PRE-EJECTION INTERVAL (PEI) MONITORING DEVICES, SYSTEMS AND METHODS - Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's pre-ejection interval (PEI). A signal indicative of cardiac electrical activity and a signal indicative of changes in arterial blood volume are obtained. One or more predetermined features of the signal indicative of cardiac electrical activity and the signal indicative of changes in arterial blood volume are detected. The patient's PEI is determined by determining an interval between the predetermined feature of the signal indicative of cardiac electrical activity and the predetermined feature of the signal indicative of changes in arterial blood volume. | 03-15-2012 |
20120172867 | SYSTEM AND METHOD FOR TREATING ARRHYTHMIAS IN THE HEART USING INFORMATION OBTAINED FROM HEART WALL MOTION - A system and method for treating an arrhythmia in a heart are provided. The system includes an electronic control unit configured to monitor movement of one or more position sensor over a period of time. The position sensors may, for example, comprise electrodes or coils configured to generate induced voltages and currents in the presence of electromagnetic fields. The positions sensors are in contact with portions of heart tissue and changes in position are representative of motion of that tissue. The electronic control unit is further configured to generate an indicator, responsive to the movements of the sensors over the period of time, of a characteristic of the heart affected by delivery of ablation energy to heart tissue. In this manner, the effectiveness and safety of cardiac tissue ablation for treatment of the arrhythmia can be assessed and a post-ablation therapy regimen determined. | 07-05-2012 |
20120215117 | SYSTEMS AND METHODS FOR ESTIMATING CENTRAL ARTERIAL BLOOD PRESSURE OF A PATIENT - In specific embodiments, a method for estimating a patient's central arterial blood pressure (CBP) for use with an implantable system, comprises (a) using an implanted sensor at a first site to obtain a first signal indicative of changes in arterial blood volume at the first site, the first site being along one or more peripheral arterial structures of the patient, (b) using an implanted sensor at a second site to obtain a second signal indicative of changes in arterial blood volume at the second site, the second site being a distance from the first site downstream along an arterial path of the peripheral arterial structure of the patient, and (c) using implanted electrodes to obtain a signal indicative of electrical activity of the patient's heart. The method further comprises (d) determining a time t | 08-23-2012 |
20120215275 | IMPLANTABLE SYSTEMS AND METHODS FOR USE THEREWITH FOR MONITORING AND MODIFYING ARTERIAL BLOOD PRESSURE WITHOUT REQUIRING AN INTRAVASCULAR PRESSURE TRANSDUCER - Embodiments of the present invention are directed to implantable systems, and methods for use therewith, that monitor and modify a patient's arterial blood pressure without requiring an intravascular pressure transducer. In accordance with an embodiment, for each of a plurality of periods of time, there is a determination one or more metrics indicative of pulse arrival time (PAT), each of which are indicative of how long it takes for the left ventricle to generate a pressure pulsation that travels from the patient's aorta to a location remote from the patient's aorta. Based on the one or more metrics indicative of PAT, the patient's arterial blood pressure is estimated. Changes in the arterial blood pressure are monitored over time. Additionally, the patient's arterial blood pressure can be modified by initiating and/or adjusting pacing and/or other therapy based on the estimates of the patient's arterial blood pressure and/or monitored changes therein. | 08-23-2012 |
20130296960 | ELECTROMECHANICAL DELAY (EMD) MONITORING DEVICES, SYSTEMS AND METHODS - Implantable systems, and methods for use therewith, enable the monitoring of a patient's electromechanical delay (EMD) and arterial blood pressure. Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient's EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal. The value indicative of EMD can be used to more accurately determine metrics indicative of pulse arrival time (PAT), which can be used to estimate arterial blood pressure. | 11-07-2013 |