Vitatron Medical B. V.

Medtronic, Inc.

Other

Vitutsom Medical B.u.

Malcolm J Begemann

Johannes S Van Der Veen

Gustaaf A Stoop

Willem Boute

Geeske Van Oort

Xander Evers

Volkert A Zeijlemaker

Alexis C Renirie

Bernhard De Vries

Karel Den Dulk

Marijn Van Gemert

Hendrikus A Westendorp

David Thompson

David Flammang

G A Stoop

Marcus O Filipovich

Henny M Leerssen

A method of pacing opposing chambers of a heart with a pacing system is provided. The pacing system comprises a first bipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second bipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second bipolar medical electrical leads. The implantable pulse generator further comprises a hermetically sealed housing capable of serving as a can electrode. The method designates a primary electrode configuration by selecting a cathode and an anode from either the first electrode, second electrode, or the can. Selection of the cathode is based on a comparison of thresholds measured in each chamber. Systems, programs and devices using the method are also provided.

Dual-chamber pacemaker system for simultaneous bi-chamber pacing and sensing

A method of pacing opposing chambers of a heart with a pacing system is provided. The pacing system comprises a first unipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second unipolar medical electrical leads. The implantable pulse generator further comprises an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode. A primary electrode configuration is determined. A cathode is selected from the first electrode, the second electrode and the can electrode based on the primary electrode configuration. An anode is selected from the first electrode, the second electrode and the can electrode based on the primary electrode configuration. A first pulse is delivered between the cathode and the anode. Systems, programs and devices using the method are also provided.

A method and system of adapting heart rate in cardiac tissue based on two types of sensed information is provided. A pulse is transmitted to the cardiac tissue. An activity signal is received. A first interval signal is also received and the pacing rate is adapted based on the first interval signal. A second interval signal is then received and the adapted pacing rate is verified using the second interval signal.

Rate adaptive pacemaker system with dual sensing component and method of using same

A method of monitoring heart failure is provided. A baseline heart rate change value is determined, wherein the baseline heart rate change value comprises a speed at which a first initial heart rate changes to a second initial heart rate. At least one subsequent heart rate change value is also determined, wherein the subsequent heart rate change value comprises a subsequent speed at which a first subsequent heart rate changes to a second subsequent heart rate. The subsequent heart rate change value is compared to the baseline heart rate change value to obtain at least one heart failure value. Systems and programs for using the method are also provided.

Method and system for monitoring heart failure using rate change dynamics

A method of measuring a source impedance of at least one cardiac electrical signal in a mammalian heart is provided. A first amplifier system is operated. A first signal from a chamber of the heart is received. The first signal is passed through a first amplifier. A second amplifier system is then operated. A second signal from the chamber of the heart is received. The second signal is passed through a second amplifier. Finally, the source impedance of at least one cardiac electrical signal is calculated. The source impedance is based on the amplified first signal and the amplified second signal.

Method and system for measuring a source impedance of at least one cardiac electrical signal in a mammalian heart

An improved system and method for analyzing far-filed R-waves detected by a sensing device located in the atrium of a patient's heart are provided.

System and method for sensing and detecting far-field R-wave

A system and method are provided for inducing ventricular tachycardia in a patient to enable testing to determine the optimum parameters for anti-tachycardia stimulation. The implantable device provides for overdrive pacing of the heart for a short sequence, followed by delivery of a series of pulse pairs. Each pulse pair has a first stimulus pulse delivered at the same or similar overdrive rate, and an inducing pulse which is delivered in timed relation to the evoked T-wave, preferably during the falling edge portion of the T-wave. In this way, each cycle the inducing pulse is timed for efficaciously inducing tachycardia. The timing of the inducing pulse is enhanced by near field sensing of the T-wave at about the location where the pulses are delivered, preferably using bipolar sensing and/or sense circuitry designed to recover the signal with an optimum time response.

System and method for inducing tachycardia

There is provided a pacing system having special functions for treating the patient's atrium with atrial pacing so as to reduce the probability of occurrence of dangerous atrial arrhythmias. The pacemaker of the system provides for atrial Pace.sub.-- Conditioning, whereby the patient's normal intrinsic atrial rate is overridden by higher rate pacing whenever a predetermined sequence of intrinsic heartbeats is sensed. The pacemaker also provides for special pacing routines following the detection of one or more PACs. The PAC response routines include pacing at an elevated rate for a predetermined time or number of beats, and smoothing out pacing intervals for one or several cycles following the occurrence of a PAC. The pacemaker also includes a post-exercise function, for overtaking the intrinsic rate and pacing the heart following exercise, the pacing being in accordance with a predetermined program which holds a relatively higher rate longer than normal post-exercise, so as to provide enhanced blood flow to the cardiac tissue and prevent the onset of ischemia.

Pacemaker system with improved techniques for preventing and suppressing

A system and method are provided for inducing ventricular tachycardia in a patient to enable testing to determine the optimum parameters for anti-tachycardia stimulation. The implantable device provides for overdrive pacing of the heart for a short sequence, followed by delivery of a series of pulse pairs. Each pulse pair has a first stimulus pulse delivered at the same or similar overdrive rate, and an inducing pulse which is delivered in timed relation to the evoked T-wave, preferably during the falling edge portion of the T-wave. In this way, each cycle the inducing pulse is timed for efficaciously inducing tachycardia. The timing of the inducing pulse is enhanced by near field sensing of the T-wave at about the location where the pulses are delivered, preferably using bipolar sensing and/or sense circuitry designed to recover the signal with an optimum time response. In one preferred embodiment, near field sensing is enabled by use of an FDC circuit. In another preferred embodiment, near field sensing is provided by a pacing lead having bipolar electrodes where the ring electrode is spaced less than 1 mm proximal to the tip electrode.

System for inducing tachycardia utilizing near field T-wave sensing

A pacemaker system is provided which provides for more flexibility in re-programming of the control software, or program which is controlling an implanted pacemaker. The system comprises an external programmer device which is capable both of programming the implanted device in a conventional way, and also downloading new control software to the implanted device, subject to predetermined system conditions. All implanted devices, e.g., pacemakers within the system of the invention, share a hardware platform, and are identified as belonging to a given one of a plurality of groups, each group being characterized as providing therapy aimed at a different condition. Each pacemaker also carries type data, indicating the type of pacemaker within the group, and a set of permissions data representative of different types within the group to which it is permitted to be programmed. Upon interrogating the implanted device, the programmer determines whether the device is part of the system, what its group and type is, and whether it is able to modify the device.

Pacemaker system with enhanced programmable modification capacity

A rate responsive pacemaker and method of pacing, having circuitry for controlling the rate of change of pacing rate in response to varying rate sensor signals. The pacemaker increments or decrements pacing rate each cycle, the change in rate being limited as a function of pacing rate, rate of change of sensor rate; the magnitude of the difference between sensor rate and pacing rate; whether prior cycles ended in sense or pace events; and/or a separate fast response sensor.

Rate responsive pacemake with improved rate change dynamics and pacing

A rate adaptive pacemaker and method of operation, where the sensor-indicated rate is adjusted as a function of sensed sinus rate. The pacemaker is particularly adapted for VDDR operation. The natural sinus rate is compared to the sensor-indicated rate at one or more rates, and the sensor response function is adjusted, or adapted as a function of such comparisons, so as to optimize sensing of the atrial rate and maintenance of synchronous operation. The rate response function may be adjusted specifically at upper pacing limit, and may also be adjusted as a function of comparisons made at other rates.

Rate adaptive pacemaker with adjustment of sensor rate as a function of

A pacemaker for providing optimized inhibit and trigger responses, operating in a VVD or AAD mode. For each pacemaker cycle, the pacemaker is controlled to time out a refractory interval, an inhibit interval or range following a refractory interval, and a trigger interval or range which follows the inhibit interval and ends at the time out of the scheduled escape interval. A signal sensed during the inhibit range results in no pace pulse delivery, the pacemaker goes to the trigger mode and extends the escape interval. Any signal thereafter sensed before the time out of the extended escape interval results in delivery of a trigger pulse and restarting of a new pacemaker cycle. If no signal is sensed during the inhibit range, any signal sensed during the trigger range results in generation of a trigger pulse and the start of a new pacemaker cycle. The overall result is that noise or other signals which occur within the inhibit range are inhibited without a trigger, with only a small extension of the escape interval so that pacing rate is not greatly affected. Any signal sensed in the trigger range results in delivery of a trigger pulse. The result is an optimized combination of inhibition and triggering which ensures pacing in the presence of any noise that is sensed with relatively minimized sacrifice in rate change and battery energy depletion.

Pacemaker with improved inhibit and trigger control

A dual chamber pacemaker system is provided having an improved Wenckebach response for optimizing tracking of atrial signals having rates within a rate range above the normal tracking range, i.e., in a designated Wenckebach range. When an atrial sense occurs in the Wenckebach range, the AV delay is extended up to a predetermined maximum extension to enable delivery of a ventricular pulse at the ventricular upper rate limit (dynamic tracking limit). When the AV delay would have to be extended beyond the maximum extension in order to pace the ventricle at the dynamic tracking limit, the next ventricular stimulus is delivered asynchronously at an escape interval greater than the escape interval corresponding to the dynamic tracking limit, e.g., at a predetermined lower pacing limit.

Pacemaker with Wenckebach operation

A dual chamber pacemaker is provided having incorporated therein a VA conduction test for concurrently testing for the conditions of retrograde conduction (RC) and far field R wave sensing (FFRS). The pacemaker changes the AV or VV interval to a predetermined interval over a number of pacemaker cycles, and determines whether the VA interval remains substantially unchanged, i.e., the VA intervals are substantially equal. When VA interval equality is determined, the pacemaker checks the measure of VA interval with stored RC and FFRS criteria to determine whether either can be verified. Respective corrective steps are taken if either RC or FFRS is verified.

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Velp, Netherlands

Malcolm J Begemann