Medtronic, Inc.

Kathleen A Prieve

David K Peterson

Ren Zhou

Jeffrey M Gillberg

Karen J Kleckner

D Curtis Deno

Vincent E Splett

Kenneth M Anderson

Ruth N Klepfer

Glenn C Zillmer

William A Graham

John E Burnes

Michael F Hess

David E Euler

Michael R Hill

Edwin G Duffin

Lawrence J Mulligan

David A Igel

Curtis A Hale

Rebn Zhou

A method of stimulation therapy and an apparatus for providing the therapy which addresses cardiac dysfunction including heart failure. The therapy employs atrial pacing pulses delivered to a heart after the atrial refractory period and timed so that they will not cause a ventricular contraction. These atrial pacing are timed to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.

Secure and efficacious therapy delivery for a pacing engine

An extra-systolic stimulation (ESS) therapy addresses cardiac dysfunction including heart failure. ESS therapy employs atrial and/or ventricular extra-systoles via pacing-level stimulation to a heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). The present invention relates to therapy delivery guidance and options for improved ESS therapy delivery. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.

Secure and efficacious therapy delivery for an extra-systolic stimulation pacing engine

The invention automatically adjusts the parameters that map pressures at a monitoring site, such as blood pressures in the chamber of a heart, to digital values. Adjusting the mapping parameters keeps the data in range while preserving sensitivity. A histogram of the digital pressure data is generated and the contents of the lowest and highest bins of the histogram are checked. Depending on whether the boundary bins of the histogram are full or empty, the mapping parameters are adjusted. A new histogram is generated using digital values generated with the adjusted mapping parameters.

Automatic pressure range and sensitivity adjustment

An implantable anti-arrhythmia device such as a defibrillator or anti-tachycardia pacemaker with an associated patient activator. The arrhythmia detection function is divided between the patient and the implanted device, rather than merely providing patient activation or a patient override. The implantable device is provided with a tachyarrhythmia recognition mechanism, which operates essentially continuously, and which, upon meeting a first set of criteria, will trigger delivery of an anti-arrhythmia therapy such as pacing, cardioversion or defibrillation. The patient is provided with an activator which informs the implanted device that the patient believes that anti-arrhythmia therapy is necessary. In response to receipt of the activation signal, the implanted device defines a time interval thereafter during which a second, less stringent set of arrhythmia detection criteria must be met, in response to which the device will deliver a cardioversion or defibrillation pulse.

Method and apparatus for diagnosis and treatment of arrhythmias

An atrial and ventricular pacemaker including an atrial pulse generator having the capability of delivering high rate atrial pacing pulses for electrophysiologic study and having the capability of delivering ventricular pacing pulses as a backup, during delivery of high rate atrial pacing pulses. Delivery of backup ventricular pacing pulses may be preconditioned upon the occurrence of a desired number, proportion or pattern of occurrences of paced ventricular beats preceding delivery of high rate atrial pacing pulses. Timing of ventricular backup pulses is synchronized to delivered atrial pacing pulses which occur closely timed to expiration of a defined ventricular escape interval for backup pacing. The defined escape interval for ventricular backup pacing may be set as a function of the average interval separating ventricular events preceding initiation of high rate atrial pacing.

Atrial anti-arrhythmia pacemaker and method using high rate atrial and

An implantable pacemaker employing an arrhythmia prevention pacing modality particularly optimized for inclusion in dual chamber pacemakers and anti-arrhythmia devices which include dual chamber pacemakers. When the pacing mode is in effect, the device alters timing of scheduled atrial and/or ventricular pacing pulses in response to depolarizations sensed during the refractory periods and to ventricular depolarizations sensed outside of the pacemaker's A-V escape intervals. The arrhythmia prevention pacing mode is activated and deactivated in conjunction with the operation of arrhythmia detection features which may also be employed by the device to trigger delivery of anti-arrhythmia therapies.

Apparatus for diagnosis and treatment of arrhythmias

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Shoreview, MN, United States of America

Kathleen A Prieve