Pacesetter, Inc.

Badie, Nima

Folman, Carin

Goil, Aditya

Rhude, Jennifer

Jennifer Rhude

Yelena Nabutovsky

Tejpal Singh

Gregory Hauck

Elia Arambula Mouchawar

Carin Folman

Monique Prue

David Houck

Taraneh Ghaffari Farazi

Edward Karst

Nima Badie

Aditya Goil

Brian Wisnoskey

Jordan Ireland Vance

Joy Catherine Wong

Gary Cranke

Stuart Rosenberg

Fujian Qu

Xing Pei

Methods and devices herein are provided for managing atrial (A) pacing in connection with premature atrial contracts (PAC). The methods and devices obtain an atrial pace-on-PAC (APAC) interval and cardiac activity (CA) signals. The methods and devices are configured to: i) during a first cardiac beat; following a ventricular paced (VP) or ventricular sensed (VS) event, activate a timer for a post ventricular-atrial refractory period (PVARP) interval; and determine whether a first atrial refractory (AR) event occurs during the PVARP interval; ii) during a second cardiac beat; in response to the detecting that the first AR event occurred, initiate an APAC interval; during the APAC interval for the second cardiac beat, determine whether a second AR event occurs; and update a count of APAC events when the second AR event occurs; and iii) repeat i) and ii) for multiple cardiac beats, to track the count of APAC events.

Method and device for avoiding competitive atrial pacing

Methods, devices and program products are provided for under control of one or more processors within an implantable medical device (IMD). Sensing near field (NF) and far field (FF) signals are between first and second combinations of electrodes coupled to the IMD. The method applies an arrhythmia detection algorithm to the NF signals for identifying events within the NF signal and designates events marker based thereon and monitors the event markers to detect a candidate arrhythmia condition in the NF signals. The candidate under-detected condition comprises at least one of an under-detected arrhythmia or over-sensing. In response to detection of the candidate arrhythmia condition, the method analyzes the FF signals for a presence of an under-detected arrhythmia indicator. The method delivers an arrhythmia therapy based on the presence of the under-detected arrhythmia indicator in the FF signals and the candidate under-detected arrhythmia condition in the NF signals.

Method and device utilizing far field signals to identify and treat under-detected arrhythmias

A method and device for dynamic device based AV delay adjustment is provided. The method comprises electrodes that are configured to be located proximate to an atrial (A) site and a right ventricular (RV) site. The method utilizes one or more processors for detecting an atrial paced (Ap) event or atrial sensed (As) event, and measures an AV interval corresponding to an interval between the Ap event or the As event and a sensed ventricular (Vs) event. The AV interval is associated with a current heart rate (HR). The method automatically dynamically adjusts a first AV delay based directly on the measured AV interval, identifies a scale factor associated with the current HR, calculates a second AV delay by scaling the first AV delay based on the scale factor and manages a pacing therapy, utilized by the IMD, based on the first and second AV delays.

Method and system for dynamic device-based delay adjustment

Methods and systems are provided for detecting arrhythmias in cardiac activity is provided. The method and systems are under control of one or more processors configured with specific executable instructions. The method and systems obtain a far field cardiac activity (CA) signal that includes a series of beats, the CA signal including paced events. The method and systems identify the paced events in the CA signals. The method and systems determine a score based on an amount of paced events and adjust at least one parameter of an atrial fibrillation (AF) detection process based on the score.

Method and device for detecting atrial fibrillation in the presence of ventricular pacing

Baseline BiV pacing is delivered and a corresponding baseline BiV efficacy score is determined. Intrinsic AV conduction is allowed and an intrinsic AV conduction interval is determined. BiV fusion pacing is delivered and a corresponding efficacy score is determined, for each of a plurality of different paced AV delays, each determined based on the intrinsic AV conduction interval and a different negative hysteresis delta. The baseline BiV pacing is selected for delivery during a period of time if the baseline BiV efficacy score is better than all of the efficacy scores. BiV fusion pacing is selected for delivery during the period of time, using one of the plurality of different paced AV delays for which a corresponding efficacy score was determined, if the efficacy score corresponding to at least one of the plurality of different paced AV delays is better than the baseline BiV efficacy score.

Methods and systems for selectively delivering different types of bi-ventricular pacing

The present disclosure provides systems and methods for integrating cardiac resynchronization therapy (CRT) and temporary induced dyssynchrony (TID) therapy. An implantable cardiac device includes one or more pulse generators coupled to a plurality of electrodes, and a controller communicatively coupled to the one or more pulse generators and configured to cause the one or more pulse generators to apply a combination of CRT and TID therapy to a patient's heart via the plurality of electrodes in accordance with at least one protocol.

Systems and methods for integrating temporary induced dyssynchrony therapy with cardiac resynchronization therapy

The present disclosure provides systems and methods for providing temporary induced dyssynchrony (TID) therapy to patients with atrial tachycardia. An implantable cardiac device includes a pulse generator coupled to a plurality of electrodes, and a controller communicatively coupled to the pulse generator and configured to cause the pulse generator to apply TID therapy to a patient's heart via the plurality of electrodes, determine that the patient's heart is experiencing atrial tachycardia, and adjust at least one parameter of the TID therapy based on the determination.

Systems and methods for providing temporary induced dyssynchrony therapy to patients with atrial tachycardia

Baseline BiV pacing is delivered and a corresponding baseline BiV efficacy score is determined. Intrinsic AV conduction is allowed and an intrinsic AV conduction interval is determined. BiV fusion pacing is delivered and a corresponding NAVH efficacy score is determined, for each of a plurality of different paced AV delays, each determined based on the intrinsic AV conduction interval and a different negative hysteresis delta. The baseline BiV pacing is selected for delivery during a period of time if the baseline BiV efficacy score is better than all of the NAVH efficacy scores. BiV fusion pacing is selected for delivery during the period of time, using one of the plurality of different paced AV delays for which a corresponding NAVH efficacy score was determined, if the NAVH efficacy score corresponding to at least one of the plurality of different paced AV delays is better than the baseline BiV efficacy score.

In a possible implementation, a method for cardiac testing is provided which includes measuring test data associated with cardiac events and storing the test data in an intracardiac stimulation device. The method further includes acquiring event electrograms corresponding with the test data and storing the event electrograms corresponding with the test data in the intracardiac stimulation device. In a possible implementation, marker data is stored associating event electrograms with measured test data, which may identify the event electrograms used for measuring the test data and/or identify when adjacent event electrograms are not contiguous. In some implementations, the test data may be measured and stored in an out-of-clinic test, and the test data and the corresponding event electrograms may be later retrieved from the intracardiac stimulation device and presented on a visual display.

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Carbondale, IL, United States of America

Jennifer Rhude