Patent application number | Description | Published |
20080228093 | Systems and methods for enhancing cardiac signal features used in morphology discrimination - Methods and devices used to classify cardiac events based on morphological analysis of sensed signals are described. A signal comprising a cardiac signal component and a noise signal component is sensed. The sensed signal is processed to preferentially alter morphology of the cardiac signal component. The altered morphology of the cardiac signal component enhances detection of one or more features of the cardiac signal component. The features of the cardiac signal component are detected and the cardiac event is classified using the detected features. Processing the sensed signal may involve the use of adaptable signal processing parameters. For example, the signal processing parameters may be selected to accentuate one or more desirable features of the cardiac signal component or to mitigate one or more undesirable features of the cardiac signal component. | 09-18-2008 |
20080262558 | PATIENT CHARACTERISTIC BASED ADAPTIVE ANTI-TACHY PACING PROGRAMMING - A system including at least one implantable sensor circuit adapted to produce an electrical sensor signal related to one or more physiologic cardiovascular events of a subject, a therapy circuit configured to provide anti-tachycardia pacing (ATP) therapy, and a controller. The controller includes a tachyarrhythmia detection circuit and an efficacy circuit. The tachyarrhythmia detection circuit is configured to detect a tachyarrhythmia episode in the subject using the electrical sensor signal, and to determine whether the tachyarrhythmia episode is of a type that is treatable with ATP. The efficacy circuit is configured to estimate an efficacy of a currently configured ATP therapy for the subject, and the controller is configured to alter a delivery regimen of the currently configured ATP therapy when the estimated ATP therapy efficacy is deemed insufficient. Other systems and methods are described. | 10-23-2008 |
20080275522 | Non-captured intrinsic discrimination in cardiac pacing response classification - Cardiac devices and methods discriminate non-captured intrinsic beats during evoked response detection and classification by comparing the features of a post-pace cardiac signal with expected features associated with a non-captured response with intrinsic activation. Detection of a non-captured response with intrinsic activation may be based on the peak amplitude and timing of the cardiac signal. The methods may be used to discriminate between a fusion or capture beat and a non-captured intrinsic beat. Discriminating between possible cardiac responses to the pacing pulse may be useful, for example, during automatic capture verification and/or a capture threshold test. | 11-06-2008 |
20090043355 | SYSTEM FOR EVALUATING PERFORMANCE OF AN IMPLANTABLE MEDICAL DEVICE - A system evaluates the performance of an implantable medical device, such as by using a remote external server and a user interface and stored historical physiological data of a population of congestive heart failure (CHF) patients. A processor is coupled to a patient data storage device to apply multiple algorithm variations against the same implantable physiological data from the patient to produce corresponding resulting CHF indicators. The user interface includes a display that is configured to display to a user information allowing comparison between the resulting CHF indicators from the multiple algorithm variations. The display also includes a population data selector to permit the user to select physiological data from a population that includes a different set of one or more patients or physiological data collected over a period of time from the patient. This permits optimization of an algorithm parameter or selection of a best performing algorithm. | 02-12-2009 |
20090069858 | Capture Detection for Multi-Chamber Pacing - Multi-chamber pacing may result in capture of one chamber, capture of multiple chambers, fusion, or non-capture. Approaches for detecting various capture conditions during multi-chamber pacing are described. Pacing pulses are delivered to left and right heart chambers during a cardiac cycle. A cardiac electrogram signal is sensed following the delivery of the pacing pulses. Left chamber capture only, right chamber capture only, and bi-chamber capture may be distinguished based on characteristics of the cardiac electrogram signal. Multi-chamber capture detection may be implemented using detection windows having dimensions of time and amplitude. The detection windows are associated with expected features, such as expected signal peaks, under a particular capture condition. The cardiac electrogram signal features are compared to detection windows to determine the capture condition. | 03-12-2009 |
20090105777 | METHOD 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 |
20090105780 | Pacing Output Determination Based on Selected Capture Threshold Values - Approaches for adjusting the pacing energy delivered by a pacemaker are provided. Adjusting the pacing energy involves performing a plurality of capture threshold tests, each capture threshold test measuring a capture threshold of the heart. One or more measured captured thresholds are selected, including at least one capture threshold that is higher relative to other measured capture thresholds acquired by the plurality of capture threshold tests. The pacing energy is adjusted based on the one or more selected capture thresholds. | 04-23-2009 |
20090240301 | Multi Channel Approach to Capture Verfication - Methods and systems involve classifying the cardiac response to pacing using a multi-channel approach. Multiple cardiac response signals are sensed via multiple sense channels. Each sense channel comprises a distinct combination of electrodes and sensing circuitry. The cardiac response to the pacing pulse is classified based on the morphology of the cardiac response signals. Classifying the cardiac response involves discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity. | 09-24-2009 |
20090264949 | ELECTROGRAM MORPHOLOGY-BASED CRT OPTIMIZATION - A method and system for determining an optimum atrioventricular delay (AVD) interval and/or ventriculo-ventricular delay (VVD) intervals for delivering ventricular resynchronization pacing in an atrial tracking or atrial sequential pacing mode. Evoked response electrograms recorded at different AVD and VVD intervals are used to determine the extent of paced and intrinsic activation. | 10-22-2009 |
20090312815 | Systems and Methods for Improving Heart Rate Kinetics in Heart Failure Patients - Adaptive rate pacing for improving heart rate kinetics in heart failure patients involves determining onset and sustaining of patient activity. The patient's heart rate response to the sustained activity is evaluated during a time window defined between onset of the activity and a steady-state exercise level. If the patient's heart rate response to the sustained activity is determined to be slow, a pacing therapy is delivered at a rate greater than the patient's intrinsic heart rate based on a profile of the patient's heart rate response to varying workloads. If determined not to be slow, the pacing therapy is withheld. Monitoring-only configurations provide for acquisition and organization of physiological data for heart failure patients. These data can be acquired on a per-patient basis and used to assess the HF status of the patient. | 12-17-2009 |
20100016920 | SYSTEMS AND METHODS FOR COLLECTING PATIENT EVENT INFORMATION - A method of and system for collecting patient event information from a cardiac rhythm management system (CRM system) is described, where the CRM system includes a cardiac rhythm management device (CRM device) and an external interface device. The method includes the steps of initiating a transmission session wherein the interface device communicates with the CRM device, prompting a user of the CRM system to select a reason for the transmission session, inputting the selected reason for the transmission session to the interface device, and storing the selected reason for the transmission session and timestamp information for the transmission session. | 01-21-2010 |
20100023078 | Cardiac resynchronization therapy parameter optimization - Systems and methods involve determination of CRT parameters using a number of CRT optimization processes. Each CRT optimization process attempts to return recommended parameters. The CRT parameters are determined based on the recommended parameters returned by one or more of the CRT optimization processes. The CRT optimization processes may be sequentially implemented and the CRT parameters may be determined based on the recommended parameters returned by a first CRT optimization process to return recommended parameters. The CRT parameters may be determined based on a combination of the recommended parameters returned. The CRT optimization processes implemented may be selected from available CRT optimization processes based on patient conditions. | 01-28-2010 |
20100023082 | INDIVIDUALIZED MORPHOLOGY FEATURE EVALUATION AND SELECTION FOR DISCRIMINATION IN IMPLANTABLE MEDICAL DEVICES - An apparatus comprises an implantable sensor, which provides a plurality of physiologic sensor signals of a subject, and a processor. The processor includes a feature module and a detection module. The feature module is configured to identify a feature in the sensor signals and to determine a measure of quality of the feature in the sensor signals. The detection module is configured to perform a morphology analysis of a subsequent portion of at least one of the sensor signals using the feature when the measure of quality of the feature satisfies a quality measure threshold. | 01-28-2010 |
20100036449 | Adaptive Windowing for Cardiac Waveform Discrimination - Cardiac devices and methods provide adaptation of detection windows used to determine a cardiac response to pacing. Adapting a detection window involves sensing a cardiac signal indicative of a particular type of cardiac pacing response, and detecting a feature of the sensed cardiac signal. The cardiac response detection window associated with the type of cardiac pacing response is preferentially adjusted based on the location of the detected cardiac feature. Preferential adjustment of the detection window may involve determining a direction of change between the detection window and the detected feature. The detection window may be adapted more aggressively in a more preferred direction and less aggressively in a less preferred direction. | 02-11-2010 |
20100087887 | TITRATED INTERMITTENT PACING THERAPY - Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's heart rate or exertion level to control the duty cycles of intermittent pre-excitation pacing. | 04-08-2010 |
20100106036 | ARRYTHMIA ADJUDICATION AND THERAPY TRAINING SYSTEMS AND METHODS - A system and method for presenting arrhythmia episode information to a user are described. An episode database has episode data regarding a plurality of different arrhythmia episodes generated from a plurality of data-generating devices. A user interface is configured to display the episode data for one of the arrhythmia episodes and receive characterization data from the user characterizing the displayed episode data. An adjudication database has adjudication conclusions associated with the arrhythmia episodes in the episode database. The system further includes an adjudication processor, configured to process characterization data relative to the adjudication database. | 04-29-2010 |
20100121402 | REVERSE HYSTERESIS AND MODE SWITCHING FOR INTERMITTENT PACING THERAPY - Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described. | 05-13-2010 |
20100211124 | Pacing 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 |
20100262204 | Anodal Stimulation Detection and Avoidance - Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse. | 10-14-2010 |
20100262207 | Methods and Systems for Managing Fusion and Noise in Cardiac Pacing Response Classification - Methods and systems for detecting noise in cardiac pacing response classification processes involve determining that a cardiac response classification is possibly erroneous if unexpected signal content is detected. The unexpected signal content may comprise signal peaks that have polarity opposite to the polarity of peaks used to determine the cardiac response to pacing. Fusion/noise management processes include pacing at a relatively high energy level until capture is detected after a fusion, indeterminate, or possibly erroneous pacing response classification is made. The relatively high energy pacing pulses may be delivered until capture is detected or until a predetermined number of paces are delivered. | 10-14-2010 |
20100274149 | METHODS FOR DETECTING ATRIAL TACHYARRHYTHMIA IN IMPLANTABLE DEVICES WITHOUT DEDICATED ATRIAL SENSING - An apparatus comprises an implantable cardiac signal sensing circuit configured to provide a sensed depolarization signal from a ventricle and a processor. The processor includes a signal analyzer module and a tachyarrhythmia discrimination module. The signal analyzer module is configured to determine a measure of stability of ventricular (V-V) depolarization intervals using the depolarization signal, and determine a rate of change of the measure of stability. The tachyarrhythmia discrimination module is configured to detect an episode of tachyarrhythmia using the depolarization signal, determine whether the detected tachyarrhythmia is indicative of atrial tachyarrhythmia using the determined rate of change, and provide the determination to a user or process. | 10-28-2010 |
20100280841 | Adjudication of Arrhythmia Episode Data Systems and Methods - A system and method for automatically adjudicating arrhythmia episode information is described, and includes an episode database having episode data regarding a plurality of different arrhythmia episodes and an adjudication processor configured to output characterization data characterizing the input episode data. The characterization data includes an arrhythmia classification. The system further includes an episode processor configured to process the characterization data and episode data, provide at least one report on the characterization data related to a plurality of the different arrhythmia episodes, and provide at least one programming recommendation or at least one alert. | 11-04-2010 |
20100286743 | Methods and Systems for Mitigating the Occurrence of Arrhythmia During Atrial Pacing - Noncaptured atrial paces can result in long-short cardiac cycles which are proarrhythmic for ventricular tachyarrhythmia. Approaches are described which are directed to avoiding proarrhythmic long-short cycles. For cardiac cycles in which the atrial pace captures the atrium, a first post ventricular refractory period (PVARP) and a first A-A interval are used. For cardiac cycles in which the atrial pace does not capture the atrium, both an extended PVARP and an extended A-A interval are used. The A-A interval following a noncaptured atrial pace is extended from an atrial depolarization sensed during the extended PVARP. | 11-11-2010 |
20100305642 | ADAPTIVE EVENT STORAGE IN IMPLANTABLE DEVICE - Monitoring physiological parameter using an implantable physiological monitor in order to detect a condition predictive of a possible future pathological episode and collecting additional physiological data associated with the condition predictive of a possible future pathological episode. Monitoring another physiological parameter in order to detect a condition indicative of the beginning of a present pathological episode and collecting additional pathological data in response to the condition. Determining that the condition predictive of a future episode and the condition indicative of a present episode are associated and, in response thereto, storing all the collected physiological data. | 12-02-2010 |
20100305646 | SYSTEMS AND METHODS FOR THE GENERATION AND DISPLAY OF FUSION STATISTICS - In an example, a cardiac rhythm management system includes an implantable physiological data monitor, a processor, a memory, and a display. The implantable physiological data monitor can be configured to monitor a plurality of cardiac responses. The processor can be configured to classify the cardiac response into one of at least three classes including pace-dominant, fusion, and pseudo-fusion. The processor can also be configured to calculate statistical information regarding the classified cardiac responses. In this example, the pace-dominant, fusion, and pseudo-fusion classes correspond to a cardiac response resulting from a corresponding electrostimulation. The memory is configured to store the classified cardiac responses and calculated statistical information for future use by the processor or for display. The display is configured to display the statistical information stored in the memory for diagnostic and device programming purposes. | 12-02-2010 |
20100318155 | SYSTEMS AND METHODS FOR PROGRAMMING IMPLANTABLE MEDICAL DEVICES - Embodiments of the invention are directed to systems and methods for programming implantable medical devices, amongst other things. In an embodiment, the invention includes a method of programming an implantable medical device. The method can include gathering parameter data representing a set of previously programmed parameter values from a plurality of implanted medical devices. The method can further include performing association analysis on the parameter data to form a set of association rules. The method can further include suggesting parameter choices to a system user regarding a specific patient based on the set of association rules. In an embodiment, the invention can include a medical system including a server configured to perform association analysis on a set of data representing previously programmed parameter values from a plurality of implanted medical devices to derive a set of association rules. Other embodiments are also included herein. | 12-16-2010 |
20110022981 | PRESENTATION OF DEVICE UTILIZATION AND OUTCOME FROM A PATIENT MANAGEMENT SYSTEM - In a graphical user interface displayed in an electronic display of a computing device, a first device profile and second device profile are presented, the first and second device profiles each comprising at least one device parameter used to configure a medical device of a subject. A user input control is presented to select one of the first or second device profiles to provide a selected device profile. A probabilistic outcome of the subject corresponding to the selected device profile is then presented. | 01-27-2011 |
20110077541 | Methods and Systems for Characterizing Cardiac Signal Morphology Using K-Fit Analysis - A system and method for automatically analyzing a cardiac signal, including the step of providing an episode database on a computer storage medium including a plurality of episode data records of one or more patients. Each episode data record includes a cardiac signal from at least one data-generating device. The method also includes the step of selecting one or more of the N beats to be one or more beat templates, for at least a first cardiac signal having N beats. Another step is determining a value K for the cardiac signal using a computer system where K beat templates can represent all the N beats in the cardiac signal. | 03-31-2011 |
20110082377 | ADAPTIVE DATA STORAGE AND DOWNLOAD IN A MEDICAL DEVICE - In an example, a medical device includes a physiological data monitor (PDM), a memory, and a processor. The PDM is configured to monitor a physiological data parameter. The memory circuit is configured to store data collected by the PDM. The processor is configured to detect a data capture event and capture a first segment of physiological data associated with the data capture event. The processor is also configured to determine an amount of memory storage space available and determine a first priority level for the first segment of physiological data. The processor is further configured to determine a second priority level for a second segment of physiological data stored previously and select a processing scheme using the first and second priority levels. Finally, the processor is configured to process, using the processing scheme, the first and second segments of physiological data and store the first segment of physiological data. | 04-07-2011 |
20110098768 | LEFT ATRIAL SENSE OR CAPTURE DETECTION FROM CORONARY SINUS - A method and device to detect and compare changes in atrial rate and morphology can be used to identify left atrial sense and capture, such as from a quadripolar or other lead located in or around the coronary sinus. | 04-28-2011 |
20110130666 | ENHANCED REPORTING OF PATHOLOGICAL EPISODES - An apparatus comprises a sensor circuit configured to produce a time-varying physiologic sensor signal of a subject and a pathology detection circuit communicatively coupled to the sensor. The pathology detection circuit is configured to detect a first pathological episode using the sensed physiologic sensor signal, deem that the first pathological episode has ended, detect at least one second pathological episode using the sensed physiologic sensor signal, and indicate the first and second pathological episodes as one pathological episode if the first and second episode are detected within a specified time interval. | 06-02-2011 |
20110224988 | INTRACARDIAC ELECTROGRAM TIME FREQUENCY NOISE DETECTION - Systems, methods, and apparatus for identifying and classifying noise of an intracardiac electrogram of a cardiac rhythm management device to prevent inaccurate detection of a cardiac episode are disclosed. In an example, three channels are analyzed to identify and determine whether an episode or noise has been detected. | 09-15-2011 |
20110245890 | METHOD AND APPARATUS FOR PACING SAFETY MARGIN - An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture. | 10-06-2011 |
20110264158 | HIS-BUNDLE CAPTURE VERIFICATION AND MONITORING - This document discusses, among other things, a system and method for generating a stimulation energy to provide His-bundle stimulation for a cardiac cycle, receiving electrical information from the heart over at least a portion of the cardiac cycle, determining a characteristic of at least a portion of the received electrical information for the cardiac cycle, and classifying the cardiac cycle using the determined characteristic. | 10-27-2011 |
20120035489 | RHYTHM DISCRIMINATION ENHANCEMENT - CHAMBER OF TACHY ORIGINATION - An apparatus comprises an implantable cardiac signal sensing circuit and a controller circuit. The implantable cardiac signal sensing circuit provides a sensed depolarization signal from a ventricle and a sensed depolarization signal from an atrium. The controller circuit includes an onset detection circuit and a classification circuit. The onset detection circuit detects an onset episode that includes fast cardiac depolarizations and identifies a depolarization that initiates the onset episode. The classification circuit classifies the onset episode as supra-ventricular tachycardia (SVT) when the initiating onset episode is identified in the atrium and the number of atrial depolarizations is greater than or equal to the number of ventricular depolarizations during the onset episode, and as ventricular tachycardia (VT) when the initiating onset depolarization is identified in the ventricle and the number of ventricular depolarizations is greater than the number of atrial depolarizations during the onset episode. | 02-09-2012 |
20120035491 | RHYTHM DISCRIMINATION ENHANCEMENT - AV DRIVE - An apparatus comprises an implantable cardiac signal sensing circuit and a controller circuit. The implantable cardiac signal sensing circuit provides a sensed depolarization signal from a ventricle and a sensed depolarization signal from an atrium. The controller circuit includes a one-to-one detector circuit and a tachyarrhythmia discrimination circuit. The one-to-one detector circuit measures cardiac depolarization intervals of the atrium and the ventricle and determines whether a relationship of atrial depolarizations to ventricular depolarizations is substantially one-to-one. The tachyarrhythmia discrimination circuit increments a counter when detecting a shortening or prolonging of a V-V interval that immediately precedes the same shortening or prolonging of an A-A interval, classifies the episode as VT according to the counter, and provides the classification of the tachyarrhythmia episode to a user or process. | 02-09-2012 |
20120165895 | Non-Captured Intrinsic Discrimination in Cardiac Pacing Response Classification - Cardiac devices and methods discriminate non-captured intrinsic beats during evoked response detection and classification by comparing the features of a post-pace cardiac signal with expected features associated with a non-captured response with intrinsic activation. Detection of a non-captured response with intrinsic activation may be based on the peak amplitude and timing of the cardiac signal. The methods may be used to discriminate between a fusion or capture beat and a non-captured intrinsic beat. Discriminating between possible cardiac responses to the pacing pulse may be useful, for example, during automatic capture verification and/or a capture threshold test. | 06-28-2012 |
20130013020 | Methods and Systems for Managing Fusion and Noise in Cardiac Pacing Response Classification - Methods and systems for detecting noise in cardiac pacing response classification processes involve determining that a cardiac response classification is possibly erroneous if unexpected signal content is detected. The unexpected signal content may comprise signal peaks that have polarity opposite to the polarity of peaks used to determine the cardiac response to pacing. Fusion/noise management processes include pacing at a relatively high energy level until capture is detected after a fusion, indeterminate, or possibly erroneous pacing response classification is made. The relatively high energy pacing pulses may be delivered until capture is detected or until a predetermined number of paces are delivered. | 01-10-2013 |