Patent application number | Description | Published |
20080215110 | METHOD AND APPARATUS FOR IDENTIFYING LEAD-RELATED CONDITIONS USING PREDICTION AND DETECTION CRITERIA - A method for delivering therapy in a medical device that includes a two-tiered approach of determining the presence of a lead-related condition, and determining, in response to a lead-related condition being present, the presence of oversensing. Deliver of therapy by the medical device is controlled in response to determining that both the lead-related condition and oversensing are present. | 09-04-2008 |
20090292331 | METHOD AND APPARATUS FOR IDENTIFYING OVERSENSING USING FAR-FIELD INTRACARDIAC ELECTROGRAMS AND MARKER CHANNELS - A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM. | 11-26-2009 |
20090299201 | ELECTRODE LEAD INTEGRITY REPORTS - In general, the disclosure relates to techniques for providing a combination of stored diagnostic information, including impedance trend data, into one displayable report that may be used to diagnose a possible condition with an implantable medical electrode lead. One example device includes a processor that is configured to obtain impedance trend data for an electrical path, the electrical path comprising a plurality of electrodes, and to obtain additional diagnostic data that is associated with the electrical path, the additional diagnostic data being distinct from the impedance trend data. The device is further configured to combine both the impedance trend data and the additional diagnostic data into a displayable report that indicates whether there is a possible condition with the electrical path. The additional diagnostic data may include non-sustained episode data, sensing integrity data, pacing threshold, and/or electrogram data (such as P-wave amplitude and/or R-wave amplitude data). | 12-03-2009 |
20090299422 | ELECTROGRAM STORAGE FOR SUSPECTED NON-PHYSIOLOGICAL EPISODES - Techniques for storing electrograms (EGMS) that are associated with sensed episodes or events that may be non-physiological and, instead, associated with a sensing integrity condition are described. In some examples, a device or system identifies suspected non-physiological NSTs, and stores an EGM for the suspected non-physiological NSTs within an episode log. In some examples, a device or system determines whether to store an EGM for a suspected non-physiological episode or event based on whether an impedance integrity criterion has been satisfied. For example, a device or system may store an EGM for a detected short interval if the impedance integrity criterion has been met. In some examples, a device or system determines whether to buffer EGM data based on whether an impedance integrity criterion or other sensing integrity criterion has been met. | 12-03-2009 |
20090299432 | IMPEDANCE VARIABILITY ANALYSIS TO IDENTIFY LEAD-RELATED CONDITIONS - In general, the disclosure relates to techniques for calculating mean impedance values and impedance variability values to detect a possible condition with a lead or device-lead pathway or connection. In one example, a device may be configured to determine an impedance value for an electrical path based on a plurality of measured impedance values for the electrical path, wherein the electrical path comprises a plurality of electrodes, and to determine an impedance variability value based on at least one of the plurality of measured impedance values. The device may be further configured to determine a threshold value based on the determined impedance value and the impedance variability value, compare a newly measured impedance value for the electrical path to the threshold value, and indicate a possible condition of the electrical path based on the comparison. | 12-03-2009 |
20100023084 | LEAD INTEGRITY TESTING TRIGGERED BY SENSED SIGNAL SATURATION - Techniques for performing a lead integrity test in response to, e.g., during or after saturation of a sensed signal, e.g., a cardiac electrogram (EGM) signal, are described. A lead integrity test may comprise one or more impedance measurements for one or more leads. Possible causes of saturation of a sensed signal include lead conductor or connector issues, or other lead related conditions. A lead integrity test triggered in response to the saturation may be able to detect any lead related condition causing the saturation. A lead integrity test triggered in response to the saturation may advantageously be able to detect an intermittent lead related condition, due to the temporal proximity of the test to the saturation. | 01-28-2010 |
20100106209 | IDENTIFICATION AND REMEDIATION OF OVERSENSED CARDIAC EVENTS USING FAR-FIELD ELECTROGRAMS - In general, the disclosure is directed to techniques for identification and remediation of oversensed cardiac events using far-field electrograms (FFEGMs). Identification of oversensed cardiac events can be used in an ICD to prevent ventricular fibrillation (VF) detection, and thereby avoid delivery of an unnecessary defibrillation shock. Alternatively, or additionally, identification of oversensed cardiac events can be used in an ICD to support delivery of bradycardia pacing during an oversensing condition. In some cases, bradycardia pacing delivered in response to detection of oversensed cardiac events may include pacing pulses from multiple vectors to provide redundancy in the event the oversensing may be due to a lead-related condition. | 04-29-2010 |
20100114206 | Patient Interface Device and Therapy Delivery System - A method and system for diagnosing a medical condition, alerting a patient that a therapy is impending, and allowing the patient to override or modify the impending therapy are provided. The system may include an implantable medical device (“IMD”) and a patient interface device. The IMD may sense a physiological parameter within a patient, determine whether the physiological parameter qualifies for therapy based on a therapy criteria, and alert the patient via the patient interface device that therapy is impending if the physiological parameter qualifies for therapy. The patient may be given an opportunity to respond to the alert with the patient interface device and send an therapy modification indication if the therapy is not needed or wanted. The IMD may wait a predetermined period of time for the patient response and deliver the therapy if the patient response is not transmitted before expiration of the predetermined period of time or withhold the therapy if the patient overrides the delivery of the therapy within the predetermined period of time. The IMD may adjust one or more operational settings applied during its operation in response to the activity of the system. The patient interface device may be configured to avoid accidental override or modification of the delivery of the therapy. | 05-06-2010 |
20100114222 | LEAD INTEGRITY TESTING TRIGGERED BY SENSED ASYSTOLE - A method includes sensing a cardiac electrogram (EGM) signal of a patient via one or more electrodes on at least one implantable medical lead. An asystolic EGM signal is detected from the patient, and a lead integrity test of the at least one implantable medical lead is initiated in response to the asystolic EGM signal. | 05-06-2010 |
20100280567 | METHOD AND APPARATUS FOR IDENTIFYING CARDIAC AND NON-CARDIAC OVERSENSING USING INTRACARDIAC ELECTROGRAMS - A method and apparatus for automatically identifying various types of cardiac and non-cardiac oversensing and automatically performing a corrective action to reduce the likelihood of oversensing is provided. EGM data, including time intervals between sensed and paced events and signal morphologies, are analyzed for patterns indicative of various types of oversensing, including oversensing of far-field R-waves, R-waves, T-waves, or noise associated with electromagnetic interference, non-cardiac myopotentials, a lead fracture, or a poor lead connection. Identification of oversensing and its suspected cause are reported so that corrective action may be taken. The corrective action may include, for example, adjusting sensing parameters such as blanking periods, decay constants, decay delays, threshold values, sensitivity values, electrode configurations and the like. | 11-04-2010 |
20110054558 | IDENTIFYING A LEAD RELATED CONDITION BASED ON DETECTING NOISE SUBSEQUENT TO SIGNAL DELIVERY - In general, the disclosure describes techniques for detecting lead related conditions, such as lead fractures or other lead integrity issues. As described herein, delivering an electrical signal through selected electrodes may result in, reveal, or amplify noise if a lead related condition is present. A processor may detect electrical noise indicative of the lead related condition subsequent to the delivery of the electrical signal, and identify a lead related condition in response to detecting the noise. | 03-03-2011 |
20110098766 | NON-SUSTAINED TACHYARRHYTHMIA ANALYSIS TO IDENTIFY LEAD RELATED CONDITION - Techniques for determining whether a lead related condition exists based on analysis of a cardiac electrical signal associated with a non-sustained tachyarrhythmia (NST) are described. In some examples, the techniques include determining the duration of intervals between consecutive cardiac events, e.g., R-R intervals, during an NST. The techniques may further include determining one or more metrics based on the durations of the intervals during the NST. Examples of metrics include an average, a minimum, a maximum, a range, a median, a mode, or a mean. A lead related condition is identified based on the values of the one or more metrics, e.g., by comparison to respective thresholds. In some examples, an alert is provided or a therapy modification is suggested if a lead related condition is identified. | 04-28-2011 |
20110112417 | METHOD AND APPARATUS FOR POST-PROCESSING OF EPISODES DETECTED BY A MEDICAL DEVICE - A method and system for determining undersensing during post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by the medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, and determines whether one of a predetermined number of undersensing criteria have been met in response to the transmitted data. | 05-12-2011 |
20110184481 | STORAGE OF DATA FOR EVALUATION OF LEAD INTEGRITY - In general, the disclosure describes techniques for storing data corresponding to sensed high-rate non-sustained episodes that occur close in time to detection of a lead integrity condition. A method comprises detecting a first high-rate non-sustained episode, activating a data storage operation for storing data associated with high rate non-sustained episodes in response to detecting the first episode, and storing data associated with the first episode in an episode log in response to activating the data storage operation. Another method comprises detecting a lead integrity condition, and activating a data storage operation for storing data associated with high rate non-sustained episodes in response to detecting the condition. | 07-28-2011 |
20120071944 | IDENTIFICATION AND REMEDIATION OF OVERSENSED CARDIAC EVENTS USING FAR-FIELD ELECTROGRAMS - In general, the disclosure is directed to techniques for identification and remediation of oversensed cardiac events using far-field electrograms (FFEGMs). Identification of oversensed cardiac events can be used in an ICD to prevent ventricular fibrillation (VF) detection, and thereby avoid delivery of an unnecessary defibrillation shock. Alternatively, or additionally, identification of oversensed cardiac events can be used in an ICD to support delivery of bradycardia pacing during an oversensing condition. In some cases, bradycardia pacing delivered in response to detection of oversensed cardiac events may include pacing pulses from multiple vectors to provide redundancy in the event the oversensing may be due to a lead-related condition. | 03-22-2012 |
20120109235 | CAPTURE 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 |
20120109240 | AUTOMATIC ADJUSTMENT OF ARRHYTHMIA DETECTION PARAMETERS - Methods and/or devices for initiating an automatic adjustment of arrhythmia detection parameters (e.g., upon delivery of cardiac therapy after detection of VT/VF). | 05-03-2012 |
20120191153 | DIAGNOSIS OF LEAD FRACTURE AND CONNECTION PROBLEMS - Techniques for diagnosing lead fractures and lead connection problems are described. One or more medical leads may be coupled to an implantable medical device (IMD) to position electrodes or other sensors at different locations within a patient than the IMD. The IMD may include a lead diagnostic module configured to diagnose problems with a coupled lead and automatically select between a lead fracture problem and a lead connection problem based on the diagnosis. The diagnosis of either lead fracture problems or lead connection problems may be based on a timing of an increased impedance value with respect to connection of the lead to the IMD, a return to baseline impedance values after the increased impedance value, an abrupt rise of the increased impedance value, maximum impedance values, or oversensing. An external device may present the diagnosis to a user to facilitate appropriate corrective action. | 07-26-2012 |
20120296386 | NON-SUSTAINED TACHYARRHYTHMIA ANALYSIS TO IDENTIFY LEAD RELATED CONDITION - Techniques for determining whether a lead related condition exists based on analysis of a cardiac electrical signal associated with a non-sustained tachyarrhythmia (NST) are described. In some examples, the techniques include determining the duration of intervals between consecutive cardiac events, e.g., R-R intervals, during an NST. The techniques may further include determining one or more metrics based on the durations of the intervals during the NST. Examples of metrics include an average, a minimum, a maximum, a range, a median, a mode, or a mean. A lead related condition is identified based on the values of the one or more metrics, e.g., by comparison to respective thresholds. In some examples, an alert is provided or a therapy modification is suggested if a lead related condition is identified. | 11-22-2012 |
20130060117 | Method and Apparatus for Identifying Oversensing Using Far-Field Intracardiac Electrograms and Marker Channels - A method for identifying oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), is described. A near-field electrogram signal and a far-field electrogram signal are obtained via a near-field electrode pair and a far-field electrode pair. The near-field electrogram signal is compared to the far-field electrogram signal and a determination of whether oversensing exists is made based on the comparison. In some instances, a scheduled therapy is withheld in response to determining that oversensing exists. | 03-07-2013 |
20130079651 | EPISODE CLASSIFIER ALGORITHM - The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data collected by an implantable medical device. The episode classification algorithm may classify may include a sinus template and a comparison of the electrogram signal to the sinus template. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing. | 03-28-2013 |
20130079654 | EPISODE CLASSIFIER ALGORITHM - The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data from a near-field channel and a far-field channel. The episode classification algorithm classifies the cardiac episode based on the evaluation of the electrogram signal data for at least one of the near-field and far-field channels. In some examples, a cardiac episode being classified may be an episode that resulted in treatment being provided by an implantable medical device. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing. | 03-28-2013 |
20130085403 | ELECTROGRAM SUMMARY - The present disclosure is directed to an electrogram summary. In various examples, a subset of cardiac episodes are selected and displayed based on a set of summary rules. The subset of cardiac episodes includes at least one episode from each of a plurality of episode categories with at least one cardiac episode. In some examples, the order in which the cardiac episodes selected are displayed is based on the set of summary rules. The electrogram summary may include images or information regarding each of the selected cardiac episodes. | 04-04-2013 |
20130085406 | ELECTROGRAM SUMMARY - The present disclosure is directed to generating and displaying an electrogram (EGM) summary for use by physicians or other clinicians. An implantable medical device (IMD) transmits EGM signal data for a number of cardiac episodes to an external computing device. The external computing device selects a subset of the cardiac episodes for which information or images are displayed to the user. In various examples, cardiac episodes may be selected for display based at least in part on a retrospective analysis classification of the cardiac episode. | 04-04-2013 |
20130289428 | METHOD AND APPARATUS FOR DISPLAY OF CARDIAC SIGNAL EPISODES WITH OVER- OR UNDER-SENSING - A medical device system senses cardiac signals and generates and stores sensing data including sensed cardiac events. A processor receiving the sensing data is configured to detect undersensed and oversensed events. The processor generates an episode display comprising event identifying codes in response to the received sensing data and produces an adjusted episode display in response to an event being identified as an undersensed event or an oversensed event. | 10-31-2013 |
20130304139 | IDENTIFYING LEAD INSULATION BREACHES AND EXTERNALIZATION OF LEAD CONDUCTORS - A technique for identifying lead-related conditions, such as insulation breaches and/or externalization of lead conductors, includes analyzing characteristics of electrical signals generated on one or more electrode sensing vectors of the lead by a test signal to determine whether a lead-related condition exists. The characteristics of the electrical signals induced on the lead by the test signal may be significantly different on a lead having an insulation breach or externalized conductor than on a lead not having such lead-related conditions. As such, the implantable medical device may be subject to a known test signal and analyze the signals on the lead to detect lead-related conditions. | 11-14-2013 |
20130304160 | IDENTIFYING LEAD INSULATION BREACHES AND EXTERNALIZATION OF LEAD CONDUCTORS - A technique for identifying lead-related conditions, such as insulation breaches and/or externalization of lead conductors, includes analyzing characteristics of electrical signals generated on one or more electrode sensing vectors of the lead by a test signal to determine whether a lead-related condition exists. The characteristics of the electrical signals induced on the lead by the test signal may be significantly different on a lead having an insulation breach or externalized conductor than on a lead not having such lead-related conditions. As such, the implantable medical device may be subject to a known test signal and analyze the signals on the lead to detect lead-related conditions. | 11-14-2013 |
20140018873 | SYSTEM AND METHOD FOR IDENTIFYING LEAD DISLODGEMENT - A medical device system and method for detecting cardiac lead dislodgement measures intervals between sensed cardiac events for detecting an event interval pattern including at least one short event interval consecutively followed by a long event interval. Responsive to detecting the event interval pattern, a cardiac signal amplitude associated with a detected short event interval is measured. Dislodgement of the cardiac lead is detected in response to the measured amplitude. | 01-16-2014 |
20140046690 | MANAGEMENT AND DISTRIBUTION OF PATIENT INFORMATION - Techniques, systems, and devices, for generating a patient management report based on clinician input and patient data are described. For example, one or more processors may be configured to receive a clinician input selecting at least one reporting characteristic for each of a plurality of diagnostic metrics and organize the diagnostic metrics based on the selected reporting characteristic. In addition, the one or more processors may be configured to receive patient data for at least one patient, determine a value for at least a subset of the diagnostic metrics based on the patient data, and generate a patient management report comprising the diagnostic metrics having a value that exceeds a respective threshold. The diagnostic metrics may be ordered in the patient management report based on the organization. | 02-13-2014 |
20140121716 | HIGH VOLTAGE THERAPY DIVERSION ALGORITHMS - An implantable medical device capable of delivering high voltage therapy includes a therapy delivery module comprising a high voltage therapy delivery circuit, a high voltage short circuit protection circuit configured to terminate delivery of a high voltage pulse by the therapy delivery module in response to a short circuit condition, and a sensing module for detecting a need for a high voltage therapy. The device further includes a therapy control unit configured to control the therapy delivery module to deliver a shock pulse in response to detecting the need for the high voltage therapy. The control unit detects a termination of the high voltage pulse by the protection circuit; a truncated shock charge remaining on the high voltage therapy delivery circuit upon terminating the high voltage pulse. The control unit controls the therapy delivery module to deliver a next shock pulse at the remaining truncated shock charge. | 05-01-2014 |
20140277229 | IDENTIFICATION OF INSULATION BREACH USING ELECTROGRAMS - An implantable medical device capable of sensing cardiac signals and delivering cardiac electrical stimulation therapies is enabled to detect a short circuit condition. In one embodiment, a cardiac signal is sensed by a sensing module coupled to electrodes. A controller identifies signal events in response to the cardiac signal and detects a short circuit condition in response to at least one of the signal events having an amplitude crossing a short circuit detection threshold and a maximum of two signal events crossing the short circuit detection threshold occurring between two adjacent events having amplitudes not crossing the short circuit detection threshold. In one embodiment, the signal events are identified from a differential signal determined from the sensed cardiac signal. | 09-18-2014 |
20140350620 | IDENTIFY INSULATION BREACH USING ELECTROGRAMS - An implantable medical device capable of sensing cardiac signals and delivering cardiac electrical stimulation therapies is enabled to detect a short circuit event. A signal is sensed by a sensing module coupled to electrodes. A controller detects a short circuit event in response to a slope of the sensed signal exceeding a short circuit threshold. | 11-27-2014 |
20140350621 | IDENTIFY INSULATION BREACH USING ELECTROGRAMS - An implantable medical device capable of sensing cardiac signals and delivering cardiac electrical stimulation therapies is enabled to detect a short circuit of a medical electrical lead. A physiological signal correlated to a motion of a patient is sensed via a physiological sensor. If a lead monitoring condition is met based on the physiological signal, a cardiac signal is acquired and analyzed to detect an abnormality. The short circuit of the medical electrical lead is detected in response to detecting the abnormality. | 11-27-2014 |