Pacesetter, Inc.

St. Jude Medical Ab

St Jude Medical, Atrial Fibrillation Division, Inc

Anders Bjorling

Kjell Noren

Yelena Nabutovsky

Dorin Panescu

Xiaoyi Min

Taraneh Ghaffari Farazi

Gene A Bornzin

Brian Jeffrey Wenzel

Tomas Svensson

Dan E Gutfinger

Mihir Naware

Jeffery Siou

Stefan Hjelm

Malin Hollmark

Caroline Sparf

Mark W Kroll

Euljoon Park

Kyungmoo Ryu

Stuart Rosenberg

John W Poore

Sven-Erik Hedberg

Allen J Keel

Richard P Williamson

Michael E Benser

Sheldon Williams

Buehl E Truex

Jay Snell

Rodney J Hawkins

Wenxia Zhao

Adam Klonecke

Cecilia Emmanuelsson

Jeffrey Siou

In response to local or systemic inflammation in a patient, photobiomodulation therapy is applied to a cardiac location to reduce the risk and/or occurrence of cardiac arrhythmia. Once inflammation is identified, photobiomodulation therapy can be applied in any suitable fashion (e.g., via a catheter- or transesophageal probe-mounted photoemitter, via an externally-applied photoemitter, or via photoemitter incorporated into an implantable medical device). Photobiomodulation therapy can also be employed to good advantage in conjunction with non-photobiomodulation therapy (e.g., traditional cardiac rhythm management therapies).

Method of reducing the occurrence of arrhythmias via photobiomodulation and apparatus for same

A patient-specific hemodyanmic status model is determined from impedance data collected during periods of normal and abnormal hemodynamic status by deriving parameter values of a set of multiple impedance-derivable parameters from impedance signals collected during periods of normal hemodynamic status and in connection with periods of abnormal hemodynamic status. The parameter values are employed to estimate coefficients of a linear parametric status model. These coefficients can then be used together with parameter values determined from impedance signals determined during status assessment periods in order to determine a current hemdoynamic status of the patient.

Hemodynamic status assessment

An implantable medical device, is designed to collect a signal representative of the electric activity of the heart and determine a cardiogenic impedance signal for at least a portion of the heart. An R-wave detector of the IMD detects the timing of an R-wave during a cardiac cycle based on the signal representative of the electric activity. A minimum detector detects the timing of a cardiogenic impedance minimum in the cardiogenic impedance signal and within a systolic time window of the cardiac cycle. A detected arrhythmia is then classified by the IMD based on the timing of the R-wave detected by the R-wave detector and the timing of the cardiogenic impedance minimum detected by the minimum detector.

Arrhythmia classification

Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

System and method for estimating cardiac pressure based on cardiac electrical conduction delays using an implantable medical device

The present invention relates to an improved medical device and method for accurately and reliably determining a cardiac status of a patient. An implantable medical device, IMD, comprises a sensor arrangement adapted to sense signals related to mechanical activity of the heart and an activity level sensor arrangement adapted to sense an activity level of the patient. Further, the IMD calculates a percentage of left ventricular diastolic time (PLVDT) for a cardiac cycle corresponding to a relation between a diastolic time interval and a cardiac cycle time interval using the determined systolic and diastolic time intervals or a percentage of left ventricular systolic time (PLVST) for a cardiac cycle corresponding to a relation between a systolic interval time interval and a cardiac cycle time interval. A cardiac status is determined based on the calculated PLVDT (or PLVST) and on an activity level of the patient.

Devices and method for determining and monitoring a cardiac status of a patient by using PLVDT or PLVST parameters

CRT settings for an implantable medical device are determined by applying pacing pulses to heart chambers of a scheme of different combinations of interchamber delays. A respective width parameter value representing an R or P wave width is determined for each such delay combination based on an ECG representing signal and the width parameter values are employed to estimate a parametric model defining the width parameter as a function of interchamber delays. Candidate interchamber delays that minimize the width parameter are determined from the parametric model and employed to determine optimal CRT settings. The technique provides an efficient way of finding optimal CRT settings when multiple pacing sites are available in a heart chamber.

Determination of cardiac resynchronization therapy settings

The invention relates to a medical implantable lead for monitoring and/or controlling an organ inside a human or animal body. The lead comprises a first electrode () at a distal end of the lead adapted to be in contact with tissue of the organ, a connector at a proximal end of the lead adapted to be connected to a monitoring and/or controlling device, a conducting arrangement comprising a first conducting coil () of at least one electrically conducting wire () for connecting the first electrode electrically to the connector to receive and/or transmit electric signals from and to the tissue, respectively, and a flexible tubing () surrounding the lead from the proximal to the distal end, wherein the lead is tapered in a distal portion and has a smaller cross sectional dimension at the distal portion than at the rest of the lead. The first conducting coil () is terminated at a termination point () on a distance from the distal end, and the conducting arrangement comprises also a first end conductor, in form of a non-coiled electric conductor () or an eccentrically positioned small diameter coil (), which connects the first electrode () electrically with the coil.

Medical implantable lead

Disclosed are systems and methods for automatically determining ST windows for ischemia detection. An IEGM signal is obtained over a period of time a derivative signal of the IEGM signal is calculated. The R-wave is identified in the derivative signal and the derivative signal data following the identified R-wave is analyzed to find portions of the derivative signal comprising samples having lower values than a predetermined threshold. Further, a portion of the derivative signal including samples having lower values than the threshold is determined to correspond to a ST window for that cardiac cycle if that portion fulfills predetermined requirements. A reference ST window based on a number of determined ST windows is determined. Using the reference ST window, ischemia can be detected by comparing IEGM data in the reference ST window with current IEGM data from a segment of the IEGM signal corresponding to the reference ST window.

Method and system for ischemia detection

The invention relates to a medical implantable lead for monitoring and/or controlling an organ inside a human or animal body. The lead comprises a conducting arrangement having a first conducting coil of at least one electrically conducting wire for connecting a first electrode electrically to a connector to receive and/or transmit electric signals from and to the tissue, respectively. The lead is tapered in a distal portion and has a smaller cross sectional dimension at the distal portion than at the rest of the lead. The first conducting coil is terminated at a termination point on a distance from the distal end. The conducting arrangement has a first end conductor in the form of a non-coiled electric conductor or an eccentrically positioned small diameter coil which connects the first electrode electrically with the coil.

Techniques are provided for detecting heart failure or other medical conditions within a patient using an implantable medical device, such as pacemaker or implantable cardioverter/defibrillator, or external system. In one example, physiological signals, such as immittance-based signals, are sensed within the patient along a plurality of different vectors, and the amount of independent informational content among the physiological signals of the different vectors is determined. Heart failure is then detected by the implantable device based on a significant increase in the amount of independent informational content among the physiological signals. In response, therapy may be controlled, diagnostic information stored, and/or warning signals generated. In other examples, at least some of these functions are performed by an external system.

Systems and methods for use by an implantable medical device for detecting heart failure based on the independent information content of immittance vectors

Methods and systems are provided for performing ventricular arrhythmia monitoring using at least two sensing channels that are each associated with different sensing vectors, for example by different pairs of extracardiac remote sensing electrodes. Myopotential associated with each of the sensing channels in monitored, and a ventricular arrhythmia monitoring mode is selected based thereon (e.g., based on determined myopotential levels). Ventricular arrhythmia monitoring is then performed using the selected monitoring mode.

Systems and methods for detection of VT and VF from remote sensing electrodes

An exemplary method includes delivering biventricular pacing therapy using one or more timing parameters, detecting loss of capture, deciding if fusion exists without adjusting the one or more timing parameters and, based on the deciding, calling for fusion avoidance or calling for a capture threshold search. Various other exemplary methods, devices, systems, etc., are also disclosed.

Methods for loss of capture and fusion avoidance in biventricular pacing therapy

A subcutaneous cardiac stimulation system verifies accelerated arrhythmia detection before delivering accelerated arrhythmia therapy to the heart. The stimulation system includes a verification circuit that verifies detection of the accelerated arrhythmia with each of first and second sense channels utilizing first and second electrode configurations. The therapy circuit delivers the stimulation therapy to the heart if the accelerated arrhythmia detection is verified with each of the first and second electrode configurations. The system also compensates for transient rate changes during the detection of the accelerated arrhythmia.

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Solna, Sweden

Anders Bjorling