Cardiac Pacemakers, Inc.

University of Minnesota

Greatbatch Ltd.

Data Sciences International, Inc.

Andres Belalcazar

Robert Patterson

Jeffrey E Stahmann

Allan Charles Shuros

Krzysztof Z Siejko

Gerrard Merrill Carlson

Abhilash Patangay

Carlos Haro

Julio Cesar Spinelli

Rodney W Salo

Joseph M Pastore

Ji Chen

Rebecca Shult

Quan Ni

Loell Boyce Moon

Aaron Lewicke

Christopher A Hartemink

Justin R Van Hee

Jack D Stewart

Julio C Spinelli

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.

Adaptive sampling of heart sounds

An amount of fluid in a thoracic or other region of a subject may be monitored by internally injecting an electrical energy stimulus (e.g., constant voltage source) through the region, detecting voltage resulting from the electrical energy stimulus, and calculating a fluid volume indicative signal. The injected energy stimulus creates a first lead field. The responsive voltage is detected using an electrode configuration that defines a second lead field, which is arranged in a negative sensitivity configuration with respect to the first lead field at the region being monitored.

Monitoring fluid in a subject using an electrode configuration providing negative sensitivity regions

An implantable pacing device for delivering ventricular pacing may be configured to intermittently reduce the AVD interval for beneficial effect in patients with compromised ventricular function (e.g., HF patients and post-MI patients). The AVD interval may be reduced in an AVD reduction mode, by shortening the AVD in an atrial triggered ventricular pacing mode or by switching to a non-atrial triggered ventricular pacing mode (e.g., VVI) and delivering paces at a rate above the intrinsic rate. The physiological effects of AVD reduction may be either positive or negative on cardiac output, depending upon the individual patient.

Reduction of AV delay for treatment of cardiac disease

A system is provided for obtaining and analyzing biological data of a subject. The system includes a biological data recording device that can sense biological signals of a subject over time and record the sensed biological signals as biological data. The system also includes an event time recording device that is physically separate from, and does not communicate with, the biological data recording device. The event time recording device includes a user actuatable component, and also includes a recording component that records user actuation data, which includes a time stamp indication as to when any instances of user actuation occurred. The system also includes equipment that can periodically receive the recorded biological data from the biological data recording device and the user actuation data from the event time recording device, and can correlate the biological data and the user actuation data to generate correlated biological data.

Sensing biological data

Electrodes of a subcutaneous monitoring system receive body electrical signals that indicate both cardiac and non-cardiac muscle activity. In general, non-cardiac muscle activity is often correlated with physical activity, and physical activity is typically a strong indicator of patient health. Exemplary systems and methods that detect non-cardiac muscle activity information in sensed body electrical waveforms may provide a diagnostic tool for monitoring physical activity level over time in patients that have subcutaneous monitoring systems. In an illustrative embodiment, systems and methods for presenting patient activity information in a graphical format over intervals of time include processing ECG waveform information to identify and to accumulate non-cardiac muscular activity information during each of the intervals of time. In various implementations, number, intensity, and/or duration of the events that are identified during a time interval may be accumulated and stored for subsequent recall.

Deriving patient activity information from sensed body electrical information

An implantable medical device includes a housing for the implantable device that is sized for implantation in a chest region of a patient and includes a housing electrode. A left ventricular lead port is connectable to a proximal end of a lead having first and second insulated conductors that extend from the proximal end of the lead to corresponding first and second electrodes near a distal end of the lead. An electrical impedance measurement circuit is electrically connected to the left ventricular lead port and the housing electrode. The circuit may inject current between the first lead electrode and the housing electrode, and measure a voltage potential, created by the current injection, between the second lead electrode and the housing electrode. The ratio of the measured voltage to injected current may be used for assessing pulmonary edema. The lead electrodes may be located in a left ventricular coronary vein.

Impedance monitoring for detecting pulmonary edema and thoracic congestion

A system and method to sense heart sounds with one or more implantable medical devices according to one or more parameters. The system alters one or more of the parameters as a function of one or more triggering events. The system then senses heart sounds with the one or more implantable medical devices according to at least the one or more altered parameters.

An implantable medical device includes a voltage measurement circuit to measure a potential difference between implanted electrodes in a thorax of a living being, the potential difference resulting from an electrical P-wave cardiac signal. The implantable medical device also includes a processing unit to calculate a vector corresponding to the P-wave cardiac signal, the vector comprising a magnitude and a direction, and derived from measured potential differences and orientations defined by locations of the implanted electrodes. The implantable medical device further includes a monitoring unit to track a rotation of the vector corresponding to the P-wave cardiac signal. In various implementations, the monitoring unit may use the rotation to detect an inter-atrial block condition.

Implantable medical device with inter-atrial block monitoring

This patent document describes, among other things, systems and methods for monitoring lung fluid status, such as monitoring the presence or absence of pulmonary edema, in a subject using information about the cardiac impedance-indicating component of a measured impedance-indicating signal. In various examples, an amplitude or contribution change over multiple cardiac cycles of the cardiac impedance-indicating component is used to compute and provide a lung status indication. In various examples, a decreasing amplitude or contribution trend of the cardiac impedance-indicating component signifies an increasing amount of fluid in the subject's lungs, as a greater portion of an injected thoracic impedance measurement current formerly traversing the heart is rerouted through the lung due to the less resistance path created by the fluid accumulation therein. In another example, measurements of the impedance-indicating signal, and thus the cardiac impedance-indicating component, are taken at one or a combination of end-inspiration or end-expiration.

Monitoring lung fluid status using the cardiac component of a thoracic impedance-indicating signal

Various different implementations of lead systems are disclosed for use with implantable stimulation systems. Generally, the lead systems incorporate, within an elongate lead body, one or more electrical conduits that connect to one or more distal electrodes, and a liquid-filled pressure transmission catheter lumen that extends proximally from a distal entry port. Use of the lead systems allows accurate pressure sensing at a location near where the electrodes are positioned. In addition, a defibrillator lead is disclosed having such features, and a system using that lead is capable of directly monitoring pressure within a heart chamber, and using that information to confirm the delivery of a defibrillation pulse.

Pressure sensing lead systems for implantable stimulators

A cardiac rhythm management (CRM) system detects tachyarrhythmia using cardiac local impedance indicative of cardiac local wall motion. A cardiac local impedance signal indicative of an impedance of a cardiac region is sensed by using a pair of bipolar electrodes placed in that cardiac region. Tachyarrhythmia such as VF is detected by analyzing one or more cardiac local impedance signals sensed in one or more cardiac regions.

Method and apparatus for detecting fibrillation using cardiac local impedance

A sensor is located within the body of a subject, such as for capturing pacing pulses transmitted as part of cardiac therapy from an implanted cardiac function management device. Counted pulses may be used to derive the onset of pulmonary edema within the body through pulse characteristics such as frequency and amplitude. The sensor may be anchored within mediastinal pleura or the airway of the body with the ability to communicate wirelessly to one or more other medical devices, such as an implanted cardiac function management device. It may also adjust transmission of the communication to discriminate among multiple sensors. Methods of use are also described.

Sensor for edema

An apparatus comprises a first impedance sensing circuit, a second sensing circuit, and an impedance-based cardiac dyssynchrony detector. The impedance sensing circuit senses an intracardiac local impedance signal that is indicative of a cardiac local wall motion of a first cardiac region from an implantable first bipolar pair of impedance sensing electrodes. The second sensing circuit is configured to produce a second sensor signal indicative of cardiovascular activity. The impedance-based cardiac dyssynchrony detector is configured for detecting cardiac dyssynchrony using a relationship between the first intracardiac local impedance signal and the second sensor signal. Other apparatuses and methods are disclosed.

Growing community of inventors

Saint Paul, MN, United States of America

Andres Belalcazar