Pacesetter, Inc.

Lisa P Weinberg

Paul A Levine

Fujian Qu

Edward Karst

Benjamin Coppola

Timothy Pflugh

Gene A Bornzin

Xing Pei

Jason A Sholder

Yongjian Wu

Pritika Toutam

Kelly Hobart McClure

Joseph J Florio

Richard M Lu

Kenneth Valikai

Samuel M Katz

Example electronic devices, including but not limited to implantable medical devices, and methods employing dynamic announcing for creation of wireless communication connections are disclosed herein. In an example, an electronic device includes a wireless communication interface to transmit announcement signals for creating a wireless communication connection with the external device. The electronic device also includes a sensor to detect a characteristic of an environment external to the electronic device, and a control circuit including an announcement timing control module to dynamically control timing of the announcement signals based on the detected characteristic.

Dynamic announcing for creation of wireless communication connections

Methods and systems are provided for discriminating rhythm patterns in cardiac activity. The method and system obtain cardiac activity data for multiple cardiac beats over a predetermined period of time. Multi-beat segments within the cardiac activity data exhibit different rhythm patterns of interest including fast and slow rhythm patterns. The method and system calculate a cardiac beats timing relation representative of intervals between the cardiac beats within a measurement window, wherein the measurement window is configured to overlap the corresponding multi-beat segment. The method and system designate the cardiac beats timing relation to have one of the rhythm patterns of interest based on a rate threshold, identifies when successive multi-beat segments exhibit rhythm patterns that transition between the fast and slow irregular rhythm patterns and records the irregular rhythm pattern transition in connection with the cardiac activity data.

Method and system to discriminate rhythm patterns in cardiac activity

An implantable cardiac device returns activations of corresponding right and left chambers of a heart to inter-chamber synchrony. A sensing circuit senses intracardiac signals representing right and left chamber ventricular electrical activity. A detector determines if a predetermined characteristic of the electrogram signals indicates dissociation of the corresponding right and left chambers. If dissociation is indicated, a pulse generator stimulates at least one of the corresponding chambers to restore inter-chamber synchrony.

Implantable cardiac device for restoring inter-chamber synchrony and method

An implantable neural stimulation device and method treats peripheral vascular disease of a patient. The device includes a pulse generator that provides stimulation pulses and an implantable lead that applies the stimulation pulses to neural tissue. An activity sensor senses activity level of the patient and a processor, responsive to the activity sensor, controls the provision of the stimulation pulses by the pulse generator. The processor causes the pulse generator to provide stimulation therapy any time the patient is active or when the patient is at rest. The processor further provides long term activity monitoring and closed loop control of neural tissue stimulation levels to adapt the stimulation therapy to changes in the patient's condition.

Implantable neural stimulation device providing activity, rest, and long term closed-loop peripheral vascular disease therapy and method

An implantable cardiac stimulation device provides long QT interval therapy for preventing abnormal ventricular activation-recovery time and ultimately ventricular arrhythmias. The device includes a sensing circuit that senses intracardiac activity of a heart and that generates electrical signals representing electrical activity of the heart. The device includes a physiologic sensor, such as body motion, or other diurnally varying sensor that reliably detects a diurnal state of the patient (i.e., not the QT interval itself). The device further includes a measuring circuit that measures a QT interval of the electrical signals, a control circuit that determines whether the QT interval is appropriate for the diurnal state, and a pulse generator that delivers pacing pulses to at least one chamber of the heart at a pacing rate when the QT Interval is pathologically too long. Furthermore, the pacing rate control circuit varies the pacing rate of the pulse generator responsive to the measured QT interval according to the measured diurnal state.

System and method for treating abnormal ventricular activation-recovery time

Methods and apparatus for stimulating the right vagal nerve within a living body via positioning an electrode portion of a lead proximate to the portion of the vagus nerve where the right cardiac branch is located (e.g., near or within an azygos vein, or the superior vena cava near the opening of the azygos vein) and delivering an electrical signal to an electrode portion adapted to be implanted therein. Stimulation of the right vagus nerve and/or the cardiac branch thereof act to slow the atrial heart rate. Exemplary embodiments include deploying an expandable or self-oriented electrode (e.g., a basket, an electrode umbrella, and/or an electrode spiral electrode, electrode pairs, etc). Various dedicated and single-pass leads are disclosed, as well as, various electrodes, and stabilization means. The methods include preserving sinus rhythm, avoiding asystole, preserving A-V synchrony, automatically determining parameter combinations that achieve these features, and further (in one embodiment) automatically determining parameter combinations achieve these features and reduce current drain.

Implantable lead and method for stimulating the vagus nerve

The progression or regression of left ventricular dysfunction (LVD) is automatically evaluated by a pacemaker or other implantable cardiac stimulation device by tracking changes in the resting sinus rate of the patient in which the device is implanted. The resting sinus rate is detected by first determining whether the patient is in a state of profound rest, such as sleep, then measuring the actual sinus rate during profound rest. Profound rest may be detected by using an activity variance sensor. An increase in the profound rest sinus rate over a period of several months indicates progression of LVD; whereas a decrease indicates regression. Appropriate LVD diagnostic information is recorded for subsequent review by a physician. Based on the progression or regression of LVD, the physician may then modify LVD drug therapy administered to the patient or may adjust control parameters of the pacemaker, such as overdrive pacing control parameters or control parameters affecting heart contractility via post-extrasystolic potentiation. If a drug pump is implanted within the patient for automatically delivering LVD drug therapy, the pacemaker controls the drug pump in view of any detected progression or regression of LVD. The technique may also be used to verify the efficacy of LVD drug therapy administered to the patient, whether delivered via an implanted drug pump or otherwise. Processing may be primarily performed within the implanted device itself or with an external programmer in communication with the implanted device. Activity state-based LVD tracking techniques are also set forth.

System and method for tracking progression of left ventricular dysfunction using implantable cardiac stimulation device

A system and method are disclosed for automatically adjusting the sense amplifier sensitivity based on the sensing threshold of the undesired signals (i.e., far-field signals or undesired near-field signals). Specifically, R-wave sensitivity is based on the peak amplitude of the T-waves. Since the relationship between R-waves and T-waves is so repeatable, high confidence is achieved in setting the sensitivity above the T-wave sensing threshold. For atrial sensing, P-wave sensitivity is based on the sensing threshold of R-waves and/or T-waves, whichever is larger. Several embodiments are disclosed for determining the threshold for sensing the undesired signals, such as, double sensing until single sensing occurs, or otherwise detecting the peak amplitude of two or more cardiac signals. Additional error checking may be employed, particularly for atrial sensitivity adjustment, to ensure proper detection of the sensing threshold for the undesired signals in patients with heart block: including analysis of the respective amplitude, cardiac signal duration, and time relationships to appropriately classify the cardiac signals.

System and method of automatically adjusting sensitivity in an implantable cardiac stimulation device

An improved system and method for performing automatic capture/threshold detection in an implantable cardiac stimulation device or any device capable of stimulating some body organ or tissue. Prior art systems determine the cardiac tissue's stimulation threshold by detecting an evoked response to a fixed duration stimulation pulse and then increasing the stimulation pulse's amplitude by a predetermined safety margin value. Such systems are inherently based upon a belief that the chronaxie of a particular patient's strength-duration curve is essentially fixed and that the rheobase is variable. While this may be true at some times during the patient's life, e.g., during the acute phase after lead implantation absent drug effects, it is reported that drugs alone may alter the chronaxie and it is believed that other factors may also affect the chronaxie either alone or in combination with the rheobase. Accordingly, the present invention compares the present stimulation pulse to at least two pulse duration regions and, if a loss-of capture criteria is met, alters the amplitude aid/or the duration of the stimulation pulse accordingly in order to take into account a rheobase and/or chronaxie shift. The decision of whether to increase amplitude and/or duration is dependent on the current operating point. For example, in an embodiment having two pulse duration regions, the amplitude and duration of the stimulation pulse may be increased in the first duration region below the chronaxie while, in the second duration region above the chronaxie, only the amplitude may be increased.

Method and device for optimally altering stimulation energy to maintain capture of cardiac tissue

An implantable cardiac device, such as a pacemaker or an implantable cardioverter-defibrillator that has a control unit which is adapted to sample a time-varying parameter relating to either the patient's changing physiological condition or to the delivery of therapeutic electrical stimulation pulse to the heart at a sampling frequency. The control unit is adapted to increase the sampling frequency when the variation between successive measurements of the parameter exceed a preselected value. The control unit is further adapted to decrease the sampling frequency when the variation between successive measurements of the parameter are less than a preselected value. In alternate embodiments, the parameter to be sampled is capture threshold, sensing threshold, lead-tissue impedance, and battery performance.

Implantable cardiac stimulation device and method for self-regulating sampling of measured parameters

Implantable cardiac stimulation device with dynamic self-regulation of

Preemptive tachyarrhythmia pacing is provided in an implantable cardiac-stimulation device, such as an implantable pacemaker or defibrillator, by modifying the operation of the implantable device in a way that minimizes the likelihood of occurrence of a tachyarrhythmia. The behavior modification is achieved through the use of an appropriate preemptive tachyarrhythmia pacing control routine stored within the memory of the device. Depending upon the needs of the patient, preemptive tachyarrhythmia pacing is invoked continuously or on demand. If invoked on demand, Preemptive tachyarrhythmia pacing is triggered only upon the sensing of one or more conditions suggest that the onset of a tachyarrhythmia is imminent. When thus invoked, preemptive tachyarrhythmia pacing remains invoked only for as long as the onset-of-a-tachyarrhythmia-is-imminent conditions persist. Various preemptive tachyarrhythmia pacing control routines are contemplated, including those based on overdrive pacing, pacing with randomicity, and mode switching. Overdrive pacing, when used, is based on an automatically-determined diurnal rate, an automatic stepped increase over the average atrial rate, or a rate set by a cycle-to-cycle negative hysteresis. Conditions which suggest the imminency of the onset of a tachyarrhythmia include, but are not limited to, a sudden change in the patient's cardiac cycle from a previously-determined normal cardiac cycle.

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Moorpark, CA, United States of America

Lisa P Weinberg