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Bruce D. Gunderson, Plymouth US

Bruce D. Gunderson, Plymouth, MN US

Patent application numberDescriptionPublished
20080215110METHOD 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
20090292331METHOD 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
20090299201ELECTRODE 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
20090299422ELECTROGRAM 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
20090299432IMPEDANCE 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
20100023084LEAD 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
20100106209IDENTIFICATION 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
20100114206Patient 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
20100114222LEAD 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
20100280567METHOD 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
20110054558IDENTIFYING 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
20110098766NON-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
20110112417METHOD 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

Patent applications by Bruce D. Gunderson, Plymouth, MN US