Cardiac Pacemakers, Inc.

James A Esler

Eric A Mokelke

Doug M Birkholz

David W Yost

Allan Charles Shuros

David J Ternes

Aaron R McCabe

Donald Lee Hopper

Lemont Baker

Chie Kawahara

Jilliann G Fricke

Michael M Morris

Pacing post-conditioning (PPC) therapy is applied to a patient to minimize ischemic injury associated with MI and/or reperfusion injury associated with a post-MI revascularization procedure. In various embodiments, a PPC therapy is delivered by executing a pacing protocol with pacing parameters determined and dynamically adjusted based on patient-specific factors to ensure efficacy and safety of the patient.

Method and apparatus for automated control of pacing post-conditioning

A cardiac rhythm management system recognizes patterns of interval durations, distinguishing between events in different heart chambers even though signals associated with those different heart chambers are processed using a commonly shared sensing circuit. A therapy delivery algorithm ignores intervals between cardiac events occurring in different heart chambers when determining a cardiac rate upon which the delivery of therapy is based. This reduces the risk of inappropriate delivery of therapy to the patient. Delayed conduction left ventricular beats are not erroneously recognized as a subsequent right ventricular beat, preventing such short intervals from inappropriately triggering a defibrillation countershock.

Cardiac rhythm management system with prevention of double counting of events

A method for implementing a neural stimulation therapy mode in an implantable medical device (IMD) comprising the acts of mapping respective device states, defined by one or more timer states that include at least one neural event timer or one or more indications of one or more sensed physiologic events, to associated device actions in a stored neural table, storing an event represented as a device status word and a time stamp in a queue in response to an action input, and comparing one or more current timer states or one or more indications of one or more sensed physiologic events to a device state contained in the neural table and, if found to match, causing performance of one or more associated device actions, wherein the device actions include one or more of a neural stimulation energy delivery or a change in one or more timer states.

Flexible neural stimulation engine

Methods and devices for treating a blockage in the coronary arterial system are provided. Some blockages in the coronary arterial system restrict the blood flow to a portion of the heart, causing ischemia or infarction. Such blockages may be treated by displacing, removing and/or breaking up the blockage, which allows blood to reperfuse into the infarcted portion of the heart. Before, during, and/or after the reperfusion, cardioprotective pacing is provided to the heart. The devices have multiple electrodes in order to provide multiple locations at which the cardioprotective pacing may be delivered. The devices are adapted to deliver cardioprotective pacing to the heart via the electrode that results in a relatively high level of dyssynchrony of the heart.

Myocardial infarction treatment system with electronic repositioning

A system includes an implantable medical device. The implantable medical device includes a control circuit and a motion sensing device. The motion sensing device is coupled to the control circuit, and the motion sensing device is configured to transmit signals to the control circuit. The control circuit is configured to identify one or more steps of a patient using the motion sensing device signal.

Implantable medical device configured as a pedometer

Systems and methods for temporarily pacing a patient's heart are provided. One system includes a vascular treatment system having a vascular access system and a therapy system. The therapy system includes an indeflator and an elongate medical device and the elongate medical device has an inflatable member and an electrode. The indeflator is adapted to provide pressurized fluid to the inflatable member and electrical signals to the electrode, with its operation manually or automatically controlled. Devices for electrically and fluidly coupling the indeflator and the elongate medical device are also provided.

Pacing system controller integrated into indeflator

This document discusses, among other things, a system including an implantable medical device. The implantable medical device includes a control circuit and a motion sensing device. The motion sensing device is coupled to the control circuit, and the motion sensing device is configured to transmit signals to the control circuit. The control circuit is configured to identify one or more steps of a patient using the motion sensing device signal.

A device and method for implementing a bradycardia pacing mode are disclosed which is mostly hardware-based but still allows the flexibility for making major changes in brady behavior normally found only in firmware-based implementations. The brady behavior of the device is encapsulated by a table in an area of RAM referred to as brady RAM, and the brady behavior can be changed by re-loading the brady RAM with a different table.

Cardiac pacemaker with table-based pacing mode implementation

An implantable medical device comprising stimulation circuitry adapted to provide neural stimulation energy to a neural stimulation electrode, one or more timers, including at least one neural event timer, a device behavior memory including a neural table, and a comparison circuit. The neural table maps a particular device state defined at least in part by a neural event timer to one or more associated device actions that include at least one of a neural stimulation energy delivery, a change in state of at least one neural event timer, and both a neural stimulation energy delivery and a change in state of one or more timers. The comparison circuit is adapted to compare a current state of one or more timers to a device state in the neural table and, if found to match, causing performance of one or more associated device actions.

A cardiac rhythm management system having a plurality of timers and programming adapted to receive a status array. The status array is based on the status of each timer of the plurality of timers and includes intrinsic activity detection for each pace sense site. The plurality of timers are initiated concurrent with a detected event or condition. The status array is masked according to an enable array and an interrupt signal is generated based on selected bit transitions of the status array. The interrupt signal initiates a predetermined therapy or function based on the status array. A FIFO buffer preserves the order of senses and paces for further processing. The predetermined therapy or function includes determining a mode of operation of the system.

Method to create pacemaker timing cycles

An implantable medical tissue stimulating device is designed to capture fault history relating to error events in a manner that allows subsequent analysis of operational performance prior to, during and subsequent to the occurrence of a detected error. Physiologic and operational data are fed through a buffer capable of temporarily storing such data over a predetermined interval. When a fault condition is detected, a trigger signal is generated a predetermined time following the occurrence of the fault condition and, upon generation of the trigger signal, the contents of the buffer are stored away in a RAM memory for subsequent read-out.

Method and apparatus for recording fault history information

A cardiac rhythm management system recognizes patterns of interval durations, distinguishing between events in different heart chambers even though signals associated with those different heart chambers are processed using a commonly shared sensing circuit. A therapy delivery algorithm ignores intervals between cardiac events occurring in different heart chambers when determining a cardiac rate upon which the delivery of therapy is based. This reduces the risk of inappropriate delivery of therapy to the patient. Delayed conduction left ventricular beats are not erroneously recognized as a subsequent right ventricular beat, preventing such short intervals from inappropriately triggering a defibrillation countershock. The system detects cardiac events, obtains a current interval between a current cardiac event and a previous cardiac event, and classifies the current interval into at least first and second categories, based on a duration of the current interval. The system determines timing of delivery of output energy based on whether a previous interval is in the first category and the current interval is in the second category. The system then stores the current interval as the previous interval.

Recognizing that delivery of pacing therapy to a patient may increase the risk of inappropriate delivery of anti-tachyarrhythmia therapy, a modified atrial-based timing device and method delivers pacing and anti-tachyarrhythmia therapy to the patient such that the risk is reduced. A ventricular-atrial (VA) time interval is increased, when an intrinsic ventricular activation is sensed during an atrial-ventricular (AV) time interval, by the time remaining in the immediately preceding AV time interval following the intrinsic ventricular activation sensed therein. As a result, the patient's heart rate is not elevated, in response to ventricular activations sensed during the AV time interval, and a tachyarrhythmia rate threshold is not exceeded, thereby avoiding inappropriate delivery of anti-tachyarrhythmia therapy.

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Coon Rapids, MN, United States of America

James A Esler