| PACESETTER, INC. Patent applications |
| Patent application number | Title | Published |
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| 20120035681 | SYSTEMS AND METHODS FOR ESTIMATING LEFT ATRIAL PRESSURE (LAP) IN PATIENTS WITH ACUTE MITRAL VALVE REGURGITATION FOR USE BY AN IMPLANTABLE MEDICAL DEVICE - Various techniques are provided for use with an implantable medical device for estimating cardiac pressure within a patient based on admittance (or related electrical values such as impedance or conductance) that takes into account the presence of acute MR within the patient. Briefly, the device detects an indication of acute MR, if occurring within the patient. The device also applies electrical fields to tissues of the patient and measures electrical parameters influenced by the electrical field, such as admittance, impedance or conductance. The device then estimates cardiac pressure within the patient based on the measured electrical parameter and the indication of acute MR. In one example, different linear correlation functions are used to convert admittance values to left atrial pressure (LAP) values depending upon the presence or absence of acute MR within the patient. | 02-09-2012 |
| 20120035590 | SYSTEM AND METHOD FOR MANIPULATING INSERTION PATHWAYS FOR ACCESSING TARGET SITES - A method for accessing a target site in the body by transferring a guidewire from an initial insertion site on the body to a different insertion site on the body is provided. In one aspect, a method for transferring a medical device or component, such as a sensor lead, from an initial insertion site to another insertion site is also provided. A guidewire of sufficient length, pliancy and deformability to perform a transfer from one insertion site to another insertion site is provided. In one aspect, the guidewire comprises a removable core mandrel to increase rigidity, facilitate insertion and/or improve steerability. A kit or system, comprising introducers, guidewires and catheters for performing a guidewire or device transfer is also provided. | 02-09-2012 |
| 20120035495 | SYSTEMS AND METHODS FOR EXPLOITING NEAR-FIELD IMPEDANCE AND ADMITTANCE FOR USE WITH IMPLANTABLE MEDICAL DEVICES - Various techniques are provided for use with an implantable medical device for exploiting near-field impedance/admittance. Examples include techniques for assessing heart chamber disequilibrium, detecting chamber volumes and pressures, calibrating near-field-based left atrial pressure (LAP) estimation procedures and for assessing the recovery from injury at the electrode-tissue interface. In one particular example, the implantable device assesses the degree of concordance between the left ventricle (LV) and the right ventricle (RV) by quantifying a degree of scatter between LV and RV near-field admittance values. An increase in RV admittance is indicative of RV failure, an increase in LV admittance is indicative of LV failure, and an increase in both LV and RV admittance is indicative of biventricular failure. | 02-09-2012 |
| 20120035493 | NEAR FIELD-BASED SYSTEMS AND METHODS FOR ASSESSING IMPEDANCE AND ADMITTANCE FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE - A new model is provided for understanding and exploiting impedance or admittance values measured by implantable medical devices, such as pacemakers or cardiac resynchronization devices (CRTs.) The device measures impedance along vectors extending through tissues of the patient between various pairs of electrodes. The device then converts the vector-based impedance measurements into near-field individual electrode-based impedance values. This is accomplished, in at least some examples, by converting the vector-based impedance measurements into a set of linear equations to be solved while ignoring far-field contributions to the impedance measurements. The device solves the linear equations to determine the near-field impedance values for the individual electrodes, which are representative of the impedance of tissues in the vicinity of the electrodes. The device then performs or controls various device functions based on the near-field values, such as analyzing selected near-field values to detect heart failure or pulmonary edema. | 02-09-2012 |
| 20120010516 | SYSTEM AND METHOD FOR EVALUATING MECHANICAL CARDIAC DYSSYNCHRONY BASED ON MULTIPLE IMPEDANCE VECTORS USING AN IMPLANTABLE MEDICAL DEVICE - A set of cardiogenic impedance signals are detected along different sensing vectors passing through the heart of the patient, particularly vectors passing through the ventricular myocardium. A measure of mechanical dyssynchrony is detected based on differences, if any, among the cardiogenic impedance signals detected along the different vectors. In particular, differences in peak magnitude delay times, peak velocity delay times, peak magnitudes, and waveform integrals of the cardiogenic impedance signals are quantified and compared to detect abnormally contracting segments, if any, within the heart of the patient. Warnings are generated upon detection of any significant increase in mechanical dyssynchrony. Diagnostic information is recorded for clinical review. Pacing therapies such as cardiac resynchronization therapy (CRT) can be activated or controlled in response to mechanical dyssynchrony to improve the hemodynamic output of the heart. | 01-12-2012 |
| 20110319954 | METRICS AND TECHNIQUES FOR OPTIMIZATION OF CARDIAC THERAPIES - An exemplary method includes, based on metrics available as input to a chronic phase optimization algorithm for selecting an optimal electrode configuration for delivery of a cardiac pacing therapy, executing the chronic phase optimization algorithm during an acute phase to select an optimal electrode configuration for delivery of a cardiac pacing therapy; during the acute phase, acquiring position information with respect to time for electrodes implanted in a body; determining one or more acute phase metrics based on the acquired position information; and validating the chronic phase optimization algorithm based at least in part on the one or more acute phase metrics. | 12-29-2011 |
| 20110319953 | SYSTEMS AND METHODS FOR USE BY AN IMPLANTABLE MEDICAL DEVICE FOR CONTROLLING MULTI-SITE CRT PACING IN THE PRESENCE OF ATRIAL TACHYCARDIA - Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. Sequential MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, sequential MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to either single-site LV pacing or simultaneous MSLV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish OATs (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes. | 12-29-2011 |
| 20110319951 | Systems and Methods for Use by an Implantable Medical Device for Controlling Multi-Site CRT Pacing in the Presence of Atrial Tachycardia - Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to single-site LV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish organized atrial tachycardias (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold that is set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes. | 12-29-2011 |
| 20110306890 | CARDIOMECHANICAL ASSESSMENT FOR CARDIAC RESYNCHRONIZATION THERAPY - A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index. | 12-15-2011 |
| 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 |
| 20110295334 | Method and System for Adjusting a Stimulation Rate of an Implantable Medical Device - An implantable medical device includes a lead, a pulse generator, a cardiac signal module, a fusion detection module and a rate modification module. The lead includes electrodes that are configured to be positioned within a heart to sense cardiac signals of the heart. The pulse generator delivers stimulus pulses to the heart through at least one of the electrodes. The cardiac signal module monitors the cardiac signals and directs the pulse generator to deliver one or more of the stimulus pulses to the heart at a stimulation rate based on the cardiac signals. The fusion detection module identifies a presence of fusion-based behavior of the heart that is associated with delivery of the one or more of the stimulus pulses. The rate modification module then adjusts the stimulation rate based on the presence of the fusion-based behavior. | 12-01-2011 |
| 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 |
| 20110288607 | SKIN RESPONSE MONITORING FOR NEURAL AND CARDIAC THERAPIES - An exemplary method includes emitting radiation subcutaneously; sensing at least some of the emitted radiation as reflected cutaneously; detecting an abnormal physiologic condition; and, based at least in part on the sensing, adjusting a stimulation therapy to treat the detected abnormal condition. In such a method, the abnormal condition may be an abnormal cardiac condition, an abnormal neural condition or other condition. Various other methods, devices, systems, etc., are also disclosed. | 11-24-2011 |
| 20110282410 | TORQUE WRENCH ACTUATED OPEN PASSAGE SEPTUM - A septum for use in an implantable pulse generator. The septum includes a soft sealing material and a hard inner portion or core having a set of lips. The lips are exposed outside the soft sealing material and act to displace the sealing material when a force is applied, for example from a tool used to tighten or loosen a set screw, enlarging a slit, seam or slot into a passageway through the septum. | 11-17-2011 |
| 20110282405 | SYSTEMS AND METHODS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE FOR DISCRIMINATING VT AND SVT BE SELECTIVELY ADJUSTING ATRIAL CHANNEL SENSING PARAMETERS - Techniques are described for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT) in circumstances when the ventricular rate exceeds the atrial rate (i.e. V>A). In one example, an initial atrial rate is detected while employing adjustable atrial channel detection parameters that can affect the detection of the true atrial rate—such as a post-ventricular atrial blanking (PVAB) interval or an atrial channel sensitivity level. If the ventricular rate exceeds a VT rate zone threshold with V>A, the device does not immediately deliver high voltage shock therapy as done in other devices. Rather, the device instead selectively adjusts the atrial channel detection parameter(s) to determine if the true atrial rate is equal to the ventricular rate. If so, then such is an indication that the arrhythmia might be SVT rather than VT and various discrimination procedures are employed to distinguish SVT from VT before therapy is delivered. | 11-17-2011 |
| 20110282226 | CARDIAC ANALYSIS SYSTEM FOR COMPARING CLINICAL AND INDUCED VENTRICULAR TACHYCARDIA EVENTS - A cardiac analysis system is provided that includes an implantable medical device (IMD), at least one sensor, and an external device. The IMD has electrodes positioned proximate to a heart that sense first cardiac signals of the heart and associated with a clinical ventricular tachycardia (VT) event and second cardiac signals associated with an induced VT event. The sensor measures first and second cardiac parameters of the heart associated with the clinical and induced VT events, respectively. The external device is configured to receive the first and second cardiac signals associated with the clinical and the induced VT events and the first and second cardiac parameters associated with the clinical and the induced VT events. The external device compares the first and second cardiac signals and compares the first and second cardiac parameters to determine if the clinical and induced VT events are a common type of VT event. | 11-17-2011 |
| 20110277324 | SIDE-LOADING COMPACT CRIMP TERMINATION - An implantable medical lead comprising a conductor extending along the lead and a crimp connector secured to the conductor comprising a body with an outer surface, an inner surface, proximal and distal ends, and first and second lateral edges, the lateral edges having edge features extending there from, the edge features adapted to opposingly interleave with one another. Methods of assembling a crimp connector with a cable conductor including parallel and cross-wise assembly are also encompassed. | 11-17-2011 |
| 20110257700 | REMOTE FOLLOW-UP AUTOMATICITY WITH INTELLIGENT DATA DOWNLOAD RESTRICTIONS - An implanted device is equipped with a flag that indicates to a remote monitoring unit that an event such as a patient medical emergency or device failure has occurred. The remote monitoring unit is configured in some embodiments to maintain a low power communication link with the implanted device when they are within range. When the flag indicates an event has occurred, the remote monitoring unit quickly downloads sensed data collected by the implanted device and transfers it over a network so that it can be utilized by a medical practitioner. The remote monitoring unit is further configured in some embodiments to query the implanted device at regular intervals. The remote monitoring unit may read a subset of the data stored by the implanted device and, based on that data, determine whether to complete a full or partial download. | 10-20-2011 |
| 20110245888 | MEDICAL DEVICE WITH CHARGE LEAKAGE DETECTION - A medical device (implantable or external) is provided that comprises a power source, a charge storage member, a terminal connector, a switch network, a controller and a leak detection module. The charge storage member is configured to receive and store energy from the power source. The terminal connector is configured to be coupled to a lead to be implanted in a patient proximate to tissue of interest. The switch network is electrically disposed between the charge storage member and the terminal connector. The switch network changes between open and closed states to disconnect and connect the charge storage member and the terminal connector. The controller controls storage of energy in the charge storage member and delivery of stimulating pulses from the charge storage member to the lead coupled to the terminal connector. The leak detection module obtains a leakage measurement by sensing at least one of i) a voltage potential of the charge storage member and ii) current flow from the charge storage member. The leak detection module compares the leakage measurement to a leakage threshold to determine when the leakage measurement satisfies the leakage threshold. | 10-06-2011 |
| 20110245842 | LEFT CHAMBER PRESSURE SENSOR LEAD DELIVERY SYSTEM - An apparatus for and method of measuring pressure through a septum in a patient's heart. A lead inserted into the right side of a heart is routed through the septum to gain access to the left side of the heart. The lead includes a mounting mechanism that secures the lead to one or both sides of the septal walls. The lead also includes one or more sensors for measuring cardiac pressure on the left side of the heart and, as necessary, the right side of the heart. | 10-06-2011 |
| 20110245699 | SYSTEMS AND METHODS RELATED TO ST SEGMENT MONITORING BY AN IMPLANTABLE MEDICAL DEVICE - Cardiac activity is sensed over a plurality of heart beats defining a beat set. For each beat in the set, it is determined whether the beat is a non-classified beat (e.g., paced beat, a beat outside of a specified heart rate range or a PVC), or a classified beat. For each classified beat, it is determined whether the beat is a non-detect beat, a minor beat or a major beat. Counts of classified beats, non-classified beats, major beats, minor beats, and non-detect beats are maintained. The beat set is declared to be one of a non-classified set, a major set, a minor set or a non-detect set based on the relative counts of classified beats, non-classified beats, major beats, minor beats, and non-detect beats. Over a period of time, counts of beat-set types are maintained and entry into and exit from ST episodes are determined based on these beat-set counts. | 10-06-2011 |
| 20110245698 | DEVICE AND METHOD FOR IDENTIFYING CARDIAC EVENTS - An implantable medical device includes leads having electrodes that are positioned within a heart. The electrodes sense signals derived from the heart that include waveform segments. The device includes a timing module that determines when the waveform segments cross a threshold and measures time intervals between at least two threshold crossings by the waveform segments. The device also includes event identification module that compares the time intervals to a predetermined pattern associated with a cardiac event. The event identification module identifies the cardiac event based on the time intervals and the predetermined pattern. | 10-06-2011 |
| 20110238102 | TRANSSEPTAL DELIVERY INSTRUMENT - Access to the left side of the heart is gained through a heart wall. A delivery instrument includes a guide that may include or carry a puncturing instrument that is adapted to be directed toward the heart wall. In some embodiments a distal portion of the delivery instrument may be adapted to be co-located with the coronary sinus. In addition, the guide may be located a known distance from the portion of the delivery instrument that is co-located with the coronary sinus. Access to the left side of the heart may thus be readily gained by positioning the delivery instrument relative to the coronary sinus. | 09-29-2011 |
| 20110230927 | METHOD AND SYSTEM FOR DETECTING AND TREATING JUNCTIONAL RHYTHMS - An implantable medical device is provided for detecting transportless ventricular rhythm of a heart lacking atrial transport and comprises a housing, sensors configured to be located proximate to a heart, a sensing module to sense cardiac signals representative of a rhythm originating from the heart and a rhythm detection module. The rhythm detection module determines a change in AV association and identifies a potential ventricular complex with loss of atrial transport (VCLAT) based on the change in AV association. | 09-22-2011 |
| 20110230771 | HEART FAILURE STATUS MONITORING - Left atrial pressure and temperature of a patient are monitored to identify a normal wake state, a normal sleep state, and any deviation from those normal states (e.g., an alarm state). In the event an alarm state is identified, a determination is made as to whether to generate an indication of heart failure exacerbation based on a heart failure score. In addition, congestion and perfusion in a patient may be monitored over time to provide a two-dimensional indication of a trend relating to the heart failure status of the patient. | 09-22-2011 |
| 20110224555 | Systems and Methods for Use By an Implantable Medical Device for Detecting and Discriminating Stroke and Cardiac Ischemia Using Electrocardiac Signals and Hemodynamic Parameters - Techniques are provided for detecting and distinguishing stroke and cardiac ischemia within a patient using an implantable medical device. In one example, a preliminary indication of stroke is detected by a pacemaker or similar implantable device based on an analysis of features of an intracardiac electrogram (IEGM) sensed by the device. Exemplary IEGM features indicative of possible stroke include the onset of prominent U-waves, the onset of notched T-waves, and changes in ST segment duration or QT duration. Upon detection of a possible stroke, the device then detects one or more hemodynamic parameters that are typically affected by cardiac ischemia. Such hemodynamic parameters can include, e.g., cardiac contractility or stroke volume. The device then distinguishes stroke and cardiac ischemia from one another based on whether any changes detected in the hemodynamic parameters are consistent with cardiac ischemia. Implantable systems that exploit subcutaneous electrocardiograms (ECGs) rather than IEGMs are also described. | 09-15-2011 |
| 20110218603 | CRIMP TERMINATIONS FOR CONDUCTORS IN IMPLANTABLE MEDICAL LEAD AND METHOD OF MAKING SAME - A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode. | 09-08-2011 |
| 20110218602 | BRAIDED IMPLANTABLE MEDICAL LEAD AND METHOD OF MAKING SAME - An implantable medical lead disclosed herein may include a longitudinally extending body, a helical anchor and a lead connector end. The longitudinally extending body may include a distal end, a proximal end, a braid-reinforced inner tubular layer extending between the proximal and distal ends, and an outer tubular layer extending between the proximal and distal ends. The braid-reinforced inner tubular layer may extend through the outer tubular layer in a coaxial arrangement. The helical anchor electrode may be operably coupled to a distal end of the braid-reinforced inner tubular layer. The lead connector end may be operably coupled to the proximal end of the body and include a pin contact operably coupled to a proximal end of the braid-reinforced tubular layer. Rotation of the pin contact relative to the lead connector end may cause rotation of the braid-reinforced inner tubular layer within the outer tubular layer, and the resulting rotation of the braid-reinforced inner tubular layer may cause rotation of the helical anchor electrode. | 09-08-2011 |
| 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 |
| 20110208261 | SYSTEMS AND METHODS FOR ASSESSING AND REPROGRAMMING SENSING VECTORS FOR USE WITH AN IMPLANTABLE CARDIAC RHYTHM MANAGEMENT DEVICE - Techniques are provided for use with a pacemaker or other implantable medical device capable of sensing electrical signals along a set of programmable sensing vectors. In one example, electrical cardiac signals are sensed within a patient using a primary sensing vector connected to a primary sensing channel for use in controlling the delivery of therapy. If the device detects a significant drop in key signal parameters such as peak signal amplitude or slew rate, an assessment is made whether an alternate sensing vector provides improved cardiac signal sensing. During the assessment, the device can continue to sense signals along the primary channel for the purposes of controlling therapy while alternate vectors are assessed in the background. If it is determined that an alternate sensing vector provides improved cardiac signal sensing, the primary sensing channel can be switched to the alternate sensing vector for use in controlling further therapy. | 08-25-2011 |
| 20110208083 | DEVICE AND METHOD FOR ADJUSTING IMPEDANCE BASED ON POSTURE OF A PATIENT - An implantable medical device includes electrodes that are configured to be positioned within at least one of a heart and a chest wall of a patient. The device also includes an impedance measurement module, a patient position sensor, and a correction module. The impedance measurement module measures an impedance vector between a predetermined combination of the electrodes. The patient position sensor determines at least one of a posture and an activity level of the patient. The correction module adjusts the impedance vector based on the at least one of the posture and the activity level of the patient. | 08-25-2011 |
| 20110208077 | SYSTEM AND METHOD FOR EXPLOITING ATRIAL EELCTROCARDIAC PARAMETERS IN ASSESSING LEFT ATRIAL PRESSURE USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for assessing left atrial pressure (LAP) based on atrial electrocardiac signal parameters, particularly intra-atrial conduction delay (IACD) and P-wave duration. In one example, a pacemaker or other implantable device senses an intracardiac electrogram (IEGM) or a subcutaneous electrocardiogram (ECG), from which IACD and P-wave duration are derived. The device tracks changes, if any, in the parameters. A significant increase in either IACD or P-wave duration is associated with an increase in LAP. In some examples, conversion factors are calibrated for use with a particular patient to relate IACD and/or P-wave duration values to LAP values to provide an estimate of actual LAP. The conversion factors are pre-calibrated using LAP measurements obtained using a wedge pressure sensor. In other examples, IACD and P-wave duration are instead used to confirm the detection of an elevation in LAP initially made using impedance signals. Other confirmation parameters are described as well. | 08-25-2011 |
| 20110202104 | METHOD AND SYSTEM FOR AUTOMATICALLY SWITCHING BETWEEN MODES OF AN IMPLANTABLE MEDICAL DEVICE BASED ON AN EXTERNAL MAGNETIC FIELD - An implantable medical device that is configured to be exposed to magnetic fields includes a lead, a detection module, a field measurement sensor, and a control module. The lead includes electrodes that are positioned within a heart to sense cardiac signals of the heart. The detection module monitors the cardiac signals to identify cardiac events based on the cardiac signals. The field measurement sensor measures a magnetic field. The sensor generates a field measurement based on the measured magnetic field. The sensor remains in an unsaturated state when exposed to the magnetic field of at least 0.2 Tesla. The control module identifies a presence of the magnetic field based on the field measurement of the sensor and switches operation of the detection module to an MR safe mode based on the field measurement. | 08-18-2011 |
| 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 |
| 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 |
| 20110196440 | ADAPTIVE DETERMINATION OF PATIENT SPECIFIC OPTIMAL AV DELAY DURING ELEVATED HEART RATES BASED ON CARDIAC OUTPUT MEASUREMENTS - Adaptively creating a table of optimal, patient-specific atrioventricular (AV) delays for a an implantable medical device (IMD) begins as the IMD detects the patient entering a target heart rates within a defined range of elevated heart rates. On detection, the device begins testing AV delays by pacing the heart at a number of different AV delays. The IMD selects the optimal AV delay based on a comparison of measurements of cardiac output obtained during each delay's test pacing period. The optimal AV delay corresponds to the one which resulted in the highest cardiac output. The device selects this optimal AV delay and stores it in an AV delay table on the device. The process continues as the device detects the patient entering the other target heart rates in order to complete the table. | 08-11-2011 |
| 20110190784 | CATHETER WITH REMOVABLE SHAPING SKELETON AND METHODS OF USING AND MAKING SAME - A delivery tool for the delivery of an implantable medical lead includes a longitudinally extending tubular body and a longitudinally extending skeleton. The longitudinally extending tubular body includes a distal end, a proximal end, a tubular body segment proximal the distal end, a first lumen extending between the proximal and distal ends, and a second lumen. The first lumen is configured to receive therein the implantable medical lead. The longitudinally extending skeleton is received in the second lumen and includes a distal end, a proximal end, and a portion near the distal end that biases into a non-linear shape. The portion of the skeleton causes the tubular body segment to generally assume the non-linear shape. The skeleton is withdrawable from the second lumen. The proximal ends of the skeleton and the tubular body may have a mechanical engagement arrangement that mechanically engages the proximal ends together in a manner that may be released to allow the proximal ends to be separated from each other. Upon withdrawal of the skeleton from the second lumen, the tubular body segment is free to assume a shape different from the non-linear shape. | 08-04-2011 |
| 20110184485 | ADAPTIVE RATE PROGRAMMING CONTROL IN IMPLANTABLE MEDICAL DEVICES USING VENTRICULAR-ARTERIAL COUPLING SURROGATES - Selection of an appropriate rate programming control (RPC) setting in an implantable medical device (IMD), uses analysis of VA coupling surrogate conditions. The VA coupling surrogate conditions are derived from signals such as cardiogenic impedance, blood pressure, and the pulsatile components of PPG. By analyzing a waveform of the measured surrogate condition, the IMD estimates wall stiffness, through the slope of the waveform, and peripheral arterial pressure, through the reflection time between the main wave and reflection wave of the waveform. These values are plotted against each other on a VA coupling coordinate plane. Based on the location and orientation of the resulting VA coupling plot, the IMD selects an appropriate RPC setting. | 07-28-2011 |
| 20110184304 | IMPLANTABLE MEDICAL DEVICE WITH SLEEP APNEA DETECTION CONTROL AND METHOD - A method for use in an implantable medical device comprises the steps of monitoring respiration with an amplifier having a gain, generating a moving apneic threshold based on recent respiration cycles, accumulating differences between amplitudes of respiration cycles and the moving apnea detection threshold and comparing the accumulated differences against an apnea detection threshold to detect the onset of an episode of apnea. The method further comprises measuring respiration levels upon detecting the onset of apnea, confirming the episode of apnea based upon the respiration levels measured upon detecting the onset of apnea; and adjusting one of the gain of the amplifier and the apnea detection threshold so that the time from the detection of onset of apnea to the time of confirmation of the episode of apnea is within a predetermined time range following the detection of the onset of apnea. | 07-28-2011 |
| 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 |
| 20110178567 | TECHNIQUES FOR PROMOTING BIVENTRICULAR SYNCHRONY AND STIMULATION DEVICE EFFICIENCY USING INTENTIONAL FUSION - A method includes providing an optimal interventricular interval, determining an atrio-ventricular conduction delay for the ventricle having faster atrio-ventricular conduction, determining an interventricular conduction delay and determining an advance atrio-ventricular pacing interval, for use in pacing the ventricle having slower atrio-ventricular conduction, based at least in part on the optimal interventricular interval and the interventricular conduction delay. | 07-21-2011 |
| 20110166617 | Implantable Cardiac Stimulation Device and Method for Measuring Intrinsic Activity Metrics in Multi-Site Pacing - An implantable cardiac stimulation device provides measurement of intrinsic heart activity metrics while sustaining pacing of the heart. The device includes a pulse generator that delivers pacing pulses to a first chamber of corresponding chambers of a heart, and a sensing circuit that senses a conducted evoked response of a second chamber of the corresponding chambers of the heart in response to the pacing pulse to provide an electrical signal representing the conducted evoked response. The device further includes a measuring circuit that measures a metric of the electrical signal to approximate a corresponding metric of an intrinsic electrical feature of the second chamber. | 07-07-2011 |
| 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 |
| 20110152989 | SOFT ABRASION-RESISTANT POLYISOBUTYLENE URETHANE COPOLYMERS - A polyisobutylene polyurethane (PIBU) copolymer comprising a polyisobutylene (PIB) having a molecular weight of about 400 to about 5,000 daltons; a hard segment (PU) formed from reacting the PIB with diisocyanates and from reacting one of the diisocyanate linked to the PIB with a chain extender. The chain extender has a length based on a number of carbon atoms in the chain extender. A shore hardness of the PIBU copolymer is determined, in part, by either one or more of a PIB:PU ratio, the length of PIB, the type of diisocyanate, and the type and length of the chain extender. | 06-23-2011 |
| 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 |
| 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 |
| 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 |
| 20110137392 | MECHANISM FOR, AND METHOD OF, ATTACHING A LEAD CONDUCTOR CABLE TO A LEAD ELECTRODE - A cardio electrotherapy lead is disclosed herein. In one embodiment, the lead includes a tubular body, a conductor cable and an electrode. The conductor cable longitudinally extends through the tubular body and includes a distal end. The electrode is located on the tubular body and includes an attachment mechanism mechanically coupling the lead distal end to the electrode. | 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 |
| 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 |
| 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 |
| 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 |
| 20110125206 | SINGLE CHAMBER IMPLANTABLE MEDICAL DEVICE FOR CONFIRMING ARRHYTHMIA THROUGH RETROSPECTIVE CARDIAC SIGNALS - An implantable medical device is provided that comprises a housing, sensors configured to be located to proximate a heart, and a sensing module to sense cardiac signals originating from the heart over a channel defined by the sensors. The cardiac signals include intrinsic R-wave events and associated intrinsic confirmation events when the heart exhibits normal sinus rhythm. The device further includes memory to store the cardiac signals sensed over a channel, and a detection module. The detection module identifies an R-wave event within the cardiac signals. The detection module captures, in the memory, a segment of the cardiac signals that precedes the R-wave event as a retrospective segment. The detection module determines whether the retrospective segment includes an intrinsic confirmation event that is associated with and occurs before the R-wave event. The detection module declares an arrhythmia based at least in part on the determination of whether the retrospective segment includes the intrinsic confirmation event is absent from the retrospective segment. | 05-26-2011 |
| 20110124983 | METHOD AND APPARATUS FOR MONITORING INGESTION OF MEDICATIONS USING AN IMPLANTABLE MEDICAL DEVICE - An implantable medical device, such as a pacemaker or implantable cardioverter defibrillator (ICD), is configured to automatically detect ingestion of medications to verify that prescribed medications are taken in a timely manner and at the correct dosage. Briefly, individual pills are provided with miniature radio frequency identification (RFID) devices capable of transmitting RFID tag signals, which identify the medication contained within the pill and its dosage. The implanted device is equipped with an RFID transceiver for receiving tag signals from a pill as it is being ingested. The implanted system decodes the tag to identify the medication and its dosage, then accesses an onboard database to verify that the medication being ingested was in fact prescribed to the patient and to verify that the correct dosage was taken. Warning signals are generated if the wrong medication or the wrong dosage was taken. Therapy may also be automatically adjusted. Non-RF-based ID devices are also described, which instead transmit ID data via biphasic current pulses. | 05-26-2011 |
| 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 |
| 20110112599 | MRI SIGNAL FILTERING FOR IMPLANTABLE MEDICAL DEVICE - A filtering scheme for an implantable medical device mitigates potentially adverse effects that may be caused by MRI-induced signals. In some aspects filtering is provided to attenuate MRI-induced signals on an implanted cardiac lead that is coupled to an implanted device. In some aspects the filter may be configured to complement a capacitor circuit (e.g., a feedthrough capacitor) that reduces the amount of EMI that enters the implanted device via the cardiac lead. In some implementations the filter consists of a LC tank circuit and a series LC circuit, where the LC tank circuit is in series with the cardiac lead and a cardiac stimulation circuit and the series LC circuit is in a shunt configuration across the cardiac stimulation circuit. | 05-12-2011 |
| 20110112597 | SYSTEMS AND METHODS FOR OFF-LINE REPROGRAMMING OF IMPLANTABLE MEDICAL DEVICE COMPONENTS TO REDUCE FALSE DETECTIONS OF CARDIAC EVENTS - Techniques are provided for use by implantable medical devices such as pacemakers or by external systems in communication with such devices. An intracardiac electrogram (IEGM) is sensed within a patient in which the device is implanted using a cardiac signal sensing system. Cardiac events of interest such as arrhythmias, premature atrial contractions (PACs), premature ventricular contractions (PVCs) and pacemaker mediated tachycardias (PMTs) are detected within the patient using event detection systems and then portions of the IEGM representative of the events of interest are recorded in device memory. Subsequently, during an off-line or background analysis, the recorded IEGM data is retrieved and analyzed to identify false detections. In response to false detections, the cardiac signal sensing systems and/or the event detection systems of the implantable device are selectively adjusted or reprogrammed to reduce or eliminate any further false detections, including false-positives or false-negatives. Various adaptive reprogramming techniques are described. | 05-12-2011 |
| 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 |
| 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 |
| 20110106194 | SYSTEMS AND METHODS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE FOR DISCRIMINATING VT AND SVT BASED ON VENTRICULAR DEPOLARIZATION EVENT TIMING - Techniques are described for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT) using an implantable medical device capable of multi-site ventricular sensing. In one example, ventricular depolarization events are detected within a patient by the implantable device during a tachyarrhythmia, at both a left ventricular sensing site and a right ventricular sensing site. Ventricular event timing differences are then ascertained. The device compares the ventricular event timing differences detected during the tachyarrhythmia with predetermined supraventricular event timing differences for the patient, such as event timing differences previously detected within the patient during sinus rhythm or extrapolated from sinus rhythm values. The device then distinguishes VT from SVT based on the comparison of the event timing differences detected during the tachyarrhythmia with the predetermined supraventricular event timing differences. Morphological waveform analysis can also be performed, when needed, to further distinguish VT from SVT. | 05-05-2011 |
| 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 |
| 20110098770 | SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE LEFT VENTRICULAR PACING BASED ON INTERELECTRODE CONDUCTION DELAYS - 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, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays. | 04-28-2011 |
| 20110098764 | FREQUENCY DOMAIN ANALYSIS TO DETECT T WAVE OVERSENSING - Detection of T wave oversensing in an ICD is accomplished in order to prevent improper application of treatment to a patient. The ICD device senses for electrical impulses representing the R waves of a beating heart. In some instances the ICD device will sense T waves that it will assume to be R waves, because the ICD device expects or assumes that such sensed signals are R waves. Time intervals between each detected, assumed R waves are measured and a list of intervals is generated. The list is transformed into its frequency domain equivalent and analyzed for peaks and randomness criteria to determine whether T wave oversensing has occurred. | 04-28-2011 |
| 20110094768 | IMPLANTABLE MEDICAL DEVICE HAVING FEEDTHRU WITH AN INTEGRATED INTERCONNECT/FILTER SUBSTRATE - Disclosed herein is an implantable pulse generator. The implantable pulse generator includes a header, a can, a feedthru, a feedthru substrate and a conductor. The header includes a lead connector block. The can is coupled to the header and includes a wall and an electronic substrate housed within the wall. The feedthru is mounted in the wall and includes a header side, a can side and a feedthru wire extending through the feedthru and having a first end and a second end opposite the first end. The first end is electrically coupled to the lead connector block. The feedthru substrate is adjacent the can side and includes capacitance layers, an electrically conductive input layer, and an electrically conductive input surface defined on a surface of the feedthru substrate and electrically coupled to the input layer. The input layer is electrically coupled to the second end. The conductor electrically couples the input surface and the electronic substrate. The conductor may be in the form of a wire bond. The input surface may include input pads oriented to match complementary electrical connection locations or pads of the electronic substrate, and the wire bonds may extend between the input pads and the complementary electrical connection locations or pads of the electronic substrate. | 04-28-2011 |
| 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 |
| 20110082350 | ASSESSING A DEGREE OF VASCULAR BLOCKAGE OR RISK OF ISCHEMIA - A system and method for determining a patient's degree of cardiac vascular blockage or, equivalently, a patient's risk of cardiac ischemia, based on the time interval between the onset of exercise activity and the onset of an episode of cardiac ischemia. In one embodiment, an implantable cardiac device may obtain an EGM and possibly other measures of patient physiologic activity. These measures are used to determine when the patient has initiated exercise activity. Analysis of the EGM then detects an elevated or depressed ST segment, which typically indicates an episode of cardiac ischemia. The time interval between the onset of exercise and the onset of ischemia is a metric reflecting the patient's degree of vascular blockage or, equivalently, the patient's risk of ischemia. Other metrics may be derived, such as a substantially workload-level invariant measure determined as the product of the exercise workload level and the ischemia onset time interval. | 04-07-2011 |
| 20110079423 | MRI COMPATIBLE IMPLANTABLE LEAD - An implantable lead is provided that includes a lead body configured to be implanted in a patient. The lead body has a distal end and a proximal end, and a lumen extending between the distal and proximal ends and includes a connector assembly provided at the proximal end of the lead body. The connector assembly is configured to connect to an implantable medical device and includes an electrode provided proximate to the distal end of the lead body with the electrode configured to at least one of deliver stimulating pulses and sense electrical activity. A multi-layer coil is located within the lumen and extends at least partially along a length of the lead body. The coil includes a first winding formed with multiple winding turns, the winding turns being segmented in an alternating pattern of insulated segments and non-insulated segments along the length of the lead body. The multi-layer coil further includes a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments. The multi-layer coil further includes a first winding formed with multiple winding turns, the winding turns being segmented into an alternating pattern of insulated segments and non-insulated segments along a length of the winding with a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments. | 04-07-2011 |
| 20110071607 | IMPLANTABLE MEDICAL LEAD AND METHOD OF MAKING SAME - An implantable medical lead is disclosed herein. The lead may include a longitudinally extending body, an electrical conductor, a tube and an electrical component, such as, for example, an electrode for sensing or pacing, a defibrillation coil, a strain gage, a pressure sensor, a piezoelectric sensor, an integrated chip, an inductor, etc. The body may include a distal end and a proximal end. The electrical conductor may extend through the body between the proximal end and the distal end. The tube may be swaged about an outer circumferential portion of the electrical conductor. The electrical component may be on the body and electrically connected to the tube. | 03-24-2011 |
| 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 |
| 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 |
| 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 |
| 20110066055 | SYSTEM AND METHOD FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE FOR DETECTING STROKE BASED ON PHYSIOLOGICAL AND ELECTROCARDIAC INDICES - Techniques are provided for detecting stroke within a patient using an implantable medical device. In one example, various electrocardiac and physiological signals are sensed within the patient by the implantable device. The device derives a set of indices from the sensed signals based on parameters affected by stroke. Stroke is then detected within the patient based on an examination of the set of indices. Warnings can then be generated, neurostimulation delivered, pacing therapy adjusted, medications dispensed, etc., in response to the stroke. In one particular example, the set of indices includes: a heart rate variability index; a heart rate turbulence index; a baroreflex index; a QT index; a respiration index; and a circadian variability index, from which a composite stroke index is derived. Time delta indices may also be generated for each individual index, which are exploited in generating the composite stroke index. | 03-17-2011 |
| 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 |
| 20110065307 | SIDE-LOACING COMPACT CRIMP TERMINATION - An implantable medical lead comprising a conductor extending along the lead and a crimp connector secured to the conductor comprising a body with an outer surface, an inner surface, proximal and distal ends, and first and second lateral edges, the lateral edges having edge features extending there from, the edge features adapted to opposingly interleave with one another. Methods of assembling a crimp connector with a cable conductor including parallel and cross-wise assembly are also encompassed. | 03-17-2011 |
| 20110060394 | MRI RF REJECTION MODULE FOR IMPLANTABLE LEAD - A high Q self-resonant inductor and method for manufacturing the same is disclosed herein for use in an implantable medical lead. The method of manufacture includes depositing a first conductive material over an elongated ceramic member and removing portions of the conductive material to leave a continuous helical metallic pattern on an elongated ceramic structure. The helical metallic pattern has a first terminal end located at a proximal end of the elongated ceramic member and a second terminal end located at a distal end of the ceramic member. The method also includes covering the helical metallic pattern with a ceramic material to form a first ceramic layer and forming vias in the ceramic material. At least one electrode is coupled to the helical metallic pattern through the vias in the ceramic material. | 03-10-2011 |
| 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 |
| 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 |
| 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 |
| 20110054405 | HEMOSTASIS VALVE WITH IRIS SEAL - A hemostasis valve is disclosed herein. The hemostasis valve may include an inner bushing, a rotation sleeve, an elastomeric sleeve, and a biasing element. The rotation sleeve may extend about the inner bushing and be rotationally displaceable relative to the inner bushing. The elastomeric sleeve may include a first end operably coupled to the inner bushing, a second end operably coupled to the rotation sleeve, and an iris valve portion. Rotation of the rotation sleeve relative to the inner bushing may cause the iris valve to transition from an open state to a closed state. The biasing element may act between the rotation sleeve and inner bushing to bias the iris valve towards at least one of a closed state or an open state. | 03-03-2011 |
| 20110034985 | BIPOLAR SCREW-IN LEAD - An implantable active fixation lead includes an outer sheath, a protector member having a peripheral surface extending between its distal and proximal end surfaces with a helical groove formed in the peripheral surface, and a fixation helix integral with the outer sheath. The fixation helix includes a tip end engageable with body tissue and slidably engaged with the helical groove for relative translation and rotation. A longitudinal force on the lead firmly engages the protector member's distal end surface with the body tissue. With the fixation helix initially retracted proximally of the protector member's distal end surface and disengaged from the body tissue, upon application of torque to the outer sheath, the distal end surface of the protector member is moved proximally with respect to the fixation helix which, simultaneously, is extended distally beyond the distal end surface of the protector member to an extended position into engagement with the body tissue. | 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 |
| 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 |
| 20110034954 | SUTURELESS REINFORCEMENT FOR AND METHOD OF TREATING A MYOCARDIAL INFARCTION - A method of treating a heart condition includes dispensing first and second sealant components to a myocardial infarction via an introducer extending through a percutaneous puncture in a subxiphoid region. The first and second sealant components combine to form a medical sealant material that bonds to the myocardial infarction to form a reinforcement for the myocardial infarction, wherein the reinforcement does not include a patch. | 02-10-2011 |
| 20110028801 | CARDIOVASCULAR VESSEL ELASTICITY MONITORING - Elasticity of a cardiovascular vessel of a patient is monitored to provide an indication of whether the patient's health is changing. In some aspects the elasticity of a cardiovascular vessel is determined irrespective of the current blood pressure level of the patient at the time the elasticity is determined. For example, vessel elasticity may be determined based on a defined set of data that maps vessel elasticity with reflectance times for different blood pressure levels. In some implementations, this set of data corresponds to a set of iso-pressure lines. | 02-03-2011 |
| 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 |
| 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 |
| 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 |
| 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 |
| 20110022057 | APPARATUS AND METHODS FOR TRANSFERRING AN IMPLANTED ELONGATE BODY TO A REMOTE SITE - A transfer guidewire assembly configured to manipulate an implanted elongate body includes a flexible elongate portion, such as a guidewire, and coupler. The flexible elongate body has a proximal end and a distal end attached to the coupler. The coupler can include a catheter and/or a handle. The handle can include a screw. The coupler is configured to be removably attached to the end of an implanted elongate body, for example, by forming an interference fit with the outside diameter of the implanted body. A method for transferring an end of an implanted medical component from first site to a second site within a patient, such as a pacemaker, defibrillator, and/or sensor lead, etc., includes inserting a guidewire into the body at the first site and externalizing the guidewire at the second site. A proximal portion of the implanted component near the first site and is attached to the guidewire. The proximal portion of the implanted component is pulled through the patient's body and out the second site with the transfer guidewire assembly. | 01-27-2011 |
| 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 |
| 20110015694 | PREFABRICATED HEADER FOR HERMETICALLY SEALED DEVICE - A prefabricated header assembly is hermetically welded to a housing of a device. The header assembly includes a metal base and a circuit embedded in an encapsulating material. The metal base includes a hermetically sealed feedthrough for providing an electrical connection between one or more components located in the housing and the circuit of the header assembly. During assembly, the metal base is placed over an aperture defined in the housing such that the metal base may be welded to the housing to complete the hermetic sealing of the device. In some implementations the header assembly also includes a battery assembly. | 01-20-2011 |
| 20110015693 | Enhanced Patient Programming Security for Remote Programming via Paired Communication / IMD Access via Custom Hardware - A system and method for enhanced patient programming security for remote programming via paired communication/implantable medical device access via custom hardware. The system comprises an implantable medical device capable of telemetric communication with an external device. The implantable medical device may be paired to a remote monitoring device. The implantable medical device and/or the remote monitoring device challenge other devices to provide information for authentication and/or authorization. The information may be information about the implantable medical device, information about the remote monitoring device, information about the patient, or heuristic information. The information may be stored in an electronic medical records system. | 01-20-2011 |
| 20110015690 | Neurostimulation and Neurosensing Techniques to Optimize Atrial Anti-Tachycardia Pacing for Prevention of Atrial Tachyarrhythmias - Implantable systems and method for use therewith are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments are for use with an implantable device that includes one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering AATP and one or more electrode for monitoring and/or stimulating atrial vagal fat pads. | 01-20-2011 |
| 20110009934 | IMPLANTABLE MEDICAL LEAD HAVING PASSIVE LOCK MECHANICAL BODY TERMINATIONS - Disclosed herein is an implantable medical lead configured to receive a stylet. The lead may include a tubular body and a structure. The tubular body may include a distal end and a proximal end. The body may be configured to receive the stylet. The structure longitudinally may extend through the body between the distal end and the proximal end. The structure may be anchored within the body such that a tensile force arising within the body by the stylet being extended through the body causes the tensile force to be substantially carried by the structure. | 01-13-2011 |
| 20110009918 | METHOD AND SYSTEM FOR IDENTIFYING A POTENTIAL LEAD FAILURE IN AN IMPLANTABLE MEDICAL DEVICE - A method for detecting potential failures by a lead of an implantable medical device is provided. The method includes sensing a first signal over a first channel between a first combination of electrodes on the lead and sensing a second signal from a second channel between a second combination of electrodes on the lead. The method determines whether at least one of the first and second signals is representative of a potential failure in the lead and identifies a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure. Optionally, when the first and second sensed signals are both representative of the potential failure, the method further includes determining whether the first and second sensed signals are correlated with one another. When the first and second sensed signals are correlated, the method declares an electrode common to both of the first and second combinations to be associated with the failure. | 01-13-2011 |
| 20110009917 | CAPACITOR-INTEGRATED FEEDTHROUGH ASSEMBLY WITH IMPROVED GROUNDING FOR AN IMPLANTABLE MEDICAL DEVICE - A feedthrough assembly for use with implantable medical devices having a shield structure, the feedthrough assembly engaging with the remainder of the associated implantable medical device to form a seal with the medical device to inhibit unwanted gas, liquid, or solid exchange into or from the device. One or more feedthrough wires extend through the feedthrough assembly to facilitate transceiving of the electrical signals with one or more implantable patient leads. The feedthrough assembly is connected to a mechanical support which houses one or more filtering capacitors that are configured to filter and remove undesired frequencies from the electrical signals received via the feedthrough wires before the signals reach the electrical circuitry inside the implantable medical device. The mechanical support may further include an isolation structure that isolates the feedthrough wires. | 01-13-2011 |
| 20110004111 | ISCHEMIA DETECTION USING INTRA-CARDIAC SIGNALS - An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave. | 01-06-2011 |
| 20100331942 | MRI COMPATIBLE IMPLANTABLE MEDICAL LEAD AND METHOD OF MAKING SAME - An implantable medical lead is disclosed herein. The implantable medical lead may include a body including an electrical insulation tube, a distal portion with an electrode, and a proximal portion with a lead connector end. The electrical insulation tube may be coaxial with a longitudinally extending center axis of the body. The lead may also include an electrical pathway extending between the electrode and lead connector end, the electrical pathway including an inductor comprising an electrical conductor helically wound directly on an outer circumferential surface of the insulation tube. | 12-30-2010 |
| 20100331940 | IMPLANTABLE MEDICAL LEAD CONFIGURED FOR IMPROVED MRI SAFETY AND HEATING REDUCTION PERFORMANCE - An implantable medical lead configured for improved MRI safety and heating reduction performance is disclosed herein. In one embodiment, the lead includes a tubular body having a proximal end and a distal end with a lead connector near the proximal end. In this embodiment the lead further includes a conductor extending longitudinally within the tubular body and having a proximal end that is electrically coupled to the connector and a distal end electrically coupled to a contact pin. The lead in this embodiment further includes a filter element electrically coupled to a distal end of the contact pin and a flange electrically coupled between a proximal end of the filter element and a proximal portion of an electrode. In this embodiment the flange and the proximal portion of the electrode form at least a first part of a hermetic chamber enclosing the filter element. | 12-30-2010 |
| 20100331921 | NEUROSTIMULATION DEVICE AND METHODS FOR CONTROLLING SAME - A stimulation device that includes a housing, a neuro lead configured to be coupled to the housing and to be located proximate to a neurostimulation site of interest, a neuro pulse generator, in the housing, configured to generate multi-polar neuro modulation (NM) pulses for delivery by the lead to the neuromodulation site of interest and the neuro pulse generator generating the NM pulses utilizing a waveform, with the frequency components of the ICMD compatible waveform in a range of 0 to 225 Hz having substantially limited NM energy content to avoid interference with sensing operation of the ICMD. A method for managing a neuromodulation (NM) device to avoid interference with an implantable medical device (ICMD) providing an ICMD having electrodes configured based on ICMD sensing parameters that define an ICMD sensing frequency range, providing an NM device having NM electrodes to be located proximate a region of interest, the NM electrodes delivering NM pulses based on NM pulse parameters, setting at least one NM pulse parameter in a manner that limits an amount of NM energy content that propagates beyond an active area surrounding the site of interest within the ICMD sensing frequency range. | 12-30-2010 |
| 20100331906 | ANODAL EXCITATION OF TISSUE - A cardiac stimulation device has a plurality of electrodes that deliver therapeutic electrical stimulation to the heart. At least one electrode is designated a cathode that cathodically induces depolarization of the surrounding heart tissue. At least one electrode is designated an anode. The device is configured, through one or more of electrode size, electrode configuration, electrode arrangement, cathode/anode number and pulse delivery circuitry, to induce depolarization of the heart tissue in the area of the at least one anode electrode, thereby resulting in greater depolarization of the heart tissue with reduced power consumption. | 12-30-2010 |
| 20100331713 | POST-EXERCISE ARRHTYMIA DETECTION - Post-exercise arrhythmias are detected by an implantable medical device. In some aspects, post-exercise arrhythmia may be prognostic of a worsening cardiovascular condition. Thus, the detection of post-exercise arrhythmia may be used as an indicator for adjusting the therapy prescribed for a patient. In some aspects post-exercise arrhythmia are detected if a patient is exercising at a level that equals or exceeds a threshold exercise level. In some aspects, therapy for a patient is modified if the detected post-exercise arrhythmia exceeds a threshold arrhythmia level. In some aspects therapy for a patient is modified if ischemia is detected in conjunction with post-exercise arrhythmia. | 12-30-2010 |
| 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 |
| 20100318153 | METHOD AND SYSTEM FOR AUTOMATICALLY SWITCHING BETWEEN MODES OF AN IMPLANTABLE MEDICAL DEVICE - An implantable medical device includes a lead, a pulse generator, an autocapture module, an autothreshold module, a fusion detection module, and a control module. The lead includes electrodes configured to be positioned within a heart. At least one of the electrodes is capable of sensing cardiac signals. The pulse generator delivers a stimulus pulse through at least one of the electrodes. The autocapture module senses an evoked response of the heart after delivery of the stimulus pulse when operating in an autocapture mode. The autothreshold module performs a threshold search when operating in an autothreshold mode. The fusion detection module identifies fusion-based behavior in the heart. The control module automatically switches between the autothreshold and autocapture modes based on a presence of the fusion-based behavior. | 12-16-2010 |
| 20100318152 | METHOD AND SYSTEM FOR OVERDRIVING A HEART CHAMBER DURING A THRESHOLD SEARCH - An implantable medical device includes a lead, a pulse generator, an autothreshold module and a control module. The lead includes electrodes positioned within a heart. At least one of the electrodes senses cardiac signals. The pulse generator delivers a stimulus pulse through at least one of the electrodes. The autothreshold module performs a threshold search when operating in an autothreshold mode and causes atrial stimulus pulses to be delivered in an atrium of the heart at an overdrive rate during the threshold search. The control module determines an AV conduction time and applies an overdrive AV adjustment to the AV conduction time to generate an AV delay. The autothreshold module uses the AV delay in connection with delivering ventricular stimulus pulses to a ventricle of the heart. | 12-16-2010 |
| 20100318148 | PAC THERAPY - An implantable cardiac device is programmed to detect and classify premature atrial contractions (PACs) and administer responsive pacing therapy. The responsive pacing therapy is in the form of an atrial extrastimulus, which is intended to preempt initiation of a reentrant tachycardia. The atrial extrastimulus is timed to occur late enough after a PAC to ensure atrial capture, but early enough that the resulting atrial depolarization does not conduct through the AV node to the ventricles if the PAC has already done so. If both of these criteria cannot be met, the device may be configured to inhibit the atrial extrastimulus. | 12-16-2010 |
| 20100318019 | ELECTROPHYSIOLOGY DEVICES EMPLOYING ELECTRICALLY CONDUCTIVE POLYMER CONDUCTORS AND METHODS OF MANUFACTURING SUCH DEVICES - A medical tubular body that may be used in an implantable medical lead, a catheter, a sheath and introducer is disclosed herein. The medical tubular body may include a tubular layer formed of an electrically insulating polymer and an electrically conductive polymer strip imbedded in and longitudinally extending through the insulating polymer. | 12-16-2010 |
| 20100298670 | ELECTROLYTE MONITORING USING IMPLANTED CARDIAC RHYTHM MANAGEMENT DEVICE - A method for diagnosing an electrolyte level with a cardiac rhythm management device includes recording intra-cardiac electrograms from multiple sites. The method determines the electrolyte level based upon a comparative analysis of intra-cardiac electrograms recorded from at least two of the sites. The electrolyte level can be quantified based upon a general model, or a patient specific model. | 11-25-2010 |
| 20100298663 | SYSTEM AND METHOD FOR DETECTION AND TREATMENT OF IRREGULAR METABOLIC FUNCTION - A system and method for detecting and treating irregular metabolic function. The systems and methods generally include an implantable medical device that measures various physiological parameters. Such physiological parameters generally provide an indication of the patient's metabolic rate, respiratory rate, and activity level. For example, the medical device may measure the patient's relative movement, or may measure the patient's oxygen consumption. These measures are then recorded, and the recorded data is used to determine the normal relationship between metabolic rate and other physiological parameters for that patient. The baseline relationship is then used to determine if the patient experiences an increase or decrease in metabolic rate that is not explained by changes in other physiological parameters. Further testing, and treatment if necessary, can be performed if the physiological parameters indicate irregular metabolic function. | 11-25-2010 |
| 20100292747 | TECHNIQUES FOR DELIVERY OF STEM CELL AND RELATED THERAPIES TO TREAT CARDIAC CONDITIONS - An exemplary method includes acquiring cardiac electrical activity information; detecting an R wave; and based on the detecting, calling for delivery of energy to cells located in a structure outside of the myocardium only during a period time within the QRS complex corresponding to the detected R wave. The energy delivered may be electrical stimulation energy or mechanical energy. | 11-18-2010 |
| 20100286736 | TECHNIQUES FOR DELIVERY OF STEM CELL AND RELATED THERAPIES TO TREAT CARDIAC CONDITIONS - An exemplary method includes acquiring cardiac electrical activity information, detecting a T wave and, based on the detecting, calling for delivery of matter to the heart where the matter may include one or more of stem cells, progenitor cells, nutrients and drugs. Another exemplary method includes calling for delivery of electrical energy to cells destined for implantation in the body or cells already implanted in the body. Such delivery may be timed according to cardiac electrical activity and/or delivered at an energy level below a capture threshold of neighboring tissue. Various other exemplary technologies are also disclosed. | 11-11-2010 |
| 20100286652 | TECHNIQUES FOR DELIVERY OF STEM CELL AND RELATED THERAPIES TO TREAT CARDIAC CONDITIONS - An exemplary method includes acquiring cardiac electrical activity information; detecting cardiac events within the information including T waves, QRS complexes and/or P waves; and calling for delivery of matter to the heart during a period of time based on the cardiac events. The delivery may occur between a detected T wave and its immediately subsequent QRS complex. The matter being delivered may include stem cells, progenitor cells, nutrients and/or drugs. | 11-11-2010 |
| 20100274323 | METHOD AND SYSTEM FOR POWER MANAGEMENT - Telemetry data from an IMD are routinely extracted in order to perform a full prognosis of a patient's condition and to alter the IMD therapy programming if necessary. Typically, while the IMD is inside of the patient, it periodically or continuously collects and stores data into its memory. These stored data can then be extracted by a physician to an external device for further analysis. In addition to the stored telemetry data, the physician may also want to collect real-time telemetry data such as real-time IEGM data or other physiological data while the patient is in the physician's office. However, transmitting telemetry data can consume a high level of power and shorten the battery life of the IMD if not properly managed. Thus, it is advantageous to have built-in features to minimize the possibility the IMD is not transmitting and/or receiving data while it is not being monitored and/or used by the physician for a predetermined amount of time. | 10-28-2010 |
| 20100268196 | BRAIDED PEELABLE CATHETER AND METHOD OF MANUFACTURE - A method of manufacturing a braid-reinforced peelable tubular body is disclosed herein. In one embodiment, the method includes: providing a braided tubular body; forming at least one longitudinally extending slit in tho braided tubular body, resulting in a longitudinally slit braided tubular body, the at least one longitudinally extending slit including slit edges and a severed braid layer of the braided tubular body; placing the longitudinally slit braided tubular body on a mandrel; placing a heat shrink tube about the longitudinally slit braided tubular body; subjecting the heat shrink tube and longitudinally slit braided tubular body to bonding conditions, such as, for example, reflow, laser bonding, thermoforming, etc., thereby causing the slit edges to be joined to each other and resulting in a braid-reinforced peelable tubular body; and removing the braid-reinforced peelable tubular body from the mandrel. | 10-21-2010 |
| 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 |
| 20100249862 | System and Method for Controlling Ventricular Pacing During AF Based on Underlying Ventricular Rates Using an Implantable Medical Device - Techniques are provided for controlling ventricular pacing during an episode of atrial fibrillation (AF) for use by a pacemaker, implantable cardioverter-defibrillator (ICD) or other implantable medical device. In one example, upon detection of AF, the underlying intrinsic ventricular rate of the patient is determined prior to delivering any ventricular pacing. Then, a ventricular pacing procedure—such as dynamic ventricular overdrive (DVO) pacing—is activated to reduce ventricular rate variability to mitigate the adverse effects of AF. The ventricular pacing procedure employed during AF is controlled based on a maximum ventricular rate set relative to the underlying intrinsic ventricular rate so as to keep an overall ventricular rate below the maximum rate. | 09-30-2010 |
| 20100249756 | SYSTEM AND METHOD FOR MONITORING CARDIOPULMONARY FLUID TRANSFER RATES USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use by a pacemaker or other implantable medical device for detecting and tracking trends in cardiopulmonary fluid transfer rates—such as heart-to-lung fluid perfusion rates and lung-to-lymphatic system fluid excretion rates—and for detecting heart failure, dyspnea or other cardiopulmonary conditions. In one example, the device periodically measures transthoracic admittance values. A first exponential time-constant (k | 09-30-2010 |
| 20100234913 | CLOSED LOOP PROGRAMMING FOR INDIVIDUAL ADJUSTMENT OF ELECTRO-MECHANICAL SYNCHRONY - An implantable therapy system including implantable stimulation and control components. The implantable components operate under a set of variable parameters that can be adjusted for improved performance for an individual patient. The implantable components are adapted to self-evaluate the patients physiologic performance and autonomously adjust an existing set of parameters to improve performance throughout an implantation period without requiring intervention of a clinician, for example with a physicians programmer. The implantable components can compare a patient's exhibited activity to a desired template of that activity to determine when adjustments are indicated. The template can be based on observations of one or more third parties exhibiting normal activity. The implantable components can adjust the operating parameters to improve synchrony of multiple heart chambers and/or to increase a peak contractility. | 09-16-2010 |
| 20100234906 | SYSTEM AND METHOD FOR CONTROLLING RATE-ADAPTIVE PACING BASED ON A CARDIAC FORCE-FREQUENCY RELATION DETECTED BY AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for use in controlling rate-adaptive pacing within implantable medical devices such as pacemakers or implantable cardioverter-defibrillators (ICDs). In one example, a force-frequency relationship is determined for the heart of the patient, which is representative of the relationship between cardiac stimulation frequency and myocardial contractile force. To this end, various parameters are detected for use as surrogates for contractile force, including selected systolic pressure parameters and cardiogenic impedance parameters. Rate-adaptive pacing is then controlled based on the detected force-frequency relationship to, for example, deactivate rate-adaptive pacing if the slope and/or abscissa of the force-frequency relationship indicates significant contractility dysfunction within the patient. In other examples, rather than deactivating rate-adaptive pacing, control parameters are adjusted to render the rate-adaptive pacing less aggressive. In still other examples, trends in the slope and/or abscissa of the force-frequency relationship are monitored to detect contractility dysfunction and/or heart failure and titrate medications accordingly. | 09-16-2010 |
| 20100228331 | IMPLANTABLE MEDICAL LEAD HAVING A BODY WITH HELICAL CABLE CONDUCTOR CONSTRUCTION AND METHOD OF MAKING SAME - Disclosed herein is an implantable medical lead. The lead may include a longitudinally extending body having a distal end, a proximal end, a helical core assembly extending between the distal and proximal ends, and an outer jacket about the helical core assembly. The helical core assembly may have at least one helical ridge. In some instances, the at least one helical ridge may be at least two helical ridges and the helical core may further include least two helical troughs. In some such cases, the at least two helical ridges may define the at least two helical troughs. | 09-09-2010 |
| 20100228330 | LEAD CONFIGURED FOR HISIAN, PARA-HISIAN, RV SEPTUM AND RV OUTFLOW TRACT PACING - Disclosed herein is an implantable medical lead for implantation within a right ventricle of a heart and powered by an implantable pulse generator. The lead includes a lead body having a proximal end configured to couple to the generator, a distal end, an electrode at the distal end, and a distal portion extending proximally from the distal end. When the distal portion is in a non-deflected state, the distal portion biases to assume a configuration including first, second and third generally straight segments and first and second bends. The first segment is proximal of the distal end, the second segment is proximal of the first segment, the third segment is proximal of the second segment, the first bend is between the first and second segments, and the second bend is between the second and third segments. When the distal portion is implanted in the right ventricle, the configuration is at least partially the cause of the electrode being at least one of: positioned against the right ventricle septum; positioned in the outflow tract of the right ventricle; positioned for Hisian pacing; and positioned for para-Hisian pacing. | 09-09-2010 |
| 20100228307 | Responding to Partial Lead Failure in an Implantable Cardioverter Defibrillator - An implanted cardioverter defibrillator (ICD) delivers an electrical therapy signal to the heart of a patient. When ventricular fibrillation or another condition of the heart requiring high voltage therapy is sensed, the therapy signal is delivered to the heart. When a partial short-circuit or other low impedance condition occurs, an over-current protection circuit will stop delivery of a shocking pulse. The ICD will then reduce the voltage of the shocking pulse and try again to deliver electrical therapy. This process is repeated until a voltage level is found that is able to deliver the electrical therapy without causing an over-voltage condition. Alternate lead configurations may also be tried in an attempt to find a signal path that is not affected by the low impedance or short-circuit condition. | 09-09-2010 |
| 20100228103 | MULTIFACETED IMPLANTABLE SYNCOPE MONITOR - MISM - A multi-channel implantable syncope monitor that monitors ECG data, myopotential data, EEG data, photoplethysmography (PPG) data, and position sensor data is used to capture physiologic data about a patient who is experiencing a syncopal event. The timing of the events within the simultaneously captured physiologic data can then be used to more accurately determine potential sources of origin of the syncopal event. | 09-09-2010 |
| 20100222860 | Implantable Leads Having Mechanisms to Impede Over-Rotation of Fixation Mechanisms - An implantable lead includes a lead body, a header body, a fixation mechanism, a rotatable shaft and a rotation limit element. The fixation mechanism is disposed in the header body and is extendable out of the header body for securing the header body to cardiac tissue of the patient. The shaft is provided in the header body and is coupled to the fixation mechanism for translating rotational movement of the shaft into linear displacement of the fixation mechanism. The rotation limit element is disposed in the header body. The rotation limit element engages the header body once the shaft is linearly displaced by a predetermined distance with respect to the header body to prevent further rotation of the shaft and limit additional displacement of the fixation mechanism with respect to the header body. | 09-02-2010 |
| 20100217366 | Implantable Medical Lead Circuitry and Methods for Reducing Heating and/or Induced Current - An implantable medical lead for coupling to an implantable pulse generator may be configured for improved safety. The lead may include: a first electrode; a second electrode in electrical communication with the first electrode; and an active circuit element in electrical communication with the first electrode and the second electrode. The active circuit element may be configured to change an impedance of the lead. The active circuit element may be configured to change the impedance of the lead in response to a pacing signal or a signal having opposite polarity to a pacing signal. A method of using an implantable medical lead for improved safety may include changing an impedance of an implantable medical lead from a relatively high impedance to a relatively low impedance and/or changing an impedance of an implantable medical lead from a relatively low impedance to a relatively high impedance. | 08-26-2010 |
| 20100217277 | DEVICE AND METHOD FOR THE IMPLANTATION OF ACTIVE FIXATION MEDICAL LEADS - A lead implantation tool is disclosed herein. The tool may be configured to operably couple to a lead connector end of an implantable cardiac electrotherapy lead including an active fixation helix tip and wherein the lead connector end includes a contact pin proximally extending from the lead connector end. The tool may include a feature configured to couple to the contact pin and a first mechanism configured to convert linear movement into rotational movement of the contact pin relative to the lead connector end. The tool may further include a second mechanism that causes a stylet extending through the tool and into the contact pin to at least one of distally and proximally displace within the contact pin. | 08-26-2010 |
| 20100211149 | IMPLANTABLE MEDICAL LEAD HAVING AN ANCHOR PROVIDING ENHANCED FIXATION - An implantable medical lead is disclosed herein wherein the lead employs a helical distal tip anchor having improved fixation capabilities. The implantable medical lead may include a body and a helical anchor. The body may include a distal end and a proximal end. The helical anchor may be at least one of extending and extendable from the distal end. The helical anchor may include at least one loop including first and second straight sides that intersect at a first corner. | 08-19-2010 |
| 20100211144 | LEAD CONNECTOR PIN AND BODY ASSEMBLY AND METHOD OF MANUFACTURE - An implantable medical lead is disclosed herein. In one embodiment, the lead includes a body, at least one electrode and a lead connector end. The body includes a distal portion and a proximal portion. The at least one electrode is on the distal portion. The lead connector end is on the proximal portion and includes a pin contact and a retainer assembly. The pin contact is electrically coupled to the at least one electrode and proximally extends from the lead connector end. The retainer assembly retains the pin contact as part of the lead connector end and includes a collar and a cap. The cap is secured within the collar via an interference fit arrangement and includes a hole through which the pin contact extends. | 08-19-2010 |
| 20100204767 | SMALL CALIBER IMPLANTABLE BIOMETRIC LEADS AND CABLES FOR SAME - Implantable medical leads have reduced diameter while providing for optimized mechanical and electrical properties, by reducing the diameters of the conducting cables used within the leads for sensing and delivery of therapeutic electrical stimulation. In an embodiment, conducting filaments within a cable have oval cross-sectional areas. Suitably orienting the oval filaments increases the contact surface between adjacent filaments, broadly distributing the pressure between filaments and reducing fretting fatigue, while the oval cross-sectional area also increases conductivity. In an embodiment, non-conducting coatings around filaments within a cable, or around groups of filaments organized into cable-layers, reduce fretting fatigue. In an embodiment, the cross-sectional area of filaments decreases as the filaments are positioned at increasing radial distances from the center of the cable. In an embodiment, the relative composition of various filament metals and/or alloys is varied in filaments at different radial distances from the center of the cable. | 08-12-2010 |
| 20100204593 | SYSTEM AND METHOD FOR IDENTIFYING A POTENTIAL CAUSE OF PULMONARY EDEMA - A method of identifying a potential cause of pulmonary edema is provided. The method includes obtaining one or more impedance vectors between predetermined combinations of the electrodes positioned proximate the heart. At least one of the impedance vectors is representative of a thoracic fluid level. The method also includes applying a stimulation pulse to the heart and sensing cardiac signals of the heart that are representative of an electrophysiological response to the stimulation pulse. The method further includes monitoring the cardiac signals and at least one of the impedance vectors with respect to time to identify the potential cause of pulmonary edema. | 08-12-2010 |
| 20100198327 | Active Fixation Implantable Medical Lead Configured to Indicate via Fluoroscopy Embedment of Helical Anchor in Cardiac Tissue - An implantable medical lead for active fixation to cardiac tissue is disclosed herein. The lead may include a lead body distal end, a tissue fixation helical anchor and a structure. The tissue fixation helical anchor may be coupled to the lead body distal end and include a distal tip. The structure may be coupled to the lead body distal end and include a structure distal end including a first radiopaque marker. The structure may be biased to project the structure distal end near the distal tip. When the tissue fixation helical anchor is progressively embedded in the cardiac tissue, the cardiac tissue progressively displaces the structure distal end proximally. | 08-05-2010 |
| 20100198326 | CRIMP-THROUGH CRIMP CONNECTOR FOR CONNECTING A CONDUCTOR CABLE AND AN ELECTRODE OF AN IMPLANTABLE CARDIAC ELECTROTHERAPY LEAD - An implantable cardiac electrotherapy lead is disclosed herein. The lead may include an electrode on a distal portion of the lead, a conductor extending proximally through the lead from the electrode, and a crimp connector coupling a distal end of the conductor to the electrode. The connector may include a body with an outer surface, an inner surface, proximal and distal ends, a cavity, and at least one splice opening. The inner surface defines the cavity, the proximal and distal ends respectively define proximal and distal openings leading to the cavity, and the at least one splice opening extends from the outer surface to the inner surface and is oriented generally transverse to an axis extending between the proximal and distal openings. | 08-05-2010 |
| 20100198082 | Systems and Methods for Use with an Implantable Medical Device for Detecting Stroke Based on Electrocardiac Signals - Techniques are provided for detecting stroke within a patient using an implantable medical device in conjunction with an external confirmation system. In one example, a preliminary detection of stroke is performed by a subcutaneous monitor based on an analysis of features of an electrocardiogram (ECG) sensed within the patient. Exemplary ECG features indicative of possible stroke include the onset of prominent U-waves, the onset of notched T-waves, and changes in ST segment duration or QT duration or dynamic trends in these parameters. The monitor transmits a signal indicative of possible stroke to a bedside monitor or other external system, which generates a stroke questionnaire for use in confirming the stroke. Family members or other caregivers input answers to the questionnaire into the external system, which confirms or disconfirms the stroke. Emergency personnel can be automatically notified. Implantable systems that detect stroke based on intracardiac electrogram (IEGM) signals are also described herein. | 08-05-2010 |
| 20100191312 | METHODS AND SYSTEMS FOR CONNECTING ELECTRICAL LEADS TO AN IMPLANTABLE MEDICAL DEVICE - An implantable medical device having a lead retention assembly is disclosed herein. In one embodiment, the lead retention assembly comprises at least two receptacles configured to receive a connective end of a respective electrical lead, a support member, a first side clamp configured to define a first port in conjunction with the support member, a second side clamp configured to define a second port in conjunction with the support member, and a fastener configured to urge both the first and second side clamps toward the support member upon actuation of the fastener. | 07-29-2010 |
| 20100185251 | METHOD AND APPARATUS FOR PREVENTING EXCESSIVE POWER DRAIN FROM AN IMPLANTABLE DEVICE - A method and apparatus are provided for controlling interrogation of an implantable device such as a pacemaker, an implantable cardioverter, or a defibrillator utilizing an external device in a home environment. The method controls how frequently a patient can retrieve status information from the implantable device based on a time period elapsed since a last interrogation and a power level of a battery. | 07-22-2010 |
| 20100185111 | Methods and Systems for Discriminating Between Ventricular Waveforms When Ventricular Rate Exceeds Atrial Rate - A ventricular rate based on first candidate waveforms and second candidate waveforms within sensed ventricular waveforms is compared to an atrial rate. If the ventricular rate exceeds the atrial rate, the first candidate waveforms and second candidate waveforms are compared to a ventricular polarization complex template to obtain a first morphology indicator and a second morphology indicator. If a morphology match inconsistency is present, the amount by which the ventricular rate exceeds the atrial rate is compared to a threshold. If the threshold is exceeded, high-ventricular-rate therapy to the heart is inhibited. The ventricular polarization complex template may be a QRS-complex template, in which case a match inconsistency is present if each of the first candidate waveforms and the second candidate waveforms do not match the QRS-complex template. Alternatively, the ventricular polarization complex template may be a T-wave template, in which case a match inconsistency is present if either of the first candidate waveforms and the second candidate waveforms matches the T-wave template. | 07-22-2010 |
| 20100174336 | Systems and Methods for Adjusting a Pacing Rate Based on Cardiac Pressure - An implantable medical device includes a pressure input, an excitation source, a detector module, and a processor. The pressure input is configured to be joined to a pressure sensor located proximate to a cardiac chamber of the heart. The pressure input receives pressure measurements representative of a pressure in the cardiac chamber. The excitation source is configured to deliver stimulation pulses to the heart. The detector module communicates with the pressure sensor to receive and compare the pressure measurements to a pressure threshold. The processor instructs the excitation source to deliver the stimulation pulses at a pressure-based rate based on the comparison of the pressure measurements to the pressure threshold. | 07-08-2010 |
| 20100161006 | SYSTEM AND METHOD FOR MONITORING DIASTOLIC FUNCTION USING AN IMPLANTABLE MEDICAL DEVICE - Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters. | 06-24-2010 |
| 20100160993 | IMPLANTABLE SYSTEMS AND METHODS FOR MONITORING BNP LEVELS, HF AND MI - Methods for monitoring a patient's level of B-type natriuretic peptide (BNP), and implantable cardiac systems capable of performing such methods, are provided. A ventricle is paced for a period of time to provoke a ventricular evoked response, and a ventricular intracardiac electrogram (IEGM) indicative of the ventricular evoked response is obtained. Based on the ventricular IEGM, there is a determination of at least one ventricular evoked response metric (e.g., ventricular evoked response peak-to-peak amplitude, ventricular evoked response area and/or ventricular evoked response maximum slope), and the patient's level of BNP is monitored based on determined ventricular evoked response metric(s). Based on the monitored level's of BNP, the patients heart failure (HF) condition and/or risks and/or occurrences of certain events (e.g., an acute HF exacerbation and/or an acute myocardial infarction) can be monitored. | 06-24-2010 |
| 20100160991 | IMPLANTABLE PULSE GENERATOR EMI FILTERED FEEDTHRU - Disclosed herein is an implantable pulse generator. The implantable pulse generator includes a header, a can and a feedthru. The header includes a lead connector block electrically coupled to a first conductor. The can is coupled to the header and includes a wall and an electronic component electrically connected to a second conductor and housed within the wall. The feedthru is mounted in the wall and includes an electrically insulating core, a PCB, a shield, a chip capacitor, a power circuit and a ground circuit. A first side of the PCB abuts against the core and a second side of the PCB abuts against an edge of the shield. The chip capacitor is mounted on the second side of the PCB. The chip capacitor is enclosed in a volume defined by an interior of the shield and the second side of the PCB. A first electrical contact of the chip capacitor is electrically coupled to the power circuit, which extends between the first and second conductors. A second electrical contact of the chip capacitor is electrically coupled to the ground circuit, which is electrically coupled to the wall. | 06-24-2010 |
| 20100160804 | MONITORING VARIATION PATTERNS IN PHYSIOLOGICAL PARAMETERS ASSOCIATED WITH MYOCARDIAL INSTABILITY - A method of analyzing myocardial instability includes obtaining a physiological parameter representative of myocardial behavior over a set of cardiac cycles and determining reversal points in the physiological parameter over the set of cardiac cycles. The method also includes identifying myocardial instability based on the reversal points in the physiological parameter. A reversal point may correspond to a value of the physiological parameter, during a current cardiac cycle, that exceeds or is less than the values of the physiological parameter during prior and subsequent cardiac cycles. Optionally, the method includes calculating differences between values of the physiological parameter for consecutive cardiac cycles and detecting the reversal points when a current difference exceeds or is less than differences for prior and subsequent cardiac cycles. | 06-24-2010 |
| 20100152806 | SYSTEMS AND METHODS FOR OPERATING AN IMPLANTABLE DEVICE FOR MEDICAL PROCEDURES - When a medical procedure is performed on a patient in whom an implantable medical device is implanted, the medical procedure may have undesired effects on the medical device, such as triggering a response that initiates therapy by the device that is unnecessary and potentially dangerous to the patient. Systems and methods may facilitate performing of such medical procedures on such patients by temporarily reprogramming the medical device, monitoring for one or more detectable characteristics associated with the medical procedure to be performed, and restoring normal programming of the device based on detection and/or lack of detection of the detectable characteristic(s). | 06-17-2010 |
| 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 |
| 20100152801 | Cardiac Resynchronization Therapy Optimization Using Vector Measurements Obtained from Realtime Electrode Position Tracking - An exemplary method includes selecting multiple electrodes located in a patient; acquiring position information during one or more cardiac cycles for the multiple electrodes where the acquiring includes using each of the electrodes for measuring one or more electrical potentials in an electrical localization field established in the patient; calculating one or more vector metrics based on the acquired position information for one or more vectors, each vector defined by two of the multiple electrodes; and analyzing the one or more vector metrics to assess cardiac performance during the one or more cardiac cycles. Various other methods, devices, systems, etc., are also disclosed. | 06-17-2010 |
| 20100152796 | MECHANICAL INDICATORS FOR INDIVIDUALLY ADAPTING THERAPY IN AN IMPLANTABLE CARDIAC THERAPY DEVICE - A system with an implantable cardiac stimulation device having an implantable stimulation generator, at least one implantable lead adapted for connection to the implantable stimulation generator and further adapted for at least one of sensing physiologic activity and delivery of therapy, memory, and a controller in communication with the memory and with the at least one implantable lead and stimulation generator. The controller is configured to automatically evaluate a patient's physiologic status and selectively induce delivery of therapeutic stimulation under variable timing parameters. The system also has a measurement system adapted to measure at least one of strain and velocity of myocardial tissue and is adapted to evaluate strain and/or velocity measures and adjust the variable timing parameters of the implantable stimulation device to increase mechanical synchrony of the myocardial tissue. | 06-17-2010 |
| 20100152795 | IDENTIFICATION OF DYSYNCHRONY USING INTRACARDIAC ELECTROGRAM DATA - Implantable stimulation devices can provide intracardiac electrograms (EGMs) and impedance measurements to detect changes in electrical, mechanical, and electromechanical activation of the heart. Many patients with congestive heart failure have conventional intracardiac devices implanted that are not capable of resynchronization therapy and these patients could benefit from resynchronization, but are not candidates based on current criteria. These patient populations can be identified through analyses of intracardiac electrogram data that is available through implantable stimulation devices comprising at least one lead for providing electrical stimulation to the heart of a patient, at least one sensor that detects electrical signals indicative of the depolarization of the heart of the patient, and a controller that is adapted to be implanted within the patient. The controller receives signals from the at least one sensor and further induces the lead to provide therapeutic electrical stimulation to the heart of the patient. The controller periodically evaluates the signals from the sensor and determines if at least one parameter of the signal is indicative of the patient being potentially subject to heart dysynchrony. The controller, upon determining that the parameter of the signal indicates that the patient is potentially subject to heart dysynchrony, records an indication thereof for subsequent communication to treating medical personnel. | 06-17-2010 |
| 20100152560 | METHODS, SYSTEMS AND DEVICES FOR MONITORING RESPIRATORY DISORDERS - Methods, systems and devices are provided for monitoring respiratory disorders based on monitored factors of a photoplethysmography (PPG) signal that is representative of peripheral blood volume. The monitored factors can be respiratory effort as well as respiratory rate and/or blood oxygen saturation level. The systems and devices may or may not be implanted in a patient. | 06-17-2010 |
| 20100145405 | Systems and Methods for Controlling Ventricular Pacing in Patients with Long Inter-Atrial Conduction Delays - Techniques are provided for use by implantable medical devices for controlling ventricular pacing. In one example, optimal atrio-ventricular and interventricular pacing delay values are determined for pacing the heart of the patient based, in part, on a measured inter-atrial conduction delay. Atrio-ventricular conduction delays are then measured within the patient. The atrio-ventricular pacing delays are compared with the measured atrio-ventricular conduction delays. If the atrio-ventricular pacing delays are less than the measured atrio-ventricular conduction delays, biventricular pacing is delivered using the atrio-ventricular pacing delay and the interventricular pacing delay. However, if the atrio-ventricular pacing delays are not less than the corresponding atrio-ventricular conduction delays, as can occur if the inter-atrial conduction delay is large, then alternative pacing regimes are selectively enabled, such as monoventricular pacing in the chamber having the longer conduction delay value, biventricular pacing with negative hysteresis, or biventricular pacing with pacing delays reduced using predetermined offset values. | 06-10-2010 |
| 20100139672 | METHOD AND APPARATUS FOR MONITORING INGESTION OF MEDICATIONS USING AN IMPLANTABLE MEDICAL DEVICE - An implantable medical device, such as a pacemaker or implantable cardioverter defibrillator (ICD), is configured to automatically detect ingestion of medications to verify that prescribed medications are taken in a timely manner and at the correct dosage. Briefly, individual pills are provided with miniature radio frequency identification (RFID) devices capable of transmitting RFID tag signals, which identify the medication contained within the pill and its dosage. The implanted device is equipped with an RFID transceiver for receiving tag signals from a pill as it is being ingested. The implanted system decodes the tag to identify the medication and its dosage, then accesses an onboard database to verify that the medication being ingested was in fact prescribed to the patient and to verify that the correct dosage was taken. Warning signals are generated if the wrong medication or the wrong dosage was taken. Therapy may also be automatically adjusted. Non-RF-based ID devices are also described, which instead transmit ID data via biphasic current pulses. | 06-10-2010 |
| 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 |
| 20100137878 | IMPLANT TOOL FOR ACTIVE FIXATION LEAD - An implant tool for use with an endocardial or other implantable lead having an extendable/retractable active fixation tip includes a housing, a shaft rotatably supported by the housing, and a shaft rotation mechanism for rotating the shaft through a predetermined angular travel. The shaft includes a lead attachment portion for selectively coupling a lead to the shaft such that the lead is rotatable with the shaft. The implant tool may include a control tab slidably supported by the housing, wherein longitudinal movement of the control tab actuates the shaft rotation mechanism. The shaft rotation mechanism may include a gear train, an electric motor, a double acting spring mechanism, or a retractable tape wound around the shaft. The gear train includes an input member coupled to the control tab and an output gear coupled to the shaft. The input member meshes with an input gear supported by the housing. | 06-03-2010 |
| 20100132184 | IMPLANTABLE MEDICAL DEVICE WITH IMPROVED BACK-FILL MEMBER AND METHODS OF MANUFACTURE THEREOF - An implantable medical device and methods of manufacture are provided for implantation in a body. The device includes a device housing having an interior cavity and electronic circuitry located in the interior cavity of the device housing. The electronic circuitry detects a physiologic condition of the body and delivers a therapy to the body. The device further includes a feed-through assembly having a feed-through housing that is joined to the device housing. The feed-through assembly includes conductors held in the feed-through housing and electronically connected to the electronic circuitry. A back-fill member is joined to the feed-through housing. The back-fill member has an opening there through communicating with the interior cavity of the device housing. A sealing element is hermetically secured in the opening through the back-fill member. The sealing element and back-fill member are formed of different first and second materials, respectively. The second material is generally harder than the first material. For example, the sealing element may constitute a titanium ball configured to be deformed when pressed into the opening in the back-fill member, where the first and second materials constitute titanium and a titanium alloy, respectively. The back-fill member is dimensioned relative to a support tool to permit the back-fill member to self-align during an initial sealing operation by shifting and/or tilting relative to a support tool. | 06-03-2010 |
| 20100125305 | USE OF IMPEDANCE TO ASSESS ELECTRODE LOCATIONS - A process for determining whether the location of a stimulation electrode meets a selected heart performance criteria includes providing stimulation to the heart through the electrode and obtaining an impedance measurement during stimulation delivery using an impedance sensing vector formed by electrodes that do not include the stimulation electrode. The impedance measurements are processed, either alone or in combination with an electrogram, also obtained during stimulation, to obtain a measure of hemodynamic performance. | 05-20-2010 |
| 20100125174 | Remote Support of Implantable Medical Devices - Exemplary medical devices and systems for providing remote support relating to implantable medical devices (IMDS) are described. One method generates a graphical user-interface (GUI) relating to an IMD on a local medical device configured to interrogate the IMD. The method also recreates the GUI on a remote medical device effective that a cursor of the GUI can be manipulated from both the local medical device and the remote medical device while selection of IMD parameter values is available only at the local medical device. | 05-20-2010 |
| 20100123587 | IMPLANTABLE MEDICAL DEVICE ALERT MANAGEMENT - Exemplary systems and methods for automatically managing implantable medical device (IMD) related alerts are described. One method receives implantable medical device-related alerts. The method automatically manages the implantable medical device alerts by parsing the alerts through a set of predefined parameters. | 05-20-2010 |
| 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 |
| 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 |
| 20100121397 | System and Method for Evaluating Mechanical Cardiac Dyssynchrony Based on Multiple Impedance Vectors Using an Implantable Medical Device - Techniques are provided for evaluating mechanical dyssynchrony within the heart of patient in which a pacemaker, implantable cardioverter-defibrillator (ICD) or other medical device is implanted. In one example, a set of cardiogenic impedance signals are detected along different sensing vectors passing through the heart of the patient, particularly vectors passing through the ventricular myocardium. A measure of mechanical dyssynchrony is detected based on differences, if any, among the cardiogenic impedance signals detected along the different vectors. In particular, differences in peak magnitude delay times, peak velocity delay times, peak magnitudes, and waveform integrals of the cardiogenic impedance signals are quantified and compared to detect abnormally contracting segments, if any, within the heart of the patient. Warnings are generated upon detection of any significant increase in mechanical dyssynchrony. Diagnostic information is recorded for clinical review. Pacing therapies such as cardiac resynchronization therapy (CRT) can be activated or controlled in response to mechanical dyssynchrony to improve the hemodynamic output of the heart. | 05-13-2010 |
| 20100121396 | ENHANCED HEMODYNAMICS THROUGH ENERGY-EFFICIENT ANODAL PACING - An implantable device may employ anodal-based cardiac stimulation to improve hemodynamics. Anodal pacing may be provided on a conditional basis (e.g., upon detection of a defined condition). An implantable device may provide anodal pacing or cathodal pacing according to a defined ratio. An implantable device may use automatic capture detection to determine a pacing energy level that provides effective anodal pacing while attempting to minimize the power consumption associated with the anodal pacing. | 05-13-2010 |
| 20100121395 | System and Method for Setting Atrioventricular Pacing Delays Based on Far-Field Atrial Signals - An intrinsic inter-atrial conduction delay is determined by a pacemaker or implantable cardioverter-defibrillator based, at least in part, on far-field atrial events sensed using ventricular pacing/sensing leads. An atrioventricular pacing delay is then set based on the inter-atrial conduction delay. By detecting atrial events using ventricular leads, rather than using atrial leads, a more useful measurement of the intrinsic inter-atrial conduction delay can be obtained. In this regard, since atrial electrodes detect atrial activity locally around the electrodes, a near-field atrial event sensed using an atrial electrode might not properly represent the actual timing of the atrial event across both the right and left atria. Far-field atrial events sensed using ventricular leads thus allow for a more useful measurement of inter-atrial conduction delays for use in setting atrioventricular pacing delays. The delivery of individual V-pulses to the heart of the patient may be timed relative to the ends of individual far-field atrial events. | 05-13-2010 |
| 20100121394 | System and Method for Setting Atrioventricular Pacing Delays Based on Far-Field Atrial Signals - An intrinsic inter-atrial conduction delay is determined by a pacemaker or implantable cardioverter-defibrillator based, at least in part, on far-field atrial events sensed using ventricular pacing/sensing leads. An atrioventricular pacing delay is then set based on the inter-atrial conduction delay. By detecting atrial events using ventricular leads, rather than using atrial leads, a more useful measurement of the intrinsic inter-atrial conduction delay can be obtained. In this regard, since atrial electrodes detect atrial activity locally around the electrodes, a near-field atrial event sensed using an atrial electrode might not properly represent the actual timing of the atrial event across both the right and left atria. Far-field atrial events sensed using ventricular leads thus allow for a more useful measurement of inter-atrial conduction delays for use in setting atrioventricular pacing delays. The delivery of individual V-pulses to the heart of the patient may be timed relative to the ends of individual far-field atrial events. | 05-13-2010 |
| 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 |
| 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 |
| 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 |
| 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 |
| 20100114236 | HYBRID BATTERY SYSTEM WITH BIOELECTRIC CELL FOR IMPLANTABLE CARDIAC THERAPY DEVICE - A system and method for powering an implantable cardiac therapy device (ICTD) via a hybrid battery system. The hybrid battery is comprised of a low voltage and low current bioelectric cell, a high voltage and high current rechargeable cell, and a charging means. Via the charging means, the bioelectric cell maintains the rechargeable cell at or near full power. The rechargeable cell is configured to power some or all operations of the ICTD. Some ICTD operations may be powered directly by the bioelectric cell. The rechargeable cell is further configured to be charged via a continuous charging process, reducing the complexity of the charging circuitry. In an embodiment, at least the bioelectric cell is external to the ICTD, enabling easy replacement of this power source. In an embodiment, a consumable anode of the bioelectric cell is external to the ICTD, enabling replacement of the power source by replacing only the anode. | 05-06-2010 |
| 20100114235 | HYBRID BATTERY SYSTEM FOR IMPLANTABLE CARDIAC THERAPY DEVICE - A system and method for powering an implantable cardiac therapy device (ICTD) uses a hybrid battery system. In an embodiment, the hybrid battery system includes of a first type of power cell and a second type of power cell. The first power cell is configured to power low voltage, low current background operations of the ICTD. The second power cell is configured to power high voltage, high current cardiac shocking. The second power cell is further configured to be charged by the first power cell via a continuous, non-regulated charging process, thereby reducing the complexity of the charging circuitry. The system is further configured so that when cardiac shocking is in progress, only the secondary power cell powers the shocking capacitor(s) of the ICTD, and the first power cell is electrically isolated from the shocking capacitor(s). This configuration contributes to longer battery life of the hybrid battery system. | 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 |
| 20100114231 | METHODS AND SYSTEMS TO MONITOR ISCHEMIA - An implantable medical device includes leads, a segment monitoring module, an impedance detection module and an ischemia module. The leads include electrodes that are configured to be positioned within a heart and that are capable of sensing cardiac signals having a segment of interest. The segment monitoring module determines segment variations of the segment of interest in the cardiac signals. The impedance detection module measures impedance vectors between predetermined combinations of the electrodes. The ischemia detection module monitors ischemia based on changes in the segment variations of the segment of interest and based on changes in the impedance vectors. | 05-06-2010 |
| 20100114228 | SYSTEM AND METHOD FOR ACCURATELY DETECTING CARDIAC EVENTS USING RETROSPECTIVE CORRELATION - A system and method enables precise detection of the time of occurrence of a cardiac event of a heart. The method includes the steps of sensing electrical activity of the heart to generate an electrogram signal including the cardiac event, storing the electrogram signal, correlating the electrogram signal with an electrogram template, and identifying the time of occurrence of the cardiac event based upon the correlation. | 05-06-2010 |
| 20100114227 | Systems and Methds for Use by an Implantable Medical Device for Controlling Vagus Nerve Stimulation Based on Heart Rate Reduction Curves and Thresholds to Mitigate Heart Failure - Systems and techniques are provided for controlling vagus nerve stimulation (VNS) delivered by an implantable medical device for mitigating heart failure in a patient. In one mode, VNS therapy is set to levels just below a heart rate reduction threshold so as to deliver VNS near the highest stimulation levels that can be achieved without reducing patient heart rate. In this manner, a maximum level of heart failure mitigation can be achieved via VNS therapy without incurring the potentially adverse consequences of inducing bradycardia within the patient. In another mode, VNS therapy is instead controlled to deliver VNS above the threshold so as to mitigate heart failure while also selectively reducing heart rate, as may be appropriate in patients susceptible to cardiac ischemia. A controlled heart rate reduction curve may additionally or alternatively be determined for use in achieving target amounts of heart rate reduction. | 05-06-2010 |
| 20100114207 | INTERFERENTIAL CARDIAC PRECONDITIONING AND DEPOLARIZATION - Exemplary systems, devices, and methods pertaining to cardiac related therapy and particularly to interferential cardiac preconditioning and depolarization are described. A cardiac arrhythmia is detected from electrogram data sensed from a patient's heart and a region of the heart affected by the cardiac arrhythmia is determined. The affected region is the interferentially energized by multiple cycles of two concurrently delivered alternating currents which are offset in frequency. | 05-06-2010 |
| 20100114194 | SYSTEM AND METHOD FOR ACCURATELY DETECTING CARDIAC EVENTS USING MULTI-THRESHOLD PROCESSING - A system and method provide precise detection of the time of occurrence of a cardiac event of a heart. The method comprises the steps of sensing electrical activity of the heart to generate an electrogram of the heart and applying the electrogram to an event detector having a plurality of spaced apart thresholds. The thresholds are selected such that the electrogram has an amplitude for crossing at least one of the thresholds. The method further comprises determining a characteristic identifying feature of the electrogram at each threshold crossing of the electrogram, comparing the determined characteristic identifying features to an electrogram template, and identifying the time of occurrence of the cardiac event based upon the comparison. | 05-06-2010 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 20100094226 | SLITTABLE DELIVERY DEVICE ASSEMBLY FOR THE DELIVERY OF A CARDIAC SURGICAL DEVICE - An assembly for the delivery of a cardiac surgical device is disclosed herein. In one embodiment, the assembly includes a slittable delivery device and a bypass assembly. The slittable delivery device may include a hub, a shaft integrated into the hub and forming at least a segment of the circumferential surface of the hub, and a hemostasis valve contained substantially within the hub. The bypass assembly may include a cap and a valve bypass tool. The cap may be on a proximal end of the hub and may include an opening in the cap extending radially outward from a point near a radial center of the cap through a circumferential edge of the cap. The valve bypass tool may be operably coupled to the cap and may include a longitudinally extending open channel. | 04-15-2010 |
| 20100094225 | SLITTABLE DELIVERY DEVICE FOR THE DELIVERY OF A CARDIAC SURGICAL DEVICE - Disclosed herein is a slittable delivery device for the delivery of a cardiac surgical device. The delivery device includes a hub and a shaft integrated into the hub. The shaft forms at least a segment of the circumferential surface of the hub. The delivery device may also include a hemostasis valve contained substantially within the hub and a cap on a proximal end of the hub. The cap may include an opening in the cap extending radially outward from a point near a radial center of the cap through a circumferential edge of the cap. | 04-15-2010 |
| 20100087891 | SYSTEMS AND METHODS FOR DIAGNOSING AN IMPLANTABLE DEVICE - A method for diagnosing an implantable cardiac device including a plurality of implanted leads may include: monitoring a plurality of parameters associated with the plurality of implanted leads; detecting a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnosing a problem with the implantable cardiac device based on the detected change and the evaluation. A system for diagnosing an implantable cardiac device including a plurality of implanted leads may include an implantable pacing device and a processor. The processor may be configured to: monitor a plurality of parameters associated with the plurality of implanted leads; detect a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnose a problem with the implantable cardiac device based on the detected change and the evaluation. | 04-08-2010 |
| 20100082087 | IMPLANTABLE LEAD/ELECTRODE DELIVERY MEASUREMENT AND FEEDBACK SYSTEM - A lead implantation system with an introducer, a lead configured to engage with the introducer such that the introducer can convey the lead to a desired internal target location, and at least one sensor. The sensor is adapted to generate an indicator of desired engagement of the system with the desired target tissue location prior to engagement of the lead with the target tissue. Also a method of implanting an implantable patient lead including advancing a lead implantation assembly towards a desired target location along an introduction axis and monitoring at least one indicator of lead implantation assembly position along the lead introduction axis. At least one indicator can be generated by the lead implantation assembly. Advancing of the lead introduction assembly can be halted when the monitoring indicates contact with the desired target tissue. The patient lead can then be advanced towards the target tissue and fixed to the target tissue. | 04-01-2010 |
| 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 |
| 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 |
| 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 |
| 20100069778 | SYSTEM AND METHOD FOR MONITORING THORACIC FLUID LEVELS BASED ON IMPEDANCE USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (Z | 03-18-2010 |
| 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 |
| 20100065529 | NANOIMPRINTING OF AN OPTIC TO CONTROL THE ETCH PATTERN ON ELECTROLYTIC CAPACITOR FOIL - A method of etching a foil for use in an electrolytic capacitor utilizes a nanoimprinted optic to control the etch pattern. The optic is formed by creating a self-assembled monolayer (SAM) of hemispheres onto the surface of an optical quartz substrate. A laser is directed onto the optic while the foil underlies the optic, and the concentrated light source is used to effectively image an array of submicron spots. The resulting spots allow for controlled initiation of etch tunnels during a subsequent electrochemical etch of the foil, with the purpose of ultimately increasing foil capacitance through the increased surface area. | 03-18-2010 |
| 20100063561 | IMPLANTABLE CARDIAC STIMULATION DEVICES WITH SAFE-MODE OPERATION - A plurality of electrodes are implanted in, on or near the patient's heart and initially configured to define first circuits or vectors enabled for at least one of sensing and stimulating and second circuits or vectors which are idle for at least one of sensing and stimulating. Selected first circuits or second circuits are tested for fault indications related to one or both of sensing and stimulating and a status record is updated to indicate corresponding sensing fault indications and stimulating fault indications. If a sensing fault is found in one of the first circuits, the first circuit is redefined when enabled for sensing to include at least one electrode of a second circuit that does not have a record of a sensing fault indication. Likewise, if a stimulating fault is found in one of the first circuits, the first circuit is redefined when enabled for stimulating to include at least one electrode of a second circuit that does not have a record of a stimulating fault indication. | 03-11-2010 |
| 20100059173 | METHOD OF MAKING A TUBULAR BODY FOR A CATHETER, SHEATH OR LEAD - A method of forming a tubular body for a catheter, sheath or lead comprises extruding a polymer core having an integrally formed core wall, first lumen, and second lumen, placing a first layer over an outer circumferential surface of the extruded polymer core, and bonding the first layer to the circumferential surface of the extruded polymer cover via a reflow process. The first and second lumens are mandrel free during the reflow process, and a temperature of the reflow process is below a softening point of the polymer core to maintain a collapse free first and second lumen. | 03-11-2010 |
| 20100057158 | Neurostimulation Based On Glycemic Condition - A glycemic condition is indicated based on variance of a feature derived from cardiac electrogram data. Neurostimulation is then used to counteract a cardiac-related autonomic response to the glycemic condition. For example, stimulation of parasympathetic innervation may be used to counteract an autonomic sympathetic response that is associated with hypoglycemia or hyperglycemia. In addition, stimulation of sympathetic innervation may be used to counteract an autonomic parasympathetic response that is associated with hypoglycemia or hyperglycemia. | 03-04-2010 |
| 20100057155 | IMPLANTABLE SYSTEMS AND METHOD FOR USE THEREWITH FOR TRACKING CHANGES IN HEMODYNAMICS AND CARDIAC DISEASE - Embodiments of the present invention relate to monitoring a patient's atrial stretch, heart failure (HF) condition, and/or risk of atrial fibrillation (AF), as well as methods for estimating a change in at least one of a patient's left atrial pressure (LAP), pulmonary capillary wedge pressure (PCWP), and right pulmonary artery pressure (RPAP). Embodiments of the present invention also relate to selecting a pacing energy level. Such embodiments involve determining atrial evoked response metrics when a patient's atrium is paced, and monitoring changes in such metrics. | 03-04-2010 |
| 20100055570 | BIOBATTERY WITH NANOCRYSTALLINE MATERIAL ANODE - A bioelectric battery used to power an implantable device comprises an anode electrode and a cathode electrode separated by an insulating member. The anode is formed from a nanocrystalline or ultra fine grain sized magnesium alloy. The magnesium alloy can be formed by subjecting a starting magnesium alloy to one or more plastic deformation treatments to reduce grain size and improve uniform material distribution, thereby reducing corrosion loss and improving service life. | 03-04-2010 |
| 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 |
| 20100049274 | DETECTION OF FEEDING INTENT FOR USE IN TREATMENT OF EATING DISORDERS - An exemplary method for treating obesity includes calling for delivery of electrical energy to a vagal nerve, detecting pre-prandial activity and, in response to the detection of pre-prandial activity, calling for delivery of electrical energy to the stomach for a pre-determined amount of time to induce satiety. Various other technologies are also disclosed. | 02-25-2010 |
| 20100049271 | IMPLANTABLE MEDICAL DEVICE WITH AUTOMATIC SENSING ADJUSTMENT - An implantable medical device system that senses physiologic processes via multiple sensor signal configurations. The device can further process the sensor configurations to obtain additional processed signal configurations. The device can utilize the processed configurations for ongoing sensing of the physiologic process. The device can also automatically evaluate the multiple sensor configurations as well as the processed configurations and select the configuration offering the best signal discrimination to reduce oversensing or erroneously interpreting secondary characteristics of the physiologic process as corresponding to primary characteristics of the process as in double-counting. The signal discrimination can be evaluated as an absolute margin and/or a ratio between amplitudes of the primary and secondary characteristics. The signal discrimination can also be evaluated based at least in part on a calculated mean and standard deviation according to each configuration. | 02-25-2010 |
| 20100049060 | IMPLANTABLE HEMODYNAMIC MONITOR AND METHODS FOR USE THEREWITH - Provided herein are implantable systems that include an implantable photoplethysmography (PPG) sensor, which can be used to obtain an arterial PPG waveform. In an embodiment, a metric of a terminal portion of an arterial PPG waveform is determined, and a metric of an initial portion of the arterial PPG waveform is determined, and a surrogate of mean arterial pressure is determined based on the metric of the terminal portion and the metric of the initial portion. In another embodiment, a surrogate of diastolic pressure is determined based on a metric of a terminal portion of an arterial PPG waveform. In a further embodiment, a surrogate of cardiac afterload is determined based on a metric of a terminal portion of an arterial PPG waveform. | 02-25-2010 |
| 20100048062 | IS-4 LEAD TO PSA INTERFACE CABLE - A universal cable connector for detachably connecting a stimulation lead to a system analyzer includes a nonconductive connector block for releasably receiving and holding fixed a proximate contact electrically in continuity with a distal electrode, a cable for selectively electrically interconnecting the proximate contact and the system analyzer, and a switch mechanism for selectively connecting electrically the system analyzer cable with the proximate contact thereby enabling the system analyzer to determine the efficacy of the chosen body tissue site. The connector block includes a nest region for receiving the proximal end of the lead and the switch mechanism includes a switch contact electrically engaged with the cable and movable between a first position disengaged from an associated and selected exposed proximate contact and a second position engaged with the proximate contact for electrically connecting the distal electrode to the system analyzer. | 02-25-2010 |
| 20100042176 | TEMPORAL-BASED CARDIAC CAPTURE THRESHOLD DETECTION - A cardiac capture threshold may be determined using a test pulse and a backup pulse. Here, delivery of a test pulse is followed almost immediately by a non-conditional backup pulse of sufficient energy such that the backup pulse should always capture in the event the test pulse does not capture. The timing of the evoked response that follows the backup pulse may then be used to determine whether the test pulse or the backup pulse captured the cardiac tissue. In some embodiments morphology discrimination may be employed to determine whether an evoked response was triggered by the test pulse or the backup pulse. In some embodiments timing information associated with one or more features of the evoked response may be analyzed to determine whether an evoked response was triggered by the test pulse or the backup pulse. | 02-18-2010 |
| 20100042174 | SELECTING PACING SITE OR SITES BASED ON CARDIO-PULMONARY INFORMATION - An exemplary method for multi-tier pacing includes delivering single site, left ventricular pacing, sensing patient activity; comparing the sensed patient activity to a patient activity threshold and, if the sensed patient activity exceeds the patient activity threshold, then delivering multi-site, left ventricular pacing for a predetermined period of time and, after the predetermined period of time, delivering single, site left ventricular pacing. In such a method, the period of time may be determined based on cardio-pulmonary demand. Other exemplary technologies are also disclosed. | 02-18-2010 |
