Medtronic, Inc.

Daniel L Hansen

Shantanu Sarkar

Grant Alan Neitzell

Jerry D Reiland

Ryan D Wyszynski

Xusheng Zhang

James D Reinke

Scott A Hareland

Vinod Sharma

Vladimir Pavlovich Nikolski

Michael B Terry

Donna M Salmi

Paul R Solheim

Robert Michael Ecker

Michael T Hemming

John R Hamilton

Kent E Samuelson

Techniques and devices for implementing the techniques for adjusting atrial arrhythmia detection based on analysis of one or more P-wave sensing windows associated with one or more R-waves. An implantable medical device may determine signal characteristics of the cardiac signal within the P-wave sensing window, determine whether the cardiac signal within the sensing window corresponds to a P-wave based on the determined signal characteristics, determine a signal to noise ratio of the cardiac signal within the sensing window, update the arrhythmia score when the P-wave is identified in the sensing window and the determined signal to noise ratio satisfies a signal to noise threshold.

Method and apparatus for atrial arrhythmia episode detection

In situations in which an implantable medical device (e.g., a subcutaneous ICD) is co-implanted with a leadless pacing device (LPD), it may be important that the subcutaneous ICD knows when the LPD is delivering pacing, such as anti-tachycardia pacing (ATP). Techniques are described herein for detecting, with the ICD and based on the sensed electrical signal, pacing pulses and adjusting operation to account for the detected pulses, e.g., blanking the sensed electrical signal or modifying a tachyarrhythmia detection algorithm. In one example, the ICD includes a first pace pulse detector configured to obtain a sensed electrical signal and analyze the sensed electrical signal to detect a first type of pulses having a first set of characteristics and a second pace pulse detector configured to obtain the sensed electrical signal and analyze the sensed electrical signal to detect a second type of pulses having a second set of characteristics.

Pace pulse detector for a medical device

Techniques and devices for implementing the techniques for adjusting atrial arrhythmia detection based on analysis of one or more P-wave sensing windows associated with one or more R-waves. An implantable medical device may determine signal characteristics of the cardiac signal within the P-wave sensing window, determine whether the cardiac signal within the sensing window corresponds to a P-wave based on the determined signal characteristics, determine a signal to noise ratio of the cardiac signal within the sensing window, update the arrhythmia score when the P wave is identified in the sensing window and the determined signal to noise ratio satisfies a signal to noise threshold.

In situations in which an implantable medical device (IMD) (e.g., an extravascular ICD) is co-implanted with a leadless pacing device (LPD), it may be important that the IMD knows when the LPD is delivering pacing, such as anti-tachycardia pacing (ATP). Techniques are described herein for detecting, with the IMD and based on the sensed electrical signal, pacing pulses and adjusting operation to account for the detected pulses, e.g., blanking the sensed electrical signal or modifying a tachyarrhythmia detection algorithm. In one example, the IMD includes a pace pulse detector that detects, based on the processing of sensed electrical signals, delivery of a pacing pulse from a second implantable medical device and blank, based on the detection of the pacing pulse, the sensed electrical signal to remove the pacing pulse from the sensed electrical signal.

Implantable medical device (IMD) sensing modifications responsive to detected pacing pulses

Pace pulse detector for an implantable medical device

A method and implantable medical device for determining a flutter event in response to a cardiac signal that includes sensing the cardiac signal, determining a sensing window in response to the sensed cardiac signal, the sensing window having a first portion and a second portion. A first derivative signal and a second derivative signal are determined in response to the sensed cardiac signal within the first portion and the second portion of the sensing window, and a sum of amplitudes of the second derivative signal within one or both of the first portion and the second portion of the sensing window is determined, and the flutter event is determined in response to the determined sum of amplitudes.

An implantable medical device and method for determining an atrial arrhythmia event that includes a cardiac sensing device comprising a housing having circuitry positioned therein, a plurality of electrodes electrically coupled to the circuitry to sense a cardiac signal, and a processor configured to generate an initial detection of an atrial arrhythmia event in response to an atrial arrhythmia threshold, determine whether a P-wave occurs during the initial detection, determine an adaptive threshold in response to the P-wave being detected, adjust the atrial arrhythmia threshold in response to the adaptive threshold, and generate a subsequent initial detection of an atrial arrhythmia event using the adjusted atrial arrhythmia threshold.

Method and apparatus for adjusting a threshold during atrial arrhythmia episode detection in an implantable medical device

A method and implantable medical device for determining noise in response to a cardiac signal that includes sensing the cardiac signal, determining a sensing window in response to the sensed cardiac signal, the sensing window comprising a first portion and a second portion, determining a first derivative signal in response to the sensed cardiac signal within only one of the first portion and the second portion of the sensing window, determining a second derivative signal in response to the sensed cardiac signal within the one of the first portion and the second portion of the sensing window, determining whether an amplitude of the second derivative signal satisfies an amplitude threshold, and determining noise in response to the amplitude of the second derivative signal satisfying the amplitude threshold.

A method and implantable medical device for determining an atrial arrhythmia event that includes sensing a cardiac signal, determining an atrial arrhythmia score for identifying the arrhythmia event in response to the sensed cardiac signal, determining a sensing window in response to the sensed cardiac signal, the sensing window having a first portion and a second portion, determining signal characteristics of the sensed cardiac signal within the first portion and within the second portion, determining whether the sensed cardiac signal within the first portion and within the second portion corresponds to a P-wave in response to the determined signal characteristics, determining whether a signal to noise ratio of the sensed cardiac signal within the first portion and the second portion of the sensing window is satisfied, determining whether to update the arrhythmia score in response to the determined P-wave and the determined signal to noise ratio, and determining whether to delivery an arrhythmia therapy in response to the updated arrhythmia score.

A method and medical device for determining a P-wave of a cardiac signal that includes sensing the cardiac signal, determining a P-wave sensing window in response to the sensed cardiac signal, the P-wave sensing window having a first portion and a second portion, determining signal characteristics of the sensed cardiac signal within the first portion and within the second portion, comparing the determined signal characteristics, and determining the P-wave in response to the comparing.

In the present disclosure, conservation of an implantable medical device power supply of is facilitated by controlling the power consumption of the device's processing component. The power supplied to the processing component is controlled to enable processing of received events as a function of predetermined criteria rather than the actual occurrence of the events which is frequent, but irregular. Accordingly, the need for the processing component to start and stop (and thereby be fully powered on each start) with receipt of each event is obviated thereby maintaining the power consumption of the processing component and increasing longevity of the device. Event data associated with received events is stored in an event queue and subsequently retrieved and transmitted for processing based on predetermined criteria. The power supplied during an idle state of the processing component may be reduced in relation to the power supplied during a wake up state.

Pacemaker event queue to control device processor operating power

In general, the invention is directed to techniques for electrically detecting physiological events. The physiological events may include cardiac events such as R waves or p waves. In addition, the physiological events may include respiratory events. In general, the techniques involve converting an analog physiological signal to a digital delta value, correlating the digital delta value with a correlation template, and detecting a physiological event based on an output of the correlation. A digital correlation-based technique, as described herein, is implemented to reliably detecting physiological events, particularly for very small signals captured in the presence of significant background noise.

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Castle Rock, CO, United States of America

Daniel L Hansen