Medtronic, Inc.

Arnoldus P Bakels

Robert Leinders

Cobus De Roos

Nicolaas M Lokhoff

Paulus Cornelis Van Venrooij

Ib M Kruse

Douglas S Hine

Paul A Gubbels

Nico M Lokhoff

Twan Peer

A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment of the invention, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.

Four-chamber pacing system for optimizing cardiac output and determining heart condition

An implantable pump apparatus and method of operating the implantable pump for infusing a fluid into a body are described. The implantable pump apparatus includes a support member. A pressure sensitive resistor member is disposed on a first side of the support member. A spring member includes a first end which is adjacent to the pressure sensitive resistor member. An expandable fluid reservoir member includes a first end which is adjacent to a second end of the spring member. The level of fluid within the expandable fluid reservoir member is determined by measuring a force applied to the pressure sensitive resistor member.

Apparatus and method for measuring the amount of fluid contained in an implantable medical device

A medical electrical lead having a pre-formed atrial portion assuming a distinctive U-shape is disclosed. The U-shaped atrial portion of the lead is configured and dimensioned to cause at least one atrial electrode disposed thereon to be pushed against the right atrial wall or right atrial sinus wall through pushing forces generated by the lead pressing against regions of the heart located near the superior vena cava or the tricuspid valve, and/or through the action of gravity. The lead provides superior coupling of the atrial electrodes thereof to the walls of the right atrium, and may be configured for single pass DDD stimulation of the right atrium and the right ventricle or other portions of the heart such as the coronary sinus or the great cardiac vein.

Medical electrical lead having pre-formed atrial section

A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.

Bi-ventricular pacing method

A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.

Four-chamber pacing system for optimizing cardic output and determining heart condition

A transvenous lead specifically designed for multi-chamber electrical stimulation or sensing. In a first embodiment the lead features one or more electrodes for communication with the right atrium as well as one or more electrodes for communication with either or both of the left chambers of the heart. The lead further features structures to simultaneously bring the first electrode into contact with a first chamber, such as the right atrial wall and the second electrode into contact with a particular portion of the coronary sinus wall, to electrically access the left atrium or ventricle. In the preferred embodiment the lead body has varying flex or stiffness characteristics along its length between each of the electrodes. The relation of the varying flex or stiffness characteristics along the lead body length as well as the various linear placements of the electrodes along the lead body length function to simultaneously bring the first electrode into contact with a first desired portion of the heart, such as the right atrial wall, and the second electrode into contact with a second desired portion of the heart, such as a portion of the coronary sinus wall.

Medical electrical right atrium and coronary sinus lead

Pacing system for optimizing cardiac output and determining heart

The present invention is directed to a single pass medical electrical lead. In one embodiment, the lead features a pair of bipolar electrodes positioned along the lead body so that they are positioned in the ventricle and atrium respectively when the lead is implanted. The lead body features a 90 degree bent reinforced section. The bend has a radius of curvature approximately 13 mm and begins approximately 90 mm from the distal end. This curved section is approximately 40 mm in length when straightened. The ventricular electrodes are positioned approximately 28 mm apart. The bend has at least one tine extending therefrom, an electrode is mounted on the tine.

Single pass medical electrical lead with cap electrodes

The present invention is directed to a single pass medical electrical lead. In one embodiment, the lead feature a pair of bipolar electrodes positioned along the lead body so that they are positioned in the ventricle and atrium respectively when the lead is implanted. The lead body features a 90 degree bent reinforced section. The bend has a radius of curvature approximately 13 mm and begins approximately 90 mm from the distal end. This curved section is approximately 40 mm in length when straightened. The ventricular electrodes are positioned approximately 28 mm apart. The ventricular cathode electrode is positioned at the distal end of the lead. The atrial electrodes are positioned approximately between 5-35 mm apart, with 28 mm preferred. The atrial anode is located at a position immediately adjacent and proximal the 90 degree bent reinforced section.

Single pass medical electrical lead

A transvenous lead specifically designed for coronary sinus implantation. In the preferred embodiment the lead features an electrode which is eccentricity placed along the lead body. Disposed on the opposite side of the lead body is a tine-like member to push or maintain the electrode into contact with the vessel wall. Because the electrode and tine-like member do not entirely block the cross sectional area of the vessel, blood flow through the vessel is not impeded. Through such a configuration electrical stimulation with the tissue comprising the left side of the heart may be accomplished. In alternative embodiments other mechanisms besides tine-like member are used to maintain the contact of the electrode with the vessel wall. In a still further alternative embodiment the eccentricity disposed electrode is positioned instead upon the tip of the tine.

Medical electrical lead

A medical electrical lead which features a portion of the lead body which may be made temporarily stiff. The lead preferred is designed for implantation into a body and would include electrodes for both the ventricle and the atrium. The temporarily stiff portion may be located along the lead body in the area strictly within the atrium or may also include portions of the lead body implanted in the ventricle or even in the superior vena cava. The atrial portion further includes one or more electrodes. The temporarily stiff portion is formed through the use of a cavity in the lead body filled with magnet-rheologic fluid (hereinafter called 'MRF'). Once the lead is implanted, a magnet may be used to communicate with the lead body and, in particular, with the MRF filled cavity. While in the magnetic field, the MRF will become solid and the lead body in such an area will become stiffer. The lead body, moreover, in this area will also be attracted to the magnet thereby causing the lead body in that portion to migrate towards the magnet. The MRF filled cavity may either be cylindrical in cross-section or have other cross-sections, such as a semi-circle. The temporarily stiff portion may be located anywhere along the lead body between the proximal and distal ends. In the preferred embodiment the temporarily stiff portion is located between approximately 0 and 20 cm from the lead distal end and is between approximately 2 cm and 20 cm in total length. In an additional embodiment the lead is disclosed for coronary sinus placement. Finally, a further embodiment is shown which features MRF for the transfer of force from a stylet to the lead.

Growing community of inventors

Simpelveld, Netherlands

Arnoldus P Bakels