Pacesetter, Inc.

Anil Keni

Harish Krishnaswamy

Cecilia Qin Xi

Heidi Hellman

Andrew W McGarvey

Sharon Standage

Andrew Miller

Richard A Block

Taryn Smith

Zachary Briggs

Diana Gavales

David Bishop

Techniques are provided for use with an implantable cardiac stimulation device equipped with a multi-pole left ventricular (LV) lead and a right ventricular (RV) lead for identifying suitable pacing vectors. In one example, RV-LV delay times are measured while using different electrodes of the LV lead as cathodes for sensing. The LV electrode having the longest RV-LV delay time is identified and LV capture thresholds and diaphragmatic stimulation thresholds are measured for pacing vectors that employ that LV electrode as a cathode. Assuming at least one vector employing the selected LV electrode is found to have acceptable thresholds, the vector is selected for use in delivering pacing therapy with the selected LV electrode. If none of the pacing vectors employing the selected LV electrode has acceptable thresholds, another LV electrode is selected and the procedure is repeated. Examples with a multi-pole RV lead are also described.

Systems and methods for selecting pacing vectors based on site of latest activation for use with implantable cardiac rhythm management devices

Methods and systems may identify a vector or a vector configuration, such as a combination of electrodes, for monitoring ischemia. The method may include: selecting a first combination of sensors as a first candidate to be used for monitoring ischemia; detecting a shift in a ST segment of one of an electrocardiogram and a cardiac electrogram using the first candidate; selecting a second combination of sensors as a second candidate to be used for monitoring ischemia; detecting a shift in a ST segment of one of an electrocardiogram and a cardiac electrogram using the second candidate; comparing the ST shifts for the first and second candidates; and identifying one of the first and second candidates for monitoring ischemia based on the comparison. A multi-electrode implantable cardiac device may include a controller configured to effectuate such functions.

Methods and systems for identifying a vector for monitoring ischemia

A method and system for automatically determining ischemia detection parameters are provided. The method includes obtaining a baseline trace indicative of a cardiac behavior, determining an ischemia detection window based on at least one physiologic state indicator within the baseline trace, and automatically identifying a fiducial point based on the baseline segment trace. The baseline trace includes a baseline segment within the ischemia detection window; where the ischemia detection window and the fiducial point may constitute ischemia detection parameters.

Method and system for automatically calibrating ischemia detection parameters

Method and systems for identifying a vector for monitoring ischemia

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Anil Keni