Medtronic, Inc.

Jean E Hudson

Todd Jon Sheldon

Subham Ghosh

Karen J Kleckner

Brian A Blow

Anthony W Schrock

Wade M Demmer

Jian L Cao

John D Wahlstrand

Aleksandre T Sambelashvili

Michael B Terry

Michael W Heinks

Michael L Hudziak

James J St Martin

Michael Kemmerer

Maureen E Lybarger

Charles A Yerich

A medical device is configured to set a post-atrial time interval in response to an atrial event and generate an event time signal in response to a ventricular electrical signal crossing an R-wave sensing threshold during the post-atrial time interval. The device accumulates oversensing evidence in response to the event time signal and adjusts a ventricular sensing control parameter based on the accumulated oversensing evidence in some examples.

Ventricular sensing control in a cardiac pacing system

An implantable device and associated method for delivering multi-site pacing therapy is disclosed. The device comprises a set of electrodes including a first ventricular electrode and a second ventricular electrode, spatially separated from one another and all coupled to an implantable pulse generator. The device comprises a processor configured for selecting a first cathode and a first anode from the set of electrodes to form a first pacing vector at a first pacing site along a heart chamber and selecting a second cathode and a second anode from the set of electrodes to form a second pacing vector at a second pacing site along the same heart chamber. The pulse generator is configured to deliver first pacing pulses to the first pacing vector and delivering second pacing pulses to the second pacing vector. The pulse generator generates a recharging current for recharging a first coupling capacitor over a first recharge time period in response to the first pacing pulses. The pulse generator for generating a recharging current for recharging a second coupling capacitor over a second recharge time period in response to the second pacing pulses. An order of recharging the first and second coupling capacitors is dependent upon one of ventricular pacing mode, left ventricle to right ventricle delay (V-V) pace delay, multiple point LV delay and latest delivered pacing pulses to one of the first and second pacing vectors.

Efficient delivery of multi-site pacing

In a bi-ventricular pacing system, an implantable pulse generator optionally having an IPG indifferent electrode is coupled to a small diameter, unipolar, left ventricular (LV) lead and a bipolar right ventricular (RV) lead. The LV lead is advanced through the superior vena cava, the right atrium, the ostium of the coronary sinus (CS), the CS, and into a coronary vein descending from the CS to locate the LV active pace/sense electrode at a desired LV pace/sense site. An LV lead placed on an epicardial surface can substitute. The RV lead in a preferred embodiment is advanced into the RV chamber to locate RV active and indifferent pace/sense electrodes therein. Sensing of RV spontaneous cardiac depolarizations to provide a RV sense event signal and delivery of RV pacing pulses is conducted across the RV active pace/sense electrode and one of the RV or IPG indifferent pace/sense electrodes. Sensing of LV spontaneous cardiac depolarizations to provide a LV sense event signal is conducted across the LV active pace/sense electrode and one of the RV active or indifferent pace/sense electrodes or the IPG indifferent pace/sense electrodes. Delivery of LV pacing pulses is conducted across the LV active pace/sense electrode and the RV indifferent pace/sense electrode. A similar arrangement is disclosed for left atrial (LA) and right atrial (RA) pacing and sensing.

Bi-chamber cardiac pacing system employing unipolar left heart chamber lead in combination with bipolar right chamber lead

Multi-chamber cardiac pacing systems for providing multi-site pacing to at least one of the right and left atria and then synchronously to the right and left ventricles in a triggered pacing sequence while providing for recharge of the output capacitors of each output amplifier in the shortest time. The recharge operations of the present invention come into play when bi-chamber pacing is invoked to deliver right and left heart chamber pacing pulses that are separated by a triggered pacing delay that overlaps, i.e., is shorter than, the recharge time period. In a truncated recharge mode, the first pacing pulse is delivered through the first pacing path, and the recharging of the first pacing path is commenced for the duration of the triggered pacing delay. Then, the second pacing pulse is delivered, and the second pacing path is recharged for a second recharge period. The recharging of the first pacing path is conducted simultaneously with or after completion of the second recharge period. In a postponed and sequential mode, recharging of the first pacing path is postponed until after delivery of the second pacing pulse and recharging of the second pacing path. In a simultaneous pacing mode, recharging of the first pacing path takes place after delivery of the second pacing pulse and simultaneously with recharging of the second pacing path. This invention can be used in cardio defibrillators with pacing capabilities if desired.

Recharge circuitry for multi-site stimulation of body tissue

Growing community of inventors

Coon Rapids, MN, United States of America

Jean E Hudson