Cardiac Pacemakers, Inc.

Jonathan T Kwok

Kent Lee

Yachuan Pu

Imad Libbus

Anthony V Caparso

Jeffrey E Stahmann

Yinghong Yu

Jiang Ding

Jesse W Hartley

Paul Allan Haefner

Kristofer J James

Yi Zhang

M Jason Brooke

Zheng Lin

Quan Ni

Kenneth C Beck

Dan Li

Barun Maskara

Abhilash Patangay

Shelley Marie Cazares

Shantha Arcot-Krishnamurthy

Marina V Brockway

Lili Liu

Michael John Kane

John D Hatlestad

Rodney W Salo

Ronald W Heil, Jr

Jeffrey Allen Von Arx

James Gregory Bentsen

Abhi Chavan

Binh C Tran

Paul F Emerson

Jennifer Lynn Pavlovic

Hugo Andres Belalcazar

Weiguang Shao

Yanchuan Pu

Abihilash Patangay

Method and systems related to monitoring right ventricular function during pacing by a cardiac rhythm management device are described. One or more pacing parameters are selected to provide cardiac resynchronization therapy. For example, the one or more pacing parameters may be selected to provide an optimal or improved therapy. The heart is paced using the selected pacing parameters. While pacing with the selected parameters, pressure is sensed via a pressure sensor disposed the pulmonary artery. The sensed pressure is analyzed to determine right ventricular function achieved during the pacing using the selected pacing parameters. A signal, such as an alert signal or control signal, is generated based on the right ventricular function achieved during the pacing.

Monitoring right ventricular hemodynamic function during pacing optimization

A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system detects apnea and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected apnea.

Method and apparatus for controlling neural stimulation during disordered breathing

A respiration pattern of a number of respiration cycles is detected and breath intervals (BI) and tidal volume (TVOL) measurements of each of the respiration cycles are respectively determined. An unevenly sampled instantaneous minute ventilation (iMV) signal is produced using the BI and TVOL measurements, and an evenly sampled iMV signal (resampled iMV signal) is produced using the unevenly sampled iMV signal. Disordered breathing is detected based on a comparison between a baseline threshold and the resampled iMV signal.

Minute ventilation-based disordered breathing detection

A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder.

Method and apparatus for neural stimulation with respiratory feedback

An inspiratory muscle stimulation system uses an implantable medical device to deliver stimulation to control diaphragmatic contractions for slower and deeper breathing, thereby conditioning and strengthening inspiratory muscles. In various embodiments, respiratory and/or cardiac performance are monitored for controlling parameters of the stimulation.

Method and apparatus for inspiratory muscle stimulation using implantable device

A system and method for treating and/or preventing is described for treating periodic breathing characterized by cyclical hyperventilation and hypoventilation, examples of which include Cheyne-Stokes respiration and central sleep apnea. The system could also be used in the treatment of other conditions involving an impairment of respiratory drive.

Respiratory stimulation for treating periodic breathing

Vector selection is automatically achieved via a thoracic or intracardiac impedance signal collected in a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

Thoracic or intracardiac impedance detection with automatic vector selection

An evaluation of heart failure status is provided based on a disordered breathing index. Patient respiration is sensed and a respiration signal is generated. Disordered breathing episodes are detected based on the respiration signal. A disordered breathing index is determined based on the disordered breathing episodes. The disordered breathing index is trended and used to evaluate heart failure status. The disordered breathing index may be combined with additional information and/or may take into account patient activity, posture, sleep stage, or other patient information.

Method and system for heart failure status evaluation based on a disordered breathing index

The invention relates to systems, devices, and methods for detecting infections associated with implantable medical devices. In an embodiment, the invention includes a method of detecting infection in a patient including measuring a physiological parameter using a chronically implanted sensor at a plurality of time points and evaluating the physiological parameter measurements to determine if infection is indicated. In an embodiment, the invention includes an implantable medical device including a first chronically implantable sensor configured to generate a first signal corresponding to a physiological parameter and a controller disposed within a housing, the controller configured to evaluate the first physiological parameter signal to determine if an infection is indicated. Other embodiments are also included herein.

Implantable medical device and methods for automated detection of infection

A system, device and method for neural control of respiration are provided. One aspect of this disclosure relates to an implantable medical device for sensing and controlling respiration during incidence of central respiratory diseases. According to various embodiments, the device includes a sensing circuit to receive sensed signals representative of an incidence of a central respiratory disease. The device also includes a neural stimulator adapted to generate neural stimulation signals, and a controller to communicate with the sensing circuit and to control the neural stimulator to stimulate a desired neural target in response to the detection of the incidence of a central respiratory disease. In an embodiment, the device includes a plurality of sensors which are adapted to monitor physiological parameters to detect the incidence of a central respiratory disease and to send signals to the sensing circuit. Other aspects and embodiments are provided herein.

System for neural control of respiration

An implantable respiration monitor can be used to detect disordered breathing or periodic breathing events that can be categorized, such as according to one or more of sleep, exercise, and resting awake states. The categorized frequency of such events can be compared to independently specifiable thresholds, such as to trigger an alert or responsive therapy, or to display one or more trends. The information can also be combined with detection of one or more other congestive heart failure (CHF) symptoms to generate a CHF status indicator or to trigger an alarm or responsive therapy or to display one or more trends. The alert can notify the patient or a caregiver, such as via remote monitoring. The sleep state information can be further categorized according to central sleep apnea (CSA) or obstructive sleep apnea (OSA) events.

Respiration monitoring for heart failure using implantable device

This document discusses, among other things, methods and systems for facilitating automated device programming at changeout. A method comprises receiving, from a first device, physiological data at a temporary storage device; and processing the received physiological data, wherein the processing includes determining if a first signal processing function was used by the first device and substantially offsetting the first signal processing function if the first signal processing function was used by the first device; and processing the resultant physiological data to be compatible with a second device. The method further comprising providing the processed resultant physiological data to the second device.

Automated device programming at changeout

Growing community of inventors

Holmdel, NJ, United States of America

Jonathan T Kwok