Patent application number | Description | Published |
20080215127 | Medical Electrical Lead Providing Far-Field Signal Attenuation - A bipolar pacing and sensing lead incorporates a range of active surface areas for each of the anode and cathode electrodes, and a range of inter-electrode spacings between the anode and cathode electrodes which, in combination, provide acceptable near-field signal amplitudes and attenuate the amplitudes of unwanted signals, such as far-field R-waves, far-field P-waves, and T-waves. | 09-04-2008 |
20080306567 | SYSTEM AND METHOD FOR IMPROVING CRT RESPONSE AND IDENTIFYING POTENTIAL NON-RESPONDERS TO CRT THERAPY - A method is disclosed that includes selecting an electrode configuration from a plurality of electrode configurations associated with electrodes of an implantable lead, sensing activity of the right ventricle and the left ventricle, determining an interval between sensed activity of the right ventricle and sensed activity of the left ventricle and determining whether the selected electrode configuration is suitable based at least in part on the interval. In one embodiment, an implantable device performs such a method to improve patient response to the CRT therapy, for example, by selecting a different electrode configuration if the current configuration is not suitable. Other exemplary methods, devices, systems, etc., are also disclosed. | 12-11-2008 |
20090018597 | System and Method for Estimating Cardiac Pressure Based on Cardiac Electrical Conduction Delays Using an Implantable Medical Device - Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom. | 01-15-2009 |
20090177104 | System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device - Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia. | 07-09-2009 |
20090177105 | System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device - Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia. | 07-09-2009 |
20090270746 | CRITERIA FOR MONITORING INTRATHORACIC IMPEDANCE - An exemplary method includes providing information (e.g., a left atrial pressure, a NYHA class, echocardiographic information, etc.), based at least in part on the information, determining a weight and, based at least in part on the weight, determining a threshold for use in intrathoracic impedance monitoring. Such an exemplary method may include comparing an intrathoracic impedance to the threshold, comparing an intrathoracic impedance change to the threshold, or comparing a product of intrathoracic impedance and time to the threshold. Various exemplary methods, devices, systems, etc., are disclosed. | 10-29-2009 |
20090287267 | System and Method for Estimating Cardiac Pressure Based on Cardiac Electrical Conduction Delays Using an Implantable Medical Device - Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom. | 11-19-2009 |
20090299423 | SYSTEMS AND METHODS FOR DETERMINING INTER-ATRIAL CONDUCTION DELAYS USING MULTI-POLE LEFT VENTRICULAR PACING/SENSING LEADS - Techniques are provided for use by a pacemaker or other implantable medical device for estimating optimal atrio-ventricular pacing delays within a patient. The inter-atrial conduction delays (IACDs) are determined based, at least in part, on atrial far-field (AFF) signals sensed using a multi-pole left ventricular (LV) lead, such as an LV lead implanted via the coronary sinus (CS) with a plurality of electrodes. In one example, for intrinsic atrial events, the IACD is equal to the interval from the beginning of a P-wave detected via a right atrial lead and the end (or peak) of an AFF event detected via a left atrial ring electrode of a CS/LV lead. For paced atrial events, the IACD is instead equal to the interval from the A-pulse to the end (or peak) of the AFF event detected via the CS/LV lead. AV/PV pacing delays are then calculated based on the IACD adjusted by an offset. | 12-03-2009 |
20100036466 | LEAD CONSTRUCTION WITH COMPOSITE MATERIAL SHIELD LAYER - A lead construction includes a lead body, an electrically conductive element disposed therein, and a shield layer disposed over the conductive element formed from a composite material comprising a polymer material and a non-ferrous particulate material. The non-ferrous material can include gold, platinum, iridium, nickel, cobalt, chromium, molybdenum, carbon/graphite powders, and alloys thereof. The composite material has a non-ferrous particulate content of from about 40 to 90 volume percent, and the shield layer has a thickness of from about 0.1 to 1 mm. The composite material forms an electrically conductive layer when exposed to RF having a frequency of greater than about 64 MHz. A layer of insulating material may be interposed between the shield layer and the conductive element. The shield layer can be part of the lead body, can be an intermediate layer within the lead body, or can be an outer surface of the lead body. | 02-11-2010 |
20100049290 | MRI COMPATIBLE LEAD - Disclosed herein is an implantable medical lead. In one embodiment, the lead includes a ring electrode, a tip electrode, first and second helically wound coaxial conductor coils, and a distal coil transition. The coils extend between the proximal and distal ends of the lead. The distal coil transition is proximal to the ring electrode and near the distal end and is where the first coil transitions from being outside the second coil proximal of the distal coil transition to being inside the second coil distal of the distal coil transition. | 02-25-2010 |
20100069768 | USE OF CARDIOHEMIC VIBRATION FOR PACING THERAPIES - An exemplary method includes receiving a signal from an intrathoracic vibration sensor, analyzing the signal for vibration associated with deceleration of blood flow into the left ventricle, based at least in part on the analyzing, deciding whether to call for adjustment to one or more parameters of a bi-ventricular pacing therapy. Other exemplary methods, devices, systems, etc., are also disclosed. | 03-18-2010 |
20100069987 | MONITORING HF EXACERBATION AND CARDIAC RESYNCHRONIZATION THERAPY PERFORMANCE - An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay parameter and an interventricular delay parameter, measuring an atrio-ventricular conduction delay, measuring an interventricular conduction delay, assessing heart failure and/or cardiac resynchronization therapy performance based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay and determining at least one of an atrio-ventricular delay parameter value and an interventricular delay parameter value based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay. Other exemplary technologies are also disclosed. | 03-18-2010 |
20100069990 | SYSTEM AND METHOD FOR DETERMINING ATRIOVENTRICULAR PACING DELAY BASED ON ATRIAL REPOLARIZATION - Techniques are provided for estimating optimal atrioventricular pacing delay values for use in pacing the ventricles based on features of an intracardiac electrogram (IEGM) signal. Briefly, atrioventricular pacing delay pacing values are set based upon the location of atrial repolarization events within the IEGM. In one example, the end of an atrial repolarization is identified, then the interval from the atrial depolarization to the end of the atrial repolarization is measured. The atrioventricular pacing delay is then set by subtracting an offset value from that interval so as to time delivery of V-pulses prior the end of atrial repolarization. In this manner, atrioventricular pacing delay values are set based only IEGM signals and hence can be set to optimal/preferred values by the device itself without requiring surface electrocardiogram (EKG) signals and Doppler echocardiography or other cardiac performance monitoring techniques. | 03-18-2010 |
20100081952 | DETECTING ISCHEMIA USING AN IMPLANTABLE CARDIAC DEVICE BASED ON MORPHOLOGY OF CARDIAC PRESSURE SIGNAL - Methods and systems are presented for using an ICD to detect myocardial ischemia. One such method includes sensing via an implantable cardiac-rhythm-management device (ICRMD) a signal indicative of cardiac pressure; determining via a processor associated with the ICRMD, a derivative signal that is a first derivative of the sensed signal; measuring via the processor, a maximum positive value of the derivative signal; measuring via the processor, a maximum negative value of the derivative signal; and indicating via the processor, an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value. | 04-01-2010 |
20100100145 | MEASUREMENT OF CARDIAC INFORMATION FOR CRT OPTIMZIATION IN THE PRESENCE OF CONDUCTION DYSFUNCTION OR ATRIAL ARRHYTHMIA - An exemplary method includes delivering a cardiac pacing therapy that includes an atrio-ventricular delay and an interventricular delay, providing a paced propagation delay associated with delivery of a stimulus to a ventricle, delivering a stimulus to the ventricle, sensing an event in the other ventricle caused by the stimulus, determining an interventricular conduction delay value based on the delivering and the sensing, determining a interventricular delay (Δ | 04-22-2010 |
20100100148 | CAPTURE ASSESSMENT AND OPTIMIZATION OF TIMING FOR CARDIAC RESYNCHRONIZATION THERAPY - An exemplary method includes performing a ventricular capture assessment, determining a ventricular paced propagation delay (PPD) and/or an interventricular conduction delay (IVCD) using information acquired during the ventricular capture assessment and optimizing at least an interventricular delay (VV) based at least in part on the ventricular paced propagation delay (PPD) and/or the interventricular conduction delay (IVCD). Another exemplary method includes performing an atrial capture assessment, determining an atrial evoked response width (ΔA) and one or more atrio-ventricular intervals (AR) using information acquired during the atrial capture assessment and optimizing an atrio-ventricular (PV or AV) delay based at least in part on the atrial evoked response width (ΔA) and the one or more atrio-ventricular intervals (AR). Other exemplary methods, devices, systems, etc., are also disclosed. | 04-22-2010 |
20100106214 | Systems and Methods for Exploiting the Tip or Ring Conductor of an Implantable Medical Device Lead During an MRI to Reduce Lead Heating and the Risks of MRI-Induced Stimulation - Systems and methods are provided for reducing heating within pacing/sensing leads of a pacemaker or implantable cardioverter-defibrillator that occurs due to induced radio frequency (RF) currents during a magnetic resonance imaging (MRI) procedure, or in the presence of other sources of strong RF fields. For example, bipolar coaxial leads are described wherein the ring conductor of the lead is disconnected from the ring electrode via a switch in response to detection of MRI fields to convert the ring conductor into an RF shield for shielding the inner tip conductor of the lead so as to reduce the strength of RF currents induced therein and hence reduce tip heating. Other exemplary leads are described wherein a band stop filter is instead used to block RF signals to likewise convert the ring conductor into an RF shield. The switches and band stop filters also help to prevent MRI-induced stimulation. | 04-29-2010 |
20100106227 | Systems and Methods for Disconnecting Electrodes of Leads of Implantable Medical Devices During an MRI to Reduce Lead Heating - Systems and methods are provided for reducing heating within pacing/sensing leads of a pacemaker or implantable cardioverter-defibrillator that occurs due to induced loop currents during a magnetic resonance imaging (MRI) procedure, or in the presence of other sources of strong radio frequency (RF) fields. For example, bipolar coaxial leads are described herein wherein the ring conductor of the lead is disconnected from the ring electrode in response to detection of MRI fields so as to convert the ring conductor into an RF shield for shielding the inner tip conductor of the lead so as to reduce the strength of loop currents induced therein and hence reduce tip heating. Techniques are also described herein for selectively disconnecting the tip electrode of the lead during an MRI procedure, except during actual delivery of pacing pulses, so as to permit delivery of individual pacing pulses to pacemaker dependent patients during the MRI. Still other techniques describe the use of both RF shielding and tip switching. | 04-29-2010 |
20100113944 | INTERPOLATING LEFT VENTRICULAR PRESSURES - Exemplary techniques and systems for interpolating left ventricular pressures are described. One technique interpolates pressures within the left ventricle from blood pressures gathered without directly sensing blood pressure in the left ventricle. | 05-06-2010 |
20100114232 | INITIATION TESTS AND GUIDELINES FOR IMPLEMENTING CARDIAC THERAPY - An exemplary system includes a programmer configured to instruct an implantable device and a qualification module with instructions to call for tests performed by an implantable device configured for delivery of CRT, to receive results from the tests, to analyze the results and to decide, based on the analysis, if the patient qualifies for automatic, implantable device-based optimization of one or more CRT parameters and, only if the patient qualifies for automatic, implantable device-based optimization of one or more CRT parameters, presenting a graphical user interface that comprises a selectable control to enable an algorithm of an implantable device to automatically optimize at least one of the one or more cardiac resynchronization therapy parameters. Other exemplary methods, devices, systems, etc., are also disclosed. | 05-06-2010 |
20100114275 | IMPLANTABLE MEDICAL LEAD INCLUDING WINDING FOR IMPROVED MRI SAFETY - An implantable medical lead for coupling to an implantable pulse generator may be configured for improved MRI safety. The lead may include: a tubular body including a proximal end and a distal end; a first electrode operably coupled to the tubular body near the distal end; and a first electrical coil conductor extending distally through the body from the proximal end and electrically connected to the first electrode. The coil conductor may include at least one transition in which the coil conductor changes from being helically coiled in a first direction to being helically coiled in a second opposite direction. A method of forming such a lead may include: helically coiling at least a portion of a first electrical coil conductor by winding the coil conductor in a first direction, and winding the coil conductor in a second direction opposite the first direction so as to form a transition. | 05-06-2010 |
20100114276 | MRI COMPATIBLE IMPLANTABLE MEDICAL LEAD AND METHOD OF MAKING SAME - An implantable medical lead is disclosed herein. In one embodiment, the lead includes a body and an electrical pathway. The body may include a distal portion with an electrode and a proximal portion with a lead connector end. The electrical pathway may extend between the electrode and lead connector end and include a coiled inductor including a first portion and a second portion at least partially magnetically decoupled from the first portion. The first portion may include a first configuration having a first SRF. The second portion may include a second configuration different from the first configuration. The second configuration may have a second SRF different from the first SRF. For example, the first SRF may be near 64 MHz and the second SRF may be near 128 MHz. | 05-06-2010 |
20100114277 | MRI COMPATIBLE IMPLANTABLE MEDICAL LEAD AND METHOD OF MAKING SAME - An implantable medical lead is disclosed herein. The lead may include a body and an electrical pathway. The body may include a distal portion with an electrode and a proximal portion with a lead connector end. The electrical pathway may extend between the electrode and lead connector end and may include a coiled inductor including first and second electrically conductive filar cores. The first and second filar cores may be physically joined into a unified single piece proximal terminal on a proximal end of the coiled inductor. The first and second cores may be physically joined into a unified single piece distal terminal on a distal end of the coiled inductor. The first and second filar cores may be helically wound into a coiled portion between the proximal and distal terminals, the filar cores being electrically isolated from each other in the coiled portion. The proximal terminal may be electrically coupled to a portion of the electrical pathway extending to the lead connector end, and the distal terminal may be electrically coupled to a portion of the electrical pathway extending to the electrode. | 05-06-2010 |
20100121179 | Systems and Methods for Reducing RF Power or Adjusting Flip Angles During an MRI for Patients with Implantable Medical Devices - Techniques are provided for controlling magnetic resonance imaging (MRI) systems for imaging patients having implantable medical devices. In one example, a scaling factor is determined based on maximum local specific absorption rate (SAR) values for patients with implants and for patients without implants. The MRI determines the radio-frequency (RF) power and flip angle sequences to be used for a given patient, without regard to the presence of an implanted device. However, for patients with implanted devices, the MRI reduces its RF power or adjusts its flip angle sequences based on the scaling factor so as to ensure that the local SAR within the patient does not exceed acceptable levels. In other examples, rather than reducing the RF power of the MRI or adjusting the flip angles, blankets or pads formed of RF power attenuating materials, such as dielectrics, are positioned around the patient near the implantable device, to reduce the RF power incident tissues adjacent the device. | 05-13-2010 |
20100121401 | OPTIMIZATION OF CARDIAC PACING THERAPY BASED ON PACED PROPAGATION DELAY - An exemplary method includes delivering stimulation energy via a right ventricular site; sensing an evoked response caused by the delivered stimulation energy at the right ventricular site; calculating a paced propagation delay for the right ventricular site (PPD | 05-13-2010 |
20100121403 | IDENTIFICATION OF ELECTRO-MECHANICAL DYSYNCHRONY WITH A NON-CARDIAC RESYNCHRONIZATION THERAPEUTIC DEVICE - An implantable cardiac therapy device and methods of using a device including an implantable stimulation pulse generator, one or more implantable leads defining sensing and stimulation circuits adapted to sense and deliver therapy in at least one right side heart chamber, and an implantable controller in communication with the stimulation pulse generator and the one or more patient leads so as to receive sensed signals indicative of a patient's physiologic activity and deliver indicated therapy. The controller is adapted to monitor at least one indicator of cardiac dysynchrony and to compare the at least one indicator to a determined dysynchrony threshold. The threshold is determined for indications that the patient be further evaluated for cardiac resynchronization therapy. The controller is further adapted to set an alert when the at least one indicator exceeds the threshold to indicate to a clinician that evaluation for bi-ventricular pacing might be indicated. | 05-13-2010 |
20100138192 | Systems and Methods for Selecting Components for Use in RF Filters Within Implantable Medical Device Leads Based on Inductance, Parasitic Capacitance and Parasitic Resistance - Techniques are provided for selecting and configuring inductors for use in radio-frequency (RF) inductive filters within pacing/sensing leads of pacemakers or implantable cardioverter-defibrillators. The filters are employed to reduce heating due to induced currents caused by magnetic resonance imaging (MRI) procedures or other sources of strong RF fields. In particular, techniques are provided for determining optimal inductance values by taking into account parasitic resistances and parasitic capacitances of the inductors. Tolerances of the inductive devices are also taken into account. | 06-03-2010 |
20100152802 | System and Method for Monitoring Patient Condition Using Atrial Timing Characteristics - A system and method for using an implantable cardiac stimulation device to monitor a patient for the progress of an existing condition and/or early detection of an emerging condition based, at least in part, on measuring and evaluating the timing characteristics of the patient's atrial activity. The atrial timing characteristics are used as indicators or predictors of conditions of interest, such as heart failure (HF) and atrial fibrillation (AF). In certain implementations, the system can determine discriminating indicators of a predominant underlying cause of a condition, such as between vagal and non-vagal AF, as an indicator of a suggested therapy. The system can store data corresponding to the observed atrial timing for trending analysis as well as transmit data for offline analysis, such as via an external device. | 06-17-2010 |
20100318164 | MRI COMPATIBLE IMPLANTABLE LEAD WITH A DISTRIBUTED BAND STOP FILTER - An implantable lead comprises a lead connector and an electrode configured to perform at least one of a sensing operation and delivery of electrical energy. The implantable lead also includes a lead body having a proximal end portion and a distal end portion with the connector located at the proximal end and the electrode located at the distal end. The lead body of the implantable lead has a length that includes a lumen that extends longitudinally between the distal and proximal end portions. The implantable lead further includes a coil conductor that has spiral sections wound within the lumen and extend from the lead connector along the lumen. The coil conductor couples the lead connector to the electrode. The coil conductor has an insulation material provided on at least a segment of the coil conductor. The insulation material has a dielectric constant set such that the coil conductor forms a distributed band stop filter when exposed to a known RF magnetic field. The coil conductor comprises a filar wound into spiral sections to fit within and extend along the lumen in the lead. The filar of the coil conductor has an insulation coating provided thereon with the insulation coating forming a dielectric layer between adjacent spiral sections of the filar. | 12-16-2010 |
20110015713 | SYSTEMS AND METHODS FOR REDUCING LEAD HEATING AND THE RISKS OF MRI-INDUCED STIMULATION - An implantable medical lead is described herein wherein the lead includes a tubular body, an electrode, a lead connector end and a helical conductor. The tubular body includes a proximal end and a distal end. The electrode is coupled to the body near the distal end. The lead connector end is coupled to the body near the proximal end. The helical conductor coil extends through the body from the lead connector end to the electrode. In extending through the body, the helical conductor coil first extends distally for a distance, then proximally for the distance, and then distally for the distance within a single helical layer of the helical conductor coil. The electrode may be a ring electrode. | 01-20-2011 |
20110022106 | SYSTEMS AND METHODS FOR OPTIMIZING VENTRICULAR PACING DELAYS DURING ATRIAL FIBRILLATION - Techniques are provided for use by implantable medical devices for controlling ventricular pacing, particularly during atrial fibrillation. In one example, during a V sense test for use in optimizing ventricular pacing, the implantable device determines relative degrees of variation within antecedent and succedent intervals detected between ventricular events sensed on left ventricular (LV) and right ventricular (RV) sensing channels. Preferred or optimal ventricular pacing delays are then determined, in part, based on a comparison of the relative degrees of variation obtained during the V sense test. In another example, during RV and LV pace tests, the device distinguishes QRS complexes arising due to interventricular conduction from QRS complexes arising due to atrioventricular conduction from the atria, so as to permit the determination of correct paced interventricular conduction delays for the patient. The paced interventricular conduction delays are also used to optimize ventricular pacing. Biventricular and monoventricular pacing regimes are provided. | 01-27-2011 |
20110022110 | SYSTEMS AND METHODS FOR OPTIMIZING VENTRICULAR PACING DELAYS FOR USE WITH MULTI-POLE LEADS - Techniques are provided for use by implantable medical devices for controlling ventricular pacing using a multi-pole left ventricular (LV) lead. In one example, a single “V sense” test is performed to determine intrinsic interventricular conduction time delays (Δ | 01-27-2011 |
20110022111 | SYSTEMS AND METHODS FOR OPTIMIZING VENTRICULAR PACING DELAYS DURING ATRIAL FIBRILLATION - Techniques are provided for use by implantable medical devices for controlling ventricular pacing, particularly during atrial fibrillation. In one example, during a V sense test for use in optimizing ventricular pacing, the implantable device determines relative degrees of variation within antecedent and succedent intervals detected between ventricular events sensed on left ventricular (LV) and right ventricular (RV) sensing channels. Preferred or optimal ventricular pacing delays are then determined, in part, based on a comparison of the relative degrees of variation obtained during the V sense test. In another example, during RV and LV pace tests, the device distinguishes QRS complexes arising due to interventricular conduction from QRS complexes arising due to atrioventricular conduction from the atria, so as to permit the determination of correct paced interventricular conduction delays for the patient. The paced interventricular conduction delays are also used to optimize ventricular pacing. Biventricular and monoventricular pacing regimes are provided. | 01-27-2011 |
20110022112 | SYSTEMS AND METHODS FOR DETERMINING VENTRICULAR PACING SITES FOR USE WITH MULTI-POLE LEADS - Techniques are provided for use by implantable medical devices for controlling multi-site left ventricular (MSLV) pacing using a multi-pole left ventricular (LV) lead. In various examples, a reduced number of “V sense”, “RV pace”, and “LV pace” tests are performed to determine preferred or optimal interventricular pacing delays (VV) for use with MSLV pacing. Additionally, techniques are described for sorting the order by which LV sites are to be paced during MSLV pacing. Furthermore, techniques are described for detecting and addressing circumstances where AV/PV delays are longer than corresponding AR/PR delays during MSLV. | 01-27-2011 |
20110034979 | IMPLANTABLE MEDICAL DEVICE LEAD INCORPORATING INSULATED COILS FORMED AS INDUCTIVE BANDSTOP FILTERS TO REDUCE LEAD HEATING DURING MRI - To provide radio-frequency (RF) bandstop filtering within an implantable lead, such as a pacemaker lead, one or more segments of the tip and ring conductors of the lead are formed as insulated coils to function as inductive band stop filters. By forming segments of the conductors into insulated coils, a separate set of discrete or distributed inductors is not required, yet RF filtering is achieved to, e.g., reduce lead heating during magnetic resonance imaging (MRI) procedures. To enhance the degree of bandstop filtering at the RF signal frequencies of MRIs, additional capacitive elements are added. In one example, the ring electrode of the lead is configured to provide capacitive shunting to the tip conductor. In another example, a capacitive transition is provided between the outer insulated coil and proximal portions of the ring conductor. In still other examples, conducting polymers are provided to enhance capacitive shunting. The insulated coils may be spaced at ¼ wavelength locations. | 02-10-2011 |
20110034983 | IMPLANTABLE MEDICAL DEVICE LEAD INCORPORATING A CONDUCTIVE SHEATH SURROUNDING INSULATED COILS TO REDUCE LEAD HEATING DURING MRI - A conducting sheath is provided along at least a portion of an implantable medical device lead, and preferably along substantially its entire length, for mitigating heating problems arising during magnetic resonance imaging (MRI) procedures, particularly problems arising due to a problem described herein as the “coiling effect.” During device implant, the clinician may elect to wrap or coil excess proximal portions of leads around or under the medical device being implanted. Thereafter, during MRI procedures, shunt capacitance may develop between the housing of the implantable device and insulated coils within the proximal portions of the lead that are near the device, resulting in greater lead heating during the MRI. The conducting sheath helps suppress induced currents and also reduces or eliminates shunt capacitance. The conducting sheath may be, for example, formed using a metal mesh or a conducting polymer tube incorporating non-ferrous metal powders. The sheath may be formed in ¼ wavelength segments. | 02-10-2011 |
20110060230 | DETERMINATION OF DIASTOLIC HEART FAILURE - An exemplary method includes detecting a change in state of a cardiac valve, detecting elongation of the left ventricle substantially along its major axis, determining a time difference between the change in state of the cardiac valve and the elongation of the left ventricle and, based at least in part on the time difference, deciding whether a diastolic abnormality exists. Other exemplary methods, devices, systems, etc., are also disclosed. | 03-10-2011 |
20110066028 | SYSTEMS AND METHODS FOR REMOTE MONITORING OF IMPLANTABLE MEDICAL DEVICE LEAD TEMPERATURES DURING AN MRI PROCEDURE - Systems and methods are provided for detecting and responding to excessive heating of implantable medical device leads, such as leads used with pacemakers or implantable cardioverter-defibrillators (ICDs), during a magnetic resonance imaging (MRI) procedure. In one example, a critical temperature is determined for the lead that is representative, e.g., of the temperature at which tissue damage might occur or pacing/sensing might be significantly impaired. A temperature threshold is then set based on the critical temperature by subtracting a predetermined safety margin. Lead temperatures are then sensed during the MRI procedure. The lead temperatures are compared against the threshold and suitable warnings are transmitted to an external monitoring system if lead temperatures exceed their thresholds so that the attending personnel can take corrective action. The implantable device may also be programmed to take corrective action, such as automatically changing pacing modes, adjusting pulse magnitudes or sensitivity values, etc. | 03-17-2011 |
20110098546 | ASSESSING MEDICAL CONDITIONS BASED ON VENOUS OXYGEN SATURATION AND HEMATOCRIT INFORMATION - Methods for assessing, diagnosing and treating medical conditions using SvO | 04-28-2011 |
20110098772 | SYTEMS AND METHODS FOR DETERMINING OPTIMAL ELECTRODE PAIRS FOR USE IN BIVENTRICULAR PACING USING MULTI-POLE VENTRICULAR LEADS - Techniques are provided for use by implantable medical devices for determining a preferred or optimal pair of electrodes for delivering biventricular pacing therapy. In one example, the implantable device is equipped with a right ventricular (RV) lead and a multi-pole left ventricular (LV) lead. Briefly, for each of a selected set of RV/LV electrode pairs, electrocardiac parameters are detected within a patient in which the device is implanted, including parameters representative of an intrinsic biventricular electrical separation between LV and RV and parameters representative of a mechanical contraction delay in the LV. An optimal RV/LV electrode pair is then determined for delivering biventricular pacing based on an analysis of the intrinsic biventricular electrical separation and the mechanical contraction delay. Pacing latency, pacing delay from LV to RV, and the maximum slope of an LV evoked response may be used as proxies or surrogates for mechanical contraction delay. | 04-28-2011 |
20110106231 | MRI-COMPATIBLE IMPLANTABLE LEAD HAVING A HEAT SPREADER AND METHOD OF USING SAME - An implantable lead is provided that comprises a lead body and a header assembly. The lead body has a distal end and a proximal end. The lead body is configured to be implanted in a patient. The header assembly is provided at the distal end of the lead body and includes an internal chamber and a tissue engaging end. An electrode is provided on the header assembly. The electrode is configured to deliver a stimulating pulse. A resonant inductor is located within the chamber in the header assembly. An electrically floating heat spreader is provided on the header assembly. The heat spreader is located proximate to the resonant inductor and is positioned on the header assembly to cover at least a portion of the resonant inductor. The heat spreader is thermally coupled to the resonant inductor to convey thermal energy away from the header assembly. | 05-05-2011 |
20110125240 | BIOCOMPATIBLE INDUCTOR FOR IMPLANTABLE LEAD AND METHOD OF MAKING SAME - A biocompatible inductor for an implantable medical lead is disclosed herein. In one embodiment the biocompatible inductor may include a biocompatible bobbin and a wire wound about a barrel of the biocompatible bobbin to form a coil. The wire may include an electrically conductive core, an electrically conductive biocompatible jacket extending over the core, and a coating of high dielectric strength insulation material extending over the jacket. Additionally, the biocompatible inductor may include medical adhesive located in gaps within the coil and a polyester shrink tube covering the coil. | 05-26-2011 |
20110137364 | MULTI-SITE PACING FOR ATRIAL TACHYARRHYTHMIAS - Tachyarrhythmia is treated by applying anti-tachycardia pacing through at least one multi-site electrode set located on, in or around the heart. The electrode set is arranged and located such that an electrical activation pattern having a wave-front between substantially flat and concave is generated through a reentrant circuit associated with the tachyarrhythmia. The electrode set may be one of a plurality of predefined, multi-site electrode sets located on, in or around the atria. Alternatively, the electrode set may be formed using at least two selectable electrodes located on, in or around the atria | 06-09-2011 |
20110137369 | OPTIMAL PACING CONFIGURATION VIA VENTRICULAR CONDUCTION DELAYS - An exemplary method for optimizing pacing configuration includes providing distances between electrodes of a series of three or more ventricular electrodes associated with a ventricle; selecting a ventricular electrode from the series; delivering energy to the ventricle via the selected ventricular electrode, the energy sufficient to cause an evoked response; acquiring signals of cardiac electrical activity associated with the evoked response via non-selected ventricular electrodes of the series; based on signals of cardiac electrical activity acquired via the non-selected ventricular electrodes and the distances, determining conduction velocities; based on the conduction velocities, deciding if the selected ventricular electrode is an optimal electrode for delivery of a cardiac pacing therapy; and, if the selected ventricular electrode comprises an optimal electrode for delivery of the cardiac pacing therapy, calling for delivery of the cardiac pacing therapy using the selected ventricular electrode. Various other methods, devices, systems, etc., are also disclosed. | 06-09-2011 |
20110144722 | MRI-COMPATIBLE IMPLANTABLE LEAD WITH IMPROVED LC RESONANT COMPONENT - An implantable lead is provided that comprises a lead body extending along a longitudinal axis. The lead body includes a distal end and a proximal end and a lumen within the lead body. The lead also includes a header assembly provided at the distal end of the lead body. The header assembly includes a tissue engaging end. The lead also includes an electrode provided on the header assembly. The electrode is configured to deliver stimulating pulses. The lead also includes an electrode conductor provided within the lumen of the lead body and extending from the electrode to the proximal end of the lead body. An LC resonant component is provided in at least one of the lead body and the header assembly. The LC resonant component comprises a capacitor having an elongated shape that extends along the longitudinal axis of the lead body. The capacitor has a core that is located about the longitudinal axis of the lead body. The LC resonant component further comprises an inductor wire wound in multiple turns about an exterior surface of the capacitor to form an inductor. | 06-16-2011 |
20110152990 | MRI COMPATIBLE LEAD EMPLOYING MULTIPLE MINIATURE INDUCTORS - An implantable medical lead is disclosed herein. The lead includes a first electrode and a first electrical circuit. The first electrode is near a distal portion of the lead. The first electrical circuit extends through the lead to the first electrode and includes at least one conductor and a first band stop filter coupled between the distal end of the conductor and the electrode. The first band stop filter includes a first group of inductors in parallel and a second group of inductors in parallel. The first group is in series with the second group. The first group of inductors may include a self resonant L. The first group of inductors may include a self resonant tank LC. The first group of inductors may include a miniature self resonant L or miniature self resonant tank LC. The first group of inductors may include an integrated circuit of L and C components. | 06-23-2011 |
20110196441 | SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE CARDIAC PACING AND SENSING CONFIGURATIONS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described. | 08-11-2011 |
20110196442 | SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE CARDIAC PACING AND SENSING CONFIGURATIONS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described. | 08-11-2011 |
20110301676 | REDUCING RESONANT CURRENTS IN A RESONATING CIRCUIT DURING MRI SCANS - An implantable medical lead configured to reduce resonant currents in a resonating circuit during MRI scans and a method of manufacturing the same are disclosed herein. The method of manufacturing includes providing a medical lead comprising an electrical pathway from a tip electrode located at a distal end of the lead to a lead connector located at a proximal end and coupling a resonating circuit to the tip electrode such that the resonating circuit is in the electrical pathway for the tip electrode. Further, the method includes coupling a capacitive element to a proximal end of the resonating circuit. The capacitive element is configured to shunt at least part of an RF current induced on the electrical pathway into surrounding tissue or fluid and also works as a heat sink to spread the heat from the internal LC resonant circuit. | 12-08-2011 |
20120109244 | PARAMETERS IN MONITORING CARDIAC RESYNCHRONIZATION THERAPY RESPONSE - An exemplary method includes analyzing data from multiple parameters detected by an implantable cardiac device and determining an extent of heart failure (HF) progression. The parameters may include electrical synchrony, mechanical synchrony, and/or electromechanical delay (EMD). A change in a width of the native and/or paced QRS complex may provide a measure of electrical synchrony. Characterization of a delay between local cardiac impedance (CI) and global CI may provide a mechanical dyssynchrony index. A delay between the timing of a peak of the QRS complex and LV contraction (e.g., detected by SVC-CAN impedance) may provide a measure for EMD. Each of the parameters may be analyzed independently or collectively to assess HF progression. Based on the analysis, one or more pacing delays (e.g. AV/PV and/or VV) of the implantable cardiac device may be modified. Other exemplary methods, devices, systems, etc., are also disclosed. | 05-03-2012 |
20120109273 | IMPLANTABLE LEAD ASSEMBLY HAVING A PLURALITY OF INDUCTORS - An implantable lead assembly includes an elongated body, a bobbin, and a conductor. The elongated body includes a distal end having an electrode and a proximal end having a header connector portion for coupling the elongated body with an implantable medical device. The bobbin is disposed in the elongated body. The conductor is disposed in the elongated body and is electrically coupled with the header connector portion and the electrode. The conductor is wound around the bobbin to form first and second inductive coils that are axially separated from each other by an inter-coil gap formed from the bobbin. The first and second inductive coils have different self resonant frequencies. | 05-03-2012 |
20120116473 | MEASUREMENT OF CARDIAC INFORMATION FOR CRT OPTIMZIATION IN THE PRESENCE OF CONDUCTION DYSFUNCTION OR ATRIAL ARRHYTHMIA - An exemplary method includes delivering a cardiac pacing therapy that includes an atrio-ventricular delay and an interventricular delay, providing a paced propagation delay associated with delivery of a stimulus to a ventricle, delivering a stimulus to the ventricle, sensing an event in the other ventricle caused by the stimulus, determining an interventricular conduction delay value based on the delivering and the sensing, determining a interventricular delay (Δ | 05-10-2012 |
20120130460 | HYBRID IMPLANTABLE LEAD ASSEMBLY - A hybrid implantable lead assembly includes a lead body, distal, proximal, and intermediate electrodes, coiled inductive elements, and an inductive circuit. The proximal and intermediate electrodes are disposed on the lead body between the distal electrode and a proximal end of the lead body. The proximal and intermediate electrodes are electrically connected with first and second pathways to sense electrical activity and/or deliver stimulus pulses. The first and second coiled inductive elements are electrically connected to the proximal and intermediate electrodes, respectively. The inductive circuit is electrically connected to the distal electrode. The first coiled inductive element and/or the second coiled inductive element has a first type of inductor structure and the inductive circuit has a different, second type of inductor structure that prevent magnetically induced electric current from flowing to the electrodes. | 05-24-2012 |
20120136406 | Systems and Methods for Determining Optimal Atrioventricular Pacing Delays Based on Cardiomechanical Delays - Techniques are provided for use with implantable medical devices such as pacemakers for optimizing atrioventricular (AV) pacing delays for use with cardiac resynchronization therapy (CRT). In one example, the end of atrial mechanical contraction and the onset of isovolumic ventricular mechanical contraction are detected within a patient in which the device is implanted based on cardiomechanical signals, such as cardiogenic impedance (Z) signals, S1 heart sounds or left atrial pressure (LAP) signals. Then, a cardiomechanical time delay (MC_AV) between the end of atrial contraction and the onset of isovolumic ventricular contraction is determined. AV pacing delays are set based on MC_AV to align the end an atrial kick with the onset of isovolumic ventricular contraction. Thereafter, pacing is controlled based on the AV pacing delays. | 05-31-2012 |
20120136421 | IMPLANTABLE MEDICAL DEVICE LEAD WITH INDUCTIVE-CAPACITIVE FILTERS HAVING INDUCTORS WITH PARALLEL CAPACITORS TO REDUCE LEAD HEATING DURING MRI - To provide radio-frequency (RF) bandstop filtering within an implantable lead for use in reducing lead heating during magnetic resonance imaging (MRI) procedures, parallel inductive-capacitive (LC) filters are provided within the lead. In one example, the ring electrode of the lead is configured to function as one of the capacitive elements of the parallel LC filter to help provide LC bandstop filtering along the ring conductor of the lead. In another example, capacitive plates are provided that sandwich an inductor mounted near the tip of the lead to provide parallel LC bandstop filtering along the tip conductor of the lead. | 05-31-2012 |
20120165890 | Systems and Methods for Determining Optimal Interventricular Pacing Delays Based on Electromechanical Delays - Techniques are provided for use with implantable medical devices such as pacemakers for optimizing interventricular (VV) pacing delays for use with cardiac resynchronization therapy (CRT). In one example, ventricular electrical depolarization events are detected within a patient in which the device is implanted. The onset of isovolumic ventricular mechanical contraction is also detected based on cardiomechanical signals detected by the device, such as cardiogenic impedance (Z) signals, S1 heart sounds or left atrial pressure (LAP) signals. Then, an electromechanical time delay (T_QtoVC) between ventricular electrical depolarization and the onset of isovolumic ventricular mechanical contraction is determined. VV pacing delays are set to minimize the time delay to the onset of isovolumic ventricular mechanical contraction. Various techniques for identifying the onset of isovolumic ventricular contraction based on Z, S1 or LAP or other cardiomechanical signals are described. In some examples, CRT nonresponders are specifically identified and/or heart failure progression is tracked. | 06-28-2012 |
20120165892 | SYSTEMS AND METHODS FOR OPTIMIZING AV/VV PACING DELAYS USING COMBINED IEGM/IMPEDANCE-BASED TECHNIQUES FOR USE WITH IMPLANTABLE MEDICAL DEVICES - Systems and methods are provided wherein intracardiac electrogram (IEGM) signals are used to determine a set of preliminary optimized atrioventricular (AV/PV) and interventricular (VV) pacing delays. In one example, the preliminary optimized AV/VV pacing delays are used as a starting point for further optimization based on impedance signals such as impedance signals detected between a superior vena cava (SVC) coil electrode and a device housing electrode, which are influenced by changes in stroke volume within the patient. Ventricular pacing is thereafter delivered using the AV/VV pacing delays optimized via impedance. In another example, parameters derived from IEGM signals are used to limit the scope of an impedance-based optimization search to reduce the number of pacing tests needed during impedance-based optimization. Biventricular and multi-site left ventricular (MSLV) examples are described. | 06-28-2012 |
20120197149 | SYSTEM AND METHOD FOR DISTINGUISHING AMONG CARDIAC ISCHEMIA, HYPOGLYCEMIA AND HYPERGLYCEMIA USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia. | 08-02-2012 |
20120203090 | SYSTEMS AND METHODS FOR TRACKING STROKE VOLUME USING HYBRID IMPEDANCE CONFIGURATIONS EMPLOYING A MULTI-POLE IMPLANTABLE CARDIAC LEAD - Techniques are provided for use with an implantable medical device for assessing stroke volume or related cardiac function parameters such as cardiac output based on impedance signals obtained using hybrid impedance configurations that exploit a multi-pole cardiac pacing/sensing lead implanted near the left ventricle. In one example, current is injected between a large and stable reference electrode and a ring electrode in the RV. The reference electrode may be, e.g., a coil electrode implanted within the superior vena cava (SVC). Impedance values are measured along a set of different sensing vectors between the reference electrode and each of the electrodes of the multi-pole LV lead. Stroke volume is then estimated and tracked within the patient using the impedance values. In this manner, a hybrid impedance detection configuration is exploited whereby one vector is used to inject current and other vectors are used to measure impedance. | 08-09-2012 |
20120215271 | SYSTEMS AND METHODS FOR DISCONNECTING ELECTRODES OF LEADS OF IMPLANTABLE MEDICAL DEVICES DURING AN MRI TO REDUCE LEAD HEATING - Systems and methods are provided for reducing heating within pacing/sensing leads of a pacemaker or implantable, cardioverter-defibrillator that occurs due to induced loop currents during a magnetic resonance imaging (MRI) procedure, or in the presence of other sources of strong radio frequency (RF) fields. For example, bipolar coaxial leads are described herein wherein the ring conductor of the lead is disconnected from the ring electrode in response to detection of MRI fields so as to convert the ring conductor into an RF shield for shielding the inner tip conductor of the lead so as to reduce the strength of loop currents induced therein and hence reduce tip heating. | 08-23-2012 |
20120226140 | SYSTEMS AND METHODS FOR REMOTE MONITORING OF SIGNALS SENSED BY AN IMPLANTABLE MEDICAL DEVICE DURING AN MRI - Systems and methods are provided for allowing an implantable medical device, such as pacemaker, to properly sense electrophysiological signals and hemodynamic signals within a patient during a magnetic resonance imaging (MRI) procedure. Systems and methods are also provided for allowing the implantable medical device to transmit the sensed data to an external monitoring system during the MRI procedure so that attending medical personnel can closely monitor the health of the patient and the operation of the implantable device during the MRI. These improvements provide the attending personnel with information needed to determine whether the MRI should be suspended in response to induced tachyarrhythmias or other adverse conditions within the patient. | 09-06-2012 |
20130053912 | SYSTEMS AND METHODS FOR ASSESSING HEART FAILURE AND CONTROLLING CARDIAC RESYNCHRONIZATION THERAPY USING HYBRID IMPEDANCE MEASUREMENT CONFIGURATIONS - Techniques are provided for use with an implantable medical device for detecting and assessing heart failure and for controlling cardiac resynchronization therapy (CRT) based on impedance signals obtained using hybrid impedance configurations. The hybrid configurations exploit right atrial (RA)-based impedance measurement vectors and/or left ventricular (LV)-based impedance measurement vectors. In one example, current is injected between the device case and a ring electrode in the right ventricle (RV) or RA. RA-based impedance values are measured along vectors between the device case and an RA electrode. LV-based impedance values are measured along vectors between the device case and one or more electrodes of the LV. Heart failure and other cardiac conditions are detected and tracked using the measured impedance values. CRT delay parameters are also optimized based impedance. In this manner, multiple hybrid impedance measurement configurations are exploited whereby different vectors are used to inject current and measure impedance. | 02-28-2013 |
20130066399 | INTRA-PERICARDIAL MEDICAL DEVICE - An intra-pericardial medical device is provided that comprises a lead body having a proximal portion, a distal end portion, and an intermediate portion extending between the proximal portion and the distal end portions. An intra-pericardial medical device further includes the control logic housed with the lead body and an energy source housed within the lead body. A stimulus conductor is included and extends along the lead body. An electrode is joined to the stimulus conduct near the distal end portion, where the electrode configured to deliver stimulus pulses. A telemetry conductor is provided within the lead and extends from the proximal portion and along the intermediate portion of the lead body. The telemetry conductor is wound into a series of coil groups to form inductive loops for at least one of receiving and transmitting radio frequency (RF) energy. | 03-14-2013 |
20130073020 | HEADER EMBEDDED FILTER FOR IMPLANTABLE MEDICAL DEVICE - A filter circuit embedded into a header of an implantable medical device attenuates energy that may otherwise enter the implantable medical device. At MRI frequencies, the impedance of the filter circuit is much higher than the impedance of the feedthrough capacitor of the implantable medical device. Thus, MRI-induced current that would otherwise enter the implantable medical device is limited by the filter circuit. Consequently, localized device heating that may otherwise occur during MRI scanning is significantly reduced by operation of the filter circuit. In some implementations, the header embedded filter circuit is electrically isolated from the header housing. In this way, localized heating of the header housing also may be avoided. | 03-21-2013 |
20130110127 | MULTI-PIECE DUAL-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE AND METHOD OF IMPLANTING SAME | 05-02-2013 |
20130116529 | LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH BUILT-IN TELEMETRY SYSTEM - A leadless intra-cardiac medical device is configured to be implanted entirely within a heart of a patient. The device includes an intra-cardiac extension and a housing. The intra-cardiac extension includes a loop body having at least one loop segment retaining at least one coil group that is configured to one or both of receive and transmit radio frequency (RF) energy, wherein the loop body is configured to extend into a first chamber of the heart. The housing is in electrical communication within the loop body, and includes a transceiver, control logic and an energy source. The housing is configured to be securely attached to an interior wall portion of a second chamber of the heart, wherein the transceiver is configured to communicate with an external device through the RF energy. | 05-09-2013 |
20130116583 | SYSTEMS AND METHODS FOR PREDICTING AND CORROBORATING PULMONARY FLUID OVERLOADS USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for corroborating a preliminary detection of pulmonary fluid overload within a patient made initially based on transthoracic impedance. In one example, corroborative parameters pertaining to hematocrit, device pocket fluid accumulations, heart rate variability (HRV) and mean atrial tachycardia/atrial fibrillation (AT/AF) times are evaluated to confirm the fluid overload. Techniques are also provided for generating proxies for evaluating hematocrit and device pocket fluid accumulation based on certain impedance measurements. Still further, techniques are provided for predicting a possible pulmonary fluid overload based on trends in HRV or mean AT/AF times. System and method examples are set forth herein. | 05-09-2013 |
20130116740 | SINGLE-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH DUAL-CHAMBER FUNCTIONALITY AND SHAPED STABILIZATION INTRA-CARDIAC EXTENSION - A leadless intra-cardiac medical device (LIMD) configured to be implanted entirely within a heart of a patient includes a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart. | 05-09-2013 |
20130116741 | DUAL-CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH INTRA-CARDIAC EXTENSION - A leadless intra-cardiac medical device includes a housing that is configured to be implanted entirely within a single local chamber of the heart. A first electrode is provided on the housing at a first position such that when the housing is implanted in the local chamber, the first electrode engages the local wall tissue at a local activation site within the conduction network of the local chamber. An intra-cardiac extension is coupled to the housing and configured to extend from the local chamber into an adjacent chamber of the heart. A stabilization arm of the intra-cardiac extension engages the adjacent chamber. A second electrode on the intra-cardiac extension engages distal wall tissue at a distal activation site within the conduction network of the adjacent chamber. | 05-09-2013 |
20130123876 | SYSTEMS AND METHODS FOR DETERMINING INDUCTANCE AND CAPACITANCE VALUES FOR USE WITH LC FILTERS WITHIN IMPLANTABLE MEDICAL DEVICE LEADS TO REDUCE LEAD HEATING DURING MRI - Techniques are provided for configuring filters for reducing heating within pacing/sensing leads of a pacemaker or implantable cardioverter-defibrillator that might occur due to induced currents during a magnetic resonance imaging (MRI) procedure or in the presence of other sources of strong radio frequency (RF) fields. In particular, techniques are provided for selecting inductors and capacitors for use in LC filters while taking into account the tolerances of the component devices, as well as the target impedance of the components and the particular RF frequencies to be filtered. | 05-16-2013 |
20130131527 | METHOD FOR GUIDING AND MONITORING INTRAPERICARDIAL LEAD POSITION FOR AN INTRAPERICARDIAL LEAD SYSTEM - A first cardiac signal associated with an activity of a first implant site of a heart during a cardiac cycle is sensed. A second cardiac signal is sensed using an intrapericardial lead located on an epicardial surface proximate a second implant site of the heart. The second cardiac signal is associated with an activity of the second implant site during the cardiac cycle. A timing delay between the activity of the first implant site and the activity of the second implant site is obtained and analyzed to determine if the intrapericardial lead location is appropriate. The preceding is repeated until an appropriate intrapericardial lead location is determined. Other measurements obtained during implant determine whether the intrapericardial lead location is at or near slow conduction zone and whether the intrapericardial lead is placed at the location having the greatest mechanical delay. Post implant measurements determine whether the intrapericardial lead has migrated. | 05-23-2013 |
20130138006 | SINGLE CHAMBER LEADLESS INTRA-CARDIAC MEDICAL DEVICE HAVING DUAL CHAMBER SENSING WITH SIGNAL DISCRIMINATION - A leadless intra-cardiac medical device (LIMD) includes multiple electrodes that allow for stimulation and sensing of the right ventricle (RV) and sensing of the right atrium (RA), even though it is entirely located in the RV. The LIMD includes a housing having a proximal end configured to engage local tissue in the local chamber and electrodes located at multiple locations along the housing. Sensing circuitry is configured to define a far field (FF) channel between a first combination of the electrodes to sense FF signals occurring in the adjacent chamber. The sensing circuitry is configured to define a near field (NF) channel between a second combination of the electrodes to sense NF signals occurring in the local chamber. A controller is configured to analyze the NF and FF signals to determine whether the NF and FF signals collectively indicate that a validated event of interest occurred in the adjacent chamber. | 05-30-2013 |
20130165801 | PASSIVE PRESSURE SENSOR FOR IMPLANTABLE LEAD - A passive pressure sensor is used with an implantable lead to measure pressure within a patient's heart. In some embodiments, the passive pressure sensor is incorporated into an implantable lead. In other embodiments, the passive pressure sensor is incorporated into a device that is slid onto an implantable lead. | 06-27-2013 |
20130282087 | IMPLANTABLE LEAD ASSEMBLY HAVING A PLURALITY OF INDUCTORS - In accordance with an embodiment, an implantable lead assembly is provided comprised of an elongated body including a distal end, a proximal end having a header connector portion for coupling the elongated body with an implantable medical device, and an intermediate segment located between the distal and proximal ends. An intermediate electrode is disposed at the intermediate segment along the elongated body. A conductor is disposed in the elongated body and electrically coupled with the header connector portion and the intermediate electrode. The conductor wound within the intermediate segment to form first and second inductive coils that are axially separated from each other by an inter-coil gap, wherein the first and second inductive coils have different self-resonant frequencies. | 10-24-2013 |
20130345770 | LEADLESS INTRA-CARDIAC MEDICAL DEVICE WITH REDUCED NUMBER OF FEED-THRUS - A leadless implantable medical device (LIMD) includes a housing formed from a battery and an end cap. A proximal end of the end cap forms an LIMD proximal end and a distal end of the battery case forms an LIMD distal end. A non-conductive coupler mechanically secures a terminal end of the battery case to a mating end of the end cap, while maintaining the battery case and end cap electrically separated. A first electrode projects from the proximal end of the end cap. An intra-cardiac (IC) device extension projects from the distal end of the battery case. The extension includes a second electrode that is electrically connected to the battery case. The second electrode is located remote from the LIMD distal end. An electronics module is located within an internal cavity of the end cap and communicates with the first and second electrodes. | 12-26-2013 |
20140039238 | SYSTEMS AND METHODS FOR CONTROLLING NEUROSTIMULATION OF ACUPUNCTURE SITES USING AN IMPLANTABLE CARDIAC RHYTHM MANAGEMENT DEVICE - Techniques are provided for use with an implantable cardiac rhythm management (CRMD) system equipped to deliver neurostimulation to acupuncture sites within anterior regions of the neck, thorax or abdomen of the patient. Parameters associated with the health of the patient are detected, such as parameters indicative of arrhythmia, heart failure and hypertension. | 02-06-2014 |
20140039332 | METHOD AND SYSTEM FOR DISCRIMINATION OF VT AND SVT ARRHYTHMIAS - Methods and systems are provided for discriminating heart arrhythmias. The methods and systems include identifying an arrhythmia, recording a predetermined number of beats during the arrhythmia as a base arrhythmia (BA) beats; delivering anti-tachy pacing (ATP) therapy to at least one chamber of the heart. After delivering the ATP therapy, the methods and system record at least one return beat representing cardiac activity following the ATP therapy, determines whether the return beat originated in a reference chamber of the heart, compares a morphology of the return beat to a morphology of the BA beat; and declares a VT or SVT based on the comparing operation. | 02-06-2014 |
20140039333 | SYSTEMS AND METHODS FOR DETECTING MECHANICAL DYSSYNCHRONY AND STROKE VOLUME FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE EMPLOYING A MULTI-POLE LEFT VENTRICULAR LEAD - Techniques are provided for use with an implantable medical device for evaluating mechanical cardiac dyssynchrony based impedance (Z) measured along different vectors between an electrode in the right ventricle (RV) and various electrodes of a multi-pole left ventricle (LV) lead. | 02-06-2014 |
20140275924 | METHODS, SYSTEMS, AND APPARATUS FOR NEURAL SIGNAL DETECTION - Methods, systems, and apparatus for signal detection are described. In one example, a detection assembly includes a signal detector. The signal detector is configured to receive a sensor signal having a peak magnitude and a first frequency and generate an output signal having a magnitude proportional to the peak magnitude of the sensor signal and having a second frequency less than the first frequency of the sensor signal. | 09-18-2014 |
20140276746 | FEEDBACK SYSTEMS AND METHODS UTILIZING TWO OR MORE SITES ALONG DENERVATION CATHETER - A renal denervation system includes a renal denervation catheter and a flow determining system. The renal denervation catheter includes a plurality of ablation members positioned at a distal end portion thereof. The renal denervation catheter is insertable into a renal artery. The flow determining system includes a processor and first and second flow determining members spaced apart on the renal denervation catheter. The processor is configured to determine a change in blood flow through the renal artery resulting from a renal denervation procedure using the renal denervation catheter in response to input from the first and second flow determining members. | 09-18-2014 |
20150018656 | METHODS, SYSTEMS, AND APPARATUS FOR NEURAL SIGNAL DETECTION - Methods, systems, and apparatus for signal detection are described. In one example, a detection assembly includes a signal detector. The signal detector is configured to receive a sensor signal having a peak magnitude and a first frequency and generate an output signal having a magnitude proportional to the peak magnitude of the sensor signal and having a second frequency less than the first frequency of the sensor signal. | 01-15-2015 |