Patent application number | Description | Published |
20080319496 | Endocardial Pacing Devices and Methods Useful for Resynchronization and Defibrillation - According to one aspect, various methods and apparatus are used for modifying cardiac operation, for treating a condition of a patient's heart, and for monitoring cardiac operation. In one approach consistent therewith, an electrode arrangement (including at least one electrode) is placed in a right ventricle (“RV”) 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. Use of a defibrillation lead may be particularly useful as the lead need not contain pacing/sensing electrodes, thereby eliminating or lessening the pull-back of the RV coil, which has been known to lower the defibrillation threshold. Other aspects involve use of such cardiac modulation technique to facilitate mechanically and/or electrically synchronous contractions for resynchronization, and a technique for pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. | 12-25-2008 |
20080319499 | Devices and Methods for Steering Electrical Stimulation in Cardiac Rhythm Management - Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, a catheter arrangement includes a fixation mechanism to attach the catheter arrangement to heart tissue, individually-addressable electrodes for providing pacing signals to the heart tissue, and an elongated structure that supports the fixation mechanism and the electrodes. The elongated structure is used to direct an end thereof to the target region in the right ventricle, and deliver an electrical pacing signal to different portions within the target region of the heart when the fixation mechanism is operative to attach to heart tissue and also when the fixation mechanism is not attaching the catheter arrangement to heart tissue. | 12-25-2008 |
20080319500 | Systems, Devices and Methods Relating to Endocardial Pacing for Resynchronization - Tools and methods are particularly suited for certain cardiac conditions advantaged by pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. Other specific aspects include: determining a pacing threshold, beyond the capture threshold, to improve heart function; delivering pulses of opposite polarity to achieve such heart-function improvement; bi-ventricular pacing from a lead in the right ventricle for such improved heart function; delivering pulses of opposite polarity at a site near the His bundle; electrode-based His-pacing, without penetrating the myocardium; generating and/or delivering multiple pacing profiles including a pacing profile that delivers pulses of opposite polarity and another pacing profile; delivering a pacing profile to generate a synchronous contraction of the septal wall and free wall of the LV from a RV pacing location; and treating one or more of distal LBBB and/or diffuse LBBB by pacing at a site near the His bundle. | 12-25-2008 |
20080319501 | Systems, Devices and Methods for Monitoring Efficiency of Pacing - Various systems, methods, devices and arrangements are implemented for use in pacing of the heart. One implementation is directed to methods and systems for determining a pacing location in the right ventricle of a heart and near the His bundle. A pacing signal is delivered to the location in the right ventricle. The pacing signal produces a capture of a left ventricle. Properties of the capture are monitored. Results of the monitored capture are used to assess the effectiveness of the delivered pacing signal as a function of heart function. The heart function can be, for example, at least one of a QRS width, fractionation and a timing of electrical stimulation of a late activation site of a left ventricle relative to the QRS. | 12-25-2008 |
20090005830 | Endocardial Pacing Relating to Conduction Abnormalities - Various systems, methods and arrangements are implemented in connection with ventricular pacing. One such method relates to a method for use in connection with ventricular pacing of a left ventricle of a heart from a pacing lead located in the right ventricle. Ventricular function of the heart is sensed. The sensed ventricular function is used to determine whether a conduction abnormality exists. The ventricular pacing is provided in response to determining a conduction abnormality exists and the ventricular pacing is inhibited in response to determining a conduction abnormality does not exist. | 01-01-2009 |
20090005832 | Circuit-Based Devices and Methods for Pulse Control of Endocardial Pacing in Cardiac Rhythm Management - Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart. | 01-01-2009 |
20090005846 | Methods, Devices and Systems for Cardiac Rhythm Management Using an Electrode Arrangement - Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications. One such device is directed to a catheter, and uses thereof, for capturing myocardium of a heart by delivering pacing signals to a location in the heart. The location is near a His Bundle of the heart. The catheter has a proximal end for interfacing with an electrical pacing signal source and a distal end. The distal end includes a fixation mechanism that attaches the catheter to heart tissue. First and second electrodes are also located at the distal end. Each electrode is individually addressable for providing pacing signals to the heart tissue and also arranged to physically contact the heart tissue when the fixation mechanism is attached to the heart tissue. | 01-01-2009 |
20090054942 | METHODS, DEVICES AND SYSTEMS FOR SINGLE-CHAMBER PACING USING A DUAL-CHAMBER PACING DEVICE - Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications including those relating to pacing devices. One such device is directed to a cardiac rhythm therapy (CRT) device designed for dual chamber pacing using two pacing signals each having a positive and negative component that has been modified for single chamber pacing. The device comprises a first output that connects to a pacing lead; a second output that connects to the pacing lead; a third output that connects to a reference point; and electrical circuitry connecting the second electrical connection to the first output, the third electrical connection to the second output, and the first and fourth electrical connections to the third output. | 02-26-2009 |
20090093859 | APPARATUS FOR TREATING THE PHYSIOLOGICAL ELECTRIC CONDUCTION OF THE HEART - A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode. The pacemaker further includes a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart. The combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle. | 04-09-2009 |
20090093861 | METHODS FOR TREATING THE PHYSIOLOGICAL ELECTRIC CONDUCTION OF THE HEART - Treating the physiological electric conduction of the heart includes methods that involve guiding an electrode to a location, near the His bundle of the heart, that is determined by pacing the heart and sensing signals in response thereto, and electrically bypassing a conduction abnormality of the heart by presenting extrinsic pacing signals to the location near the His bundle of the heart. The pacing electrode may then be fixed at the location, near the His bundle, to provide subsequent pacing of the heart such that the subsequent pacing exhibits electrical bypassing of the conduction abnormality. | 04-09-2009 |
20090187226 | VENTRICULAR 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. | 07-23-2009 |
20110307026 | SYSTEMS, DEVICES AND METHODS FOR MONITORING EFFICIENCY OF PACING - Various systems, methods, devices and arrangements are implemented for use in pacing of the heart. One implementation is directed to methods and systems for determining a pacing location in the right ventricle of a heart and near the His bundle. A pacing signal is delivered to the location in the right ventricle. The pacing signal produces a capture of a left ventricle. Properties of the capture are monitored. Results of the monitored capture are used to assess the effectiveness of the delivered pacing signal as a function of heart function. The heart function can be, for example, at least one of a QRS width, fractionation and a timing of electrical stimulation of a late activation site of a left ventricle relative to the QRS. | 12-15-2011 |
20110319956 | SYSTEMS, DEVICES AND METHODS RELATING TO ENDOCARDIAL PACING FOR RESYNCHRONIZATION - Disclosed are certain methods, apparatus, and processor-readable mediums that may be used to treat a conduction abnormality of the heart. In one example, the apparatus includes an implantable pacing profile generator configured to generate a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including a first pulse for delivery via a first electrode; and a second pulse for delivery via a second electrode; and wherein the first and second pulses are at least partially concurrent in time and opposite in polarity to each other. | 12-29-2011 |
20120041500 | ENDOCARDIAL 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 |
20120041503 | CIRCUIT-BASED DEVICES AND METHODS FOR PULSE CONTROL OF ENDOCARDIAL PACING IN CARDIAC RHYTHM MANAGEMENT - Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart. | 02-16-2012 |
20120101539 | DEVICES, 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 |
20130041423 | METHODS, DEVICES AND SYSTEMS FOR SINGLE-CHAMBER PACING USING A DUAL-CHAMBER PACING DEVICE - Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications including those relating to pacing devices. One such device is directed to a cardiac rhythm therapy (CRT) device designed for dual chamber pacing using two pacing signals each having a positive and negative component that has been modified for single chamber pacing. The device comprises a first output that connects to a pacing lead; a second output that connects to the pacing lead; a third output that connects to a reference point; and electrical circuitry connecting the second electrical connection to the first output, the third electrical connection to the second output, and the first and fourth electrical connections to the third output. | 02-14-2013 |
20130096638 | VENTRICULAR 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 |
20130184774 | DEVICES AND METHODS FOR STEERING ELECTRICAL STIMULATION IN CARDIAC RHYTHM MANAGEMENT - Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, a catheter arrangement includes a fixation mechanism to attach the catheter arrangement to heart tissue, individually-addressable electrodes for providing pacing signals to the heart tissue, and an elongated structure that supports the fixation mechanism and the electrodes. The elongated structure is used to direct an end thereof to the target region in the right ventricle, and deliver an electrical pacing signal to different portions within the target region of the heart when the fixation mechanism is operative to attach to heart tissue and also when the fixation mechanism is not attaching the catheter arrangement to heart tissue. | 07-18-2013 |
20130261689 | METHODS, DEVICES AND SYSTEMS FOR CARDIAC RHYTHM MANAGEMENT USING AN ELECTRODE ARRANGEMENT - Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications. One such device is directed to a catheter, and uses thereof, for capturing myocardium of a heart by delivering pacing signals to a location in the heart. The location is near a His Bundle of the heart. The catheter has a proximal end for interfacing with an electrical pacing signal source and a distal end. The distal end includes a fixation mechanism that attaches the catheter to heart tissue. First and second electrodes are also located at the distal end. Each electrode is individually addressable for providing pacing signals to the heart tissue and also arranged to physically contact the heart tissue when the fixation mechanism is attached to the heart tissue. | 10-03-2013 |
20130261690 | APPARATUS FOR TREATING THE PHYSIOLOGICAL ELECTRIC CONDUCTION OF THE HEART - A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode. The pacemaker further includes a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart. The combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle. | 10-03-2013 |
20140018871 | ENDOCARDIAL 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. | 01-16-2014 |
20140018874 | SYSTEMS, DEVICES AND METHODS FOR MONITORING EFFICIENCY OF PACING - Various systems, methods, devices and arrangements are implemented for use in pacing of the heart. One implementation is directed to methods and systems for determining a pacing location in the right ventricle of a heart and near the His bundle. A pacing signal is delivered to the location in the right ventricle. The pacing signal produces a capture of a left ventricle. Properties of the capture are monitored. Results of the monitored capture are used to assess the effectiveness of the delivered pacing signal as a function of heart function. The heart function can be, for example, at least one of a QRS width, fractionation and a timing of electrical stimulation of a late activation site of a left ventricle relative to the QRS. | 01-16-2014 |