Medtronic, Inc.

Medtronic, Ind.

Michael T Hemming

Saul E Greenhut

Bradley C Peck

Brian A Blow

Scott M Morrison

Robert John Schuelke

Subham Ghosh

James D Reinke

David Jerome Peichel

Jonathan P Roberts

Michael B Terry

Juan Du

Kent E Samuelson

Karen J Kleckner

John D Wahlstrand

Paul Gordon Krause

Michael W Heinks

Eric R Williams

Daniel L Hansen

Joel B Artmann

Steven N Lu

David E Ritscher

Ross O Starkson

John R Hamilton

Cameron J Kaszas

Lori Durose-Schrimpf

Steven Ning Lu

An implantable medical device includes a memory storing criteria for transitioning between states of a cardiac cycle model, the states including a P-wave state. The device also includes sensing circuitry that senses a cardiac signal that varies as a function of a cardiac cycle of a patient, and also includes processing circuitry coupled to the sensing circuitry. The processing circuitry is configured to detect an R-wave in the sensed cardiac signal, to determine an elapsed time since the detection of the R-wave, to determine one or more morphological values of a post-R-wave segment of the cardiac signal to compare the elapsed time and the one or more morphological values to the stored criteria for transitioning between the plurality of states of the cardiac cycle model, and to detect a P-wave in the sensed cardiac signal in response to a transition to the P-wave state of the cardiac cycle model.

State-based atrial event detection

A system, such as an IMD system, includes a tissue conductance communication (TCC) transmitter configured to generate a beacon signal by generating a carrier signal and modulating a first property of the carrier signal according to a first type of modulation. The TCC transmitter is configured to generate a data signal subsequent to the beacon signal by generating the carrier signal and modulating a second property of the carrier signal different than the first property according to a second type of modulation different than the first type of modulation.

Tissue conduction communication between devices

A device includes a tissue conduction communication (TCC) transmitter that generates a TCC signal including a carrier signal having a peak-to-peak amplitude and a carrier frequency cycle length including a first polarity pulse for a first half of the carrier frequency cycle length and a second polarity pulse opposite the first polarity pulse for a second half of the carrier frequency cycle length. Each of the first polarity pulse and the second polarity pulse inject a half cycle charge into a TCC pathway. The TCC transmitter starts transmitting the TCC signal with a starting pulse having a net charge that is half of the half cycle charge and transmits alternating polarity pulses of the carrier signal consecutively following the starting pulse.

Signal transmission optimization for tissue conduction communication

A medical device and medical device system for controlling delivery of therapeutic stimulation pulses that includes a sensing device to sense a cardiac signal and emit a trigger signal in response to the sensed cardiac signal, a therapy delivery device to receive the trigger signal and deliver therapy to the patient in response to the emitted trigger signal, and a processor positioned within the sensing device, the processor configured to determine whether the sensed cardiac signal exceeds a possible P-wave threshold, compare a portion of the sensed cardiac signal to a P-wave template having a sensing window having a length less than a width of the P-wave, confirm an occurrence of a P-wave signal in response to the comparing, emit the trigger signal in response to the occurrence of a P-wave signal being confirmed, and inhibit delivery of the emitting signal in response to the occurrence of a P-wave signal not being confirmed.

Confirming sensed atrial events for pacing during resynchronization therapy in a cardiac medical device and medical device system

A medical device is configured to deliver a high-energy electrical stimulation pulse to a patient that produces a post-stimulation polarization signal. A cardiac signal analyzer of the medical device is configured to detect a cardiac electrical signal superimposed on the post-stimulation polarization signal, determine at least one feature of the detected cardiac electrical signal, compare the feature to criteria that differentiate an intrinsic cardiac event during the post-stimulation polarization signal from an evoked response signal and identify the detected cardiac electrical signal as the intrinsic cardiac event if the feature meets the criteria.

Method and apparatus for detection of intrinsic depolarization following high energy cardiac electrical stimulation

Method and apparatus for detecetion of intrinsic depolarization following high energy cardiac electrical stimulation

The disclosure describes techniques and systems for filtering noise from a physiological signal. In one example, one or more processors are configured to receive a signal indicative of physiological activity of a patient, wherein the signal comprises noise at one or more frequencies, and filter the noise from the signal according to a noise rejection model, wherein the noise rejection model predicts the noise at the one or more frequencies. The one or more processors may also be configured to, responsive to initiation of a blanking period for the signal, advance the noise rejection model in time during the blanking period, and, responsive to termination of the blanking period, filter, based on the noise rejection model advanced in time, the noise at the one or more frequencies from the signal.

Filtering noise from a signal subjected to blanking

An implantable medical device and associated method monitor a physiological signal for sensing physiological events and detecting a physiological condition in response to the sensed physiological events. The device senses a first event from the physiological signal, senses a noise signal in the physiological signal and senses a next event from the physiological signal wherein the first event and the next event define a signal interval. The signal interval is declared as a noisy interval in response to the sensed noise signal.

Method and apparatus for detecting noise in an implantable medical device

In general, the invention is directed to techniques for electrically detecting physiological events. The physiological events may include cardiac events such as R waves or p waves. In addition, the physiological events may include respiratory events. In general, the techniques involve converting an analog physiological signal to a digital delta value, correlating the digital delta value with a correlation template, and detecting a physiological event based on an output of the correlation. A digital correlation-based technique, as described herein, is implemented to reliably detecting physiological events, particularly for very small signals captured in the presence of significant background noise.

Physiological event detection

A system and method for acquiring and processing an EGM signal during a pacing event, wherein a unique converter code is generated upon digitizing of the EGM signal and encrypted in the EGM signal to demarcate a transient event. The system further provides dynamic filtering of the EGM signal and subsequent detection of an intrinsic event signal during the pacing event, from which rhythm events may be diagnosed and classified.

EGM signal acquisition and processing system

A software programmable device means such as a microprocessor discriminates between evoked response signals and post-pace polarization signals sensed by an implantable medical device. The polarity of the positive or negative change in voltage in respect of time (or dv/dt) of the waveform incident on the lead electrodes is monitored during a short period of time immediately following a paced event. It has been discovered that the post-pace polarization signal exhibits a relatively constant polarity during the capture detect window, and that the evoked response signal may cause the polarity of post-pace polarization signal to reverse during the capture detect window . The sign of the post-pace polarization polarity, either positive or negative, is determined by the design of the specific output circuitry. The evoked response signal may reverse the polarity of the sensed signal in either case, from positive to negative or from negative to positive, during the time window of interest. In another embodiment of the present invention, and when the magnitude of the post-pace polarization is so great that the evoked response does not reverse the polarity of the waveform, discrimination of the evoked response is achieved by noting an acceleration (or increasing magnitude of dv/dt) in the sensed signal or waveform.

Microprocessor capture detection circuit and method

A method and apparatus for discriminating between evoked response signals and post-pace polarization signals sensed by a sense amplifier of an implantable medical device. The polarity of the positive or negative change in voltage in respect of time (or dv/dt) of the waveform incident on the lead electrodes is monitored during a short period of time immediately following a paced event. The post-pace polarization signal exhibits a relatively constant polarity during the capture detect window, and the evoked response signal may cause the polarity of post-pace polarization signal to reverse during the capture detect window. The sign of the post-pace polarization polarity, either positive or negative, is determined. The evoked response signal may reverse the polarity of the sensed signal from positive to negative or from negative to positive, during the time window of interest. When the magnitude of the post-pace polarization is so great that the evoked response does not reverse the polarity of the waveform, discrimination of the evoked response is achieved by noting an acceleration (or increasing magnitude of dv/dt) in the sensed signal or waveform. In one embodiment, sensing of the evoked response is based upon a relationship between a maximum magnitude of a derivative of a sensed signal and a predetermined threshold reference value. The evoked response is declared when the maximum amplitude of the a derivative of the sensed signal equals or exceeds the threshold reference value.

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Kiowa, CO, United States of America

Michael T Hemming