Pacesetter, Inc.

Other

Packsetter, Inc.

Euljoon Park

Gene A Bornzin

Steve Koh

Joseph J Florio

Taraneh Ghaffari Farazi

Kerry A Bradley

Michael E Benser

Mark W Kroll

Dorin Panescu

Eric Falkenberg

Xiaoyi Min

Andre B Walker

Peter Boileau

Louis Wong

Cem M Shaquer

Junyu Mai

Paul A Levine

Kyungmoo Ryu

Jong Gill

Shahrooz Shahparnia

Jiong Xia

Michael Xiaoxuan Yang

Stuart Rosenberg

John W Poore

Laurence S Sloman

Robert G Turcott

Said Mortazavi

Douglas T Kurschinski

Jong Kil

You-Ho Kim

Anne Margaret Pianca

Jeffery D Snell

Jason A Sholder

Brian Jeffrey Wenzel

Lee Jay Mandell

Alan B Vogel

Robert R Weyant

Michael J Coyle

Saul E Greenhut

Fujian Qu

Edward Karst

Wenbo Hou

Kjell Noren

Allen J Keel

Rupinder Bharmi

Mark William Kroll

Anders Bjorling

Riddhi Shah

Nils Holmstrom

Weiqun Yang

Russell Klehn

Mihir Naware

Ryan Rooke

Malin Öhlander

Siew Bee Er

Chris Sorensen

Thao T Ngo

Laleh Jalali

George L Walls

Scott Patrick Simon

Ajit Pillai

Ruth Lyons

Michael Hardage

Patrick Tchou

William Gibb

Malin Ohlander

Connie Wright

Brett Schleicher

Reuben Westmoreland

Alexander Huemmer

Qiuju Huang

Jorgen Edvinsson

Ken Bruhns

Alan H Kadish

An implantable cardiac stimulation device provides electrical stimulation therapy to stabilize the ventricular rate of a heart during episodes of atrial fibrillation. The stimulation therapy may be a plurality of sub-threshold stimulation pulses delivered to capture AV node vagal innervations following the detection of atrial fibrillation.

Implantable cardiac stimulation device and method that stabilizes ventricular rate during episodes of atrial fibrillation

A method to provide electrical stimulation therapy to stabilize ventricular rate of a heart during episodes of atrial fibrillation. The stimulation therapy may be a plurality of stimulation pulses delivered to the AV node during the AV node refractory period following the sensing of an atrial event.

Method to stabilize ventricular rate during episodes of atrial fibrillation

A system and method for treating an arrhythmia in a heart are provided. The system includes an electronic control unit configured to monitor movement of one or more position sensor over a period of time. The position sensors may, for example, comprise electrodes or coils configured to generate induced voltages and currents in the presence of electromagnetic fields. The positions sensors are in contact with portions of heart tissue and changes in position are representative of motion of that tissue. The electronic control unit is further configured to generate an indicator, responsive to the movements of the sensors over the period of time, of a characteristic of the heart affected by delivery of ablation energy to heart tissue. In this manner, the effectiveness and safety of cardiac tissue ablation for treatment of the arrhythmia can be assessed and a post-ablation therapy regimen determined.

System and method for treating arrhythmias in the heart using information obtained from heart wall motion

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 implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

Tissue characterization using intracardiac impedances with an implantable lead system

Techniques are provided for use by implantable medical devices such as pacemakers or by external systems in communication with such devices. An intracardiac electrogram (IEGM) is sensed within a patient in which the device is implanted using a cardiac signal sensing system. Cardiac events of interest such as arrhythmias, premature atrial contractions (PACs), premature ventricular contractions (PVCs) and pacemaker mediated tachycardias (PMTs) are detected within the patient using event detection systems and then portions of the IEGM representative of the events of interest are recorded in device memory. Subsequently, during an off-line or background analysis, the recorded IEGM data is retrieved and analyzed to identify false detections. In response to false detections, the cardiac signal sensing systems and/or the event detection systems of the implantable device are selectively adjusted or reprogrammed to reduce or eliminate any further false detections, including false-positives or false-negatives. Various adaptive reprogramming techniques are described.

Systems and methods for off-line reprogramming of implantable medical device components to reduce false detections of cardiac events

Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

Systems and methods for use by implantable medical devices for detecting and discriminating stroke and cardiac ischemia using electrocardiac signals

An implantable cardiac stimulation device and method provide electrical stimulation therapy to stabilize the ventricular rate of a heart during episodes of atrial fibrillation. The stimulation therapy may be a plurality of stimulation pulses delivered to the AV node during the AV node refractory period following the sensing of an atrial event. Alternatively, the stimulation therapy may be a plurality of sub-threshold stimulation pulses delivered to capture AV node vagal innervations following the detection of atrial fibrillation.

Systems and methods are provided for detecting the orientation and/or movement of a patient having an implantable cardiac stimulation device and evaluating whether a change in the patient's cardiac activity can be at least in part due to a change in the patient's orientation. In one particular embodiment, signals from an orientation sensor and/or a pressure sensor are evaluated to determine static positional orientation of the patient and determine based on the static orientation whether the patient's cardiac activity is abnormal.

Posture detection using pressure and other physiologic sensors

A cardiac analysis system is provided that includes an implantable medical device (IMD), at least one sensor, and an external device. The IMD has electrodes positioned proximate to a heart that sense first cardiac signals of the heart and associated with a clinical ventricular tachycardia (VT) event and second cardiac signals associated with an induced VT event. The sensor measures first and second cardiac parameters of the heart associated with the clinical and induced VT events, respectively. The external device is configured to receive the first and second cardiac signals associated with the clinical and the induced VT events and the first and second cardiac parameters associated with the clinical and the induced VT events. The external device compares the first and second cardiac signals and compares the first and second cardiac parameters to determine if the clinical and induced VT events are a common type of VT event.

Cardiac analysis system for comparing clinical and induced ventricular tachycardia events

A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. An arrhythmia monitoring module is configured to declare a potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The hemodynamic performance assessment module is further enabled to compare a current ECI pattern with a prior baseline ECI waveform.

Method and system for discriminating and monitoring atrial arrhythmia based on cardiogenic impedance

Embodiments of the present invention relate to implantable systems, and methods for use therewith, for monitoring myocardial mechanical stability based on a signal that is indicative of mechanical functioning of a patient's heart for a plurality of consecutive beats. Certain embodiments use time domain techniques, while other embodiments use frequency domain techniques, to monitor myocardial mechanical stability. In certain embodiments the patient's heart is paced using a patterned pacing sequence that repeats every N beats. In other embodiments, the patient's heart need not be paced. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

Methods and devices for monitoring myocardial mechanical stability

An implantable device monitors and treats heart failure, pulmonary edema, and hemodynamic conditions and in some cases applies therapy. In one implementation, the implantable device applies a high-frequency multi-phasic pulse waveform over multiple-vectors through tissue. The waveform has a duration less than the charging time constant of electrode-electrolyte interfaces in vivo to reduce intrusiveness while increasing sensitivity and specificity for trending parameters. The waveform can be multiplexed over multiple vectors and the results cross-correlated or subjected to probabilistic analysis or thresholding schemata to stage heart failure or pulmonary edema. In one implementation, a fractionation morphology of a sensed impedance waveform is used to trend intracardiac pressure to stage heart failure and to regulate cardiac resynchronization therapy. The waveform also provides unintrusive electrode integrity checks and 3-D impedancegrams.

Systems and methods to monitor and treat heart failure conditions

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Valencia, CA, United States of America

Euljoon Park