Patent application number | Description | Published |
20080306567 | SYSTEM AND METHOD FOR IMPROVING CRT RESPONSE AND IDENTIFYING POTENTIAL NON-RESPONDERS TO CRT THERAPY - A method is disclosed that includes selecting an electrode configuration from a plurality of electrode configurations associated with electrodes of an implantable lead, sensing activity of the right ventricle and the left ventricle, determining an interval between sensed activity of the right ventricle and sensed activity of the left ventricle and determining whether the selected electrode configuration is suitable based at least in part on the interval. In one embodiment, an implantable device performs such a method to improve patient response to the CRT therapy, for example, by selecting a different electrode configuration if the current configuration is not suitable. Other exemplary methods, devices, systems, etc., are also disclosed. | 12-11-2008 |
20090157136 | MOTION-BASED OPTIMIZATION FOR PLACEMENT OF CARDIAC STIMULATION ELECTRODES - An exemplary method includes use of a multielectrode device that can help position a cardiac stimulation lead to an optimal site in the heart based at least in part on cardiac motion information acquired via the multielectrode device and one or more pairs of current delivery electrodes that establish potential fields (e.g., for use as a coordinate system). An exemplary multielectrode device may be a multielectrode catheter or a multifilar, electrode-bearing guidewire. Various other exemplary methods, devices, systems, etc., are also disclosed. | 06-18-2009 |
20090270936 | IMPLANTABLE MEDICAL DEVICE WITH COORDINATED VENTRICULAR OVERDRIVE AND TRIGGER MODE PACING - A method and system are provided for providing coordinated ventricular overdrive and triggered pacing through an implantable system. A lead senses signals from a heart to obtain sensed signals representative of tachycardia occurring in at least one chamber of the heart. The lead includes an electrode. A control module detects tachycardia in at least one chamber of the heart and based thereon, initiates an overdrive pacing mode and a triggered pacing mode. The control module controls delivery of overdrive pacing pulses through the electrode to a first chamber of the heart in accordance with the overdrive pacing mode. The control module controls delivery of a triggered pacing pulse through the electrode to the first chamber of the heart in accordance with the triggered pacing mode. The triggered pacing pulse is temporally interspersed with the overdrive pacing pulses. The triggered pacing pulse may be delivered at a time that is independent of, and unrelated to, the timing of the overdrive pacing pulses. | 10-29-2009 |
20100042173 | SYSTEM AND METHOD FOR EVALUATING AND OPTIMIZING THE CONTRIBUTION OF PARTICULAR HEART CHAMBERS TO THE OVERALL EFFICACY OF CARDIAC PACING THERAPY - Techniques are provided for evaluating and optimizing the contribution of particular heart chambers to pacing efficacy. Briefly, a pacemaker temporarily alters the mode with which pacing therapy is delivered so as to selectively alter the heart chambers that are paced. The pacemaker detects any transient changes in pacing efficacy following the alteration in pacing mode. The pacemaker then assesses the contribution of particular heart chambers to pacing efficacy based on the alteration in the pacing mode and on any transient changes in the pacing efficacy. Additionally, techniques are provided herein for automatically adjusting pacing parameters to optimize the contribution of particular chambers to pacing efficacy. | 02-18-2010 |
20100069778 | SYSTEM AND METHOD FOR MONITORING THORACIC FLUID LEVELS BASED ON IMPEDANCE USING AN IMPLANTABLE MEDICAL DEVICE - Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (Z | 03-18-2010 |
20100160805 | MONITORING SHORT TERM FLUCTUATIONS IN PR INTERVALS FOLLOWING PREMATURE VENTRICULAR CONTRACTIONS - Implantable systems, and methods for use therein, perform at least one of a cardiac assessment and an autonomic assessment. Short-term fluctuations in PR intervals, that follow the premature contractions in the ventricles, are monitored. At least one of a cardiac assessment and an autonomic assessment is performed based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles. This can include assessing a patient's risk of sudden cardiac death (SCD), assessing a patient's autonomic tone and/or detecting myocardial ischemic events based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles. | 06-24-2010 |
20100179610 | METHODS AND DEVICES FOR MONITORING MYOCARDIAL MECHANICAL STABILITY - Embodiments of the present invention relate to implantable systems, and methods for use therewith, for monitoring myocardial mechanical stability based on a signal that is indicative of mechanical functioning of a patient's heart for a plurality of consecutive beats. Certain embodiments use time domain techniques, while other embodiments use frequency domain techniques, to monitor myocardial mechanical stability. In certain embodiments the patient's heart is paced using a patterned pacing sequence that repeats every N beats. In other embodiments, the patient's heart need not be paced. This abstract is not intended to be a complete description of, or limit the scope of, the invention. | 07-15-2010 |
20100198082 | Systems and Methods for Use with an Implantable Medical Device for Detecting Stroke Based on Electrocardiac Signals - Techniques are provided for detecting stroke within a patient using an implantable medical device in conjunction with an external confirmation system. In one example, a preliminary detection of stroke is performed by a subcutaneous monitor based on an analysis of features of an electrocardiogram (ECG) sensed within the patient. Exemplary ECG features indicative of possible stroke include the onset of prominent U-waves, the onset of notched T-waves, and changes in ST segment duration or QT duration or dynamic trends in these parameters. The monitor transmits a signal indicative of possible stroke to a bedside monitor or other external system, which generates a stroke questionnaire for use in confirming the stroke. Family members or other caregivers input answers to the questionnaire into the external system, which confirms or disconfirms the stroke. Emergency personnel can be automatically notified. Implantable systems that detect stroke based on intracardiac electrogram (IEGM) signals are also described herein. | 08-05-2010 |
20100204593 | SYSTEM AND METHOD FOR IDENTIFYING A POTENTIAL CAUSE OF PULMONARY EDEMA - A method of identifying a potential cause of pulmonary edema is provided. The method includes obtaining one or more impedance vectors between predetermined combinations of the electrodes positioned proximate the heart. At least one of the impedance vectors is representative of a thoracic fluid level. The method also includes applying a stimulation pulse to the heart and sensing cardiac signals of the heart that are representative of an electrophysiological response to the stimulation pulse. The method further includes monitoring the cardiac signals and at least one of the impedance vectors with respect to time to identify the potential cause of pulmonary edema. | 08-12-2010 |
20100280348 | METHOD AND IMPLANTABLE SYSTEM FOR BLOOD-GLUCOSE CONCENTRATION MONITORING USING PARALLEL METHODOLOGIES - In an implantable medical device for monitoring glucose concentration in the blood, a blood-glucose concentration analysis is performed using correlations of blood-glucose concentration with measures of metabolic oxygen consumption including oxymetric, and/or temperature. Analysis of electrocardiographic data is used in a parallel method to detect and/or confirm the onset and/or existence and/or extent of hypoglycemia and/or hyperglycemia. Blood-glucose concentration calculation is enhanced by using the combination of the oxygen metabolism analysis and electrocardiographic analysis. | 11-04-2010 |
20110112597 | SYSTEMS AND METHODS FOR OFF-LINE REPROGRAMMING OF IMPLANTABLE MEDICAL DEVICE COMPONENTS TO REDUCE FALSE DETECTIONS OF CARDIAC EVENTS - Techniques are provided for use by implantable medical devices such as pacemakers or by external systems in communication with such devices. An intracardiac electrogram (IEGM) is sensed within a patient in which the device is implanted using a cardiac signal sensing system. Cardiac events of interest such as arrhythmias, premature atrial contractions (PACs), premature ventricular contractions (PVCs) and pacemaker mediated tachycardias (PMTs) are detected within the patient using event detection systems and then portions of the IEGM representative of the events of interest are recorded in device memory. Subsequently, during an off-line or background analysis, the recorded IEGM data is retrieved and analyzed to identify false detections. In response to false detections, the cardiac signal sensing systems and/or the event detection systems of the implantable device are selectively adjusted or reprogrammed to reduce or eliminate any further false detections, including false-positives or false-negatives. Various adaptive reprogramming techniques are described. | 05-12-2011 |
20110144510 | METHODS TO IDENTIFY DAMAGED OR SCARRED TISSUE BASED ON POSITION INFORMATION AND PHYSIOLOGICAL INFORMATION - An exemplary system includes one or more processors; memory; and control logic, of one or more modules operable in conjunction with the one or more processors and the memory, to acquire myocardial potential data associated with position information, acquire myocardial electrical activation data associated with position information, acquire myocardial position data with respect to time, generate isopotential contours based on the potential data, generate isochronal contours based on the electrical activation data, generate isomotion contours based on the position data with respect to time, and overlay the generated isopotential contours, isochronal contours and isomotion contours on a display to indicate a region of myocardial damage or myocardial scarring with respect to a map that comprises anatomical markers. Various other methods, devices, systems, etc., are also disclosed. | 06-16-2011 |
20110224555 | Systems and Methods for Use By an Implantable Medical Device for Detecting and Discriminating Stroke and Cardiac Ischemia Using Electrocardiac Signals and Hemodynamic Parameters - Techniques are provided for detecting and distinguishing stroke and cardiac ischemia within a patient using an implantable medical device. In one example, a preliminary indication of stroke is detected by a pacemaker or similar implantable device based on an analysis of features of an intracardiac electrogram (IEGM) sensed by the device. Exemplary IEGM features indicative of possible stroke include the onset of prominent U-waves, the onset of notched T-waves, and changes in ST segment duration or QT duration. Upon detection of a possible stroke, the device then detects one or more hemodynamic parameters that are typically affected by cardiac ischemia. Such hemodynamic parameters can include, e.g., cardiac contractility or stroke volume. The device then distinguishes stroke and cardiac ischemia from one another based on whether any changes detected in the hemodynamic parameters are consistent with cardiac ischemia. Implantable systems that exploit subcutaneous electrocardiograms (ECGs) rather than IEGMs are also described. | 09-15-2011 |
20110230771 | HEART FAILURE STATUS MONITORING - Left atrial pressure and temperature of a patient are monitored to identify a normal wake state, a normal sleep state, and any deviation from those normal states (e.g., an alarm state). In the event an alarm state is identified, a determination is made as to whether to generate an indication of heart failure exacerbation based on a heart failure score. In addition, congestion and perfusion in a patient may be monitored over time to provide a two-dimensional indication of a trend relating to the heart failure status of the patient. | 09-22-2011 |
20110282226 | CARDIAC ANALYSIS SYSTEM FOR COMPARING CLINICAL AND INDUCED VENTRICULAR TACHYCARDIA EVENTS - A cardiac analysis system is provided that includes an implantable medical device (IMD), at least one sensor, and an external device. The IMD has electrodes positioned proximate to a heart that sense first cardiac signals of the heart and associated with a clinical ventricular tachycardia (VT) event and second cardiac signals associated with an induced VT event. The sensor measures first and second cardiac parameters of the heart associated with the clinical and induced VT events, respectively. The external device is configured to receive the first and second cardiac signals associated with the clinical and the induced VT events and the first and second cardiac parameters associated with the clinical and the induced VT events. The external device compares the first and second cardiac signals and compares the first and second cardiac parameters to determine if the clinical and induced VT events are a common type of VT event. | 11-17-2011 |
20120089032 | METHOD AND SYSTEM FOR DISCRIMINATING AND MONITORING ATRIAL ARRHYTHMIA BASED ON CARDIOGENIC IMPEDANCE - A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An arrhythmia monitoring module is configured to analyze intra-cardiac electrogram (IEGM) signals from the at least one IC electrode to identify a potential atrial arrhythmia. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. The hemodynamic performance (HDP) assessment module is configured to determine a hemodynamic performance based on the ECI measurements. The arrhythmia monitoring module is configured to declare the potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The medical device further provides the HDP assessment module that derives a current ECI waveform from current ECI measurements and compares the current ECI pattern with a prior ECI waveform that is derived from prior ECI measurements. | 04-12-2012 |
20120165643 | MOTION-BASED OPTIMIZATION FOR PLACEMENT OF CARDIAC STIMULATION ELECTRODES - An exemplary method includes use of a multielectrode device that can help position a cardiac stimulation lead to an optimal site in the heart based at least in part on cardiac motion information acquired via the multielectrode device and one or more pairs of current delivery electrodes that establish potential fields (e.g., for use as a coordinate system). An exemplary mutlielectrode device may be a multielectrode catheter or a multifilar, electrode-bearing guidewire. Various other exemplary methods, devices, systems, etc., are also disclosed. | 06-28-2012 |
20120172867 | SYSTEM AND METHOD FOR TREATING ARRHYTHMIAS IN THE HEART USING INFORMATION OBTAINED FROM HEART WALL MOTION - A system and method for treating an arrhythmia in a heart are provided. The system includes an electronic control unit configured to monitor movement of one or more position sensor over a period of time. The position sensors may, for example, comprise electrodes or coils configured to generate induced voltages and currents in the presence of electromagnetic fields. The positions sensors are in contact with portions of heart tissue and changes in position are representative of motion of that tissue. The electronic control unit is further configured to generate an indicator, responsive to the movements of the sensors over the period of time, of a characteristic of the heart affected by delivery of ablation energy to heart tissue. In this manner, the effectiveness and safety of cardiac tissue ablation for treatment of the arrhythmia can be assessed and a post-ablation therapy regimen determined. | 07-05-2012 |
20130041274 | SYSTEMS AND METHODS FOR USE BY IMPLANTABLE MEDICAL DEVICES FOR DETECTING AND DISCRIMINATING STROKE AND CARDIAC ISCHEMIA USING ELECTROCARDIAC SIGNALS - Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke. | 02-14-2013 |
20140114203 | SYSTEMS AND METHODS FOR OFF-LINE REPROGRAMMING OF IMPLANTABLE MEDICAL DEVICE COMPONENTS TO REDUCE FALSE DETECTIONS OF CARDIAC EVENTS - Techniques are provided for use by implantable medical devices such as pacemakers or by external systems in communication with such devices. An intracardiac electrogram (IEGM) is sensed within a patient in which the device is implanted using a cardiac signal sensing system. Cardiac events of interest such as arrhythmias, premature atrial contractions (PACs), premature ventricular contractions (PVCs) and pacemaker mediated tachycardias (PMTs) are detected within the patient using event detection systems and then portions of the IEGM representative of the events of interest are recorded in device memory. Subsequently, during an off-line or background analysis, the recorded IEGM data is retrieved and analyzed to identify false detections. In response to false detections, the cardiac signal sensing systems and/or the event detection systems of the implantable device are selectively adjusted or reprogrammed to reduce or eliminate any further false detections, including false-positives or false-negatives. Various adaptive reprogramming techniques are described. | 04-24-2014 |
20140214110 | SYSTEMS AND METHODS TO MONITOR AND TREAT HEART FAILURE CONDITIONS - An implantable device monitors and treats heart failure, pulmonary edema, and hemodynamic conditions and in some cases applies therapy. In one implementation, the implantable device applies a high-frequency multi-phasic pulse waveform over multiple-vectors through tissue. The waveform has a duration less than the charging time constant of electrode-electrolyte interfaces in vivo to reduce intrusiveness while increasing sensitivity and specificity for trending parameters. The waveform can be multiplexed over multiple vectors and the results cross-correlated or subjected to probabilistic analysis or thresholding schemata to stage heart failure or pulmonary edema. In one implementation, a fractionation morphology of a sensed impedance waveform is used to trend intracardiac pressure to stage heart failure and to regulate cardiac resynchronization therapy. The waveform also provides unintrusive electrode integrity checks and 3-D impedancegrams. | 07-31-2014 |
20140221771 | Method and Implantable System for Blood-Glucose Concentration Monitoring Using Parallel Methodologies - In an implantable medical device for monitoring glucose concentration in the blood, a blood-glucose concentration analysis is performed using correlations of blood-glucose concentration with measures of metabolic oxygen consumption including oxymetric, and/or temperature. Analysis of electrocardiographic data is used in a parallel method to detect and/or confirm the onset and/or existence and/or extent of hypoglycemia and/or hyperglycemia. Blood-glucose concentration calculation is enhanced by using the combination of the oxygen metabolism analysis and electrocardiographic analysis. | 08-07-2014 |
20150088217 | IMPLANTABLE CARDIAC STIMULATION DEVICE AND METHOD THAT STABILIZES VENTRICULAR RATE DURING EPISODES OF ATRIAL FIBRILLATION - An implantable cardiac stimulation device provides electrical stimulation therapy to stabilize the ventricular rate of a heart during episodes of atrial fibrillation. The stimulation therapy may be a plurality of sub-threshold stimulation pulses delivered to capture AV node vagal innervations following the detection of atrial fibrillation. | 03-26-2015 |
20150088218 | METHOD TO STABILIZE VENTRICULAR RATE DURING EPISODES OF ATRIAL FIBRILLATION - A method to provide electrical stimulation therapy to stabilize ventricular rate of a heart during episodes of atrial fibrillation. The stimulation therapy may be a plurality of stimulation pulses delivered to the AV node during the AV node refractory period following the sensing of an atrial event. | 03-26-2015 |