Pacesetter, Inc.

Case Western Reserve University

Vasonova, Inc.

Sensys Medical, Inc.

Instrumentation Metrics, Inc.

Brian Jeffrey Wenzel

Taraneh Ghaffari Farazi

Edward Karst

Wenbo Hou

Jong Gill

Timothy A Fayram

Allen J Keel

Dorin Panescu

Mihir Naware

Jeffery Siou

Stuart Rosenberg

Yelena Nabutovsky

Cecilia Qin Xi

William Hsu

Gene A Bornzin

Xiaoyi Min

Timothy Lewis Ruchti

Joseph W Boggs, Ii

Warren M Grill

Rupinder Bharmi

Thomas B Blank

Michael E Benser

Stephen L Monfre

Anders Bjorling

Dan E Gutfinger

Kenneth J Gustafson

Kichang Lee

Stephen P Hanlon

Jin Jiang

Euljoon Park

Eric Falkenberg

Jessica Rennert

Miroslav Navratil

Ken Meissner

Frank S Grochocki

Paul A Levine

Kyungmoo Ryu

Fujian Qu

Eric Steven Fain

Steven Hanlon

Jeffrey Siou

A method for determining the location of a medical device within a body is provided. The method includes transmitting from the medical device an acoustic signal; receiving with the medical device a reflected acoustic signal; advancing the medical device based on a first algorithm, the first algorithm including a first weighting factor and a first feature extracted from the reflected acoustic signal; determining a first location of the medical device based on the first algorithm; and moving the medical device to a second location based on a second algorithm, the second algorithm based on the determined first location and including at least one of a second weighting factor and a second feature extracted from the reflected acoustic signal. Also disclosed are systems and devices for performing the methods described herein.

Right atrium indicator

Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

Arterial blood pressure monitoring devices, systems and methods for use while pacing

In an implantable medical device for monitoring glucose concentration in the blood, a blood-glucose concentration analysis is performed using correlations of blood-glucose concentration with measures of metabolic oxygen consumption including oxymetric, and/or temperature. Analysis of electrocardiographic data is used in a parallel method to detect and/or confirm the onset and/or existence and/or extent of hypoglycemia and/or hyperglycemia. Blood-glucose concentration calculation is enhanced by using the combination of the oxygen metabolism analysis and electrocardiographic analysis.

Method and implantable system for blood-glucose concentration monitoring using parallel methodologies

In specific embodiments, a method for estimating central arterial blood pressure (CBP), comprises determining a time tfrom a predetermined feature of a signal indicative of electrical activity to a predetermined feature of one of a first and second signals, the time tbeing a first pulse arrival time (PAT) indicative of how long it takes a pulse wave to travel from the aorta to one of a first and second sites, determining a time t, the time tbeing a second pulse arrival time (PAT) indicative of how long it takes a pulse wave to travel from the aorta to the other of the first and second sites, and (f) estimating the patient's central arterial blood pressure (CBP) based on the first pulse arrival time (PAT) and the second pulse arrival time (PAT).

Systems and methods for estimating central arterial blood pressure of a patient

Techniques are provided for estimating electrical conduction delays with the heart of a patient based on measured immittance values. In one example, impedance or admittance values are measured within the heart of a patient by a pacemaker or other implantable medical device, then used by the device to estimate cardiac electrical conduction delays. A first set of predetermined conversion factors may be used to convert the measured immittance values into conduction delay values. In some examples, the device then uses the estimated conduction delay values to estimate LAP or other cardiac pressure values. A second set of predetermined conversion factors may be used to convert the estimated conduction delays into pressure values. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP.

System and method for estimating electrical conduction delays from immittance values measured using an implantable medical device

Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

System and method for estimating cardiac pressure based on cardiac electrical conduction delays using an implantable medical device

An exemplary embodiment includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Acquiring nerve activity from carotid body and/or sinus

Techniques are provided for use with an implantable medical device for assessing left ventricular (LV) sphericity and atrial dimensional extent based on impedance measurements for the purposes of detecting and tracking heart failure and related conditions such as volume overload or mitral regurgitation. In some examples described herein, various short-axis and long-axis impedance vectors are exploited that pass through portions of the LV for the purposes of assessing LV sphericity. In other examples, impedance measurements taken along a vector between a right atrial (RA) ring electrode and an LV electrode implanted near the atrioventricular (AV) groove are exploited to assess LA extent, biatrial extent or mitral annular diameter. The assessment techniques can be employed alone or in conjunction with other heart failure detection techniques, such as those based on left atrial pressure (LAP.)

Systems and methods for assessing the sphericity and dimensional extent of heart chambers for use with an implantable medical device

Described herein are systems, devices and methods to increase the accuracy of intravascular catheter placement, and to improve electrocardiogram (ECG), intravascular electrogram, and ultrasound Doppler signal processing to detect the Superior Vena Cava (SVC) area. Embodiments of the invention are intended to place an intravascular catheter within the lower &#x2153; of SVC to the junction of the SVC and the right atrium (RA)&#x2014;called the cavoatrial junction (CAJ). In particular, the improved accuracy of CAJ location detection during an intravascular catheter placement can be provided by optimization of ECG parameters and ultrasound Doppler signal using Neuro-Fuzzy logic and/or other processing techniques.

Systems and methods for detection of the superior vena cava area

Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

Method for hemodynamic optimization using plethysmography

A method for trending heart failure measures cardiogenic impedance (CI) and obtains signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The method identifies correction factors based on the signals and applies the correction factors to the contractility estimates. A system for trending heart failure includes a contractility module to determine contractility estimates from CI measurements taken along at least a first vector through a heart, and a collection module to receive signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The system further includes a factor module to identify correction factors based on the signals and a correction module to apply the correction factors to the contractility estimates.

Method and system to correct contractility based on non-heart failure factors

Methods and apparatuses for monitoring, with improved specificity, occurrences of episodes relating to disorders that are known to affect T-wave morphology. T-wave variability is monitored. When T-wave variability, or a change therein, exceeds a corresponding threshold for a specific period of time, monitoring for a specific change in T-wave morphology that is known to be indicative of episodes relating to a disorder may be triggered.

Systems and methods for increased specificity in diagnostics

Method and system for hemodynamic optimization using plethysmography

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San Jose, CA, United States of America

Brian Jeffrey Wenzel