Cardiac Pacemakers, Inc.

Pacesetter, Inc.

The Uab Research Foundation (the University of Alabama at Birmingham)

Donald Lee Hopper

Yinghong Yu

Allan Charles Shuros

Bruce R Jones

Jeffrey E Stahmann

Avram Scheiner

Gerrard Merrill Carlson

Weimin Sun

Shantha Arcot-Krishnamurthy

Douglas J Lang

Jesse W Hartley

Veerichetty A Kadhiresan

John M Voegele

Aaron R McCabe

Lemont Baker

Richard Morris

Bruce Wilkoff

Michael John Kane

Marina V Brockway

Luke C McSpadden

Gene A Bornzin

David J Ternes

James O Gilkerson

Barun Maskara

Fujian Qu

Yanting Dong

Gary Thomas Seim

Kenneth C Beck

Richard Fogoros

James A Esler

Paul F Emerson

James P Nelson

Michael A Querimit

Chie Kawahara

Jilliann G Fricke

Sinny Delacroix

Daniel O'Brien

Jiang Ding

David L Perschbacher

John D Hatlestad

Yi Zhang

Rodney W Salo

Joseph M Pastore

Dan Li

Scott A Meyer

Tamara Colette Baynham

Carlos Alberto Ricci

Nima Badie

Shelley Marie Cazares

Yayun Lin

Louis-Philippe Richer

Chunlan Jiang

Wyatt Keith Stahl

Jan Mangual

G Neal Kay

Richard O Kuenzler

John C Layton

Randall L McPherson

Brian Ralph Larson

Efdal Elferri

Jeff Hall

Jan-Pieter Heemells

Stephen R Pitzl

Mary Jane Rasmussen

Computer implemented methods and systems are provided that comprise, under control of one or more processors of a medical device, where the one or more processors are configured with specific executable instructions. The methods and systems obtain motion data indicative of at least one of a posture or a respiration cycle; obtain cardiac activity (CA) signals for a series of beats; identify whether a characteristic of interest (COI) from at least a first segment of the CA signals exceeds a COI limit; analyze the motion data to determine whether at least one of the posture or respiration cycle at least in part caused the COI to exceed the COI limit. Based on the analyzing operation, the methods and systems automatically adjust a CA sensing parameter utilized by the medical device to detect R-waves in subsequent CA signals; and detect an arrhythmia based on a presence or absence of one or more of the R-waves in at least a second segment of the CA signals.

Methods and systems for reducing false declarations of arrythmias

Methods, systems, and devices that are used for improving cardiac resynchronization therapy (CRT) are described herein. Such a method can include, for each set of pacing parameters, of a plurality of sets of pacing parameters, performing CRT using a set of pacing parameters and simultaneously therewith sensing a plurality of intracardiac electrograms (IEGMs) using different combinations of implanted electrodes. Additionally, for each set of pacing parameters, of the plurality of sets of pacing parameters, the method includes producing a respective reconstructed multi-lead surface electrocardiogram (ECG) based on the plurality of IEGMs that were sensed while CRT was performed using the set of pacing parameters. The method also includes analyzing the reconstructed multi-lead surface ECGs that were produced for the plurality of sets of pacing parameters, and based on results thereof, identifying a set of pacing parameters to be use for further CRT.

Methods, system and device for improving cardiac resynchronization therapy (CRT)

Methods and systems for reducing false declarations of arrhythmias

Systems and methods for rate-adaptive pacing are disclosed. In one illustrative embodiment, a medical device for delivering electrical stimulation to a heart may include a housing configured to be implanted on the heart or within a chamber of the heart, one or more electrodes connected to the housing, and a controller disposed within the housing. The controller may be configured to sense a first signal and determine a respiration rate based at least in part on the sensed first signal. In at least some embodiments, the controller may be further configured to adjust a rate of delivery of electrical stimulation by the medical device based at least in part on the determined respiration rate.

Systems and methods for treating cardiac arrhythmias

Embodiments described herein generally relate to methods and systems for monitoring and responding to changes in a patient's physiologic status. A method includes sensing pulmonary arterial pressure (PAP) and thoracic impedance of a patient at rest. The method also includes detecting, based on the sensed PAP, whenever the patient's PAP at rest is outside an acceptable range of PAP measures for the patient at rest, and detecting, based on the sensed thoracic impedance, whenever the patient's respiration at rest is outside an acceptable range of respiration measures for the patient at rest. Various different actions are triggered depending upon whether the patient's PAP at rest is outside the acceptable range of PAP measures for the patient at rest, and whether the patient's respiration at rest is within the acceptable range of respiration measures for the patient at rest. Other embodiments relate to similar methods performed at other levels of exertion.

Methods and systems that monitor and respond to changes in physiological status based on measurements of respiration characteristics and pulmonary arterial pressure obtained from implantable sensors

An implantable pacing device for delivering ventricular pacing may be configured to intermittently and variably reduce the AV delay interval used in an atrial triggered pacing mode in a manner that simulates exercise. The device may be programmed to intermittently switch to and from a variably shortened AV delay mode according to defined entry and exit conditions.

Variable shortening of AV delay for treatment of cardiac disease

Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

Implantable cardiac device with dyspnea measurement

An apparatus comprises an implantable cardiac signal sensing circuit that provides an electrical cardiac signal representative of cardiac activity of a subject, an implantable therapy circuit that delivers electrical pacing stimulation energy to a heart of a subject, and a controller circuit. The controller circuit includes a chronotropic incompetence detection circuit that initiates pacing of an atrium of the subject at a rate higher than a device-indicated rate or a sensed intrinsic rate, monitor the AV interval, initiates an increase in the pacing rate while continuing the monitoring of the AV interval, calculates a change in AV intervals between a highest paced rate used in the monitoring and a lowest paced rate used in the monitoring, and indicates that the AV intervals are evidence of chronotropic incompetence when the calculated change in the AV intervals exceeds a specified threshold AV interval change value.

Automatic determination of chronotropic incompetence using atrial pacing at rest

Changes in patient status are assessed based at least in part on respiration parameters. A user can make selections regarding alert criteria options to be used in assessing patient status. Respiration is implantably sensed and respiration data is stored by an implantable device. A respiration parameter, such as respiration rate, is measured from the respiration data. The change in patient status is assessed by comparing the respiration parameter to the configured alert criteria. If the comparison of the respiration parameter and the configured alert criteria indicates a significant change in patient status, an alert signal is generated.

Respiration as a trigger for therapy optimization

A cardiac rhythm management (CRM) device can extract ventilation information from thoracic impedance or other information, and adjust a delivery rate of the CRM therapy. A tidal volume of a patient is measured and used to adjust a ventilation rate response factor. The measured tidal volume can optionally be adjusted using a ventilation rate dependent adjustment factor. The ventilation rate response factor can also be adjusted using a maximum voluntary ventilation (MVV), an age predicted maximum heart rate, a resting heart rate, and a resting ventilation determined for the patient. In various examples, a global ventilation sensor rate response factor (for a population) can be programmed into the CRM device, and automatically tailored to be appropriate for a particular patient.

Ventilation sensor rate response normalization and calculation

An implantable cardiac device is configured and programmed to assess a patient's cardiopulmonary function by evaluating the patient's minute ventilation response. Such evaluation may be performed by computing a minute ventilation response slope, defined as the ratio of an incremental change in minute ventilation to an incremental change in measured activity level. The minute ventilation response slope may then be compared with a normal range to assess the patient's functional status.

Cardiopulmonary functional status assessment via metabolic response detection by implantable cardiac device

An indication of an actual or potential heart failure condition is computed. One example includes monitoring a first heart rate preceding a first onset of a first sinus tachyarrhythmia episode. Upon detecting the first sinus tachyarrhythmia episode, the indication is automatically provided using information about the first heart rate and how quickly the first onset occurs.

Apparatus and method for heart failure indication based on heart rate, onset and tachyarrhythmia

Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals.

Automatic modulation of pacing timing intervals using beat to beat measures

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Maple Grove, MN, United States of America

Donald Lee Hopper