St. Jude Medical Ab

Pacesetter, Inc.

Malin Öhlander

Nils Holmström

Andreas Blomqvist

Sven-Erik Hedberg

Euljoon Park

Kjell Norén

Karin Ljungström

Dorin Panescu

Xiaoyi Min

Andre B Walker

Shahrooz Shahparnia

Kenth A Nilsson

Kjell Noren

Anders Björling

Weiqun Yang

Louis Wong

Cem M Shaquer

Johan Eckerdal

Mihir Naware

Tom Eriksson

Michael Broome

Ajit Pillai

Anna-Karin Johansson

Sven Kalling

Maria Torpo

Nils Holmstöm

Johan Svahn

Urban Lönn

Cecilia Tuvstedt

Anders BJÖRLING

In a method and a device for determining the posture of a patient, a bio-impedance measurement device, having a number of electrodes configured to interact with the patient in a number of different electrode configurations, is operated to initiate a patient posture determining session by measuring an impedance value of the patient with the electrodes in at least one configuration among the number of configurations. A reference impedance value from among a number of stored reference impedance values for the at least one configuration is selected. The number of stored reference impedance values are respectively associated with different postures of the patient, and the posture associated with the selected reference impedance value represents a candidate posture. The measured impedance value is compared with the selected reference impedance value, thereby obtaining a comparison result. Dependent on said comparison result, it is automatically determined whether the current posture of the patient conforms to the candidate posture.

Medical device for determining the posture of patient

In an implantable heart monitoring device and a monitoring method, an impedance is measured across at least part of an atrium, such that variation of the impedance is related to the volume change of the atrium. Values are stored at different occasions that indicate the rate of change of the measured impedance. The stored values are determined such that, when the device is used in a living being, the variation of the stored values will be related to the variation of the speed with which the atrium is filled with blood during the atrial diastole.

Implantable heart monitoring device, system and method

An implantable device monitors and treats heart failure, pulmonary edema, and hemodynamic conditions and in some cases applies therapy. In one implementation, the implantable device applies a high-frequency multi-phasic pulse waveform over multiple-vectors through tissue. The waveform has a duration less than the charging time constant of electrode-electrolyte interfaces in vivo to reduce intrusiveness while increasing sensitivity and specificity for trending parameters. The waveform can be multiplexed over multiple vectors and the results cross-correlated or subjected to probabilistic analysis or thresholding schemata to stage heart failure or pulmonary edema. In one implementation, a fractionation morphology of a sensed impedance waveform is used to trend intracardiac pressure to stage heart failure and to regulate cardiac resynchronization therapy. The waveform also provides unintrusive electrode integrity checks and 3-D impedancegrams.

Systems and methods to monitor and treat heart failure conditions

An implantable medical device has an impedance determiner for determining a cardiogenic impedance signal based on electric signals sensed by connected electrodes. A parameter calculator processes the impedance signal to calculate an impedance parameter representative of the cardiogenic impedance in connection with the diastolic phase of a heart cycle. This parameter is then employed by the device for monitoring acute decompensated heart failure status of a subject.

Method and device for monitoring acute decompensated heart failure

Implantable heart stimulator connectable to an electrode arrangement has a pulse generator adapted to deliver stimulation pulses to a heart of a subject; an impedance measurement unit adapted monitor at least one heart chamber of the heart of the subject to measure the impedance in the at least one monitored heart chamber for generating an impedance signal corresponding to the measured impedance. The impedance signal is applied to a processor where the signal is processed, according to specified criteria, and a fractionation index value is determined represented by the curve length of the impedance signal during a predetermined measurement period. The fractionation index value is a measure of different degrees of mechanical dyssynchrony of the heart.

Implantable heart stimulator for measuring dyssynchrony using impedance

In a method and implantable medical device for ventricular tachyarrhythmia detection and classification, upon detection of a ventricular tachyarrhythmia based on an electrocardiogram signal, cardiogenic impedance data representative of ventricular volume dynamics are collected and used for classifying the detected tachyarrhythmia as stable or unstable. In the latter case but typically not in the former case, defibrillation shocks or other forms of therapy are applied to combat the unstable ventricular tachyarrhythmia.

Implantable medical device and a method comprising means for detecting and classifying ventricular tachyarrhythmias

An implantable cardiac device has a heart stimulator for electrically stimulating the heart of a patient, detector that measures a physiologic parameter that is affected by the status of a cardiovascular disease associated with sympathetic activation, a signal processor that determines at least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the measured parameter, and analyzer that automatically analyzes the determined Mayer wave component in relation to a predetermined reference value to determine the status of the cardiovascular disease. The detector is a cardio-mechanical parameter detector that measures, as said physiologic parameter, a mechanical change in at least one of the four chambers of the heart. In a corresponding method for monitoring the status of a cardiovascular disease associated with sympathetic activation of a patient having an implantable electric heart stimulator a physiologic parameter affected by the cardiac disease is measured. At least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the parameter is determined, and the wave component is analyzed in relation to a predetermined reference value to determine the status of the cardiovascular disease. A mechanical change in at least one of the four chambers of the heart is measured as the physiologic parameter.

Implantable cardiac device and method for monitoring the status of a cardiovascular disease

In a method and an apparatus for creating hemodynamic sensor signal templates using an implantable medical device connectable to a patient heart activity of the patient is sensed in order to identify a paste or sensed sequence of events of a heart cycle. Hemodynamic sensor signals for consecutive heart cycles are sensed and the sensed hemodynamic sensor signals for consecutive heart cycles are stored. The sensed sensor signals are classified dependent on at least one predetermined heart event sequence condition. A template may be created using the classified sensor signals.

Method and implantable medical device for classifying sensor signals

An implantable medical apparatus for detecting diastolic heart failure, DHF, has a DHF determining device for determining at least one DHF parameter for detecting a DHF state of the heart of a patient. The DHF includes circuitry for determining, as the DHF parameter, the time duration of a predetermined phase of diastole. A pacemaker has such an apparatus and a control unit that optimizes pacing therapy and pacemaker settings depending on the determined time duration. A corresponding method of detecting diastolic heart failure, DHF, includes determining at least one DHF parameter for detecting a DHF state of the heart of a patient. As the DHF parameter, the time duration of a predetermined phase of diastole is determined.

Apparatus for detecting diastolic heart failure

An exemplary method includes acquiring impedance values over one or more respiratory cycles, determining an impedance span based on the impedance values and, based at least in part on the impedance span, determining cardiac condition or respiratory condition. Another exemplary method includes acquiring IEGMs over one or more respiratory cycles, determining evoked response measure values based on the IEGMs, determining an evoked response span based on the evoked response measure values and, based at least in part on the evoked response span, determining cardiac condition or respiratory condition. Other exemplary methods, devices, systems, etc., are also disclosed.

Evoked response and impedance measures for monitoring heart failure and respiration

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Stockholm, Sweden

Malin Öhlander