Impulse Dynamics Nv

Sulzer Intermedics, Inc.

Intermedics Inc.

Andre G Routh

David Prutchi

Ziv Belsky

Yuval Mika

Nissim Darvish

Joseph W Vandegriff

Yves Verboven

Annette Bruls

Edward A Schroeppel

Edward Haluska

Drury L Woodson, Iii

Shlomo Ben-Haim

Benny Rousso

Bella Felzen

Don C Deno

Parick J Paul

William Bruce Rottenber

Craig Housworth

Apparatus () is provided for defibrillating a heart () of a person. The apparatus () includes one or more electrodes () that are adapted to be coupled to the heart, and a control unit () that is adapted to drive the electrodes to apply electrical pulses to the heart at a rate which is typically greater than about 10 Hz. The control unit terminates the electrical pulses, so that the heart beats without fibrillation. Other embodiments are also described.

Shockless defibrillation

A cardiac contractility modulating (CCM) device () includes an anti-arrhythmic therapy unit () for detecting a cardiac arrhythmia in a heart () of a patient based on processing electrical signals related to cardiac activity sensed at the heart, and for delivering anti-arrhythmic therapy to the heart. The device includes a cardiac contractility modulating (CCM) unit () capable of delivering cardiac contractility modulating (CCM) signals to the heart for modulating the contractility of a portion of the heart. The device may provide to the anti-arrhythmic therapy unit control signals associated with the delivery of the CCM signals to the heart. The control signals may be used to prevent interference of the CCM signals with the detecting of the cardiac arrhythmia. The device () includes a power source. The device may be an implantable device or a non-implantable device. The device may also include a pacing unit.

Cardiac contractility modulation device having anti-arrhythmic capabilities and method of operating thereof

A multi-modal cardiotherapy device () includes an anti-arrhythmic unit () for delivering multiple types of anti-arrhythmic therapy to a heart, a cardiac contractility modulating unit () for delivering cardiac contractility modulating signals to the heart, and for applying anti-arrhythmic cardiac contractility modulating signal therapy to the heart, one or more sensing units () for sensing electrical signals related to electrical activity of the heart to provide an output signal, one or more detecting units () operatively connected to the sensing unit(s) () for detecting in the output signal cardiac events of the heart, a controller unit () operatively connected to the anti-arrhythmic unit (), the cardiac contractility modulating unit () and the detecting unit(s) (). The controller unit () processes the output of the detecting unit(s) () to detect a cardiac arrhythmia or indications of a possible arrhythmia in the heart and controls the application of anti-arrhythmic therapy, anti-arrhythmic cardiac contractility modulating signal therapy, and cardiac contractility modulating therapy to the heart. The device may be an implantable device or a non-implantable device. The device () may also include a pacing unit (). Methods are disclosed for using the device for delivering multi-modal cardiotherapy to the heart.

Device for cardiac therapy

A cardiac contractility modulating (CCM) device includes an anti-arrhythmic therapy unit for detecting a cardiac arrhythmia in a heart of a patient based on processing electrical signals related to cardiac activity sensed at the heart, and for delivering anti-arrhythmic therapy to the heart. The device includes a cardiac contractility modulating unit capable of delivering cardiac contractility modulating signals to the heart for modulating the contractility of a portion of the heart. The device may provide to the anti-arrhythmic therapy unit control signals associated with the delivery of the CCM signals to the heart. The control signals may be used to prevent interference of the CCM signals with the detecting of the cardiac arrhythmia. The device includes a power source. The device may be an implantable device or a non-implantable device. The device may also include a pacing unit.

Cardiac contractility modulation device having anti-arrhythmic capabilities and a method of operating thereof

A method for setting the parameters of an alert time window in an excitable tissue control device operative under a plurality of different cardiac conditions of a heart of a patient. The method includes providing said excitable tissue control device with a set of data including a plurality of sets of alert time window parameters. Each set of window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of the different cardiac conditions. Each set of window parameters includes at least a set of timing parameters usable for obtaining a beginning time point and an ending time point of the alert window. The sets of window parameters are obtained by processing data collected within a data collection session from a plurality of cardiac beats of the same patient under the different cardiac conditions.

Apparatus and method for setting the parameters of an alert window used for timing the delivery of ETC signals to a heart under varying cardiac conditions

Apparatus and method for obtaining from a patient's heart data useful for on-line setting of the parameters of a detection time window in an excitable tissue control device. The method includes applying electrodes to a first cardiac site and a second cardiac site of a patient and electrically connecting the electrodes to a data collecting device. The device is then operated under a plurality of different cardiac conditions to obtain a plurality of different histogram data sets. Each histogram data set represents a cumulative time distribution histogram of cardiac depolarization events detected at the second cardiac site in a plurality of cardiac beats. Each histogram data set is defined by a plurality of histogram parameters having values indicative of the cardiac conditions common to the plurality of cardiac beats used to obtain the histogram data set. The histogram parameters include a sensitivity level parameter representing the sensitivity level used for detecting the cardiac depolarization events of the plurality of cardiac beats at the second cardiac site. Another histogram parameter represents the range of values of the beat to beat time interval for the beats who's data is included in the histogram data set. Another histogram parameter has values indicating if the beats who's data is included in the histogram data set were acquired under conditions in which the delivery of non-excitatory ETC signals substantially affected or did not substantially affect the velocity of propagation of depolarization waves in the myocardium. Another histogram parameter, which may be used in devices having pacing capability has values indicating whether the beats who's data is included in the histogram data set are paced beats or non-paced beats. The histogram data sets are processed for computing a set of data usable for on-line setting of the parameters of a detection time window. This set of data may then be used for operating an implanted or external ETC device operatively connected to the electrodes.

Apparatus and method for collecting data useful for determining the parameters of an alert window for timing delivery or ETC signals to a heart under varying cardiac conditions

A method for setting the parameters of an alert time window in an excitable tissue control device operative under a plurality of different cardiac conditions of a heart of a patient. The method includes providing said excitable tissue control device with a set of data including a plurality of sets of alert time window parameters. Each set of window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of the different cardiac conditions. Each set of window parameters includes at least a set of timing parameters usable for obtaining a beginning time point and an ending time point of the alert window. The sets of window parameters are obtained by processing data collected within a data collection session from a plurality of cardiac beats of the same patient under the different cardiac conditions. The methods updates for each current beat cycle the values of a plurality of cardiac condition defining variables corresponding to said cardiac condition defining parameters, automatically selects a current set of alert time window parameters based on the current values of the cardiac condition defining variables, starts and terminates the alert time window based on the time of detecting a first depolarization event at a first cardiac site, detects within the duration of the alert window a second depolarization event at a second cardiac site, and triggers the delivery of a delayed non-excitatory excitable tissue control signal at the second cardiac site based on the time of detection of the second depolarization event. The different cardiac conditions include different beat cycle lengths, and may include beats which are or are not influenced by prior application of ETC signals to the heart and, where relevant, naturally and artificially paced beats. The alert window parameters may include an event detection sensitivity level parameter. Implantable and external devices are describe which are adapted for implementing the disclosed method.

Apparatus and method for collecting data useful for determining the parameters of an alert window for timing delivery of ETC signals to a heart under varying cardiac conditions

A method and apparatus for evaluating heart rate variability of the heart of a person in order to forecast a cardiac event. A cardiac stimulator receives heart beat signals from the heart and determines a measurement of heart rate variability based on statistical data derived from the heart beat signals and sensing data derived from a sensor. This measurement of heart rate variability is compared with previously stored heart rate variability zones defining normal and abnormal heart rate variability. These zones are modifiable after the occurrence of a cardiac event. Once a cardiac event is detected, a pathway is computed which extends from a generally normal heart rate variability condition to an abnormal heart rate variability condition. Subsequent measurements of heart rate variability are compared with this pathway. Selective therapy regimes are initiated depending on the measurement of heart rate variability.

Implantable medical device responsive to heart rate variability analysis

An endocardial apparatus for pacing four chambers of a heart, comprising: a power source housed in an implantable can, first, second and third leads having proximal and distal ends, each lead being electrically connected to the power source at its proximal end and extending into a vein proximal the heart, the first lead connecting at its distal end to an electrode that is in electrical contact with the right atrium of the heart, the second lead connecting at its distal end to an electrode that is in electrical contact with the right ventricle of the heart, the third lead connecting at a point proximal its distal end to a first electrode that is in electrical contact with the inside of the coronary sinus and oriented so as to stimulate the left atrium of the heart and connecting at its distal end to a second electrode that is in electrical contact with the inside of the great cardiac vein and oriented so as to stimulate the left ventricle of the heart. Devices are also disclosed for orienting and maintaining the position of the electrodes on the third lead.

Four chamber pacer for dilated cardiomyopthy

An implantable medical device for electrically stimulating the heart to beat includes a sense circuit for detecting cardiac electrical activity. The sense circuit includes a band pass filter with an adjustable frequency response. The frequency response can be repeatedly adjusted after implantation of the medical device and preferably is adjusted upon detection of the loss of normal sinus rhythm (NSR) in the heart's atria. The loss of NSR often indicates atrial fibrillation (AF), and the filter's frequency response is adjusted to increase the sensitivity of the sense circuit to the cardiac electrical activity typical during AF. The medical device is calibrated during implantation or at subsequent doctor visits with the aid of a calibration device external to the body. Cardiac electrical activity in the form of an electrogram is transmitted from the medical device to the external calibration device. The transmitted electrogram preferably includes both NSR and AF rhythms. The calibration device computes two sets of filter coefficients; one set for increased filter sensitivity during NSR and another set for increased sensitivity during AF. The coefficients are transmitted to the medical device which uses the appropriate set of coefficients to increase the filter's frequency response during both NSR and AF.

Dynamic bandwidth control in an implantable medical cardiac stimulator

An implantable medical device for electrically stimulating the heart to beat includes a sense circuit for detecting cardiac electrical activity. The sense circuit includes an amplifier with a dynamically adjustable gain to provide increased sensitivity to the electrogram during atrial fibrillation. Alternatively, sensitivity control is provided by dynamically adjusting threshold limits associated with a threshold detector included in the sense circuit. The sensitivity level of the medical device to the electrogram can be repeatedly adjusted after implantation and preferably is increased upon detection of the loss of normal sinus rhythm (NSR) in the heart's atria. The medical device is calibrated with the aid of a calibration device external to the body to determine appropriate sensitivity levels. A method for calibrating and operating an implanted medical device with dynamically adjustable sensitivity is also disclosed for improving the medical device's sensitivity to atrial fibrillation.

Dynamic atrial detection sensitivity control in an implantable medical

An implantable medical device for electrically stimulating the heart to beat including a sense circuit for detecting cardiac electrical activity. The sense circuit includes a sense amplifier, band pass filter, and threshold detector. The threshold detector determines whether sensed cardiac electrical activity resulted from a normal heart beat or an ectopic beat such as a premature ventricular contraction. In a preferred embodiment, latches in the threshold detector are activated by output pulses from a pair of comparators. A positive comparator produces an output pulse upon detection of cardiac electrical activity exceeding a positive threshold voltage and a negative comparator produces an output pulse upon detection of cardiac electrical activity more negative than a negative threshold. Threshold logic produces output signals indicative of which comparator first produced an output pulse. A logic and control unit monitors the output signals from the threshold logic and thus determines whether the associated cardiac electrical activity represented a normal heart beat or resulted from an ectopic beat so that appropriate pacing may be provided by the implantable device.

Implantable cardiac stimulator with polarity detection for detecting

A pacemaker is disclosed that includes circuitry for monitoring the current and/or voltage delivered to the heart during a pacing pulse. A microprocessor connects to the monitoring circuitry and analyzes the current (and/or voltage) to determine when capture occurs. When capture occurs, the microprocessor terminates the pacing pulse to save energy. Conversely, if capture does not occur within a predetermined maximum time period, or if the pacing pulse amplitude falls below a predetermined threshold value, the processor immediately causes a safety pulse to fire to insure a regular beating of the heart. By monitoring the current and/or voltage delivered, and by permitting the pacing pulse width to be variable, the pacemaker of the present invention can closely track the pacing threshold of the patient with a minimum expenditure of energy.

Growing community of inventors

Lake Jackson, TX, United States of America

Andre G Routh