Medtronic, Inc.

Kenneth M Riff

Michael B Shelton

Michael F Hess

Robert S Kieval

Gregory J Linden

James Kevin Carney

Rahul Mehra

Tommy Dean Bennett

William J Combs

Kurt R Smith

Amisha Somabhai Patel

Brian Bruce Lee

Luc Roland Mongeon

Michael R Ujhelyi

George J Klein

Ray S McDonald

Anthony J Varrichio

Nancy Perry Pool

Dwight H Warkentin

Nirav Vijay Sheth

James E Willenbring

Gregg Turi

Michael R Tollinger

Patrick M Mahoney

Michael J German

Clifton W Owens

A system and associated method receives, by a database coupled to a communication network, patient medical data from multiple data sources including data retrieved from implantable medical devices implanted in patients. A processor accesses the database to generate a dataset from the medical data having at least one data characteristic matching a corresponding data characteristic of a patient group of at least one patient. At least one subset of the dataset is identified that had a therapy intervention subsequent to a time point that the subset had the matching data characteristic(s). An outcome of the subset is determined and a predictive outcome for the patient group is produced based on the outcome of at least one subset.

System for using patient data combined with database data to predict and report outcomes

A device includes a plurality of electrodes and a detection module. The plurality of electrodes are configured to acquire an electrical signal in a patient. The detection module is configured to determine whether the acquired electrical signal includes signal content in each of N different frequency bands and detect operation of an electrosurgical device on the patient based on how many of the N different frequency bands include signal content. N is an integer that is greater than 1.

Electrosurgery detection

A system for on-line psycho-physiological profiling and support implementing a personalization engine operating in a plurality of network systems. An implanted medical device (IMD) in data communication with the personalization engine provides physiological, therapy and diagnostic data pertinent to the patient. Based on one or a combination of explicit, implicit and transactional input from the patient and in consideration of the IMD data underlying therewith, the patient is guided to consult with the most pertinent database.

Personalization software for implanted medical device patients

A system and method for computer enabled network patient management of medical devices used in chronic disease management. Utilizing web site and push alert notification of alert level physiologic data derived via analysis of continuous stream wireless data transmissions from a patient, a full cycle improvement over existing modalities is achieved. Proxy and medical device user integration and access is enabled to achieve further contribution to the technical advantages of the system.

Medical device systems implemented network scheme for remote patient management

A method and system facilitates the access by a patient of implanted medical device related data for patient participation in their own clinical care and therapy. In an example embodiment, the method includes establishing a communications link between an implanted medical device and a data processor via an implanted medical device interface. Access to a secured database is obtained via the implanted device data processor using a set of patient identification data. A query is then submitted via the data processor to the secured database in response to input patient diagnostic data. Data received from the secured database is then displayed for use in a patient evaluation.

Method and a system for using implanted medical device data for accessing therapies

An external physiologic or implanted device monitor/controller ('monitor') designed to be attached to the body, as for example, to the skin of the patient. The monitor is designed to detect the therapeutic outputs actually produced by the implanted medical device. Having knowledge of the operation of the implanted medical device, the monitor may then deduce, or decode, the physiologic conditions and/or devices conditions sensed by the implanted medical device. The monitor is then able to perform an action appropriate to the sensed condition and the specific implementation.

Transcutaneous monitor and method of use, using therapeutic output from an implanted medical device

An implantable medical device determines activity levels and Heart Rate and from a combination of these produces a value for a heart rate activity coefficient (HRAC). This value has significant diagnostic and patient tracking value. Methods and apparatus for determining this HRAC value are described. This enables physician review of patient cardiac status. Additional physiologic data can be recorded along with the HRAC data if desired, and this too, as well as the HRAC data alone, may be reported out from the implanted device to a medical communications system for alarm purposes, titrating drugs/therapies or other monitoring tasks. Further, substitutes for heart rate measurements and activity measurements are described which can be used to augment or substitute for heart rate measurements and activity measurements. These substitutes should represent cardiovascular or cardiac responsiveness to substitute for heart rate in the HRAC signal; and should represent cardiac demand to substitute for activity in the HRAC signal.

Implantable medical device for tracking patient cardiac status

A minimally invasive implant, means for insertion, and description of how to most efficiently use it are described n several embodiments. This implant preferably has a segmented looping memory for storing triggered physiologic events. Preferred events for setting autotriggers to record physiologic signals occurring during events include arrhythmias and syncopal events. Preferably the device can function without a microprocessor. An outside device or other patient activated manual trigger is included. Auto triggers and manually set triggers may be of different sizes. The preferred physiologic events are ECG signals. Electrode spacing can be critical. Additional sensors may be provided to the device. Preferred communications with the device is through telemetry such as is used for pacemakers and other implanted devices.

Minimally invasive implantable device for monitoring physiologic events

An impedance monitor for discerning edema through evaluation of respiratory rate. Preferred embodiment includes edema monitor and trigger to initiate diagnostic reporting or corrective action when activated. Recording of Long Term Average and Short Term Average values for secondary edema measure based on DC signal level are described as are methods and apparatus for removing unwanted recurring noise.

Impedance monitor for discerning edema through evaluation of respiratory

A method and apparatus of cardiac pacing, in which pacing at an increased rate is provided in response to a detected rapid drop in detected heart rate, to a stable rate below a defined threshold rate.

Pacemaker with vasovagal snycope detection

A rate-responsive cardiac pacemaker implements a novel scheme which detects incipient vasovagal syncope (or other episodes caused by a vasodepressive or cardioinhibitory disorder) when a) the heart rate drops below a programmable minimum size, and b) the rate after said drop is below a programmable maximum drop ending rate. The pacemaker implements a stability and intervention procedure upon the detection of an episode, in which it ignores transient drops in rate, and paces at a predetermined high rate if the drops are stable. The pacemaker then gradually reduces the pacing rate over a predetermined time to the pre-episodic level. A sleep disable feature disables the vasovagal syncope detection and therapy features during the patient's sleeping hours to reduce or eliminate false positive responses.

Pacemaker with vasovagal syncope detection

A method and apparatus for morphologic analysis of an electrical signal, implementable in an implantable device such as a pacemaker, cardioverter, defibrillator or the like. The morphologic analysis uses a phase plane representation of the signal, where the signal and its first derivative are plotted along orthogonal axes. A magnitude signal corresponding to the magnitude component of the trajectory of the phase plane representation is generated and applied to a comparator. The comparator produces an activation signal when the magnitude signal exceeds a predetermined threshold. In response to the activation signal, a quadrant detector selectively applies the magnitude signal to one of four integrators, the selection of one integrator over the others being based at all times upon which quadrant of the phase plane the trajectory is in. When the magnitude decreases below a predetermined threshold, the activation signal is deasserted, whereupon the respective outputs from the four integrators may be interpreted as reflecting of the trajectory of the phase plane representation of the signal. In operation, a particular cardiac event to be detected is induced in a patient, and the resultant phase plane signals are examined to determine particular aspects of the phase plane signals which can be used as an indication that the particular event has occurred. The apparatus is then conditioned to recognize such aspects in subsequent phase plane signals, in order to provide an indication when such aspects are again present in the signals.

Method and apparatus for intracardiac electrogram morphologic analysis

A rate-responsive cardiac pacemaker in which deceleration of the pacing rate is modulated according to recent patient activity or 'work'. Based on signals provided from an activity sensor in the pacemaker, the pacemaker maintains and periodically recomputes a work value corresponding to the amount of patient activity detected over time. In response to a decrease in or cessation of detected patient activity, the pacemaker reduces the pacing rate, first at a more rapid deceleration rate, then at a lower deceleration rate, and then once again at a more rapid deceleration rate. The length of time during which the pacing rate is reduced at the lower deceleration rate is modulated according to the work value maintained by the pacemaker. The work-modulated pacing rate deceleration occurs only if certain achievement criteria are met, the achievement criteria being specified in terms of the amount of time the pacemaker's target pacing rate exceeds a predetermines rest value, and the difference between the target rate and the rest rate.

Rate responsive cardiac pacemaker and method for work-modulating pacing

Apparatus and method for detecting changes in the posture of a patient. Two pressure sensors are chronically implanted at different places in the cardiovascular system. One may be positioned in the right heart, for example, and the other placed in the inferior vena cava. The positioning is selected for ease of chronic implantation. However, the positions chosen must be such that the differences in pressure with changes in posture are differentially measurable. The differences in pressure changes sensed at the two positions enable electronic circuitry to determine changes in posture of the patient. These changes in posture may be used to indicate associated physiological changes such as increased or decreased demand on the cardiovascular system or changes in other homeostatic functions. Compensation for this changing cardiovascular or other homeostatic functions may be partially met through increasing or decreasing the escape interval of a demand cardiac pacemaker or by altering the drug delivery regimen of an implantable drug dispenser.

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Orono, MN, United States of America

Kenneth M Riff