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Combined cardioverting/defibrillating and pacing

Subclass of:

607 - Surgery: light, thermal, and electrical application

607001000 - LIGHT, THERMAL, AND ELECTRICAL APPLICATION

607002000 - Electrical therapeutic systems

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DocumentTitleDate
20100016909IMPLANTABLE CARDIAC DEVICE FEEDTHRU/HEADER ASSEMBLY - In one embodiment, an ICD is provided which includes a case having a connector block and a conductor post integrally formed with the connector block and extending through a dielectric feedthrough extending through the case. A capacitor is located within the dielectric. In some embodiments, the conductor post is a straight conductor post extending from a side of the connector block facing the feedthrough directly toward the feedthrough. The conductor post and the connector block may be formed of the same material, such as titanium. In some embodiments, a plurality of straight conductor posts and connector blocks are integrally formed. In some embodiments, the dielectric may be a single matrix dielectric, such that each of the straight conductor posts extends through the single matrix dielectric. In other embodiments, each of the straight conductor posts extends through a separate dielectric portion.01-21-2010
20100152795IDENTIFICATION 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
20100152796MECHANICAL 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
20110196439DETECTING HEMODYNAMIC STABILITY DURING ARRHYTHMIA USING THE CHANGES IN ATRIAL ACTIVATION - Detected changes in atrial activation can be used to discriminate between hemodynamically stable and hemodynamically unstable tachyarrhythmias.08-11-2011
20100076509Means for Augmenting Medical Electrical Systems - A medical electrical system includes a device including a connector port and an external electrically active surface and an auxiliary lead including a supplemental electrode and a connector end. The external electrically active surface of the device is adapted to receive the auxiliary lead connector end, thereby electrically coupling the supplemental electrode to the device via contact between the connector end and the external surface.03-25-2010
20100114194SYSTEM 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
20100114195IMPLANTABLE MEDICAL DEVICE INCLUDING EXTRAVASCULAR CARDIAC STIMULATION AND NEUROSTIMULATION CAPABILITIES - An implantable medical device may deliver pacing, cardioversion, and/or defibrillation stimulation to a heart of a patient via extravascular electrodes and delivers electrical stimulation to a nonmyocardial tissue site to modulate the autonomic nervous system of the patient. The implantable medical device may include a cardiac therapy module that generates and delivers at least one of pacing, cardioversion, or defibrillation therapy to a patient via an extravascular electrode, and a neurostimulation therapy module that generates and delivers a neurostimulation signal to the patient via a neurostimulation electrode. The cardiac therapy module and neurostimulation therapy module may be disposed in a common housing of the medical device. In some examples, at least one common lead may electrically couple the neurostimulation electrode and the extravascular electrode to the neurostimulation and cardiac therapy modules, respectively.05-06-2010
20100036447NEURAL STIMULATION FOR ARRHYTHMIA RECOGNITION AND THERAPY - A system and method can sense a tachyarrhythmia, compare the sensed tachyarrhythmia with a ventricular tachyarrhythmia criterion, provide a ventricular tachyarrhythmia therapy when the sensed tachyarrhythmia satisfies the ventricular tachyarrhythmia criterion, provide a neural stimulation when the sensed tachyarrhythmia does not satisfy the ventricular tachyarrhythmia criterion, determine whether the tachyarrhythmia continues during or after the neural stimulation when the tachyarrhythmia is sustained, compare the tachyarrhythmia sensed during or after the neural stimulation with a supraventricular tachyarrhythmia (SVT) criterion, and provide a ventricular tachyarrhythmia therapy when the sensed tachyarrhythmia does not satisfy the SVT criterion.02-11-2010
20100094367Non-electrode-lead ultra-thin flexible micro multifunctional heart rate adjusting device - A non-electrode-lead ultra-thin flexible micro multifunctional heart rate adjusting device comprises an integrative ultra-thin flexible micro non-electrode-lead pacemaker formed by assembling a micro battery, an ultra-low-power source circuit, a wireless receiving/transmitting circuit and an application circuit unit together, the needle electrodes are positioned on one side of the pacemaker and all of them form a small electrode body which can directly implanted into heart or external surface of heart; a multifunctional microcomputer heart rate adjusting remote controller connects with various non-electrode-lead pacemakers via wireless communication; the non-electrode-lead pacemakers and/or the heart rate adjusting remote controller connect with a control base station via wireless network, and the control base station connects with a computer.04-15-2010
20130035735MULTI-MODAL ELECTROTHERAPY METHOD AND APARATUS - A multi-modal electrotherapy apparatus including circuitry for administering defibrillation therapy and for administering medium voltage therapy (MVT). A combined-use capacitor bank of at least one capacitor stores energy to be administered as defibrillation therapy and MVT. Combined-use discharge circuitry electrically is coupled between the combined-use capacitor bank and patient terminals for selectively administering energy from the capacitor bank according to a plurality of controllable waveforms as either defibrillation therapy or MVT. A controller is configured to cause the discharge circuitry to apply the MVT from the capacitor bank while the capacitor bank undergoes charging in preparation for administration of the defibrillation therapy.02-07-2013
20130079836RF TRANSCEIVER HOPPING FOR COMMUNICATION WITH IMPLANTABLE MEDICAL DEVICE - Dynamically switching between different external RF transceivers for communication with an implantable medical device maintains high communication quality in the face of interference, fading, detuning, or other adverse wireless communication conditions. Quality information associated with communications between an implantable medical device and different external devices is monitored to select one,of these external devices to conduct subsequent communication with the implantable medical device. This monitoring is conducted on a repeated basis such that communication is switched to a different RF transceiver whenever such an RF transceiver is able to achieve a higher quality communication than the currently selected RF transceiver. In some embodiments, RF transceivers are deployed in different devices. For example, one or more RF transceivers may be deployed at a portable programmer (e.g., in the form of a computer tablet) and one or more other RF transceivers may be deployed at an associated base station.03-28-2013
20090157129METHOD AND APPARATUS TO TERMINATE VENTRICULAR TACHYCARDIA VIA PACING - An implantable device for terminating ventricular tachycardia is disclosed. The device includes a processor configured to determine a first antitachycardia pulse routine of N pulses. In the routine the first N−1 pulses are separated by a first cycle length and the Nth pulse is separated by a second cycle length that is shorter than the first cycle length. The device also comprises a lead coupled to the processor. The lead comprises an electrode configured to sense a tachycardia and further configured, under control of the processor, to administer the antitachycardia pulse routine.06-18-2009
20090157128SENSING THRESHOLD CONTROL TO LIMIT AMPLITUDE TRACKING - A depolarization sensing threshold can be determined using an amplitude-limited portion of a cardiac signal received using an implantable medical device. One or more cardiac depolarizations can be detected using the cardiac signal and the depolarization sensing threshold.06-18-2009
20090157127TELEMETRY DURING SAFETY MODE OPERATION - This document discusses, among other things, n implantable device comprising a communication circuit configured to communicate with an external device, a logic circuit communicatively coupled to the communication circuit, and a processor, communicatively coupled to the logic circuit and the communication circuit. The processor is configured to communicate information with the external device, via the communication circuit and the logic circuit, using a set of communication messages. While in a device safety mode, the processor is held in an inactive state and the logic circuit is configured to communicate with the external device using a subset of the set of communication messages.06-18-2009
20090306729ELECTROTHERAPY DEVICE FOR TREATING TACHYCARDIAC ARRHYTHMIAS OF A HEART - An electrotherapy system, particularly an implantable heart stimulator, is configured as an electronic implant for electrical anti-tachycardia therapy of the heart, and includes at least one programmable therapy sequence (i.e. a sequence of several therapies that are delivered, one after the other, to treat a VT/VF episode). The implant has a therapy success memory for storing therapy success statistics for each therapy, as well as a therapy control unit that is configured to automatically undertake adaptation of the order of the therapies within a therapy sequence as a function of currently stored therapy success statistics.12-10-2009
20090076557Closed Loop Cardiac Resynchronization Therapy Using Cardiac Activation Sequence Information - Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.03-19-2009
20090299421EVALUATION OF IMPLANTABLE MEDICAL DEVICE SENSING INTEGRITY BASED ON EVOKED SIGNALS - The disclosure describes techniques for evaluating sensing integrity of an implantable medical device (IMD) based on sensing of evoked signals. Sensing integrity may provide an indication of reliability of implantable leads associated with an IMD. The sensed signals may be signals that are evoked by tissue in response to delivery of electrical stimulation. The techniques may involve evaluation of sensing integrity based on sensing of evoked cardiac potentials generated in response to cardiac stimulation, such as pacing pulses. Signals evoked in response to electrical stimulation may be measured and trended to permit analysis of evoked signals over time. Lead integrity may be inferred from sensing integrity. By analyzing evoked signals, sensing integrity may be evaluated without sensing intrinsic events. Evaluation of sensing integrity can facilitate analysis in the presence of pacing, including pacing delivered by IMDs that pace substantially continuously, such as IMDs configured to support cardiac resynchronization therapy (CRT).12-03-2009
20090234400Apparatus and method for treating ventricular tachyarrhythmias - A system and method for selectively treating a ventricular tachycardia based on sensed atrial and ventricular intervals from the patient's heart. A detection window of the ten most recent atrial and ventricular intervals are analyzed for the occurrence of either tachycardia or fibrillation. When a majority of the sensed intervals are satisfied, the apparatus starts a duration time interval. Ventricular intervals and atrial intervals are compare, ventricular interval greater than the atrial interval by a bias factor the system delivers tachycardia therapy to the heart. Alternatively, the method withholds tachycardia therapy to the heart when the atrial rate is classified as atrial fibrillation and the ventricular response is unstable.09-17-2009
20130165983MONITORING ACTIVATION TIMES FOR USE IN DETERMINING PACING EFFECTIVNESS - Methods and/or devices may be configured to track effectiveness of pacing therapy by monitoring activation times over time, e.g., between pacing stimulus and electrical activity resulting from the pacing stimulus. Generally, the methods and/or devices may determine whether the delivered pacing therapy was effective based on the measured activation times.06-27-2013
20100087882VENTRICULAR EVENT FILTERING FOR AN IMPLANTABLE MEDICAL DEVICE - Pacing parameters are provided to address cross talk and intrinsic ventricular events occurring within a predefined blanking period following an atrial event. The parameters are used in conjunction with protocol for minimizing or reducing ventricular pacing, wherein ignoring intrinsic ventricular events during the blanking period might otherwise affect the performance of the protocol.04-08-2010
20110301656PREFERRED ADI/R: A PERMANENT PACING MODE TO ELIMINATE VENTRICULAR PACING WHILE MAINTAINING BACKUP SUPPORT - A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).12-08-2011
20110288603POST-SHOCK RECOVERY MONITORING FOR TACHYARRHYTHMIA DISCRIMINATION - A cardiac rhythm management device is configured to discriminate between ventricular and supraventricular tachycardias (referred to as SVT/VT discrimination) by utilizing a morphology criterion in which the morphology of electrogram waveforms during ventricular beats are analyzed to determine if the beats are normally conducted. After the delivery of a cardioversion/defibrillation shock, however, the intraventricular conduction system is left in a modified state which alters the subsequently generated electrogram signal. Use of the morphology criterion for to SVT/VT discrimination is discontinued after delivery of such a shock and resumed after a predetermined minimum number of normally conducted ventricular beats has been detected.11-24-2011
20120271369ENDOCARDIAL STIMULATION/DEFIBRILLATION SYSTEM OF THE LEFT VENTRICLE - A system for the endocardial stimulation/defibrillation of the left ventricle. This system includes a generator (10-25-2012
20090138057ELECTROCARDIOGRAM MONITORING AND CARDIAC THERAPY PULSE DELIVERY SYSTEM AND METHOD - A cardiac therapy pulse delivery system includes a plurality of electrodes, an ECG signal processor circuit, and a pulse generator circuit. Each of the electrodes has at least one therapy element and at least one monitor element that are electrically insulated from one another. The ECG signal processor circuit is electrically coupled to each monitor element on each electrode and is operable to convert ECG signals detected by the monitor elements into ECG data. The cardiac pulse generator circuit is electrically coupled to each therapy element on each electrode and is operable to supply one or more cardiac therapy pulses thereto.05-28-2009
20120191150IMPLANTABLE CARDIAC DEVICES AND METHODS - Embodiments relate to an implantable cardiac system, including a housing, electronic circuitry for controlling one or more of power management, processing unit, information memory and management circuit, sensing and simulation output. The system also includes diagnosis and treatment software for diagnosing health issues, diagnosing mechanical issues, determining therapy output and manage patient health indicators over time, a power supply system including at least one rechargeable battery, a recharging system, an alarm (or alert) system to inform patient of energy level and integrity of system, communication circuitry, one or more electrodes for delivering therapeutic signal to a heart and one or more electrodes for from delivering electrocardiogram signal from the heart to the electronic circuitry. The power supplies can include rechargeable batteries. The housing can include a plurality of physically distinct structures that can be implanted in different locations in patient's body.07-26-2012
20100211125Method and Apparatus for Identifying Potentially Misclassified Arrhythmic Episodes - An implantable cardiac device is configured to classify cardiac arrhythmias using a plurality of arrhythmia discrimination algorithms. Data is provided that is associated with a plurality of cardiac arrhythmic episodes for which a cardiac electrical therapy was delivered or withheld by the implantable medical device based on the plurality of arrhythmia discrimination algorithms. A metric for each of the arrhythmic episodes is computed. The metric defines a measure by which the implantable cardiac device properly classified the arrhythmia. Potentially misclassified arrhythmic episodes of the plurality of cardiac arrhythmic episodes for which cardiac electrical therapy was inappropriately delivered or withheld are algorithmically identified using the metric.08-19-2010
20100211124Pacing Management During Cardiopulmonary Resuscitation - Systems and methods provide for coordinated cardiac pacing with delivery of cardiopulmonary resuscitation (CPR) to a patient. Managing cardiac pacing in a patient during a cardiac arrhythmia involves detecting a cardiac arrhythmia using a patient implantable medical device, prompting a cardiopulmonary resuscitation compression, and delivering, using the patient implantable medical device, a pacing pulse to a heart chamber in coordination with the compression prompt.08-19-2010
20100211123SYSTEMS AND METHODS FOR PROVIDING ARRHYTHMIA THERAPY IN MRI ENVIRONMENTS - Systems and methods for arrhythmia therapy in MRI environments are disclosed. Various systems disclosed utilize ATP therapy rather than ventricular shocks when patients are subjected to electromagnetic fields in an MRI scanner bore and shock therapy is not available. As the patient is moved out from within the scanner bore and away from the MRI scanner, the magnetic fields diminish in strength eventually allowing a high voltage capacitor within the IMD to charge if necessary. The system may detect when the electromagnetic fields no longer interfere with the shock therapy and will transition the IMD back to a normal operational mode where shock therapy can be delivered. Then, if the arrhythmia still exists, the system will carry out all of the system's prescribed operations, including the delivery of electric shocks to treat the arrhythmia.08-19-2010
20100114204INTERDEVICE IMPEDANCE - An electrical parameter value indicative of an impedance of an electrical path between a first medical device implanted within a patient and a second medical device implanted within the patient may be determined by generating and delivering an electrical signal between electrodes connected to the first medical device and sensing the electrical signal with two or more sense electrodes connected to the second medical device. In some examples, the electrical parameter value indicative of the impedance may be used to detect a system integrity issue, such as relative movement between the first and second medical devices, such as between leads connected to the medical devices, or a lead-related condition. In other examples, the determined impedance may indicate a transthoracic impedance of the patient.05-06-2010
20100114201IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20100114205SHUNT-CURRENT REDUCTION HOUSING FOR AN IMPLANTABLE THERAPY SYSTEM - Techniques for minimizing interference between first and second medical devices of a therapy system may include providing an outer housing for at least one of the medical devices that comprises an electrically insulative layer formed over at least the electrically conductive portions (e.g., an electrically conductive layer) of the housing, or providing an electrically insulative pouch around an electrically conductive housing of at least the first medical device. The electrically insulative layer or electrically insulative pouch may reduce or even eliminate shunt-current that flows into the medical device via the housing. The shunt-current may be generated by the delivery of electrical stimulation by the second medical device. In some examples, the techniques may also include shunt-current mitigation circuitry that helps minimize or even eliminate shunt-current that feeds into the first medical device via one or more electrodes electrically connected to the first medical device.05-06-2010
20100114203IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20100114202IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20100114200IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20100114199IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20100114198IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20100114196IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20090149902IMPLANTED CARDIAC DEVICE FOR DEFIBRILLATION - An implantable medical device for delivering electrical cardiac therapy includes a first implantable housing containing a battery. There is also a second implantable housing separate from the first implantable housing and containing at least one of: electronic circuitry adapted to evaluate and initiate electrical cardiac therapy, a storage capacitor and an electrode structure comprising a sensing electrode, a pacing electrode and a therapy electrode. The electronic circuit, the storage capacitor or the electrode structure are electrically connected to the battery. Alternatively, there is an implantable medical device for delivering electrical cardiac therapy having an implantable structure containing the following electrically connected components: a battery, electronic circuitry adapted to evaluate and initiate electrical cardiac therapy, a storage capacitor and an electrode structure comprising a sensing electrode, a pacing electrode and a therapy electrode. A method of providing electrical cardiac therapy is also provided.06-11-2009
20080319494System and method for preventing recurrence of atrial tachyarrhythmia - A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.12-25-2008
20120109236LEADLESS CARDIAC PACEMAKER WITH CONDUCTED COMMUNICATION - A leadless pacemaker for pacing a heart of a human includes a hermetic housing and at least two electrodes on or near the hermetic housing. The at least two electrodes are configured to deliver energy to stimulate the heart and to transfer information to or from at least one external device.05-03-2012
20120109235CAPTURE DETECTION IN RESPONSE TO LEAD RELATED CONDITIONS - Various techniques for detecting cardiac capture in response to a detected lead related condition are described. One example method described includes delivering a pacing therapy to a heart of a patient, periodically determining whether the pacing therapy captures the heart of the patient, detecting a lead related condition, and, in response to the detected lead related condition, increasing a frequency of determining whether the pacing therapy captures the heart.05-03-2012
20090198294BAROREFLEX ACTIVATION FOR ARRHYTHMIA TREATMENT - Devices, systems and methods provide baroreflex activation to prevent, or at least reduce the likelihood of occurrence of, cardiac arrhythmias. Various embodiments may additionally or alternatively promote recovery from arrhythmias. In one embodiment, a device for preventing or reducing the likelihood of occurrence of arrhythmias includes one or more baroreflex activation devices, one or more sensors coupled to the baroreflex activation device(s), and a processor for processing information from the sensor and activating and/or modulation the baroreflex activation device. Sensors, such as electrocardiogram devices, generally sense factors indicative of a potential, ensuing arrhythmia.08-06-2009
20110172727REDUCING INAPPROPRIATE DELIVERY OF THERAPY FOR SUSPECTED NON-LETHAL ARRHYTHMIAS - An implantable medical device (IMD) identifies suspected non-lethal ventricular arrhythmia, and takes one or more actions in response to the identification to avoid or delay delivery of a defibrillation or cardioversion shock. The IMD employs number of intervals to detect (NID) thresholds for detection of ventricular arrhythmias. When a NID threshold is met, the IMD determines whether the ventricular rhythm is a suspected non-lethal rhythm despite satisfying a NID threshold. In some embodiments, the IMD increases the NID threshold, i.e., extends the time for detection, in response to identifying a rhythm as a suspected non-lethal rhythm, and monitors subsequent ventricular beats to determine if the increased NID threshold is met before detecting a ventricular arrhythmia and delivering therapy. The IMD can determine whether a rhythm is a suspected non-lethal arrhythmia by, for example, comparing the median ventricular cycle length (VCL) to the median atrial cycle length (ACL).07-14-2011
20090275998EXTRA-CARDIAC IMPLANTABLE DEVICE WITH FUSION PACING CAPABILITY - According to this disclosure, a non-transvenous pacing and, optionally defibrillation, therapy device is implanted subcutaneously and oriented to provide cardiac sensing from electrodes spaced from a heart and deliver pacing and/or defibrillation from one or more non-transvenous electrodes (e.g., an epicardial or pericardial electrode or electrode patch). A subject receiving a device according to this disclosure is monitored to confirm a relatively stable bundle branch block (i.e., delayed activation) of one ventricle. The subcutaneous device has electrodes disposed on the housing and/or having an electrode on a subcutaneous medical lead is oriented so that the pacing (and sensing) vector impinges mainly upon the one ventricle, and/or optionally an epicardial or pericardial lead is deployed to a last-to-depolarize ventricle (e.g., a left ventricle) so that single-ventricular pacing is delivered to achieve fusion depolarization of both ventricles.11-05-2009
20090281584IMPLANTABLE SENSOR ARRANGEMENT - An implantable medical sensor arrangement has a sensor body configured for implantation in a subject, to which at least one sensor head is connected through at least one connective wire. The sensor head(s) and at least a portion of the connective wire(s) are tightly packed and enclosed by a protective sensor shell. This sensor shell is composed of a dissolvable material that will dissolve or can be triggered to dissolve following introduction of the sensor arrangement into a subject.11-12-2009
20120296383METHOD AND DEVICE FOR PROVIDING ANTI-TACHYARRHYTHMIA THERAPY - Various system embodiments comprise at least one sensor input adapted to receive at least one sensed signal associated with a tachyarrhythmia, a feature set extractor adapted to extract at least two features from the at least one sensed signal associated with the tachyarrhythmia, a feature set generator adapted to form a feature set using the at least two features extracted by the feature set extractor, at least one generator adapted for use to selectively apply an anti-tachycardia pacing (ATP) therapy and a neural stimulation (NS) therapy, and a controller adapted to respond to the feature set. The controller is adapted to initiate the NS therapy when the feature set corresponds to criteria for applying the NS therapy to modify the tachyarrhythmia, and initiate the ATP therapy to terminate the modified tachyarrhythmia. Other aspects and embodiments are provided herein.11-22-2012
20120296382INTEGRATED CARDIAC RHYTHM MANAGEMENT SYSTEM WITH HEART VALVE - Systems and methods using a heart valve and an implantable medical device, such as for event detection and optimization of cardiac output. The cardiac management system includes a heart valve, having a physiological sensor. The physiological sensor is adapted to measure at least one of an intrinsic electrical cardiac parameter, a hemodynamic parameter or the like. The system further includes an implantable electronics unit, such as a cardiac rhythm management unit, coupled to the physiological sensor of the heart valve to receive physiological information. The electronics unit is adapted to use the received physiological information to control delivery of an electrical output to the subject.11-22-2012
20120296381CONTROL OF A DEFIBRILLATOR AND/OR PACEMAKER - An electronic medical monitoring and treatment apparatus allows a person access to a medical professional (MP) who can monitor, diagnose and treat the person from a remote site. The apparatus includes a medical monitoring and treatment device (MMTD) coupled to an electronic adapter designed to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving (T/R) device used by the MP. The MMTD may comprise a cardiac treatment circuit for effecting cardiac pacing and/or defibrillation and a cardiac signal circuit for receiving cardiac signals. The cardiac signals are (1) transmitted from the signal circuit to the second T/R device for evaluation by the MP, (2) the MP may transmit a control signal to the treatment circuit, and (3), in response thereto, the treatment circuit may generate one or more electrical pulses for treatment of the person.11-22-2012
20100114197IMPLANTABLE MEDICAL DEVICE CROSSTALK EVALUATION AND MITIGATION - Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.05-06-2010
20110270334METHOD OF DUAL EGM SENSING AND HEART RATE ESTIMATION IN IMPLANTED CARDIAC DEVICES - A method and apparatus for monitoring a patient's heart rate sense first cardiac events in a heart chamber using a first cardiac electrode pair and sense second cardiac events in the heart chamber using a second cardiac electrode pair. The method includes estimating a first heart rate using the first cardiac events, comparing the first heart rate to a heart rate threshold and estimating a second heart rate using the second cardiac events in response to the first heart rate exceeding the heart rate threshold, determining whether the second cardiac events are unreliable, and setting the second heart rate equal to the first heart rate in response to the second cardiac events being unreliable.11-03-2011
20080281368IMPLANTABLE DIGITAL DEVICE FOR TISSUE STIMULATION - An implantable vagal stimulation device with high-energy efficiency and novel data sensing is provided for use in a wide variety of applications where neural stimulation is required, including human heart rate control. The stimulation device uses low-impedance circuitry and digital waveforms to minimize energy losses, thereby requiring a relatively small battery. Front-loaded, passive filtering is employed to reduce electromagnetic noise sensitivity, leaving a clear physiological signal without degradations. This physiological signal is processed by a derivative zero transition detector (DZD), which is immune to variations in input signal dynamic range unlike traditional methods. Information that the DZD receives can be then interpreted and used along with an algorithm to execute appropriate vagal nerve stimulation.11-13-2008
20080281367SYSTEM AND METHOD TO DETERMINE HEMODYNAMIC TOLERABILITY - An implantable medical device detects a tachyarrhythmia of a heart. During the detected tachyarrhythmia, the device determines a local myocardial impedance. Using the local myocardial impedance, the device determines whether there is sufficient perfusion to the heart. The device can then either deliver a less aggressive device therapy in response to the detected tachyarrhythmia when there is sufficient perfusion to the heart, or deliver a more aggressive device therapy in response to the detected tachyarrhythmia when there is insufficient perfusion to the heart. The perfusion information can also be used to alter tachyarrhythmia detection or classification.11-13-2008
20090264947ANTITACHYCARDIAC STIMULATOR - Implantable cardiac stimulator, with chamber stimulation unit connectable to left/right ventricular stimulation electrode to generate/deliver chamber stimulation pulses for stimulation of ventricle; ventricular sensing unit (VSU) to detect respective chamber contraction and deliver ventricular sensing signal when chamber contraction detected; optional atrial stimulation unit, connectable to atrial stimulation electrode to generate atrial stimulation pulses to stimulate atrium; atrial sensing unit, to detect atrial contraction, deliver atrial sensing signal indicating respective atrial event; tachycardia detection unit, connected to VSU to detect and categorize ventricular/supraventricular tachycardia; treatment control unit (TCU), triggers chamber stimulation unit to deliver antitachycardiac stimulation (ATP); analyzer unit, connected to atrial sensing unit and TCU. Analyzes atrial events from sensing unit before/during/after delivering antitachycardiac stimulation for atrial rhythm pattern during ventricular ATP by comparison atrial rhythm pattern immediately before ATP and to trigger TCU as function of ATP response signal representing comparison result for selection of the following antitachycardiac treatment.10-22-2009
20090264946VENTRICULAR HEART STIMULATOR - The invention relates to an implantable ventricular heart stimulator (10-22-2009
20090264945CARDIAC STIMULATOR WITH STIMULATION SUCCESS MONITORING - An implantable cardiac stimulator having an at least partially electrically conductive housing, a ventricular stimulation unit connectable to left ventricular or right ventricular stimulation electrode and designed to generate ventricular stimulation pulses for stimulation of heart ventricle, having terminal for right ventricular defibrillation electrode. Has far-field electrogram detection unit (FFEDU) and stimulation success detecting unit (SSDU), of which FFEDU has first input connected to the terminal for right ventricular defibrillation electrode and second input connected to housing. FFEDU detects far-field electrocardiogram based on electric potentials applied to inputs and deliver these potentials to SSDU. SSDU has electrogram input and signal input receives a far-field electrogram generated by FFEDU and receives stimulation signal that represents a ventricular stimulation pulse generated and delivered by ventricular stimulation unit and analyzes section of received far-field electrogram immediately following delivery of ventricular stimulation impulse to determine whether it represents an effective or ineffective ventricular stimulation.10-22-2009
20100145400Arrhythmia Classification and Therapy Selection - Different types of cardiac arrhythmia are classified based on the morphology of the arrhythmic beats. Cardiac beats associated with an arrhythmic episode are compared to a plurality of representative beat morphologies, each representative beat morphology characterizing a type of arrhythmia of the heart. An arrhythmic episode may be classified as a particular type of arrhythmia if the morphology of the arrhythmic cardiac beats matches a representative beat morphology characterizing the particular type of arrhythmia. An appropriate therapy for the particular type of arrhythmia may be selected based on the arrhythmia classification. A particular type of arrhythmia may be associated with one or more therapies used to treat the arrhythmia. The therapy used to treat the arrhythmia may comprise a therapy identified as a previously successful therapy.06-10-2010
20090157126ANTI-TACHYARRHYTHMIA SYSTEM WITH SELECTIVELY ACTIVATED DETECTION ENHANCEMENTS - A cardiac rhythm management (CRM) system includes an implantable cardioverter defibrillator (ICD) and an external system. The ICD detects a tachyarrhythmia episode and classifies the detected tachyarrhythmia episode using none, one, or more of detection enhancements selected according to a selection command including a classification mode. The detection enhancements are each an algorithm for detecting and analyzing one or more indications of a type of the detected tachyarrhythmia episode. The external system allows a user to select the classification mode from a plurality of available classification modes each using none, one, or more of the detection enhancements.06-18-2009
20120197324MEDICAL DEVICE ADJUSTING OPERATION WHEN USED WITH NON-AUTHENTICATED PATIENT PARAMETER COLLECTING ACCESSORY - Embodiments are directed to a medical device, such as a defibrillator, for use with an accessory capable of collecting a parameter of a patient. The medical device is capable of at least performing a basic functionality, an advanced functionality, and of defibrillating the patient. The medical device includes an energy storage module within a housing for storing an electrical charge that is to be delivered to the patient for the defibrillating. The medical device includes a processor structured to determine whether a data set received from the accessory confirms or not a preset authentication criterion about the accessory. Although when the accessory is coupled to the housing the medical device is capable of the defibrillating and the basic functionality, the medical device is capable of the advanced functionality only when the accessory is coupled to the housing and it is determined that the preset authentication criterion is confirmed. Embodiments also include methods of operation and a programmed solution.08-02-2012
20120197323RESPIRATORY PARAMETERS FOR ARRHYTHMIA DETECTION AND THERAPY - An implantable or ambulatory medical device can include a cardiac signal sensing circuit configured to provide a sensed cardiac depolarization signal of a heart of a subject, a respiration sensing circuit configured to provide a signal representative of respiration of the subject, and a control circuit communicatively coupled to the cardiac signal sensing circuit and the respiration circuit. The control circuit includes a tachyarrhythmia detection circuit configured to determine heart rate using the depolarization signal, determine a respiration parameter of the subject using the respiration signal, calculate a ratio using the determined heart rate and the determined respiration parameter, generate an indication of tachyarrhythmia when the calculated ratio satisfies a specified detection ratio threshold value, and provide the indication of tachyarrhythmia to a user or process.08-02-2012
20090030469Cardiac Resynchronization Therapy Systems and Methods - Systems and methods for cardiac resynchronization therapy include a right side component and a left side component, wherein the right side component includes at least one ventricular lead and the left side component includes at least one epicardial electrode. Epicardial electrodes are insertable via a minimally invasive procedure, and are positionable via imaging techniques.01-29-2009
20100268290METHOD AND APPARATUS FOR SELECTING AND TIMING ANTI-TACHYARRHYTHMIA PACING USING CARDIAC CYCLE LENGTH STABILITY - An implantable medical device delivers anti-tachyarrhythmia therapies including anti-tachyarrhythmia pacing (ATP). When a tachyarrhythmia episode is detected, the implantable medical device analyzes cardiac cycle length stability to determine whether and/or when to deliver an ATP. In one embodiment, the cardiac cycle length stability is measured by existence of stable ventricular tachyarrhythmia clusters (SVTCs) during the tachyarrhythmia episode. Each SVTC includes at least a specified minimum number of heart beats over which the cardiac cycle lengths meet a stability criterion.10-21-2010
20090143833DISABLE FOR ATRIOVENTRICULAR DELAY ADJUSTMENT - An apparatus comprises an electrical stimulation circuit, a ventricular sensing circuit, a ventricular sensing timer, and an atrial pacing timer. The ventricular sensing circuit detects an intrinsic ventricular tachyarrhythmia depolarization. The ventricular sensing timer initiates timing of a lowest tachy rate (LTR) zone interval and also a ventricular pace interval that is calculated using a lower rate limit (LRL). The atrial pacing timer calculates an atrial pace interval to follow the intrinsic ventricular depolarization using the ventricular pace interval less a paced atrioventricular (AV) delay interval, delays generation of the atrial pace until after expiration of the LTR zone interval by decreasing the paced AV delay interval when the calculated atrial pace interval is within the LTR zone interval, and disables decreasing of the paced AV delay interval when the LRL interval less the paced AV delay interval at the LRL is less than the LTR zone interval.06-04-2009
20090143832Automated Assessment Of Atrioventricular And Ventriculoatrial Conduction - A method discriminates between ventricular arrhythmia and supraventricular arrhythmia by determining the direction of an electrical signal conducted through the atrioventricular node. An implantable cardiac defibrillator provides atrioventricular and ventriculoatrial pacing bursts to determine if an arrhythmia with a 1:1 atrial to ventricular relationship is due to ventricular tachycardia or supraventricular tachycardia. This discrimination capability reduces the incidence of inappropriate shocks from dual-chamber implantable cardiac defibrillators to near zero and provides a method to differentially diagnose supraventricular tachycardia from ventricular tachycardia.06-04-2009
20090326596TEMPORARY DISABLEMENT FEATURE FOR IMPLANTABLE DEVICE WITH ANTI-TACHYARRHYTHMIA FUNCTIONS - An implantable cardiac rhythm management device for delivering anti-tachyarrhythmia therapy is provided with a temporary disablement feature so that the delivery of anti-tachyarrhythmia therapy may be conveniently disabled and re-enabled. The feature is particularly useful to patients who are undergoing imaging procedures or surgical procedures where electro-cauterizing instruments may cause inadvertent triggering of cardioversion/defibrillation shocks and/or anti-tachycardia pacing.12-31-2009
20090198295Intravascular Medical Device - An implantable medical device is configured so that all of the major components including a housing and attached leads are disposed within the vasculature of a patient. A tether extends from the housing of the device to an implant location where the tether is secured to tissue outside of the vasculature. In this manner, an intravascular medical device may be implanted at a location remote from final placement, delivered via the vasculature and anchored at the initial entry point.08-06-2009
20110230922Device And Method For Peri-Hisian Pacing And/Or Simultaneous Bi-Ventricular or Tri-Ventricular Pacing For Cardiac Resynchronization - The present invention provides a pacing device and method that allows for preferential right atrial, at or near the His bundle, and ventricular pacing, either individually or in combination, including tri-ventricular pacing. The pacing device includes a power source and one or more logic circuits allowing for programmable delivery of pacing to any combination of the right atria, the para-Hisian region, and the right and/or the left ventricles. The pacing device allows the user to select which site(s) to pace as well at the appropriate relative timing of pacing impulse delivery to any of these three previously mentioned sites. The device is constructed and arranged to be combined with an atrial sensing/pacing electrode to allow for atrio-ventricular sequential tri-ventricular pacing or variants of such. Also, a defibrillator lead can be incorporated into the device to allow for protection from ventricular arrhythmias and sudden death.09-22-2011
20080288009SELF-ADJUSTING ECG MORPHOLOGICAL FEATURE CORRELATION THRESHOLD - An apparatus comprising an implantable cardiac signal sensing circuit configured for sensing an intrinsic cardiac signal, a memory to store a template of a morphology of normal atrial-ventricular conduction, and a controller that includes a tachyarrhythmia detection circuit and a correlation circuit. The tachyarrhythmia detection circuit is configured for detecting a rhythm with elevated ventricular rate using the sensed intrinsic cardiac signal. The correlation circuit is configured for iteratively calculating a correlation between the sensed intrinsic cardiac signal and the template, and comparing the calculated correlation to a variable correlation threshold to determine whether the detected rhythm correlates to the template. The apparatus also includes a therapy circuit configured for inhibiting a ventricular tachycardia therapy when the detected rhythm correlates to the template. Other apparatuses and methods are described.11-20-2008
20090210020Method and Apparatus for Determining Cardiac Performance in a Patient - An apparatus for determining heart transplant rejection of a heart in a patient includes at least two electrodes adapted to be sewn into the heart that span the left ventricle. The apparatus includes a voltage generator adapted to be inserted in the patient which generates a voltage to the two electrodes and senses the resulting voltage from the two electrodes. A method for determining heart transplant rejection of a heart in a patient. A pacemaker for a patient (including bi-ventricular pacing and AICDs). The pacemaker includes an RV lead having four electrodes adapted to be inserted into the RV apex. The pacemaker includes a voltage generator which generates a voltage signal to the electrodes and senses the instantaneous voltage along the length of the RV and determines the real and imaginary components to remove the myocardial components of the septum and RV free wall to determine absolute RV blood volume. The pacemaker includes a battery connected to the voltage generator. The pacemaker includes a defibrillator connected to the battery. The pacemaker can also be a bi-ventricular pacemaker to restore RV and LV synchrony during contraction. A method for assisting a heart of a patient.08-20-2009
20100152797ACTIVE IMPLANTABLE MEDICAL DEVICE HAVING ANTITACHYCARDIA ATRIAL AND ANTIBRADYCARDIA VENTRICULAR PACING - An active implantable medical device of the cardiac prosthesis type, including antitachycardia atrial pacing and antibradycardia ventricular pacing therapies. The device includes circuits and control logic for detecting electrical atrial and ventricular spontaneous events (R), delivering low energy antitachycardia atrial pacing, and antibradycardia ventricular pacing, and able to deliver a ventricular pacing (V) in the absence of a detected spontaneous ventricular event (R) after a calculated ventricular escape interval (IE). The device includes a sensor delivering an endocardiac acceleration signal (EA) representative of the movements produced by the contractions of the ventricle. The ventricular sensing switches from detection of an electric potential of spontaneous ventricular depolarization (R), to detection of an endocardiac acceleration peak (PEA06-17-2010
20090254135HIGH-ENERGY ANTI-TACHYCARDIA THERAPY - Embodiments of the invention are related to medical devices and methods for delivery high-energy anti-tachycardia therapy to a subject, amongst other things. In an embodiment, the invention includes a medical device including a controller module configured to administer a plurality of electrical pulses to a patient in response to a detected tachycardia, the electrical pulses comprising an amplitude of greater than 3 Volts and less than 40 Volts, the controller configured to modulate the amplitude of the electrical pulses. In an embodiment, the invention includes a method of treating a tachyarrhythmia including administering a first series of electrical pulses to a patient with an implantable medical device, the electrical pulses including an amplitude of greater than 8 Volts and less than 40 Volts, the first series of electrical pulses having an interval of less than about 600 ms in between individual pulses. Other embodiments are also included herein.10-08-2009
20100160989Implantable Cardiac Prosthesis Generator Having Protection From an MRI Examination - A generator for an implantable cardiac prosthesis, having a safekeeping mode of operation during an exposure to a magnetic field. The generator is connected to a lead including a first conductor (06-24-2010
20100160988DEVICES, SYSTEMS AND METHODS FOR PACING, RESYNCHRONIZATION AND DEFIBRILLATION THERAPY - Devices, systems, and methods for leadlessly stimulating the heart. Through a magnetic signal generator positioned outside or inside the thoracic cavity, a magnetic signal is transmitted through the chest to stimulate electrical activity within the myocardial muscles. The magnetic signal may function as a pacemaker, cardioverter or defibrillator. Advantages of magnetic stimulation include, without limitation, non invasiveness, a reduction or even elimination in pain, and access to tissues covered by poorly conductive structures.06-24-2010
20100179607METHOD AND SYSTEM FOR DETECTING AND TREATING JUNCTIONAL RHYTHMS - A method and an apparatus for treating cardiac arrhythmias are provided. An interval between first and second consecutive beats of a heart, having first and second chamber types, is determined. The heart is paced at a first rate if the first beat is from the first chamber type and the second beat is from the second chamber type and the interval is less than a predetermined amount of time or if the first and second beats are both from the second chamber type. The heart is paced at a second rate if the first beat is from the first chamber type and the second beat is from the second chamber type and the interval is more than the predetermined amount of time.07-15-2010
20100217342METHODS AND SYSTEMS FOR TREATING CARDIAC ARRHYTHMIAS - The disclosure includes methods and systems for treating cardiac arrhythmias. Some methods for treating an abnormal heart rhythm include determining a change in a sinus node cycle length of a heart of a patient between a time prior to the abnormal heart rhythm and a time during the abnormal heart rhythm; when the change is within a first range, delivering a first therapy to the patient for treating the abnormal heart rhythm; and when the change is within a second range, delivering a second therapy to the patient for treating the abnormal heart rhythm, wherein the first therapy is different from the second therapy. In some embodiments, the first therapy may include shock therapy and the second therapy may include anti-tachycardia pacing.08-26-2010
20100241180COMBINED HEMODYNAMIC AND EGM-BASED ARRHYTHMIA DETECTION - A medical device and associated method for detecting arrhythmias that includes electrodes for sensing cardiac electrical signals and a hemodynamic sensor for sensing a hemodynamic signal. An episode of cardiac electrical event intervals meeting cardiac arrhythmia detection criteria is detected from the sensed electrical signals. Cardiac mechanical events and/or cardiac mechanical event intervals are measured from the hemodynamic signal and used to withhold or confirm a cardiac arrhythmia detection of the episode.09-23-2010
20100222832METHODS FOR USING A PULMONARY ARTERY ELECTRODE - According to some method embodiments, a left pulmonary artery electrode is positioned in a left pulmonary artery, and the left pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation. According to some method embodiments, a right pulmonary artery electrode is positioned in a right pulmonary artery and a left pulmonary artery electrode is positioned in a left pulmonary artery, the right pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation, and the left pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation.09-02-2010
20100198283Automatic Orientation Determination for ECG Measurements Using Multiple Electrodes - Cardiac monitoring and/or stimulation methods and systems provide monitoring, defibrillation and/or pacing therapies. A signal processor receives a plurality of composite signals associated with a plurality of sources, separates a signal using a source separation algorithm, and identifies a cardiac signal using a selected vector. The signal processor may iteratively separate signals from the plurality of composite signals until the cardiac signal is identified. The selected vector may be updated if desired or necessary. A method of signal separation involves detecting a plurality of composite signals at a plurality of locations, separating a signal using source separation, and selecting a vector that provides a cardiac signal. The separation may include a principal component analysis and/or an independent component analysis. Vectors may be selected and updated based on changes of position and/or orientation of implanted components and changes in patient parameters such as patient condition, cardiac signal-to-noise ratio, and disease progression.08-05-2010
20100198284DETECTING AND TREATING ELECTROMECHANICAL DISSOCIATION OF THE HEART - In some examples, an electromechanical disassociation state (EMD) of a heart of a patient can be treated by delivering electrical stimulation to a tissue site to at least one of modulate afferent nerve activity or inhibit efferent nerve activity upon determining that the heart is in an electromechanical dissociation state, where the tissue site comprises at least one of a nonmyocardial tissue site or a nonvascular cardiac tissue site. The delivery of electrical stimulation may effectively treat the EMD state of the heart, e.g., by enabling effective mechanical contraction of the heart. In another example, an electromechanical disassociation state of a heart of a patient can be treated by determining autonomic nervous system activity associated with a detected EMD state of the heart of a patient, and delivering electrical stimulation therapy to the patient based on the determined autonomic nervous system activity of the patient associated with the EMD state.08-05-2010
20090318985METHOD AND APPARATUS FOR CONTROLLING ANTI-TACHYARRHYTHMIA THERAPY USING HEMODYNAMIC TOLERABILITY - A cardiac rhythm management system identifies a relationship between one or more hemodynamic parameters sensed from a patient and levels of hemodynamic tolerability of the patient. The identified relationship allows an implantable medical device to control delivery of anti-tachyarrhythmia therapy using the patient's hemodynamic tolerability during a detected tachyarrhythmia episode, in addition to classifying the detected tachyarrhythmia episode by its type and origin.12-24-2009
20090318986Systems, Methods and Apparatus for Treating Cardiac Dysfunction with Neurostimulation - Methods, systems, and apparatus for the treatment of heart failure (both systolic and diastolic), hypertension, and arrhythmia in patients by stimulating one or more nerves, particularly peripheral nerves, using neurostimulation are described. The therapeutic treatment is accomplished by applying electrical signals to at least one or more nerves using cutaneous, subcutaneous, implantable, or catheter-based neurostimulation assemblies, alone or in combination with one or more additional therapy or stimulation devices associated with the patient's heart, and/or with one or more therapeutic drug infusions or therapies, such as immune modulation therapy (IMT).12-24-2009
20090318987ISCHEMIA DETECTION FOR ANTI-ARRHYTHMIA THERAPY - An exemplary method includes detecting arrhythmia, detecting myocardial ischemia, determining whether the myocardial ischemia comprises local ischemia or global ischemia and, in response to the determining, calling for delivery of either a local ischemic anti-arrhythmia therapy or a global ischemic anti-arrhythmia therapy. Various other exemplary methods, devices, systems, etc., are also disclosed.12-24-2009
20090318984EXTERNAL PACEMAKER WITH AUTOMATIC CARDIOPROTECTIVE PACING PROTOCOL - A pacing system includes a pacemaker and a pacing protocol module externally attached to the pacemaker. The pacing protocol module stores the pacing protocol. The pacemaker controls delivery of pacing pulses by automatically executing the pacing protocol. In one embodiment, the pacing protocol is a cardioprotective pacing protocol for preventing and/or reducing cardiac injury associated with myocardial infarction (MI) and revascularization procedure. The pacing pulses are generated from the pacemaker and delivered through one or more pacing electrodes incorporated onto one or more percutaneous transluminal vascular intervention (PTVI) devices during the revascularization procedure.12-24-2009
20090105777METHOD AND APPARATUS TO TREND AND OPTIMIZE AN IMPLANTABLE MEDICAL DEVICE USING A PATIENT MANAGEMENT SYSTEM - A remote external interface for an implantable cardiac function management device is configured to be communicatively coupled to the implantable cardiac function management device via a network to a local external interface and via telemetry between the local external interface and the implantable cardiac function management device. The remote external interface includes a communication circuit and a processor circuit. The communication circuit is configured to communicate with the implantable cardiac function management device. The processor circuit is configured to perform an analysis of physiologic data received from the implantable cardiac function management device in response to operation of the implantable cardiac function management device using a plurality of therapy control parameter sets. The processor circuit can be further configured to select a particular therapy control parameter set using the analysis.04-23-2009
20110054552ELECTRODE LAYOUT METHOD OF HEART TREATMENT APPARATUS - The purpose is to provide an electrode layout method of a heart treatment apparatus, which is capable of improving the heart treatment efficiency by setting electrodes in the heart as well as reducing the invasion into the patient so as to effectively stimulate a site which needs to be stimulated. There is provided an electrode layout method of a heart treatment apparatus comprising: inserting at least two lines of leads which are provided to the heart treatment apparatus and which have electrodes on their distal ends, into a vein communicated to the interior of a right atrium and extending along a cardiac wall; and placing the electrodes provided on the respective leads in the vein located at approximately opposite positions across a heart.03-03-2011
20090312811CLASSIFICATION OF SUPRAVENTRICULAR AND VENTRICULAR CARDIAC RHYTHMS USING CROSS CHANNEL TIMING ALGORITHM - A system and method for classifying cardiac complexes sensed during a tachycardia episode. A first cardiac signal and a second cardiac signal are sensed, where the first cardiac signal has a voltage. A first cardiac complex and a second cardiac complex of a cardiac cycle are detected in the first and second cardiac signal, respectively. A predetermined alignment feature is identified in the second cardiac complex. A datum is defined, or positioned, at a specified interval from the predetermined alignment feature of the second cardiac complex. Voltage values are then measured from the first cardiac complex at each of two or more measurement intervals from the datum. The voltage values are then compared voltage values measured from NSR cardiac complexes to classify the first cardiac complex is either a ventricular tachycardia complex or a supraventricular tachycardiac complex.12-17-2009
20090312810Post-Shock Management of Implantable Cardiac Device Features - Systems and methods of managing features or functions of an implantable cardiac device involve forming a baseline evoked response template prior to delivery of defibrillation therapy to a patient's heart, and acquiring a post-shock evoked response signal subsequent to defibrillation therapy delivery. The baseline evoked response template is compared to the post-shock evoked response signal. A determination is made whether to enable, disable or adjust a cardiac device feature based on the comparison. The cardiac device feature may be a therapy feature, a monitoring feature, or a diagnostic feature.12-17-2009
20100057151DEVICE FOR THE DEFIBRILLATION OF THE HEART03-04-2010
20100057152SUSTAINING VENTRICULAR TACHYCARDIA DETECTION - An apparatus comprises an implantable ventricular depolarization sensing circuit configured to provide a sensed ventricular depolarization signal, a timer circuit configured to provide a ventricular time interval between ventricular depolarizations, and a controller circuit communicatively coupled to the ventricular depolarization sensing circuit and the timer circuit. The controller circuit includes a ventricular tachycardia (VT) detection circuit configured to declare an episode of VT when a number of accelerated beats are detected, calculate a hysteresis VT detection threshold interval, and deem whether the episode of VT persists using the hysteresis VT detection threshold interval.03-04-2010
20100069977CARDIAC FUNCTION MANAGEMENT INTEGRATING CARDIAC CONTRACTILITY MODULATION - An implantable cardiac rhythm/function management system integrates cardiac contractility modulation (CCM) and one or more other therapies, such as to preserve device safety, improve efficacy, enhance sensing and detection, or enhance therapy effectiveness and delivery. Examples of the one or more other therapies can include pacing, defibrillation/cardioversion, cardiac resynchronization therapy (CRT), or neurostimulation.03-18-2010
20110098763VENTED SET SCREW FOR IMPLANTABLE MEDICAL DEVICE - A vented set screw is used to secure a connection between an implantable medical device and an implantable lead. The vented set screw includes one or more venting channels that allow liquid and/or gas to flow out of the implantable medical device when the implantable lead is being inserted into the implantable medical device and secured during an implantation procedure. This prevents pressure from building up at the connection, thereby ensuring proper performance of sensing and/or therapy delivery functions of the implantable medical device.04-28-2011
20110152956ELECTRICAL INIBITION OF THE PHRENIC NERVE DURING CARDIAC PACING - According to various method embodiments for pacing a heart and avoiding unwanted stimulation of a phrenic nerve during cardiac pacing, a desired pacing time for delivering a cardiac pace is determined, and a desired nerve traffic inhibition time to inhibit nerve traffic in the phrenic nerve is determined using the desired pace time. The cardiac pace is delivered at the desired pacing time and nerve traffic in the phrenic nerve is inhibited at the desired nerve traffic inhibition time.06-23-2011
20110071584METHOD AND APPARATUS FOR AUTOMATED CONTROL OF PACING POST-CONDITIONING - Pacing post-conditioning (PPC) therapy is applied to a patient to minimize ischemic injury associated with MI and/or reperfusion injury associated with a post-MI revascularization procedure. In various embodiments, a PPC therapy is delivered by executing a pacing protocol with pacing parameters determined and dynamically adjusted based on patient-specific factors to ensure efficacy and safety of the patient.03-24-2011
20110071583Galectin-3 and Cardiac Resynchronization Therapy - The present invention relates to materials and methods for monitoring and predicting a heart failure patient's physiological response to cardiac resynchronization therapy. More specifically, the present invention relates to the endogenous protein galectin-3 and its use in monitoring progression of disease in a patient undergoing cardiac resynchronization therapy, and as a predictor of response to cardiac resynchronization therapy.03-24-2011
20120123488Devices For Tachyarrhythmia Sensing And High-Pass Filter Bypass - The present invention, in illustrative embodiments, includes devices for analyzing cardiac signals in an implantable cardiac stimulus system. Within the analysis, a threshold may be defined related to a cardiac event rate. If the cardiac event rate does not exceed the threshold, filtering of captured cardiac signals occurs, including attenuating T-waves. If the cardiac event rate does exceed the threshold, circuitry for analog filtering or programming for digital filtering is bypassed to avoid attenuating low frequency components of the captured cardiac signals.05-17-2012
20120303078SENSOR RESPONSE DELAY FOR HEMODYNAMIC STABILITY DETECTION DURING ARRHYTHMIA - An apparatus comprises a cardiac signal sensing circuit, a physiologic sensor circuit configured to provide a physiologic sensor signal representative of mechanical cardiac activity, a therapy circuit, and a control circuit. The control circuit includes a cardiac depolarization detection circuit, a tachyarrhythmia detection circuit, and a timer circuit. A time interval between a mechanical cardiac event and a detected fiducial electrical cardiac event is monitored. The control circuit is configured to correct the monitored time interval for variation with heart rate to form a corrected electromechanical time interval, initiate anti-tachyarrhythmia therapy when the corrected electromechanical time interval satisfies a specified time interval threshold value during a detected episode of tachyarrhythmia, and withhold anti-tachyarrhythmia therapy otherwise.11-29-2012
20100069978DUAL SENSING FOR BRADY-TACHY PACEMAKER/ICD - A system detects events related to cardiac activity. The system comprises a primary cardiac signal sensing circuit, at least one secondary cardiac signal sensing circuit having a higher sensitivity than the primary sensing circuit, and a controller circuit coupled to the primary and secondary cardiac signal sensing circuits. The controller circuit determines a rate of depolarization using the primary sensing circuit and detects tachyarrhythmia using the rate. The controller circuit also detects tachyarrhythmia using the secondary sensing circuit and also deems the tachyarrhythmia valid if the controller circuit detects the tachyarrhythmia using both the primary and secondary sensing circuit.03-18-2010
20090171408Intra Cardiac Device, System And Methods - An intra cardiac device is disclosed. The device comprises means for transforming kinetic energy from heart tissue movement into electrical energy in use, from which electrical energy information in respect of heart function is obtainable. Furthermore, a system is disclosed, comprising one such intra cardiac device and at least one receiver, wherein the intra cardiac device comprises means of communication, through which said at least one device communicates with the receiver(s) wirelessly. In this way energy from heart movement provides self contained intra cardiac devices for conveniently monitoring or stimulating a patient's heart.07-02-2009
20110022104METHODS AND APPARATUS FOR DETECTING VENTRICULAR DEPOLARIZATIONS DURING ATRIAL PACING - AV synchronous, dual chamber pacing systems are disclosed having improved sensing of ectopic ventricular depolarizations or PVCs coincidentally occurring at or shortly following delivery of an A-PACE pulse. A first ventricular sense amplifier that is blanked during and following delivery of an A-PACE pulse is coupled to active and indifferent ventricular pace/sense electrodes defining a ventricular sense vector for sensing natural ventricular depolarizations and declaring a V-EVENT. A far field PVC sense amplifier coupled to a far field PVC sense electrode pair defining a PVC sense vector detects such PVCs while the ventricular sense amplifier is blanked. A PVC declared during the ventricular blanking period by the far field PVC sense amplifier is employed to deliver a VSP pulse upon time-out of a VSP delay, if the VSP function is provided and programmed ON, and/or to halt time-out of an AV delay.01-27-2011
20110118798METHOD AND APPARATUS FOR ANTI-TACHYCARDIA PACING AND DEFIBRILLATION - An implantable cardioverter/defibrillator (ICD) includes an Anti-Tachycardia Pacing Before Charge (ATP-BC) mode according to which one or more high-voltage capacitors for storing defibrillation energy are charged in preparation of delivering a defibrillation shock only if a ventricular tachycardia (VT) sustains after an ATP delivery. Fast ATP delivery and effect verification methods are applied to avoid significant delay in delivering the defibrillation shock when found necessary to terminate the VT. A switch is provided such that a user decides whether to activate the ATP-BC mode or to deliver the defibrillation shock without delivering the ATP.05-19-2011
20110137360CONCURRENT THERAPY DETECTION IN IMPLANTABLE MEDICAL DEVICES - Various method embodiments detect a concurrent therapy, where the concurrent therapy includes a plurality of therapy pulses. Detecting the concurrent therapy includes detecting at least one electrical pulse, extracting at least one characteristic from the at least one electrical pulse, comparing the at least one characteristic of the detected pulse to at least one characteristic of therapy pulses, and detecting that the concurrent therapy is being applied if the at least one characteristic of the detected pulse favorably compares to the at least one characteristic of the therapy pulses.06-09-2011
20110137359IMPLANTABLE MEDICAL DEVICE WITH AUTOMATIC TACHYCARDIA DETECTION AND CONTROL IN MRI ENVIRONMENTS - An implantable medical device (IMD) includes a lead having one or more sensing electrodes and one or more therapy delivery electrodes, and a sensor configured to detect the presence of static and time-varying scan fields in a magnetic resonance imaging (MRI) environment. A controller, in electrical communication with the lead and the sensor, is configured to process signals related to tachycardia events sensed via the one or more sensing electrodes and to deliver pacing and shock therapy signals via the one or more therapy delivery electrodes. The controller compares the sensed static and time-varying scan fields to static and time-varying scan field thresholds. The controller controls delivery of anti-tachycardia pacing and shock therapy signals as a function of the detected tachycardia events, the comparison of the sensed static scan field to the static scan field threshold, and the comparison of the time-varying scan fields to the time-varying scan field thresholds.06-09-2011
20090210021Defibrillation Pacing Circuitry - Electrical circuit componentry is switchable into a defibrillator circuit to deliver a constant pacing current to a patient. The circuitry may include a constant current source inserted in a leg of the defibrillator circuit or a resistor of selected value inserted between a high voltage source and the high side of a defibrillator circuit.08-20-2009
20110202099APPARATUS AND METHOD FOR AUTOMATIC OPTIMIZATION OF ATRIOVENTRICULAR DELAY FOR AN ACTIVE MEDICAL DEVICE - An active medical device such as pacemaker, defibrillator and/or resynchronizer with automatic optimization of atrioventricular delay is disclosed. The active medical device is adapted for analyzing a signal delivered by a hemodynamic sensor such as an endocardial acceleration sensor, whose variation according to the AVD is represented by a sigmoid function. An optimal AVD is searched by: applying a reference AVD (XC), at least one left AVD (XL, XLL) and at least one right AVD (XR, XRR); measuring the corresponding hemodynamic parameters (Y08-18-2011
20100030289PRE-QUALIFICATION OF AN ALTERNATE SENSING CONFIGURATION - Multiple sensing configurations may be qualified based on one induced tachyarrhythmia, e.g., ventricular fibrillation, or other qualification event during an implantation procedure. Each sensing configuration comprises a different combination of two or more electrodes used for sensing electrical signals of the heart of the patient. In some examples, an implantable medical device or other device generates qualification information for each sensing configuration, which may indicate whether the sensing configuration is qualified for subsequent cardiac event detection based on an accuracy of the cardiac event detection for the sensing configuration during the qualification event. One of the qualified configurations may initially be selected as a primary sensing configuration for subsequent cardiac event detection. Switching to an alternate sensing configuration, e.g., upon identification of any sensing integrity condition of the primary sensing configuration, may be expedited by the previous collection of qualification data for at least one other sensing configuration.02-04-2010
20100030288EXTRAVASCULAR ARRHYTHMIA INDUCTION - A cardiac arrhythmia may be induced by delivering a sequence of pulses to a patient via one or more extravascular electrodes. In one example, one or more pacing pulses may be delivered to a patient via an extravascular electrode and a shock pulse may be delivered to the patient the extravascular electrode. In some examples, the pacing pulses and the shock pulse may be generated with energy from a common energy storage module and without interim charging of the module. For example, the pacing and shock pulses may be generated as the energy storage module dissipates. In another example, a cardiac arrhythmia may be induced in a patient by delivering a burst of pulses to a patient via an extravascular electrode. In some cases, the burst of pulses may be generated with energy from a common energy storage module and without interim charging of the energy storage module.02-04-2010
20100023073DETERMINATION OF UPPER LIMIT OF VULNERABILITY USING A VARIABLE NUMBER OF SHOCKS - A method and apparatus sense a cardiac electrical signal and determine a signal quality parameter of the cardiac electrical signal. A number of shock pulses to be delivered to a patient's heart is determined in response to the signal quality parameter. Each of the shock pulses are scheduled to be delivered at a unique offset from a T-wave shock interval in one embodiment of the invention.01-28-2010
20100023072Methods for the Determination of T-Shock Vulnerable Window from Far-Field Electrograms in Implantable Cardioverter Defibrillators - Methods for determination of timing for electrical shocks to the heart to determine shock strength necessary to defibrillate a fibrillating heart. The timing corresponds the window of most vulnerability in the heart, which occurs during the T-wave of a heartbeat. Using a derivatized T-wave representation, the timing of most vulnerability is determined by a center of the area method, peak amplitude method, width method, or other similar methods. Devices are similarly disclosed embodying the methods of the present disclosure.01-28-2010
20120041500ENDOCARDIAL PACING DEVICES AND METHODS USEFUL FOR RESYNCHRONIZATION AND DEFIBRILLATION - According to one aspect, various methods and apparatus are used for treating a condition of a patient's heart, and for monitoring cardiac operation. In one approach consistent therewith, an electrode arrangement is placed in a right ventricle of the heart. The electrode arrangement is used to capture the myocardium for re-synchronization of the left and right ventricles by providing first and second signal components having opposite polarity on respective electrodes. The electrode arrangement is connected to an implantable CRM device that has the capability of pacing/sensing atrium, pacing/sensing ventricles, and deliver defibrillation therapy from the right side of the heart. The CRM device captures ventricular contractions to treat conduction abnormalities in one or more of the ventricles.02-16-2012
20090131997AUTOMATIC DEFIBRILLATOR MODULE FOR INTEGRATION WITH STANDARD PATIENT MONITORING EQUIPMENT - A defibrillator module is described which includes a cardiac sensor, a pulse generator and a controller that generates commands responsive to intrinsic cardiac signals for the operation of said pulse generator. The defibrillator module synergistic and arranged so that it can be coupled to a generic patient monitor so that the two can share certain functions. For example, operational parameters and other signals indicative of the operation of the defibrillator module can be shown to the clinician by the patient monitor. Data between the defibrillator module and the patient monitor is exchanged using either a standard or a customized protocol.05-21-2009
20100063557ENERGY HARVESTING MECHANISM - Embodiments of the invention provide an energy harvesting mechanism comprising a central conductive element and a plurality of transductive elements. Each transductive element is positioned to be in contact with a corresponding peripheral length segment of the central conductive element. Also each transductive element is deformable in a characteristic radial direction to convert its deformation into a corresponding electrical signal. The plurality of transductive elements are arranged so that any one of the plurality of transductive elements is capable of being deformed in the characteristic radial direction to trigger the corresponding electrical signal. Embodiments of the mechanism can be used for harvesting energy from a variety of bio-kinetic events such as a heartbeat, respiration, muscle contraction or other movement. Such embodiments can be used for powering a variety of implanted medical devices such as pacemakers, defibrillators and various monitoring devices.03-11-2010
20120046703METHOD AND DEVICE FOR COMPREHENSIVE ANTI-TACHYARRHYTHMIA THERAPY - A method and apparatus for delivering therapy to treat ventricular tachyarrhythmias is described. In one embodiment, neural stimulation, anti-tachycardia pacing, and shock therapy are employed in a progressive sequence upon detection of a ventricular tachycardia.02-23-2012
20120116471DYNAMIC BATTERY MANAGEMENT IN AN IMPLANTABLE DEVICE - One aspect of this disclosure relates to a system for dynamic battery management in implantable medical devices. An embodiment of the system includes two or more devices for measuring battery capacity for an implantable medical device battery. The embodiment also includes a controller connected to the measuring devices. The controller is adapted to combine the measurements from the measuring devices using a weighted average to determine battery capacity consumed. According to various embodiments, at least one of the measuring devices includes a coulometer. At least one of the measuring devices includes a capacity-by-voltage device, according to an embodiment. The system further includes a display in communication with the controller in various embodiments. The display is adapted to provide a depiction of battery longevity in units of time remaining in the life of the implantable medical device battery, according to various embodiments. Other aspects and embodiments are provided herein.05-10-2012
20110166613Automatic Multi-Level Therapy Based on Morphologic Organization of an Arrhythmia - Methods and systems for selecting tachyarrhythmia therapy based on the morphological organization level of the arrhythmia are described. Morphological organization levels of arrhythmias are associated with cardiac therapies. The morphological organization levels are related to cardiac signal morphologies of the arrhythmias. An arrhythmia episode is detected and the morphological organization level of the arrhythmia episode is determined. A cardiac therapy associated with the morphological organization level of the arrhythmia episode is delivered to treat the arrhythmia. For example, the morphological organization levels may be associated with the cardiac therapies based on one or more of retrospective database analysis, patient therapy tolerance, and physician input. The associations may be static or may be dynamically adjusted based on therapy efficacy.07-07-2011
20120016432EVALUATION OF IMPLANTABLE MEDICAL DEVICE DATA - A system includes an episode classification module and a data retrieval module. The episode classification module receives electrograms (EGMs) from N implantable medical devices (IMDs) and determines whether the EGMs are associated with deliveries of therapy by the N IMDs. The episode classification module analyzes at least some of the EGMs and determines whether the deliveries or non-deliveries of therapy by the IMDs were appropriate. The data retrieval module receives a request from a computing device, via a network, that indicates at least two groups of the N IMDs. The data retrieval module provides to the computing device via the network, in response to the request, data for presentation to a user that indicates for each of the groups, at least one of how many of the one or more deliveries or non-deliveries were appropriate, or how many of the one or more deliveries or non-deliveries were inappropriate.01-19-2012
20120022607VENTRICULAR CAPTURE TESTING BY ANALYSIS OF AN ENDOCARDIAL ACCELERATION SIGNAL IN AN ACTIVE IMPLANTABLE MEDICAL DEVICE - An active implantable medical device such as a cardiac prosthesis, including ventricular capture testing by analysis of an endocardial acceleration signal. The device isolates in an endocardial acceleration (“EA”) signal an EA component, extracts from it, n representative indicators (PEA_i, LEA_i), and forms a vector EA (X_i) from these indicators. A classifier allows acquiring reference EA signals at a stimulation energy level sufficient to cause a capture, and in spontaneous rhythm in the absence of ventricular pacing and forms a corresponding plurality of first reference EA vectors. The n-dimensional space of the EA vectors is partitioned into two corresponding subspaces. The presence or absence of a capture is discriminated based on the position of the current EA vector (X_i) in one or other of these two sub-spaces. The representative indicators may be: the value of peak to peak amplitude, the width, the moment of occurrence of the peak, the starting time and the ending time of the EA01-26-2012
20120209342METHOD AND APPARATUS OF ACOUSTIC COMMUNICATION FOR IMPLANTABLE MEDICAL DEVICE - An implantable medical device includes an acoustic transducer for intra-body communication with another medical device via an acoustic couple. The acoustic transducer includes one or more piezoelectric transducers. In one embodiment, an implantable medical device housing contains a cardiac rhythm management (CRM) device and an acoustic communication circuit. The acoustic transducer is electrically connected to the acoustic communication circuit to function as an acoustic coupler and physically fastened to a wall of the implantable housing, directly or via a supporting structure.08-16-2012
20110071585INTRAVASCULAR IMPLANTABLE DEVICE HAVING SUPERIOR ANCHORING ARRANGEMENT - Methods, systems and devices are provided for anchoring an intravascular implantable device within a vessel that is located superior to the heart, i.e. above the heart in a direction toward the head of a patient. Also provided is a method of providing an intravascular device and instructions for implanting the intravascular device, comprising providing an intravascular device having an elongate device body with a proximal end and a distal end that is adapted for chronic implantation within the vasculature of a patient and that includes a distal portion of the intravascular device proximate the distal end of the elongate device body, and providing instructions for chronically implanting the intravascular device substantially wholly within the vasculature of a patient in a target vessel superior to the heart of the patient.03-24-2011
20110066198METHOD AND APPARATUS FOR POST-SHOCK EVALUATION USING TISSUE OXYGENATION MEASUREMENTS - A method and device for delivering therapy that includes an electrode to sense cardiac signals and to deliver a therapy, a therapy delivery module coupled to the electrode to deliver a therapy via the electrode in response to the sensed cardiac signals, a sensor emitting light and detecting emitted light scattered by a tissue volume adjacent the optical sensor to generate a corresponding detected light intensity output signal, a control module coupled to the sensor to control light emission of the sensor in response to delivering the therapy, and a controller coupled to the therapy delivery module and the sensor, the controller configured to determine tissue oxygenation measurements in response to the output signal, determine a tissue oxygenation trend in response to the tissue oxygenation measurements, and determine whether the delivered therapy restored cardiac hemodynamic function in response to the determined tissue oxygenation trend.03-17-2011
20120165884FLUID ACCUMULATION MONITORING DEVICES, SYSTEMS AND METHODS - Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's fluid accumulation level. A thoracic impedance signal for the patient is obtained. Based on the thoracic impedance signal, a duration metric indicative of a duration of drop of the thoracic impedance signal, a magnitude metric indicative of a magnitude of drop of the thoracic impedance signal, and a rate metric indicative of a rate of drop of the thoracic impedance signal is determined. The patient's fluid accumulation level is monitored based on the duration metric, the magnitude metric and the rate metric.06-28-2012
20090131996Tachycardia hemodynamics detection based on cardiac mechanical sensor signal regularity - Systems and methods provide for sensing, within a patient and during an event of tachycardia, a signal indicative of a mechanical response of the patient's heart to the tachycardia. Regularity of the signal relative to a threshold established for the patient is determined. A state of patient hemodynamics during the tachycardia event is determined based at least in part on the regularity of the signal. One or more anti-tachycardia therapies to treat the tachycardia may be selected based at least in part on the determined state of patient hemodynamics. The selected one or more anti-tachycardia therapies may be delivered to treat the tachycardia.05-21-2009
20100249860EXTERNAL CARDIAC STIMULATION PATCH - An external cardiac stimulation patch integrates a transcutaneous cardiac stimulation device and body-surface electrodes with a skin patch. The skin patch is to be attached onto a patient to provide for electrical contacts between the body-surface electrodes and a patient. The transcutaneous cardiac stimulation device delivers pacing pulses to the heart of the patient through pacing electrodes selected from the body-surface electrodes.09-30-2010
20120221066Systems and Methods for Activating and Controlling Impedance-Based Detection Systems of Implantable Medical Devices - Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.08-30-2012
20120215269Method and Device for Treating Cardiac Arrhythmias - The present invention provides both methods and devices for termination of arrhythmias, such as ventricular or atrial tachyarrhythmias. The device and method involves application of alternating current (AC) for clinically significant durations at selected therapeutic frequencies through the cardiac tissue to a subject experiencing arrhythmia. Methods are also provided to minimize or eliminate pain during defibrillation.08-23-2012
20100298896Selection of Cardiac Capture Verification Modes - Systems and methods provide for selection of automatic capture verification modes. A number of capture verification modes are evaluated, wherein at least one of the capture verification modes has a distinct temporal relationship between delivery of a pacing pulse and detection of capture of heart tissue by the pacing pulse than the other capture verification modes. One or more capture verification modes are selected based on the evaluation. Capture verification is implemented using the selected one or more capture verification modes.11-25-2010
20120179216NEURAL STIMULATION SYSTEM FOR CARDIAC FAT PADS - Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein.07-12-2012
20100010551METHOD AND APPARATUS FOR TRANSCUTANEOUS CARDIOPROTECTIVE PACING - A transcutaneous cardiac stimulation system delivers pacing pulses according to a cardioprotective pacing protocol. The pacing pulses are delivered through body-surface electrodes attached onto a patient. The cardioprotective pacing protocol specifies pacing parameters selected to augment cardiac stress on the patient's myocardium to a level effecting cardioprotection against ischemic and reperfusion injuries.01-14-2010
20120232604SYSTEM TO TREAT AV-CONDUCTED VENTRICULAR TACHYARRHYTHMIA - Various aspects of the present subject matter provide devices and methods to treat AV-conducted ventricular tachyarrhythmia (AVCVT). According to various embodiments of the method, an AVCVT is sensed, an IVC-LA fat pad is stimulated when the AVCVT is sensed to block AV conduction, and bradycardia support pacing is provided while the IVC-LA fat pad is stimulated. Other aspects and embodiments are provided herein.09-13-2012
20100324612SYSTEM FOR CARDIAC RESUSCITATION - System and method for monitoring and controlling, defibrillation and pacing which allows a victim of a cardiac rhythm abnormality immediate access to a medical professional at a central station, who will remotely monitor, diagnose and treat the victim at one of a plurality of remote sites in accordance with the following steps: 12-23-2010
20110004262VAGAL STIMULATION DURING ATRIAL TACHYARRHYTHMIA TO FACILITATE CARDIAC RESYNCHRONIZATION THERAPY - The disclosure describes techniques for delivering vagal stimulation to decrease the ventricular rate response during an atrial tachyarrhythmia, such as atrial fibrillation. Decreasing the ventricular rate response during an atrial tachyarrhythmia may facilitate increased ventricular pacing for cardiac resynchronization therapy (CRT), and may also reduce the likelihood of inappropriately detecting a ventricular tachyarrhythmia during the atrial tachyarrhythmia. Furthermore, the vagal stimulation may augment vagal tone, which may facilitate long term left ventricular reverse remodeling and decrease atrial and ventricular arrhythmic burden in heart failure patients. An example system that delivers CRT comprises a processor that detects an atrial tachyarrhythmia in one or more atria of the heart, and monitors at least one of a ventricular rate or degree of ventricular pacing subsequent to the detected atrial arrhythmia. The processor controls a stimulation generator to deliver vagal stimulation based on the least one of a ventricular rate or degree of ventricular pacing.01-06-2011
20120265263Medical Device Sensing and Detection During MRI - A medical device includes a sensor for sensing for an MRI gradient magnetic field and a microprocessor configured to operate in a signal processing mode in which electrical signals induced by the gradient magnetic field are not counted as cardiac events.10-18-2012
20120271368DEVICES, SYSTEMS AND METHODS FOR CHARACTERIZING A TACHYCARDIA AND/OR SELECTING TREATMENT FOR A TACHYCARDIA USING RESULTS OF A FRACTIONATION ANALYSIS - Provided herein are implantable systems, and methods for use therewith, for characterizing a tachycardia and/or selecting treatment for a tachycardia using results of a fractionation analysis. One or more electrogram (EGM) signal(s) indicative of cardiac electrical activity are obtained. At least one of the EGM signal(s) is analyzed to determine whether the EGM signal is fractionated, and the results of the analyzing are used to characterize a tachycardia and/or to select treatment for a tachycardia.10-25-2012
20120271367DEVICES, SYSTEMS, AND METHODS FOR CHARACTERIZING A TACHYCARDIA AND/OR SELECTING TREATMENT FOR A TACHYCARDIA USING RESULTS OF A DOMINANT FREQUENCY ANALYSIS - Provided herein are implantable systems, and methods for use therewith, for characterizing a tachycardia and/or selecting treatment for a tachycardia using results of a dominant frequency analysis. One or more electrogram (EGM) signal(s) indicative of cardiac electrical activity are obtained. For at least one of the EGM signal(s) a dominant frequency (DF) analysis is performed, and the results of the DF analysis are used to characterize a tachycardia and/or to select treatment for a tachycardia.10-25-2012
20120323289METHOD AND APPARATUS FOR ESTABLISHING CONTEXT AMONG EVENTS AND OPTIMIZING IMPLANTED MEDICAL DEVICE PERFORMANCE - An apparatus and method for adjusting the performance of an implanted device based on data including contextual information. Contextual information, including operational and performance data concerning the implanted device as well as the patient with the implanted device, is stored by a portable electronic device. In one embodiment, the portable electronic device is adapted for battery operation and includes a personal digital assistant (PDA). The portable electronic device is adapted for use as an interface to conduct wireless communications with the implanted device. In one embodiment, the portable electronic device interfaces with a clinical programmer for use by a physician.12-20-2012
20110276102REDUNDANT PACING SYSTEM WITH LEADED AND LEADLESS PACING - A pacing system includes a controller operable to provide control signals indicating desired pacing signals, a pulse generator connected to the controller and operable to receive the control signals and to generate the desired pacing signals based on the control signals, at least one lead electrically connected to the pulse generator and extending into a user's heart and operable to provide the pacing signals to the heart, at least one electrode positioned in the user's heart and electrically connected to the at least one lead, the at least one electrode in contact with the user's heart and operable to stimulate the heart based on the pacing signals; and a transceiver, in communication with the pulse generator and operable to selectively transmit the pacing signals to the electrode wirelessly. The transceiver is controlled by the controller to transmit the pacing signals when pacing signals are not received by the electrode from the at least one lead. The lead may include multiple leads held together in a sugar moiety as a unitary body for insertion into the heart. Once in the heart, the sugar moiety dissolves to allow the leads to separate for implantation at different points in the heart.11-10-2011
20120101539DEVICES, METHODS, AND SYSTEMS INCLUDING CARDIAC PACING - A pacing output circuit can be configured to generate a ventricular pacing signal configured to be delivered to an electrode near the His bundle in a right ventricle of a heart to pace the right and left ventricles and improve synchronization of at least one of the ventricles relative to intrinsic activity. In an example, the ventricular pacing signal can include first and second signal components in opposite polarity from each other with respect to a reference component, the first and second signal components having substantially identical duration and magnitude.04-26-2012
20100168807BIOACTIVE TERPOLYMER COMPOSITIONS AND METHODS OF MAKING AND USING SAME - Described herein are terpolymer compositions, kits comprising the compositions, implant devices comprising the compositions, and methods of making and using same, including point of use methods.07-01-2010
20110160782Systems and Methods for Placing Electronic Devices into "Cautery-Safe" Mode - A method and device to enable a medical or surgical procedure using electro-cautery on a patient with an implantable device in a cautery-safe mode of operation. In one embodiment, the invention provides an electronic implantable device programmer having a computer processor, and a display screen configured to display information based on signals from the computer processor. The programmer also includes an input device, and a wireless transmitter controlled by the computer processor. The programmer display and input give the operator the option of programming an implanted electronic device in a cautery-safe mode. With this input, from the operator, instructions are provided in the programmer to transmit a signal from the wireless transmission device to the implanted electronic device to program the electronic device to be in a dedicated bipolar mode where electrical noise produced when operating an electro-cautery device during and medical/surgical procedure does not interfere with operation of the electronic device.06-30-2011
20130023944UNIPOLAR MULTIPURPOSE ELECTRODE LINE AND STIMULATION AND DEFIBRILLATION ASSEMBLY - A unipolar multipurpose electrode line, comprising a line body, a unipolar plug, a defibrillation electrode attached to the line body, and a stimulation and sensing electrode, which are connected by way of a common feed line to the unipolar plug, wherein the defibrillation electrode is connected by means of at least one voltage-dependent component to the electrode feed line so that the connection has low impedance only in response to the application of a defibrillation voltage at the plug.01-24-2013
20080243201PACER WITH COMBINED DEFIBRILLATOR TAILORED FOR BRADYCARDIA PATIENTS - A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.10-02-2008
20080243200METHODS AND APPARATUS FOR ENHANCING SPECIFICITY OF ARRHYTHMIA DETECTION USING FAR-FIELD SENSING AND INTRACARDIAC SENSING OF CARDIAC ACTIVITY - Improved implantable medical devices (IMDS) and more particularly, a subcutaneous multiple electrode sensing and recording system for acquiring far- and near-field electrocardiographic (ECG) data and waveform tracings. The far-field ECG data and/or waveform tracings is used to confirm or refute sensing and detection performed by the near-field (e.g., epicardial and/or intracardiac) electrodes which collect electrograms (or EGMs). Thus, subcutaneously implanted devices adapted to sense near- and far-field cardiac activity offer improved specificity and sensitivity in arrhythmia sensing and detection. The far-field ECG signals are collected via at least a pair of electrodes that are directly mechanically coupled to the housing for the IMD (and thus spaced from the myocardium) which are filtered and processed and used in addition to the near-field EGM signals collected by lead-based electrodes.10-02-2008
20100087881PREFERENTIAL MECHANICAL UNLOADING DURING ANTI-TACHYCARDIA PACING - A pacing device and method for operating same is disclosed in which the point of origin of an arrhythmia is estimated in order to more provide more effective treatment. The origin of an arrhythmia may be estimated by analyzing the timing of electrical events as detected at different electrode sites and/or using different sensing vectors. Anti-tachycardia pacing (ATP) may then be delivered to the most appropriate location.04-08-2010
20080234769SUBCUTANEOUS CARDIAC STIMULATION DEVICE PROVIDING ANTI-TACHYCARDIA PACING THERAPY AND METHOD - An implantable subcutaneous cardiac device includes at least two subcutaneous electrodes adapted for placement external to a heart beneath the skin of a patient. The device further includes an arrhythmia detector that detects a sustained tachyarrhythmia of the heart and a pulse generator that delivers anti-tachycardia pacing pulses to the subcutaneous electrodes in response to detection of a sustained tachyarrhythmia. The pacing pulses preferably have waveforms devoid of any exponential voltage decay and include rounded or substantially constant portions to minimize pain.09-25-2008
20080234768Systems for monitoring and applying electrical currents in an organ perfusion system - Electrode systems have been developed for use in perfusion systems to measure the electrical activity of an explanted heart and to provide defibrillation energy as necessary. The perfusion systems maintain the heart in a beating state at, or near, normal physiological conditions; circulating oxygenated, nutrient enriched perfusion fluid to the heart at or near physiological temperature, pressure and flow rate. These systems include a pair of electrodes that are placed epicardially on the right atrium and left ventricle of the explanted heart, as well as an electrode placed in the aortic blood path.09-25-2008
20080228234METHODS AND APPARATUS FOR IMPROVED IPG RATE RESPONSE USING SUBCUTANEOUS ELECTRODES DIRECTLY COUPLED TO AN IMPLANTABLE MEDICAL DEVICE (IMD) - Per the disclosure subcutaneously implantable medical devices (IMDs) with rate responsive implantable pulse generator (IPG) capability that also include dual patient activity sensors are adaptively controlled. One of the activity sensors uses multiple electrodes adapted to acquire electrocardiographic signals and signals from non-cardiac muscle tissue (myopotentially-based signals). The signals from the electrode-based activity sensor are used to confirm and/or override the patient-activity sensor signals from the other non-myopotentially-based patient activity sensor. The electrodes are directly mechanically coupled to the housing of the IMD and electrically coupled to circuitry that filters, processes, and interprets both the patient activity sensor signals.09-18-2008
20110270333METHOD OF DUAL EGM SENSING AND HEART RATE ESTIMATION IN IMPLANTED CARDIAC DEVICES - A method and apparatus for monitoring a patient's heart rate sense first cardiac events in a heart chamber using a first cardiac electrode pair and sense second cardiac events in the heart chamber using a second cardiac electrode pair. The method includes estimating a first heart rate using the first cardiac events, comparing the first heart rate to a heart rate threshold and estimating a second heart rate using the second cardiac events in response to the first heart rate exceeding the heart rate threshold.11-03-2011
20130096638VENTRICULAR PACING - A method and apparatus are disclosed for treating a condition of a patient's heart includes placing a first electrode and/or a second electrode in a right ventricle of the heart. In one example, a reference electrode is placed within the patient and internal or external to the heart. A pacing signal is generated including a first signal component, a second signal component and a reference component with the first and second signal components having opposite polarity and with both of the first and second components having a potential relative to the reference component. The pacing signal and the placement of the electrodes are selected to alter a contraction of a left ventricle of the heart.04-18-2013
20130123869VENTRICLE PACING DURING ATRIAL FIBRILLATION EPISODES - An adaptive dual chamber pacemaker and/or cardioverter defibrillator for delivering ventricular stimulation to the heart correlated with hemodynamic performance of the heart, including a hemodynamic sensor for monitoring the hemodynamic performance of the heart, an atrial electrode and a ventricular electrode for sensing ventricular and atrial signals, and a learning module having a spiking neural network processor for learning to associate the ventricular-atrial intervals sensed by the electrodes with the hemodynamic performance sensed by the hemodynamic sensor, calculating ventricular-atrial intervals, replacing the ventricular-atrial intervals calculated from the sensed ventricular and atrial signals with the learned associated ventricular-atrial intervals, and causing delivery according to the learned associated ventricular-atrial intervals of a ventricular stimulation to the heart during atrial fibrillation episodes.05-16-2013
20130184772CENTRAL CONTROL UNIT OF IMPLANTS - The entire electronics of a control system and of implantable passive and active medical implants connected to or cooperating with the control system are integrated in a central control unit (ZSE) which, by way of detachable cables or by telemetry or radio contact, controls and monitors all of the implants that are present and, if appropriate, implants that are fitted subsequently in the patient (07-18-2013

Patent applications in class Combined cardioverting/defibrillating and pacing