Pacesetter, Inc.

St Jude Medical, Atrial Fibrillation Division, Inc

Eric Falkenberg

Gene A Bornzin

Mark W Kroll

John R Helland

Euljoon Park

Taraneh Ghaffari Farazi

Paul A Levine

Yougandh Chitre

Joseph J Florio

Peter Boileau

Michael Xiaoxuan Yang

Kevin L Morgan

Michael E Benser

Sheldon Williams

Andrew W McGarvey

Janice Barstad

Xiaoyi Min

John W Poore

Yelena Nabutovsky

Eric Steven Fain

Brian Jeffrey Wenzel

Kerry A Bradley

Jong Gill

Gabriel A Mouchawar

Steve Koh

Matthew G Fishler

Anne M Shelchuk

Scott Salys

Junyu Mai

Drew A Hoffmann

Ruth Lyons

Alan H Kadish

A chamber or vasculature of a heart may be accessed via the pericardial space of the heart. Initially, the pericardial space may be accessed via a transmyocardial approach or a subxiphoid approach. A lead or other implantable apparatus may thus be routed into the pericardial space, through myocardial tissue and into the chamber or vasculature. The lead or other apparatus may be used to sense activity in or provide therapy to the heart.

Cardiac access methods and apparatus

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

Embodiments of the present invention relate to implantable systems, and methods for use therewith, for monitoring myocardial electro-mechanical stability, and responding to the same. One or more signal indicative of electrical functioning of a patient's heart is obtained, as is one or more signal indicative of mechanical functioning of the patient's heart. The patient's myocardial electrical stability is monitored based on the one or more signal indicative of electrical functioning of the patient's heart, and the patient's myocardial mechanical stability is monitored based on the one or more signal indicative of mechanical functioning of the patient's heart. Based on both the myocardial electrical stability and myocardial mechanical stability, the patient's risk of an adverse cardiac event is monitored. Further, when the patient is at risk of an adverse cardiac event, a response is triggered that is specific to both the myocardial electrical stability and the myocardial mechanical stability. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

Methods and devices for monitoring myocardial electro-mechanical stability

An exemplary method includes detecting a change in state of a cardiac valve, detecting elongation of the left ventricle substantially along its major axis, determining a time difference between the change in state of the cardiac valve and the elongation of the left ventricle and, based at least in part on the time difference, deciding whether a diastolic abnormality exists. Other exemplary methods, devices, systems, etc., are also disclosed.

Determination of diastolic heart failure

Implantable systems, and methods for use therein, perform at least one of a cardiac assessment and an autonomic assessment. Premature atrial contractions (PACs) are induced to thereby cause corresponding premature contractions in the ventricles. Short-term fluctuations in cardiac intervals, that follow the premature contractions in the ventricles caused by the induced PACs, are monitored. At least one of a cardiac assessment and an autonomic assessment is performed based on the monitored fluctuations in cardiac intervals that follow the premature contractions in the ventricles caused by the induced PACs. This can include assessing a patient's risk of sudden cardiac death (SCD), assessing a patient's autonomic tone and/or detecting myocardial ischemic events based on the monitored fluctuations in cardiac intervals that follow the premature contractions in the ventricles caused by the induced PACs.

Inducing premature atrial contractions for the purpose of monitoring autonomic tone risk of sudden cardiac death and ischemic events

A delivery apparatus for accessing the pericardial space of a heart including an elongated body defining a lumen and a piercing member that extends from a distal portion of the elongated body for piercing tissue of the heart. A spring expands from a distal end of the piercing member in response to the distal end of the piercing member passing through the tissue and into the pericardial space. An electrode located on the spring in order to sense signals indicative of a distal end of the spring passing through the tissue and into the pericardial space.

An implantable subcutaneous cardiac device includes at least two subcutaneous electrodes adapted for placement external to a heart beneath the skin of a patient. The device further includes an arrhythmia detector that detects a sustained tachyarrhythmia of the heart and a pulse generator that delivers anti-tachycardia pacing pulses to the subcutaneous electrodes in response to detection of a sustained tachyarrhythmia. The pacing pulses preferably have waveforms devoid of any exponential voltage decay and include rounded or substantially constant portions to minimize pain.

Subcutaneous cardiac stimulation device providing anti-tachycardia pacing therapy and method

Implantable systems, and methods for use therewith, are provided for using an implantable sensor for detecting body position and/or body movement, and using what is learned therefrom to improve accuracy of an implantable sensor that is sensitive to at least one of body position and/or body movement. Also provided are implantable systems, and methods for use therewith, that detect body position and/or body movement in order to monitor a condition and/or detect specific episodes. Other embodiments are also provided.

Use of implantable body position and body movement sensors

A subcutaneous implantable cardiac device system applies defibrillation currents in pathways aligned with the heart's own electrical system to decrease defibrillation thresholds. In one implementation, one or more subcutaneous sensors detect ventricular fibrillation. Positioning of subcutaneous sensors and filtering result in improved sensing with reduced noise. A subcutaneous patch component of the system that is in communication with a subcutaneous pacemaker or cardioverter-defibrillator may perform the sensing and apply the defibrillation. The subcutaneous patch may include one or more electrodes that perform both sensing and defibrillation. Variations of the subcutaneous patch may include battery and capacitor for generating onboard defibrillation current and may also include a microprocessor for advanced programmable operation.

Subcutaneous implantable cardiac device system with low defibrillation thresholds and improved sensing

Use of implantable sensors for proprioception and accurate sensor detection

Embodiments include methods and devices for detecting ischemia in a patient and treating the ischemia with a pacing therapy that increases cardiac efficiency, output, or both, without substantially increasing myocardial oxygen consumption. Such therapy may also be used to mitigate the adverse effects of decreased blood flow to the ischemic tissue by increasing the blood flow an oxygenation thereto.

Pacing therapy for transient ischemia treatment

In one implementation, a failsafe method for implantable satellite pacemaker pacing is provided, which includes pacing with a satellite pacemaker and monitoring for a local pacing pulse with an other satellite pacemaker. This implementation further includes, pacing with a surrogate satellite pacemaker if the local pacing pulse is not detected by the other satellite pacemaker. Certain implementations may include transmitting a wireless signal from the other satellite pacemaker to a master pacemaker if the local pacing pulse is not detected by the other satellite pacemaker and using the master pacemaker to select the surrogate satellite pacemaker. Certain implementations may include monitoring for the local pacing pulse with a plurality of satellite and causing the plurality of satellite pacemakers to select the surrogate satellite pacemaker.

Failsafe satellite pacemaker system

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Simi Valley, CA, United States of America

Eric Falkenberg