Cardiac Pacemakers, Inc.

Arthur L Olive

Qingsheng Zhu

Avram Scheiner

Don Villalta

Rodney W Salo

Brian D Pederson

Veerichetty A Kadhiresan

Jungkuk Kim

Jan-Pieter Heemels

John Anderson Hauck

Ronald W Heil, Jr

Geng Zhang

Bruce R Jones

Mark Gryzwa

William C Lincoln

William L Zimmer

Michael W Dooley

Renold J Russie

Donald L Villalta

Jan P Heemels

Frank R Walmsley

Brian P Citak

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

Apparatus and method for outputting heart sounds

A cardiac lead introducing apparatus, the cardiac lead introducing apparatus having a sleeve with a peripheral surface, a first end and a second end, where the sleeve includes an opening extending from the first end to the second end and adapted to hold at least a portion of a cardiac lead. The cardiac lead introducing apparatus further includes a first slit extending from the peripheral surface to the opening and from the first end to the second end which permits the sleeve to separate so the cardiac lead can pass through the cardiac lead introducing apparatus without any longitudinal motion of the device with respect to the cardiac lead. In one embodiment, the diameter of the opening is smaller than the outer diameter of the cardiac lead which permits the cardiac lead to be held static within the introducing apparatus as the lead connector of the cardiac lead is inserted into the socket of an implantable pulse generator connector block.

Pulse generator header lead introducer tool

A method for reducing the affects of intrinsic detection latency in a cardiac rhythm management device, wherein said method is initiated immediately prior to delivering a stimulation pulse to the heart tissue. A coincidence of intrinsic and cardiac rhythm management initiated stimulus or the delivery of a stimulation pulse proximate the time of an intrinsic event due to intrinsic detection latency may results in delivery of unnecessary backup stimulus and/or imprecise determination of a pacing threshold. When stimulating the heart, the timing sequence for delivering a stimulation pulse typically depends upon the timing of a previous intrinsic or device initiated event. Further, the method of the present invention reduces the affects of intrinsic detection latency thereby facilitating improved detection of capture and determination of capture threshold for minimizing power consumption while assuring therapeutic efficacy.

Pseudo-fusion management during automatic capture verification

An implantable cardiac rhythm management device adapted to receive and digitize electrocardiogram signals from leads placed on or in the heart and capable of automatically adjusting an evoked response detection threshold dependent upon a modulation of the amplitude of the evoked response. Respiration, activity level, and lead maturation, among others, all effect the modulation of the evoked response and the amplitude of a signal associated with evoked response. The present invention automatically adjusts the evoked response detection threshold to account for this modulation. Without limitation, the automatic adjustment of the evoked response detection threshold may be utilized during an automatic capture verification sequence. In the event of non-capture or fusion beats during an automatic adjustment, the evoked response detection threshold is not adjusted.

Adaptive evoked response sensing for automatic capture verification

An implantable electronic circuit for monitoring a patient's aerobic capacity includes an accelerometer for detecting the onset and termination of a period of exercise and a means for measuring the patient's minute volume. By computing the time interval from the cessation of exercise to the point where the patient's minute volume reaches a predetermined value at or near an at-rest value thereof, a measure of aerobic capacity relating to a patient's physical fitness can be determined.

Implantable device for monitoring aerobic capacity of patients

A cardiac pacing and sensing system includes a body implantable unit for generating tissue stimulation pulses and manipulating information based on sensed signals, and a catheter for transmitting pulses from the unit to a pacing electrode adjacent myocardial tissue. The unit incorporates circuitry for generating response values, one associated with each stimulation pulse, based on a predetermined characteristic or parameter of the signals evoked by the pulses. To evaluate the efficacy of the parameter in distinguishing capture versus non-capture, the stimulation pulses are generated according to a protocol of high energy pulses guaranteed to effect capture interspersed with low energy pulses guaranteed not to effect capture. Data, accumulated and sorted into separate 'capture' and 'non-capture' sets, provides respective capture and non-capture composite values. The ratio of the composite values is compared to a predetermined threshold, to generate an indication either accepting or rejecting the chosen parameter. A parameter, once accepted, can be employed in a self-test that either increments or decrements stimulation of signals to evaluate the capture threshold. Optionally, two or more designated parameters can be screened simultaneously and compared, with the most favorable ratio then being compared to the threshold.

Self-calibration system for capture verification in pacing devices

A dual chamber pacemaker incorporating an adaptive PVARP for breaking pacemaker mediated tachycardia episodes and adjusting the PVARP interval in a way that reduces future incidences of PMT without extending PVARP beyond what is required.

Dual chamber pacer having automatic PVARP

A cardiac pacemaker having an automatic pulse rate response gain factor responsive to at least one cardiac-related physiological characteristic of a patient. The pacemaker includes a rate controller that comprises a detector for detecting a plurality of individual measurements of at least one physiological characteristic over each of a plurality of pre-determined time periods, with each of the individual measurements being an average of values detected over each of a respective multiple number of incremental time periods occurring within each of the pre-determined time periods. The pacemaker saves the highest measurement from one incremental time period of each of several consecutive pre-determined time periods, and these highest measurements are averaged. Thereafter, the rate controller adjusts the rate response gain factor or slope of the pulse rate in relation to the physiological characteristic measurement and a pre-determined target pulse rate. In a preferred embodiment, two physiological characteristics are measured, with high values averaged of only one characteristic when that characteristic exceeds a threshold level of the other characteristic. One embodiment is pulse rate responsive to minute volume measurement in combination with accelerometer measurement, with accelerometer measurement requiring a threshold value over an increment of time prior to minute volume recordation for input toward rate response gain factor.

Rate responsive cardiac pacemaker

A rate adaptive cardiac rhythm management device in which the pacing rate is adjusted in accordance with changes in the patient's minute ventilation. An adaptive four-pole elliptic digital filter, preferably implemented in software, functions to attenuate any signal components due to cardiac activity and motion from the minute ventilation signal over the range of breathing frequencies encountered in going from a sedentary state to active exercise. The pacemaker incorporates a microprocessor-based controller that is programmed to compute from peak-to-peak excursions of the sensed parameter the instantaneous tidal volume. Likewise, it computes, using a zero-crossing technique, the breathing interval. Knowing the breathing interval and the instantaneous tidal volume, it is possible to compute minute ventilation over a predetermined time interval and it is that factor that is employed in developing the ultimate control signal used to vary the stimulating rate between a lower rate limit and an upper rate limit.

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Stacy, MN, United States of America

Arthur L Olive