Pacesetter, Inc.

Vivalnk, Inc.

Cecilia Qin Xi

Stuart Rosenberg

Yelena Nabutovsky

Jong Gill

Brian Jeffrey Wenzel

William Hsu

Weiqun Yang

Allan Olson

Ajit Pillai

Yasser Sowb

Jimmy Johansson

Kyungmoo Ryu

Michael D Paris

Heidi Hellman

Cem M Shaquer

Mihir Naware

Andrew W McGarvey

Anil Keni

Sergio Shkurovich

Lanitia Ness

Sharon Standage

Richard A Block

Andrew Miller

Zachary Briggs

David Bishop

Taryn Smith

Rafael Donnay

Diana Gavales

A wearable thermometer patch for monitoring healing of a wound on a user's skin includes a circuit substrate comprising an electric circuit and a plurality of temperature probe units distributed in a two-dimensional array. Each of the plurality of temperature probe units can include a temperature sensor in electric connection with the electric circuit in the circuit substrate. The plurality of temperature probe units can measure temperature values on a user's skin at different positions defined by the two-dimensional array.

Wearable thermometer patch comprising a temperature sensor array

An implantable system includes terminals, a pulse generator, a sensing circuit, separate signal processing channels, and first, second and third multiplexers. The terminals are connected to electrodes via conductors of leads. Different subsets of the electrodes are used to define different electrical pulse delivery vectors, and different subsets of the electrodes are used to define different sensing vectors. The pulse generator produces electrical pulses, and the sensing circuit senses a signal indicative of an impedance associated with a selected sensing vector. The first multiplexer selectively connects outputs of the pulse generator to a selected one of the different electrical pulse delivery vectors at a time. The second multiplexer selectively connect inputs of the sensing circuit to a selected one of the different sensing vectors at a time. The third multiplexer selectively connects an output of the sensing circuit to one of the plurality of separate signal processing channels at a time.

Systems and methods for obtaining substantially simultaneous multi-channel impedance measurements and related applications

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, systems and devices efficiently identify cardiac resynchronization therapy (CRT) pacing parameter set(s) that provide improved hemodynamic response relative to an initial CRT pacing parameter set, wherein each CRT pacing parameter set includes at least two CRT pacing parameters. User input(s) are accepted that specify a maximum amount of time and/or parameter sets that can be used to perform testing, and specify relative importance of parameters within the sets. Based on the accepted user input(s), there is a determination of how many different variations of each of the CRT pacing parameters can be tested, and based on this determination different CRT pacing parameter sets are selected and tested to obtain a hemodynamic response measure corresponding to each of the different sets tested. Additionally, one or more of the tested CRT pacing parameter sets, if any, that provide improved hemodynamic response relative to the initial CRT pacing parameter set is/are identified.

Devices, systems and methods for efficient identification of improved CRT parameters

Methods and systems described herein are especially useful wherein monitoring for atrial fibrillation (AF) is based on RR interval variability as measured from an electrocardiogram (ECG) signal. An activity threshold, which can be patient specific, is obtained. Patient activity is monitored. Based on the monitored patient activity and the activity threshold, there is a determination of when it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity. When it has been determined that it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity, whether and/or how AF monitoring is performed is modified.

Systems and methods for improved atrial fibrillation (AF) monitoring

Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, SCS treatment is delivered to a patient and nerve impulse firing signals are sensed along the spinal cord following the SCS treatment. The nerve impulse signals are analyzed to determine whether the signals are associated with effective SCS and then the delivery of additional SCS is controlled to improve SCS efficacy. For example, the nerve impulse signals can be analyzed to determine whether the signals are consistent with a positive patient mood associated with pain mitigation and, if not, SCS control parameters are adjusted to improve the efficacy of the SCS in reducing pain. In other examples, heart rate variability (HRV) is also used to control SCS. Still further, adjustments may be made to SCS control parameters to improve antiarrhythmic or sympatholytic effects associated with SCS. Techniques employing baseline/target calibration procedures are also described.

Systems and methods for controlling spinal cord stimulation to improve stimulation efficacy for use by implantable medical devices

A nerve stimulation system includes a pulse generator and implantable lead. The pulse generator includes a sensing module and a pace circuit. The lead has an electrode array near the distal end and a connector at the proximal end for connection to the pulse generator. Conductors in the lead electrically connect the electrode array with the sensing module and pace circuit. The electrode array includes a first pair of small electrodes and a large electrode close to each other. The small electrodes and large electrode are physically separated from each other by insulative spaces extending generally transversely to a longitudinal axis of the lead. When the conductors are in electrical communication with the sensing module and pace circuit, the first pair of small electrodes are in electrical communication with both the sensing module and the pace circuit and the large electrode is in electrical communication with the pace circuit only.

System for nerve sensing and stimulation employing multi-electrode array

Systems and methods for obtaining substantially simultaneous mult-channel impedance measurements and related applications

Methods and systems are provided to control a configuration of a neural stimulation (NS) system having an NS device coupled to an NS lead. The methods and systems change between configurations of the NS system and collect cardiac signals from a patient that are representative of cardiac rhythms experienced by the patient over a period of time and in connection with multiple NS configurations. The methods and systems derive, from the cardiac signals, characteristic values for at least one physiologic characteristic indicative of at least one of normal and abnormal cardiac rhythms in connection with the multiple NS configurations; and select, from the multiple NS configurations, an NS operating configuration to be used by the NS system based on the characteristic values.

Method and system to select a neurostimulation system configuration based on cardiac rhythm feedback

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

Techniques are provided for use by implantable medical devices such as cardiac resynchronization therapy (CRT) devices for detecting pulmonary edema based on transthoracic impedance sensed using cardiac pacing/sensing leads, wherein detection can be performed while lead maturation occurs. Briefly, the implantable device determines whether the leads are within an initial post-implant interval following implant during which lead maturation generally occurs. The device then detects pulmonary edema or related medical conditions within the patient based on transthoracic impedance using a set of detection parameters adjusted for use during the post-implant interval. Thus, rather than 'blanking' impedance data during lead maturation, the device instead detects and processes impedance during this period to identify possible episodes of pulmonary edema so that appropriate measures can be undertaken, such as delivery of warnings or titration of appropriate medications.

System and method for detecting pulmonary edema based on impedance measured using an implantable medical device during a lead maturation interval

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

Testing lead conditions in an implantable medical device includes continuously sampling the impedance values of a lead associated with the implantable medical device. The sampling is conducted over a predetermined period of time. An impedance histogram is then generated using the sampled impedance values by separating each measured impedance value into a specific bin assigned to contain a particular range of impedance levels. The lead condition of the tested lead can then be determined based on one or more characteristics of the impedance histogram.

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Sunnyvale, CA, United States of America

Cecilia Qin Xi