Pacesetter, Inc.

Eliot L Ostrow

Paul A Levine

Xiaoyi Min

Heidi Hellman

Rohan More

George L Walls

Christopher B Houghton

Eric Steven Fain

Armando M Cappa

Allan R Schwartz

John White

Edward Geiselhart

Jay Snell

Gregory C Bevan

Ronald R Rios

Derrick W Reed

Donald S Cogan

Ashok Kaul

Matthew J Jordan

Bari Wieselman Schulman

Scott Alan Godoy

Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked. Additionally, when a log of arrhythmias is displayed, for each arrhythmia there is an indication of whether a myocardial ischemic episode was detected within the specified temporal proximity of the arrhythmia. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

Methods and systems to correlate arrhythmic and ischemic events

Methods and systems are provided for discriminating heart arrhythmias. The methods and systems include identifying an arrhythmia, recording a predetermined number of beats during the arrhythmia as a base arrhythmia (BA) beats; delivering anti-tachy pacing (ATP) therapy to at least one chamber of the heart. After delivering the ATP therapy, the methods and system record at least one return beat representing cardiac activity following the ATP therapy, determines whether the return beat originated in a reference chamber of the heart, compares a morphology of the return beat to a morphology of the BA beat; and declares a VT or SVT based on the comparing operation.

Method and system for discrimination of VT and SVT arrhythmias

Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to single-site LV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish organized atrial tachycardias (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold that is set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes.

Systems and methods for use by an implantable medical device for controlling multi-site CRT pacing in the presence of atrial tachycardia

Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial, ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked. Additionally, when a log of arrhythmias is displayed, for each arrhythmia there is an indication of whether a myocardial ischemic episode was detected within the specified temporal proximity of the arrhythmia. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. Sequential MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, sequential MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to either single-site LV pacing or simultaneous MSLV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish OATs (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes.

Post-exercise arrhythmias are detected by an implantable medical device. In some aspects, post-exercise arrhythmia may be prognostic of a worsening cardiovascular condition. Thus, the detection of post-exercise arrhythmia may be used as an indicator for adjusting the therapy prescribed for a patient. In some aspects post-exercise arrhythmia are detected if a patient is exercising at a level that equals or exceeds a threshold exercise level. In some aspects, therapy for a patient is modified if the detected post-exercise arrhythmia exceeds a threshold arrhythmia level. In some aspects therapy for a patient is modified if ischemia is detected in conjunction with post-exercise arrhythmia.

Post-exercise arrhythmia detection

Techniques are described for generating diagnostic information to aid in determining whether cardiac ischemia within a patient is clinically actionable. In one example, a pacemaker or implantable cardioverter/defibrillator (ICD) detects information pertaining to arrhythmia precursors and to episodes of sustained arrhythmias, as well as information pertaining to episodes of cardiac ischemia. The implanted device then correlates the arrhythmia precursors and the sustained arrhythmias with the episodes of cardiac ischemia so as to generate diagnostics permitting a physician reviewing the diagnostics to determine whether the ischemia is clinically actionable. In some implementations, the diagnostics are instead generated by an external system based on raw data provided by the implanted device. In some implementations, the device itself determines whether the ischemia is clinically actionable and automatically controls therapy or generates warning signals accordingly.

System and method for generating and using cardiac ischemia diagnostics based on arrhythmia precursors and arrhythmia episodes

When a medical procedure is performed on a patient in whom an implantable medical device is implanted, the medical procedure may have undesired effects on the medical device, such as triggering a response that initiates therapy by the device that is unnecessary and potentially dangerous to the patient. Systems and methods may facilitate performing of such medical procedures on such patients by temporarily reprogramming the medical device, monitoring for one or more detectable characteristics associated with the medical procedure to be performed, and restoring normal programming of the device based on detection and/or lack of detection of the detectable characteristic(s).

Systems and methods for operating an implantable device for medical procedures

An exemplary device includes a processor, one or more communication interfaces, memory and one or more modules stored in the memory that comprise processor executable instructions to receive data from an implantable device via at least one of the one or more communication interfaces, to interrogate the data for one or more particular types of data, to process one or more particular types of data and to transmit information via at least one of the one or more communication interfaces. Various other exemplary devices, methods, systems, etc., are also disclosed.

Housecall device for patients with implanted devices

Exemplary external medical devices are configurable to communicate with an implantable medical device (IMD). One medical device includes multiple IMD telemetry ports operable to connect IMD telemetry mechanisms to the medical device. The medical device also includes a control unit configured to control the IMD telemetry mechanisms.

External medical device configurations for communicating with implantable medical devices

Embodiments of the present invention are for use with implantable cardiac devices that have discriminator parameters that the devices use to discriminate between ventricular tachycardia (VT) and supraventricular tachyarrhythmia (SVT). A user is allowed to select a balance setting that specifies a balance between sensitivity and specificity, where an increase in sensitivity results in a decrease in specificity, and vice versa. In response to the user selecting the balance setting, a value of at least one of the discriminator parameters and/or how at least one of the discriminator parameters is used is automatically adjusted. The more the balance setting favors sensitivity, then the more likely an actual VT will be characterized as VT, but the more likely an actual SVT may be characterized as VT. The more the balance setting favors specificity, then the less likely an actual SVT will characterized as VT, but the less likely an actual VT may be characterizes as VT.

Method for programming arrhythmia discrimination algorithms in ICDs

An implantable medical device and associated method are provided including a vibratory alert and a vibration-sensitive sensor. Further included is a circuit in communication with the vibratory alert and the vibration-sensitive sensor. Such circuit is adapted for at least reducing an affect of the vibratory alert on the vibration-sensitive sensor.

Implantable medical device and associated method for reducing an affect of a vibratory alert on a vibration-sensitive sensor

Methods and devices (e.g., pacemakers or ICDs with pacemaker functions) are provided for maintaining a high percentage of bi-ventricular pacing after a pacemaker switches from an atrial tracking bi-ventricular pacing mode to a non-atrial tracking bi-ventricular pacing mode, wherein the ventricles are paced in accordance with a mode switch base rate (MSBR) during the non-atrial tracking ventricular pacing mode. Monitoring is performed to determine whether or not pacing in according with the MSBR satisfies a minimum acceptable pacing criterion (MAPC). The MSBR is increased and pacing is performed in accordance with the increased MSBR, when the MAPC is not satisfied. The MSBR is decreased (e.g., periodically) and pacing is performed in accordance with the decreased MSBR when the MAPC is satisfied.

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Sunnyvale, CA, United States of America

Eliot L Ostrow