Patent application number | Description | Published |
20080262368 | HEART SOUND TRACKING SYSTEM AND METHOD - A system and method provide heart sound tracking, including an input circuit, configured to receive heart sound information, and a heart sound recognition circuit. The heart sound recognition circuit can be coupled to the input circuit and can be configured to recognize, within a particular heart sound of a particular heart sound waveform, a first intra heart sound energy indication and a corresponding first intra heart sound time indication using the heart sound information from the particular heart sound waveform and the heart sound information from at least one other heart sound waveform. The particular heart sound can include at least a portion of one of S1, S2, S3, and S4. Further, the first intra heart sound energy indication and the corresponding first intra heart sound time indication can correspond to the at least a portion of one of S1, S2, S3, and S4, respectively. | 10-23-2008 |
20080294212 | Trending of systolic murmur intensity for monitoring cardiac disease with implantable device - Described is an implantable device configured to monitor for changes in the intensity and/or duration of a systolic murmur such as mitral regurgitation by means of an acoustic sensor. Such changes may be taken to indicate a change in a patient's heart failure status. Upon detection of a worsening in the patient's heart failure statue, the device may be programmed to alert clinical personnel over a patient management network and/or make appropriate adjustments to pacing therapy. | 11-27-2008 |
20090018461 | Method and apparatus for third heart sound detection - A cardiac rhythm management system includes a heart sound detector providing for detection of the third heart sounds (S | 01-15-2009 |
20090247889 | DETERMINING A PATIENT'S POSTURE FROM MECHANICAL VIBRATIONS OF THE HEART - A system for determining a patient's posture by monitoring heart sounds. The system comprises an implantable medical device that includes a sensor operable to produce an electrical signal representative of heart sounds, a sensor interface circuit coupled to the sensor to produce a heart sound signal, and a controller circuit coupled to the sensor interface circuit. The heart sounds are associated with mechanical activity of a patient's heart and the controller circuit is operable to detect a posture of the patient from a heart sound signal. | 10-01-2009 |
20090287106 | ISCHEMIA DETECTION USING A HEART SOUND SENSOR - A system comprising an implantable medical device (IMD) includes an implantable heart sound sensor to produce an electrical signal representative of at least one heart sound. The heart sound is associated with mechanical activity of a patient's heart. Additionally, the IMD includes a heart sound sensor interface circuit coupled to the heart sound sensor to produce a heart sound signal, and a signal analyzer circuit coupled to the heart sound sensor interface circuit. The signal analyzer circuit measures a baseline heart sound signal, and deems that an ischemic event has occurred using, among other things, a measured subsequent change in the heart sound signal from the established baseline heart sound signal. | 11-19-2009 |
20090312659 | MANAGING PRELOAD RESERVE BY TRACKING THE VENTRICULAR OPERATING POINT WITH HEART SOUNDS - A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator. | 12-17-2009 |
20100073170 | SYSTEM AND METHOD FOR DETECTION OF HF DECOMPENSATION BASED ON SIGNS AND SYMPTOMS - In an example, physiologic information about a patient can be obtained and mapped to a first set of fuzzy logic membership functions, and a symptom status can be derived from the mapping of the physiologic information using a first fuzzy logic inference. In an example, the symptom status can be mapped to a second set of fuzzy logic membership functions, and a disease status can be derived from the mapping of the symptom status to the second set of fuzzy logic membership functions using a second fuzzy logic inference. | 03-25-2010 |
20100094102 | MULTI-SENSOR STRATEGY FOR HEART FAILURE PATIENT MANAGEMENT - An apparatus comprises plurality of sensors and a processor. Each sensor provides a sensor signal that includes physiological information and at least one sensor is implantable. The processor includes a physiological change event detection module that detects a physiological change event from a sensor signal and produces an indication of occurrence of one or more detected physiological change events, and a heart failure (HF) detection module. The HF detection module determines, using a first rule, whether the detected physiological change event is indicative of a change in HF status of a subject, determines whether to override the first rule HF determination using a second rules, and declares whether the change in HF status occurred according to the first and second rules. | 04-15-2010 |
20100099997 | METHOD FOR CORRECTION OF POSTURE DEPENDENCE ON HEART SOUNDS - A system to monitor heart sounds. The system comprises an implantable heart sound sensor configured to produce an electrical signal representative of at least one heart sound, an implantable posture sensor operable to produce an electrical signal representative of a patient's posture, and a controller circuit. The controller circuit is configured to determine a patient posture, measure at least one heart sound in correspondence with at least one corresponding patient posture, adjust the heart sound measurement by using the corresponding determined patient posture to reduce or remove variation in the heart sound measurement due to patient posture, detect a change in the adjusted heart sound measurement, and provide an indication of congestive heart failure to a user or an automated process in response to the detected change. | 04-22-2010 |
20100125211 | ASSESSMENT OF PULMONARY VASCULAR RESISTANCE VIA PULMONARY ARTERY PRESSURE - Methods and systems for assessing pulmonary or systemic vascular resistance in a patient using pressure measurements are disclosed. An illustrative method of measuring pulmonary vascular resistance includes electrically inducing a retrograde pressure pulse within the heart, sensing at least one arterial pressure parameter in response to the retrograde pressure pulse using a pressure sensor located within a pulmonary artery, and computing a value of the pulmonary vascular resistance using the at least one sensed arterial pressure parameter. Data from multiple pulmonary vascular resistance assessments can be taken over an extended period of time within the patient to aid in detecting an underlying cardiac or pulmonary condition such as cardiogenic pulmonary edema. | 05-20-2010 |
20100145403 | SENSING RATE OF CHANGE OF PRESSURE IN THE LEFT VENTRICLE WITH AN IMPLANTED DEVICE - An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing. | 06-10-2010 |
20100222653 | PHYSIOLOGICAL EVENT DETECTION SYSTEMS AND METHODS - Systems and methods using constant false alarm rate techniques for event detection. One example of an event detection method includes collecting a first distribution of measurements for a first physiological parameter. In another example, the first distribution of measurements includes only non-event measurements. One or more values are determined corresponding to at least a first tail area of the first distribution from at least one measurement of the first physiological parameter toward an end point of the distribution. A threshold is established based on a specified false alarm rate. The one or more values are compared to the threshold. The method includes determining if the measurement is representative of a detected event using the comparison. | 09-02-2010 |
20100280564 | MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE - The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed. | 11-04-2010 |
20110004264 | Systems and Methods for Ranking and Selection of Pacing Vectors - Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds. | 01-06-2011 |
20110009914 | CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY - Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion. | 01-13-2011 |
20110015702 | REMOTE SENSING IN AN IMPLANTABLE MEDICAL DEVICE - An embodiment uses an accelerometer to sense heart sounds, and determines heart rate info nation using the sensed heart sounds. An embodiment uses an accelerometer to sense respiratory activity. An embodiment delivers a programmed neural stimulation therapy with a programmed duty cycle, where the programmed duty cycle includes a stimulation ON portion followed by a stimulation OFF portion. An electrode electrically connected to the implanted neural stimulation device is used to remotely detect cardiac activity. The remotely detected cardiac activity is used to detect heart rate information during the stimulation ON portion and to detect heart rate information during the stimulation OFF portion. The detected heart rate information and/or the detected respiration information are used to control a neural stimulation therapy performed by the neural stimulator device and/or are used to provide diagnostic information for the patient's condition. | 01-20-2011 |
20110015704 | PHYSIOLOGICAL VIBRATION DETECTION IN AN IMPLANTED MEDICAL DEVICE - An embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy. | 01-20-2011 |
20110061647 | Patient Monitoring, Diagnosis, And/Or Therapy Systems and Methods - Systems and methods involve an implantable device configured to perform at least one cardiac-related function, a patient-external respiratory therapy device, and a communication channel configured to facilitate communication between the implantable device and the respiratory therapy device. The implantable and respiratory therapy devices operate cooperatively via the communication channel to provide one or more of patient monitoring, diagnosis, and therapy. The communication channel may be configured to facilitate communication between an external processing system and at least one of the implantable device and the respiratory therapy device. The processing system is communicatively coupled to at least one of the implantable and respiratory therapy devices via the communication channel to provide one or more of patient monitoring, diagnosis, and therapy. | 03-17-2011 |
20110071411 | METHOD AND APPARATUS FOR SENSING MECHANICAL ENERGY OF AN IMPLANTABLE LEAD - An apparatus comprises an implantable sensor and a signal analyzer circuit communicatively coupled to the implantable sensor. The implantable sensor is configured for coupling to an implantable lead and the implantable sensor provides an electrical vibration sensor signal representative of mechanical vibration of the implantable lead. The signal analyzer circuit is configured to determine a baseline of the vibration sensor signal, detect a change in the vibration sensor signal from the baseline vibration sensor signal, and provide an indication of the change to a user or process. | 03-24-2011 |
20110077543 | HEART SOUND TRACKING SYSTEM AND METHOD - A system and method provide heart sound tracking, including an input circuit, configured to receive heart sound information, and a heart sound recognition circuit. The heart sound recognition circuit can be coupled to the input circuit and can be configured to recognize, within a particular heart sound of a particular heart sound waveform, a first intra heart sound energy indication and a corresponding first intra heart sound time indication using the heart sound information from the particular heart sound waveform and the heart sound information from at least one other heart sound waveform. The particular heart sound can include at least a portion of one of S | 03-31-2011 |
20110077707 | DUAL-USE SENSOR FOR RATE RESPONSIVE PACING AND HEART SOUND MONITORING - An implantable medical device includes a dual-use sensor such as a single accelerometer that senses an acceleration signal. A sensor processing circuit processes the acceleration signal to produce an activity level signal and a heart sound signal. The implantable medical device provides for rate responsive pacing in which at least one pacing parameter, such as the pacing interval, is dynamically adjusted based on the physical activity level. The implantable medical device also uses the heart sounds for pacing control purposes or transmits a heart sound signal to an external system for pacing control and/or diagnostic purposes. | 03-31-2011 |
20110098588 | METHOD AND APPARATUS FOR MONITORING OF DIASTOLIC HEMODYNAMICS - A cardiac rhythm management system provides for ambulatory monitoring of hemodynamic performance based on quantitative measurements of heart sound related parameters for diagnostic and therapeutic purposes. Monitoring of such heart sound related parameters allows the cardiac rhythm management system to determine a need for delivering a therapy and/or therapy parameter adjustments based on conditions of a heart. This monitoring also allows a physician to observe or assess the hemodynamic performance for diagnosing and making therapeutic decisions. Because the conditions of the heart may fluctuate and may deteriorate significantly between physician visits, the ambulatory monitoring, performed on a continuous or periodic basis, ensures a prompt response by the cardiac rhythm management system that may save a life, prevent hospitalization, or prevent further deterioration of the heart. | 04-28-2011 |
20110263988 | SENSING RATE OF CHANGE OF PRESSURE IN THE LEFT VENTRICLE WITH AN IMPLANTED DEVICE - An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing. | 10-27-2011 |
20110301530 | MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE - The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed. | 12-08-2011 |
20110301660 | HEART FAILURE MANAGEMENT SYSTEM - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 12-08-2011 |
20110319776 | CARDIAC CONTRACTION DETECTION USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods for cardiac contraction detection using information indicative of lead motion are described. In an example, an implantable medical device can include a receiver circuit configured to be electrically coupled to conductor comprising a portion of an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The device can include a processor circuit configured to determine whether a cardiac mechanical contraction occurred during a specified interval included in the obtained information indicative of the movement of the implantable lead. The processor circuit can be configured to determine information about the cardiac mechanical contraction using the obtained information indicative of the movement of the implantable lead. | 12-29-2011 |
20110319778 | CARDIAC FUNCTION MONITOR USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods to monitor cardiac function using information indicative of lead motion are described. In an example, a system including an implantable medical device can include a receiver circuit configured to be electrically coupled to conductor comprising a portion of an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The system can include a sensing circuit configured to obtain information indicative of cardiac electrical activity. The system can include a processor circuit configured to construct a template representative of a contraction of the heart, where the template can be constructed using the information indicative of the movement of the implantable lead due at least in part to the motion of the heart during the contraction, and using the information indicative of the cardiac electrical activity sensed during the contraction. | 12-29-2011 |
20110319779 | RHYTHM DISCRIMINATION USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods for rhythm discrimination using the motion of an implantable lead are described. In an example, an implantable medical device can include a receiver circuit configured to be electrically coupled to an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The device can include an arrhythmia detection circuit configured to determine an arrhythmia status using the information indicative of the movement of the implantable lead and an arrhythmia classification circuit configured to determine one or more of a location or a type of an arrhythmia, using the information indicative of the movement of the implantable lead, when the arrhythmia status indicates that an arrhythmia is occurring or has occurred. | 12-29-2011 |
20110319782 | CARDIAC MECHANICAL VIBRATION MONITOR USING INFORMATION INDICATIVE OF LEAD MOTION - Systems and methods to monitor cardiac mechanical vibrations using information indicative of lead motion are described. In an example, a system including an implantable medical device can include an excitation circuit configured to provide a non-tissue stimulating, non-therapeutic electrical excitation signal to a portion of an implantable lead. A receiver circuit can be configured to obtain information indicative of a mechanical vibration of the implantable lead due at least in part to one or more of an impact of at least a portion of the heart to the implantable lead, or friction contact between the implantable lead and cardiac tissue. The system can include a processor circuit configured to determine one or more of a lead mechanical status, or information indicative of valvular activity using the information indicative of the mechanical vibration of the implantable lead. | 12-29-2011 |
20120004565 | ISCHEMIA DETECTION USING A HEART SOUND SENSOR - A system comprising an implantable medical device (IMD) includes an implantable heart sound sensor to produce an electrical signal representative of at least one heart sound. The heart sound is associated with mechanical activity of a patient's heart. Additionally, the IMD includes a heart sound sensor interface circuit coupled to the heart sound sensor to produce a heart sound signal, and a signal analyzer circuit coupled to the heart sound sensor interface circuit. The signal analyzer circuit measures a baseline heart sound signal, and deems that an ischemic event has occurred using, among other things, a measured subsequent change in the heart sound signal from the established baseline heart sound signal. | 01-05-2012 |
20120035685 | USER INTERFACE SYSTEM FOR USE WITH MULTIPOLAR PACING LEADS - An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device. | 02-09-2012 |
20120041317 | METHOD AND APPARATUS FOR DETECTING ATRIAL FILLING PRESSURE - A cardiac rhythm management system provides for ambulatory monitoring of hemodynamic performance based on quantitative measurements of heart sound related parameters for diagnostic and therapeutic purposes. Monitoring of such heart sound related parameters allows the cardiac rhythm management system to determine a need for delivering a therapy and/or therapy parameter adjustments based on conditions of a heart. This monitoring also allows a physician to observe or assess the hemodynamic performance for diagnosing and making therapeutic decisions. Because the conditions of the heart may fluctuate and may deteriorate significantly between physician visits, the ambulatory monitoring, performed on a continuous or periodic basis, ensures a prompt response by the cardiac rhythm management system that may save a life, prevent hospitalization, or prevent further deterioration of the heart. | 02-16-2012 |
20120089040 | ADAPTIVE SAMPLING OF HEART SOUNDS - A system and method to sense heart sounds with one or more implantable medical devices according to one or more signal processing parameters. The method alters one or more of the parameters as a function of one or more physiologic triggering events. The method then senses heart sounds with the one or more implantable medical devices according to at least the one or more altered signal processing parameters. | 04-12-2012 |
20120158083 | LEFT VENTRICULAR PACING PROTECTION IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - In a pacing mode where the left ventricle is paced upon expiration of an escape interval that is reset by a right ventricular sense, there is the risk that the left ventricular pace may be delivered in the so-called vulnerable period that occurs after a depolarization and trigger an arrhythmia. To reduce this risk, a left ventricular protective period (LVPP) may be provided. Methods and devices for implementing an LVPP in the context of multi-site left ventricular pacing are described. | 06-21-2012 |
20120158084 | LEFT VENTRICLE-ONLY AND RIGHT VENTRICULAR SAFETY PACING IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - One way in which cardiac resynchronization therapy may be delivered is to only deliver paces to the left ventricle. If left ventricular pacing is inhibited during a cardiac cycle, it may be desirable to deliver a right ventricular safety pace to prevent asystole. Methods and devices for implementing right ventricular safety pacing in the context of multi-site left ventricular-only pacing are described. | 06-21-2012 |
20120158085 | BIVENTRICULAR-TRIGGERED PACING IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - Biventricular-triggered pacing is a pacing mode that can employ in cardiac resynchronization pacing at elevated heart rates. Described herein are methods and devices for implementing biventricular pacing in the context of multi-site left ventricular pacing. | 06-21-2012 |
20120158087 | REFRACTORY AND BLANKING INTERVALS IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - A refractory period for a pacemaker sensing channel refers to a period of time during which the sensing channel is either blind to incoming electrical signals, termed a blanking interval, and/or during which the device is configured to ignore such signals for purposes of sense event detection. Methods and devices for implementing refractory periods in the context of multi-site left ventricular pacing are described. | 06-21-2012 |
20120203116 | MANAGING PRELOAD RESERVE BY TRACKING THE VENTRICULAR OPERATING POINT WITH HEART SOUNDS - A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator. | 08-09-2012 |
20120245656 | CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY - Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion. | 09-27-2012 |
20120271186 | THIRD HEART SOUND ACTIVITY INDEX FOR HEART FAILURE MONITORING - A cardiac rhythm management system provides for the trending of a third heart sound (S3) index. The S3 index is a ratio, or an estimate of the ratio, of the number of S3 beats to the number of all heart heats, where the S3 beats are each a heart beat during which an occurrence of S3 is detected. An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including S3. An S3 detector detects occurrences of S3 from the acoustic signal. A heart sound processing system trends the S3 index on a periodic basis to allow continuous monitoring of the S3 activity level, which is indicative of conditions related to heart failure. | 10-25-2012 |
20120330174 | SENSING RATE OF CHANGE OF PRESSURE IN THE LEFT VENTRICLE WITH AN IMPLANTED DEVICE - An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing. | 12-27-2012 |
20130023956 | REMOTE SENSING IN AN IMPLANTABLE MEDICAL DEVICE - An embodiment uses an accelerometer to sense heart sounds, and determines heart rate information using the sensed heart sounds. An embodiment uses an accelerometer to sense respiratory activity. An embodiment delivers a programmed neural stimulation therapy with a programmed duty cycle, where the programmed duty cycle includes a stimulation ON portion followed by a stimulation OFF portion. An electrode electrically connected to the implanted neural stimulation device is used to remotely detect cardiac activity. The remotely detected cardiac activity is used to detect heart rate information during the stimulation ON portion and to detect heart rate information during the stimulation OFF portion. The detected heart rate information and/or the detected respiration information are used to control a neural stimulation therapy performed by the neural stimulator device and/or are used to provide diagnostic information for the patient's condition. | 01-24-2013 |
20130085407 | METHOD AND APPARATUS FOR THIRD HEART SOUND DETECTION - A cardiac rhythm management system includes a heart sound detector providing for detection of the third heart sounds (S | 04-04-2013 |
20130096451 | HEART SOUND TRACKING SYSTEM AND METHOD - A system and method provide heart sound tracking, including an input circuit, configured to receive heart sound information, and a heart sound recognition circuit. The heart sound recognition circuit can be coupled to the input circuit and can be configured to recognize, within a particular heart sound of a particular heart sound waveform, a first intra heart sound energy indication and a corresponding first intra heart sound time indication using the heart sound information from the particular heart sound waveform and the heart sound information from at least one other heart sound waveform. The particular heart sound can include at least a portion of one of S1, S2, S3, and S4. Further, the first intra heart sound energy indication and the corresponding first intra heart sound time indication can correspond to the at least a portion of one of S1, S2, S3, and S4, respectively. | 04-18-2013 |
20130123873 | HEART FAILURE MANAGEMENT - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 05-16-2013 |
20130137997 | METHOD AND APPARATUS FOR DETECTING ATRIAL FILLING PRESSURE - A cardiac rhythm management system provides for ambulatory monitoring of hemodynamic performance based on quantitative measurements of heart sound related parameters for diagnostic and therapeutic purposes. Monitoring of such heart sound related parameters allows the cardiac rhythm management system to determine a need for delivering a therapy and/or therapy parameter adjustments based on conditions of a heart. This monitoring also allows a physician to observe or assess the hemodynamic performance for diagnosing and making therapeutic decisions. Because the conditions of the heart may fluctuate and may deteriorate significantly between physician visits, the ambulatory monitoring, performed on a continuous or periodic basis, ensures a prompt response by the cardiac rhythm management system that may save a life, prevent hospitalization, or prevent further deterioration of the heart. | 05-30-2013 |
20130138008 | SYSTEM AND METHOD FOR SYSTOLIC INTERVAL ANALYSIS - A system and method provide for systolic interval analysis. In an example, an implantable device measures a cardiac impedance signal. A transformation of the cardiac impedance interval is generated. The device also measures a heart sound signal. A time interval between a point on the transformed signal of the cardiac impedance signal and a point on the heart sound signal is calculated. | 05-30-2013 |
20130226078 | MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE - The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed. | 08-29-2013 |
20130289476 | MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE - The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed. | 10-31-2013 |
20130296728 | THIRD HEART SOUND ACTIVITY INDEX FOR HEART FAILURE MONITORING - A cardiac rhythm management system provides for the trending of a third heart sound (S3) index. The S3 index is a ratio, or an estimate of the ratio, of the number of S3 beats to the number of all heart beats, where the S3 beats are each a heart beat during which an occurrence of S3 is detected. An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including S3. An S3 detector detects occurrences of S3 from the acoustic signal. A heart sound processing system trends the S3 index on a periodic basis to allow continuous monitoring of the S3 activity level, which is indicative of conditions related to heart failure. | 11-07-2013 |
20130310891 | AUTOMATIC PACING CONFIGURATION SWITCHER - A system or apparatus can provide electrostimulations via an electrode configuration that can be selected from multiple electrode configurations, the electrostimulations of the type for inducing a desired heart contraction, or a neurostimulation response. The system or apparatus can allow communicating with an external device to receive an input indicating a degree of patient discomfort with an electrostimulation delivered using a first electrode configuration, and can associate information about the degree of discomfort with information about the corresponding first electrode configuration for use by a controller circuit in determining a second electrode configuration for delivering a subsequent electrostimulation. | 11-21-2013 |
20140005742 | SYSTEM AND METHOD FOR SELECTION OF PACING VECTORS | 01-02-2014 |
20140018690 | SENSING RATE OF CHANGE OF PRESSURE IN THE LEFT VENTRICLE WITH AN IMPLANTED DEVICE - An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing. | 01-16-2014 |
20140018872 | ADAPTIVE PHRENIC NERVE STIMULATION DETECTION - An example of a system comprises a cardiac pulse generator configured to generate cardiac paces to pace the heart, a sensor configured to sense a physiological signal for use in detecting pace-induced phrenic nerve stimulation (PS), a storage, and a phrenic nerve stimulation detector. The storage is configured for use to store patient-specific PS features for PS beats with a desirably large signal-to-noise ratio. The phrenic nerve stimulation detector may be configured to detect PS features for the patient by analyzing a PS beat with a desirably large signal-to-noise ratio induced using a pacing pulse with a large energy output and store patient-specific PS features in the storage, and use the patient-specific PS features stored in the memory to detect PS beats when the heart is paced heart using cardiac pacing pulses with a smaller energy output. | 01-16-2014 |
20140052209 | PHYSIOLOGICAL VIBRATION DETECTION IN AN IMPLANTED MEDICAL DEVICE - An embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy. | 02-20-2014 |
20140058472 | BIVENTRICULAR-TRIGGERED PACING IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - Biventricular-triggered pacing is a pacing mode that can employ in cardiac resynchronization pacing at elevated heart rates. Described herein are methods and devices for implementing biventricular pacing in the context of multi-site left ventricular pacing. | 02-27-2014 |
20140073971 | MANAGING PRELOAD RESERVE BY TRACKING THE VENTRICULAR OPERATING POINT WITH HEART SOUNDS - A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator. | 03-13-2014 |
20140094875 | REMOTE SENSING IN AN IMPLANTABLE MEDICAL DEVICE - An embodiment uses an accelerometer to sense heart sounds, and determines heart rate information using the sensed heart sounds. An embodiment uses an accelerometer to sense respiratory activity. An embodiment delivers a programmed neural stimulation therapy with a programmed duty cycle, where the programmed duty cycle includes a stimulation ON portion followed by a stimulation OFF portion. An electrode electrically connected to the implanted neural stimulation device is used to remotely detect cardiac activity. The remotely detected cardiac activity is used to detect heart rate information during the stimulation ON portion and to detect heart rate information during the stimulation OFF portion. The detected heart rate information and/or the detected respiration information are used to control a neural stimulation therapy performed by the neural stimulator device and/or are used to provide diagnostic information for the patient's condition. | 04-03-2014 |
20140100625 | LEFT VENTRICULAR PACING PROTECTION IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - In a pacing mode where the left ventricle is paced upon expiration of an escape interval that is reset by a right ventricular sense, there is the risk that the left ventricular pace may be delivered in the so-called vulnerable period that occurs after a depolarization and trigger an arrhythmia. To reduce this risk, a left ventricular protective period (LVPP) may be provided. Methods and devices for implementing an LVPP in the context of multi-site left ventricular pacing are described. | 04-10-2014 |
20140114370 | HEART FAILURE MANAGEMENT - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 04-24-2014 |
20140207206 | SYSTEM AND METHOD FOR SYSTOLIC INTERVAL ANALYSIS - According to a system or method, information indicative of a cardiac depolarization signal can be obtained. Information indicative of an acoustic signal from an implantable acoustic sensor included as a portion of an implantable therapy device can be obtained. A feature indicative of an R wave can be identified from the information indicative of the cardiac depolarization signal, and a feature indicative of an S2 heart sound can be identified from the information indicative of the acoustic signal. A time interval between an instant corresponding to the feature indicative of the R wave and an instant corresponding to the feature indicative of the S2 heart sound can be determined. Using information about the determined time interval, an adjusted pacing therapy parameter can be provided for use in a pacing therapy to be provided by the implantable therapy device. | 07-24-2014 |
20140221786 | MULTI-SENSOR STRATEGY FOR HEART FAILURE PATIENT MANAGEMENT - An apparatus comprises plurality of sensors and a processor. Each sensor provides a sensor signal that includes physiological information and at least one sensor is implantable. The processor includes a physiological change event detection module that detects a physiological change event from a sensor signal and produces an indication of occurrence of one or more detected physiological change events, and a heart failure (HF) detection module. The HF detection module determines, using a first rule, whether the detected physiological change event is indicative of a change in HF status of a subject, determines whether to override the first rule HF determination using a second rules, and declares whether the change in HF status occurred according to the first and second rules. | 08-07-2014 |
20140243929 | CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY - Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion. | 08-28-2014 |
20140277244 | AMBULATORY PHRENIC NERVE STIMULATION DETECTION - An example of a system includes an implantable medical device (IMD) for implantation in a patient, where the IMD includes a cardiac pace generator, phrenic nerve stimulation (PS) sensor, a memory, and a controller, and where the controller is operably connected to the cardiac pace generator to generate cardiac paces. The controller is configured to provide a trigger for conducting a PS detection procedure and perform the PS detection procedure in response to the trigger. In performing the PS detection procedure the controller is configured to receive a signal from the sensor, detect PS using the signal from the sensor, and record the PS detection in storage within the IMD. | 09-18-2014 |
20140277280 | PHRENIC NERVE STIMULATION DETECTION WITH POSTURE SENSING - A method and a system of phrenic nerve stimulation detection in conjunction with posture sensing is disclosed. In an embodiment, the method may include receiving a trigger for conducting a pace-induced phrenic nerve stimulation (PS) search using the IMD within the patient. On receiving the trigger, the IMD may be used for conducting the PS search. A procedure of conducting the PS search may include measuring a posture of the patient using an implantable posture sensor, searching for PS while the patient is in the measured posture and obtaining a PS result from the PS search for the measured posture. The method may include recording both the PS result and the measured posture in a memory of the IMD. | 09-18-2014 |
20140350425 | THIRD HEART SOUND ACTIVITY INDEX FOR HEART FAILURE MONITORING - A cardiac rhythm management system provides for the trending of a third heart sound (S3) index. The S3 index is a ratio, or an estimate of the ratio, of the number of S3 beats to the number of all heart beats, where the S3 beats are each a heart beat during which an occurrence of S3 is detected. An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including S3. An S3 detector detects occurrences of S3 from the acoustic signal. A heart sound processing system trends the S3 index on a periodic basis to allow continuous monitoring of the S3 activity level, which is indicative of conditions related to heart failure. | 11-27-2014 |
20150039044 | SYSTEMS AND METHODS FOR RANKING AND SELECTION OF PACING VECTORS - Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds. | 02-05-2015 |