St. Jude Medical Ab

Pacesetter, Inc.

Andreas Blomqvist

Sven-Erik Hedberg

Nils Holmström

Malin Öhlander

Karin Järverud

Michael Broome

Alex C Soriano

Karin Ljungström

Andreas Karlsson

Yelena Nabutovsky

Fujian Qu

Kjell Noren

Rolf Hill

Kjell Norén

Riddhi Shah

Tomas Svensson

Dan E Gutfinger

Ryan Rooke

Berit Larsson

Leif Lindkvist

Michael Broomé

Torbjorn Persson

John Gustafsson

Anna-Karin Alm

Jörgen Edvinsson

Kjell Norèn

Christopher Graae

Michael Broomè

Nils Holmstöm

Johan Svahn

Leif Lindqvist

Urban Lönn

An implantable medical device applies an electric signal to at least a portion of a heart in a subject. A resulting electric signal is collected from the heart and is used together with the applied signal for determining a cardiogenic impedance signal. The impedance signal is processed in order to estimate an isovolumetric contraction time, an isovolumetric relaxation time and an ejection time for a heart cycle. These three time parameters are employed for calculating a Tei-index of the heart. The Tei-index can be used as myocardial performance parameter in heart diagnosis and/or cardiac therapy adjustment.

Method and device for estimating a myocardial performance parameter

Methods and systems for optimizing stimulation of a heart of a patient are disclosed. The method comprises: determining recommended pacing settings including recommended AV delays and/or recommended VV delays based on IEGM data. Further, at least one hemodynamical parameter is determined based on measured at least one hemodynamical signal. Reference pacing settings are determined including reference AV delays and/or reference VV delays based on said hemodynamical parameters. An AV delay correction value and a VV delay correction value are calculated as a difference between recommended AV and/or VV delays and reference AV and/or VV delays, respectively. The correction values are used for updating recommended AV and/or VV delays, respectively.

Methods and systems for stimulating a heart

An implantable medical device has an impedance processor for determining atrial impedance data reflective of the cardiogenic impedance of an atrium of a heart during diastole and/or systole of heart cycle. Ventricular impedance data reflective of the cardiogenic impedance of a ventricle during diastole and/or systole are also determined. The determined impedance data are processed by a representation processor for estimating a diastolic and/or a systolic atrial impedance representation and a diastolic and/or a systolic ventricular impedance representation. A condition processor determines the presence of any heart valve malfunction, such as valve regurgitation and/or stenosis, of at least one heart valve based on the estimated atrial and ventricular impedance representations.

System for determining the condition of a heart valve

Method, implantable medical device, and system for determining the condition of a heart valve

An implantable medical device has an impedance processor that determines impedance data reflective of the transvalvular impedance of a heart valve of a heart during a heart cycle. The determined impedance data are processed by a representation processor that estimates diastolic and systolic transvalvular impedance representations. A condition processor determines the presence of any heart valve malfunction, such as valve regurgitation and/or stenosis, of the heart valve based on the estimated diastolic and systolic transvalvular impedance representations.

An implantable medical device has an impedance processor that determines impedance data reflective of the transvalvular impedance of a heart valve of a heart during a heart cycle. The determined impedance data are processed by a representation processor that estimates diastolic and systolic transvalvular impedance representations. A condition processor determines the presence of any heart valve malfunction, such as valve regurgitation andor stenosis, of the heart valve based on the estimated diastolic and systolic transvalvular impedance representations.

Techniques are provided for detecting pulmonary congestion based on an increase in right ventricular (RV) stroke volume over left ventricular (LV) stroke volume. In one example, the device generates an index based on accumulated differences between RV stroke volume and LV stroke volume while RV stroke volume exceeds LV stroke volume, such that the index is indicative of an ongoing imbalance between RV and LV stroke volume. The index is compared to a suitable threshold to detect a severe imbalance indicative of pulmonary edema. Additionally, techniques are described for estimating RV and LV stroke volumes based on pulmonary artery pressure, left atrial pressure, aortic pressure, LV strain or on various intracardiac or extracardiac impedance measurements.

System and method for detecting pulmonary congestion based on stroke volume using an implantable medical device

In a device and a method for providing correlated measures for predicting potential occurrence of atrial fibrillation, an impedance of the patient is measured to obtain impedance information; cardiogenic data is determined from the information; respiratory data is determined from the information; at least one hemodynamic measure is calculated from the cardiogenic data and at least one apnea measure is calculated from the respiratory data; the hemodynamic and apnea measures are correlated such that the correlated measures can be utilized for predicting potential occurrence of atrial fibrillation.

Medical device for Atrial fibrillation prediction

In an implantable medical device, such as a bi-ventricular pacemaker and a method for detecting and monitoring mechanical dyssynchronicity of the heart, a dyssynchronicity measure indicating a degree of mechanical dyssynchronicity of a heart of a patient is calculated. A first intracardiac impedance set is measured using electrodes placed such that the first intracardiac impedance set substantially reflects a mechanical activity of the left side of the heart and a second intracardiac impedance set is measure using electrodes placed such that the second intracardiac impedance set substantially reflects a mechanical activity of the right side of the heart. The measure of a dyssynchronicity is calculated based on a resulting parameter set from a comparison between at least a subset of the first and the second impedance sets, respectively, the subsets containing information of the mechanical systole, wherein a reduced dyssynchronicity measure corresponds to an improved synchronicity between the right side and the left side of the heart.

Medical device and method for determining a dyssynchronicity measure technical field

In a method and system for monitoring mechanical properties of a heart in a subject, multiple cardiogenic impedance values reflective of the impedance of the heart in connection with a transition from inhalation to exhalation in the subject are determined. Correspondingly, multiple cardiogenic impedance values reflective of the impedance of the heart in connection with a transition from exhalation to inhalation are determined. The impedance values are collectively processed to form a trend parameter. The value determination and processing is performed over several respiratory cycles spaced apart in time to form a plurality of trend parameters over time. The mechanical properties of the heart are monitored by processing these different trend parameters. The data collection and optionally at least a part of the data processing is performed by an implantable medical device.

Monitoring mechanical heart properties

In an implantable medical device and a method for stimulating a heart of a patient, at least one left atrial pressure (LAP) signal over a cardiac cycle is obtained. The A-wave is identified using the LAP signal and a maximum positive rate of change of the A-wave of the LAP signal is determined. The maximum positive rate of change of the A-wave corresponds to the rate which the pressure in the atrium raises as the atria contraction forces more blood into the ventricle during the very last stage of diastole. Further, AV and/or VV delay is adjusted in response to the maximum positive rate of change of the A-wave, wherein a reduction of the maximum positive rate of change of the A-wave indicates an AV and/or VV delay providing an enhanced hemodynamic performance.

Method and system for stimulating a heart of a patient

A medical device having an impedance measurement circuit connected to at least two intracorporeal measurement electrodes arranged to measure the impedance of tissue inside the body of a patient. The impedance measurement circuit is adapted to apply a measurement current/voltage signal to the electrodes to measure and calculate the impedance of the measurement tissue, and to apply the calculated impedance value to a storage unit. The stored impedance values are used, by an analysis unit, to measure the amount of visceral fat of the tissue object inside the body of the patient.

Medical device comprising an impedance measurement means to measure visceral fat

An implantable medical device is connectable to an epicardial left ventricular lead having at least one epicardial electrode and a myocardium penetrating catheter with at least one endocardial electrode and present in a lumen of the lead. The device comprises a pulse generator controller that controls a ventricular pulse generator to generate pulses to be applied to the epicardial and endocardial electrodes. The controller uses an endocardial-to-epicardial time interval or epicardial-to-endocardial time interval to coordinate endocardial and epicardial activation of the left ventricle to thereby achieve cardiac pacing that closely mimics the natural electrical activation pattern of a healthy heart.

Physiologically adapted cardiac resynchronization therapy

In an implantable heart monitoring device and method, particularly for monitoring diastolic dysfunction, a control circuit (a) detects the heart rate, (b) derives information correlated to the stroke volume of the heart at the detected heart rate, and (c) stores the detected heart rate and the derived information correlated to the stroke volume in a memory. The control circuit automatically implements (a), (b) and (c) at a number of different occasions for a number of different, naturally varying heart rates, so that the memory contains information indicating the stroke volume as a function of the heart rate.

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Spånga, Sweden

Andreas Blomqvist