Cardiac Pacemakers, Inc.

Kent Lee

Quan Ni

Jesse W Hartley

Jeffrey E Stahmann

John D Hatlestad

Jonathan T Kwok

Yachuan Pu

Imad Libbus

Yi Zhang

Anthony V Caparso

Douglas R Daum

Marina V Brockway

Abhilash Patangay

Jaeho Kim

Paul Allan Haefner

Kristofer J James

Qingsheng Zhu

Krzysztof Z Siejko

M Jason Brooke

Kenneth C Beck

Zheng Lin

Yinghong Yu

Jiang Ding

Yousufali H Dalal

Carlos Haro

Richard O Kuenzler

Jeff E Stahmann

Pramodsingh Hirasingh Thakur

Gerrard Merrill Carlson

Dan Li

Shantha Arcot-Krishnamurthy

Shelley Marie Cazares

Zoe Hajenga

Bruce H KenKnight

Allan Charles Shuros

Lili Liu

Kenneth L Baker

Ankur Garg

Kenneth Tobacman

Michael A Querimit

Rob Sweeney

Corey J Miklos

Apurv Ullas Kamath

Robert J Sweeney

Joseph M Pastore

Ronald W Heil, Jr

Aaron R McCabe

Yanting Dong

Viktoria A Averina

Eric G Lovett

Kevin John Stalsberg

Gary Thomas Seim

Eric A Mokelke

Paul F Emerson

Jon Peterson

Jennifer Lynn Pavlovic

Hugo Andres Belalcazar

David L Whitehouse

Weiguang Shao

Gerard M Carlson

Yanchuan Pu

Krzysztof J Siejko

A differential or relative measurement between an orthogonal measurement vector and another measurement vector can be used to determine the location where fluid accumulation is occurring or the local change in such fluid accumulation. This can help diagnose or treat infection or hematoma or seroma at a pocket of an implanted cardiac rhythm management device, other implanted medical device, or prosthesis. It can also help diagnose or treat pulmonary edema, pneumonia, pulmonary congestion, pericardial effusion, pericarditis, pleural effusion, hemodilution, or another physiological condition.

Multiple vector fluid localization

The presence of disordered breathing is detected using an implantable medical device. A cardiac condition is detected that is indicative of the patient's cardiac status. Based on the presence of disordered breathing and the cardiac condition, the patient is identified as suitable for a cardiac resynchronization therapy.

Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection

An approach to treating congestive heart failure includes monitoring pulmonary congestion. Monitoring pulmonary congestion includes sensing a physiologic parameter using a sensor implanted within the patient. The method further comprises delivering a congestive heart failure therapy using a stimulator implanted within the patient. Delivering the congestive heart failure therapy includes delivering electrical stimulation to the patient using the sensed parameter to control the congestive heart failure therapy.

Method and system for treating congestive heart failure

Disordered breathing events may be classified as central, obstructive or a combination of central an obstructive in origin based on patient motion associated with respiratory effort. Central disordered breathing is associated with disrupted respiration with reduced respiratory effort. Obstructive disordered breathing is associated with disrupted respiration accompanied by respiratory effort. A disordered breathing classification system includes a disordered breathing detector and a respiratory effort motion sensor. Components of the disordered breathing classification system may be fully or partially implantable.

System and method for discrimination of central and obstructive disordered breathing events

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

The present disclosure describes methods, devices, and systems for generating, adjusting, and using cardiac waveform morphology templates. The morphology templates include target regions associated with features of cardiac waveforms. The target regions may be adjusted based on relationships between the target regions and features of detected cardiac waveforms associated with the target regions. The templates may be used to analyze cardiac waveforms to classify or monitor various waveform morphologies. Templates may be created or eliminated, for instance, based on a frequency of use. According to one approach, template creation involves providing target regions defined by one or more characteristics. The target regions are adjusted based on detected cardiac waveform features having similar characteristics. A template may be created using the target regions adjusted by this process.

Cardiac waveform template creation, maintenance and use

Various approaches to detecting arousals from sleep involve generating signals modulated by muscle tone, brainwave activity, and/or other nervous system activity associated with a patient's autonomic arousal response. Generating the signals and/or detecting autonomic arousals from sleep may be performed using an implantable device. Arousal information may be useful to identify sleep disorder events associated with arousals from sleep, for diagnostic purposes, and/or for therapy adjustment.

Autonomic arousal detection system and method

An apparatus comprises a physiologic sensing circuit and a control circuit. The physiologic sensing circuit is configured to sense an electrical respiration signal representative of respiration of a subject. The control circuit includes a respiration monitor circuit and a therapy circuit. The respiration monitor circuit is configured to extract a respiration parameter from the respiration signal and detect that a value of the respiration parameter is outside of a target value range for the respiration parameter. The therapy circuit is configured to deliver neural stimulation to the carotid sinus of the subject to stimulate respiration and to adjust respiration to maintain the value of the respiration parameter within the target value range.

Neural control of central sleep apnea

Devices and methods for sleep detection involve the use of an adjustable threshold for detecting sleep onset and termination. A method for detecting sleep includes adjusting a sleep threshold associated with a first sleep-related signal using a second sleep-related signal. The first sleep-related signal is compared to the adjusted threshold and sleep is detected based on the comparison. The sleep-related signals may be derived from implantable or external sensors. Additional sleep-related signals may be used to confirm the sleep condition. A sleep detector device implementing a sleep detection method may be a component of an implantable pulse generator such as a pacemaker or defibrillator.

Sleep detection using an adjustable threshold

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

Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.

Reverse hysteresis and mode switching for intermittent pacing therapy

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

A sleep quality assessment approach involves collecting data based on detected physiological or non-physiological patient conditions. At least one of detecting patient conditions and collecting data is performed using an implantable device. Sleep quality may be evaluated using the collected data by an implantable or patient-external sleep quality processor. One approach to sleep quality evaluation involves computing one or more summary metrics based on occurrences of movement disorders or breathing disorders during sleep.

Sleep quality data collection and evaluation

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

Growing community of inventors

Shoreview, MN, United States of America

Kent Lee