Medtronic, Inc.

Lee Stylos

Keith Alan Miesel

Todd Jon Sheldon

Robert W Stadler

Steven N Lu

Shannon D Nelson

William J Combs

Paul Gordon Krause

William K Wenger

Brian Bruce Lee

Robert T Taepke

John T Meador

Robert J Nehls

William J Plombon

Louis E Halperin

Sean B McAdams

Judy B Salzer

G Jordan Montgomery

Mark A Christopherson

Catherine R Condie

Glenn M Roline

Richard Penn

Sudha Nagavarapu

Willaim K Wenger

Adaptations to the OptiVol&#x2122; alert algorithm are disclosed which may reduce the number of false positive alerts while retaining the desired sensitivity. Some embodiments monitor fluid levels in patients. Some embodiments reset a cumulative index when a short-term impedance value is greater than a baseline impedance value minus a predetermined positive hysteresis value.

Adaptations to optivol alert algorithm

A system, comprising a sterilizable package; an implantable medical device placed inside the sterilizable package; and an electrical interface electrically coupled to the implantable medical device and extending from inside the sterilizable package to outside the sterilizable package. In various embodiments, the interface may include package contacts electrically coupled to electrode terminals on the implantable medical device, patient terminals and conductors extending between the package contacts and the patient terminals.

Medical device packaging system

Adaptations to an intra-thoracic fluid-status-trend indication and/or alert algorithm are disclosed. Some embodiments monitor fluid levels in heart failure patients and others suffering from pulmonary edema and the like. Some embodiments reset a cumulative fluid index when a short-term intra-thoracic impedance value exceeds a baseline impedance value minus a predetermined positive hysteresis value. Many device, system, and method embodiments hereof serve to reduce the number of false positive alerts while retaining the desired sensitivity.

Adaptations to intra-thoracic fluid monitoring algorithm

An implantable medical device (IMD) performs periodic testing of a patient to determine ischemia threshold information. At selected times while the patient is at rest, the IMD increases the pacing rate over time until it receives feedback either from the patient or from an ischemia sensor. The IMD determines the threshold based upon the pacing rate at the time when the feedback was received. The threshold information can be used to adjust the upper pacing rate that can be used during rate adaptive pacing, to determine the effects of drug therapy, and to provide a general indication of the state of coronary artery disease in the patient. The periodic increase of pacing rate to the ischemic zone also provides a preconditioning of the myocardium to allow the patient greater exercise benefit without angina.

Implantable medical device with automatic ischemia threshold determination

An implantable medical device system and method in which the implantable device is adapted to operate in a minimum ventricular pacing mode. The device delivers cardiac pacing pulses in a first pacing mode during a normal mode of operation and upon detecting myocardial ischemia alters the first pacing mode in response to the myocardial ischemia detection.

System and method for delivery of cardiac pacing in a medical device in response to ischemia

Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart that are sensed by an accelerometer sensor. The heart acceleration signal can be obtained from an single- or multiple-axis accelerometer and/or a pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.

Ischemia detection

Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart. Dynamic mechanical activity can be represented, for example, by a heart acceleration signal or pressure signal. The electrical signal can be obtained from a set of implanted or external electrodes. The heart acceleration signal can be obtained from an accelerometer or pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.

Various implantable medical devices (IMDs) are disclosed for implantation in a patient. The IMD includes pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate. In one embodiment, the IMD is configurable to subject a patient to a stress test. The IMD may be configurable to subject the patient to the stress test at the time specified by stored timing information, or in response to a signal (e.g., from a patient activator). Another embodiment of the implantable medical device (IMD) includes sensor circuitry, a memory for storing data, and a control unit. The sensor circuitry produces sensor data relating to cardiac condition. The control unit is configurable to store the sensor data in the memory until a trigger signal is received. Methods are described for performing a stress test in a patient with an IMD, and for subsequently reproducing cardiac operational states.

Implantable medical device (IMD) system configurable to subject a patient to a stress test and to detect myocardial ischemia within the patient

A system and method for measuring and communicating parameters of a brain, tissue, or other organs is disclosed. The system includes a sensor to sense the parameter of interest, an external device where the parameter may be displayed, processed or cause action to be taken, and a communication system to communicate the sensed parameter from the sensor to the external device. In another embodiment, the system includes a processing system for processing the sensed parameters and controlling an associated medical device.

Device and method to measure and communicate body parameters

An implantable medical device having an hermetically sealed enclosure housing electrical and electronic circuitry and a battery for powering such circuitry is connected to an intracranial lead or pigtail which measures or senses intracranial physiologic signals such as intracranial fluid pressure and/or temperature. The implantable medical device is preferably implanted subcutaneously beneath a patient's skin and telemeters stored data or real-time-sensed data to an external device which may be configured to combine barometric pressure data with intracranial pressure data to derive intracranial gage pressure. The implantable medical device and its associated lead reduce the risk of intracranial infections.

Intracranial monitoring and therapy delivery control device, system and method

An implantable barometric pressure sensor coupled with an implantable medical device (IMD) provides a barometric pressure related, reference pressure value for use in combination with an absolute pressure value measured by an implantable absolute pressure sensor coupled to the IMD. In one embodiment, the barometric pressure sensor is implanted under the skin and subcutaneous tissue layer at or near the implant site of the IMD. In variations of this embodiment, the barometric pressure is formed as part of a connector module of the IMD or extends from the connector module. In a further embodiment, a percutaneous access device is provided which is adapted to be implanted to extend through the skin and subcutaneous tissue layer of the patient and is coupled with the barometric pressure sensor to provide for an air chamber extending between the atmosphere and the barometric pressure sensor. The barometric pressure sensor is preferably enclosed within an air chamber of the implantable medical device, and a catheter extends between the air chamber of the implantable medical device and the percutaneous access device. Or the barometric pressure sensor is enclosed within an air chamber of the percutaneous access device, and a lead extends between the barometric pressure sensor and the implantable medical device.

Implantable medical device for sensing absolute blood pressure and barometric pressure

A system and method for determining a patient's cardiac output in a non-invasive manner and transmitting cardiac output data to a remote host processor, a communications system, or a local output device is disclosed. A non-invasive cardiac monitoring approach utilizes an implantable medical device coupled to an oxygen sensor. The oxygen sensor provides venous oxygen saturation data to the implantable medical device. An oxygen consumption unit produces oxygen consumption data using air exhaled by a patient. A processing unit calculates a cardiac output result in real-time using the venous oxygen saturation data, the oxygen consumption data, and arterial oxygen saturation data assumed to be about 100% or acquired using a sensor external to the patient. The implantable medical device may transmit the venous oxygen saturation data to the processing unit using electromagnetic signals or acoustic signals. The implantable medical device may be a pacemaker, a pacemaker/cardioverter/defibrillator (PCD), an oxygen sensing device, or an implantable hemodynamic monitor. The processing unit may store the cardiac output data/result for a period of time and/or communicate the cardiac output result to the remote host processor substantially in real-time via a communications interface. The interface may include a modem, a computer interface, a network interface, or a communications system interface, for example. The processing unit may communicate the cardiac output result to the remote host processor in an analog, digital or optical form.

Non-invasive cardiac monitoring system and method with communications

In determining whether a patient has ischemia or other conditions discernible in the variation occurring in the ST portion of the electrocardiogram signal, we filter out bad ST change parameters that are not changing at a rate representative of human ischemia ST change parameter rates of change. This can be used for driving therapy systems to alleviate cardiac ischemia. This filtering can be enhanced by using multiple cardiac electrical vectors for the electrogram signal vectors, and using a determination of Axis shift to modify filter parameters and the expected ranges of precursors to the ST change parameter (an ST change variable) to eliminate bad cardiac cycles, that is cardiac cycle information that may be misleading.

Method for ischemia detection and apparatus for using same

In using electrogram signals to determine physiologic conditions like ischemia, the bad cardiac cycle information due to noise, axis shifts in the cardiac electrical axis, and the like must be removed if the electrogram signal can be made to be a good indicator. If this is accomplished through the adaptive filtering techniques shown here, the signal can be used to drive a closed loop therapy system responsive to those physiologic conditions discernible from good cardiac cycle electrocardiogram signals.

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Stillwater, MN, United States of America

Lee Stylos