Pacesetter, Inc.

Other

St. Jude Medical, Cardiology Division, Inc.

St. Jude Medical Ab

Pacestter, Inc.

Allen J Keel

Stuart Rosenberg

Kyungmoo Ryu

Wenbo Hou

Michael Xiaoxuan Yang

Taraneh Ghaffari Farazi

Steve Koh

Kjell Noren

Edward Karst

Thao Thu Nguyen

Brian Jeffrey Wenzel

Timothy A Fayram

Xiaoyi Min

Thao T Ngo

Jong Gill

Yelena Nabutovsky

Rupinder Bharmi

Riddhi Shah

Fujian Qu

Kjell Norén

Tomas Svensson

Paul A Levine

Euljoon Park

Eric Steven Fain

Sven-Erik Hedberg

Michael E Benser

Anders Björling

Anders Bjorling

Heidi Hellman

Edith Merle Arnold

Kritika Gupta

Ryan Rooke

Ryan Bennett Sefkow

John VanScoy

Hedi Razavi

Taraneh Ghaffari Farzi

Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

Arterial blood pressure monitoring devices, systems and methods for use while pacing

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.

System and method for treating arrhythmias in the heart using information obtained from heart wall motion

Described herein are implantable systems and devices, and methods for use therewith, that can be used to monitor and treat heart failure (HF). Such implantable systems preferably includes a lead having at least two electrodes implantable in a patient's left ventricular (LV) chamber. A plurality of different sensing vectors are used to obtain a plurality of IEGMs each of which is indicative of an evoked response at a corresponding different region of the LV chamber. For each of the IEGMs, there is a determination of one or more evoked response metrics indicative of a localized cardiac function at the corresponding region of the LV chamber. The evoke response metrics can be, e.g., paced depolarization integral (PDI) and/or maximum upward slope of an R-wave, but are not limited thereto. The patient's HF condition is monitored based on the localized cardiac function at the plurality of different regions of the LV chamber as determined based on the one or more evoked response metrics determined for each of the IEGMs.

Devices, systems and methods to monitor and treat heart failure (HF)

Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays.

Systems and methods for optimizing multi-site left ventricular pacing based on interelectrode conduction delays

Methods and systems are provided to deliver a neural stimulation therapy to treat apnea episodes. The methods and systems detect a respiratory pattern of a patient and identify a type associated with the respiratory pattern. A sleep stage is detected that the patient is experiencing and the method and system identify when the sleep stage warrants therapy. When the respiratory pattern corresponds to an apnea episode (AE) and the sleep stage warrants therapy, the methods and systems deliver an apnea episode terminating neuro-stimulation (AET-NS) therapy configured to terminate the AE. A type of AE therapy that is delivered may be based on the sleep stage that was detected. The methods and systems may determine whether the AET-NS therapy successfully terminated the AE, and, if not, adjust the AET-NS therapy and deliver a new AET-NS therapy.

Neurostimulation method and system to treat apnea

In specific embodiments, a method for estimating central arterial blood pressure (CBP), comprises determining a time tfrom a predetermined feature of a signal indicative of electrical activity to a predetermined feature of one of a first and second signals, the time tbeing a first pulse arrival time (PAT) indicative of how long it takes a pulse wave to travel from the aorta to one of a first and second sites, determining a time t, the time tbeing a second pulse arrival time (PAT) indicative of how long it takes a pulse wave to travel from the aorta to the other of the first and second sites, and (f) estimating the patient's central arterial blood pressure (CBP) based on the first pulse arrival time (PAT) and the second pulse arrival time (PAT).

Systems and methods for estimating central arterial blood pressure of a patient

An ablation catheter includes an elongated body having a proximal end and a distal end. At least one ablation element is disposed on the body between the proximal end and the distal end and configured to ablate renal tissue to control hypertension. At least one localization sensor is disposed on the body and configured to interact with a magnetic field. The at least one localization sensor aids in determining an appropriate target tissue for ablation.

Mediguide-enabled renal denervation system for ensuring wall contact and mapping lesion locations

An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.

Method to enhance electrode localization of a lead

Various embodiments of the present invention are directed to, or are for use with, an implantable system including a lead having multiple electrodes implantable in a patient's left ventricular (LV) chamber. In accordance with an embodiment, the patient's LV chamber is paced at first and second sites within the LV chamber using a programmed LV1-LV2 delay, wherein the LV1-LV2 delay is a programmed delay between when first and second pacing pulses are to be delivered respectively at the first and second sites within the LV chamber. Evoked responses to the first and second pacing pulses are monitored for, and one or more LV pacing parameter is/are adjusted and/or one or more backup pulse is/are delivered based on results of the monitoring.

Capture verification and pacing adjustments for use with multisite left ventricular pacing

Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination based on activation times. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in the left atrial (LA) chamber, the right atrial (RA) chamber, and at least one ventricular chamber of a patient's heart. For each of a plurality of cardiac cycles, there is a determination, based on the plurality of obtained IEGMs, of an LA activation time, an RA activation time, and a ventricular activation time. Arrhythmia discrimination is then performed based on the determined activation times.

Devices, systems and methods to perform arrhythmia discrimination based on the atrial and ventricular activation times

A method for use with an implantable system including a lead having multiple electrodes implantable proximate to a patient's left ventricular (LV) chamber includes simultaneously delivering pacing pulses over corresponding pacing vectors defined by electrodes proximate to the LV chamber. The method includes recording evoked responses responsive to the pacing pulses that are measured over separate corresponding sensing channels. The method also includes comparing the evoked responses to a template that represents local capture of a local LV tissue region along one or more of the corresponding pacing vectors. The comparison is used to determine whether the pacing pulses achieved local capture along the corresponding pacing vectors. At least one of the pacing pulses or pacing vectors are updated based on the comparison of the evoked responses to the template in order to determine a local capture threshold for the corresponding pacing vectors.

Method and system for validating local capture in multisite pacing delivery

Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination. A plurality of different sensing vectors are used to obtain a plurality of different IEGMs, each of which is indicative of cardiac electrical activity at a different ventricular region. The plurality of different IEGMs can include, e.g., an IEGM indicative of cardiac electrical activity at a first region of the patient's left ventricular (LV) chamber and an IEGM indicative of cardiac electrical activity at a second region of the patient's LV chamber. Additionally, the plurality of different IEGMs can further include an IEGM indicative of cardiac electrical activity at a region of a patient's right ventricular (RV) chamber. For each of the IEGMs, there is a determination of a corresponding localized R-R interval stability metric indicative of the R-R interval stability at the corresponding ventricular region. This can include, e.g., determining, for each of the IEGMs, a plurality of R-R intervals corresponding to a plurality of consecutive cardiac cycles of the IEGM. For each IEGM, a measure of variation (e.g., standard deviation, range or variance, but not limited thereto) can then be determined for the plurality of R-R intervals to thereby determine the localized R-R interval stability metric for the IEGM. Arrhythmia discrimination is then performed using the plurality of determined localized R-R interval stability metrics.

Devices, systems and methods to perform arrhythmia discrimination based on R-R interval stability corresponding to a plurality of ventricular regions

Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure.

Closed-loop systems and methods for controlling neurostimulation based on far-field cardiac signals sensed by a spinal cord stimulation device

An apparatus and method for quantifying myocardial kinetics by positioning two sensors on a myocardial substrate site so that one sensor is directly opposing the other along a ventricular wall; tracking a relative displacement between the two sensors; and determining whether there is an infarct based on the tracked relative displacement.

Growing community of inventors

San Jose, CA, United States of America

Allen J Keel