Medtronic, Inc.

The United States Government As Represented by the Department of Veterans Affairs

Nathan A Grenz

Amy E Thompson-Nauman

Xusheng Zhang

Karen J Kleckner

Zhongping C Yang

Ronald A Drake

Douglas S Hine

Robert W Stadler

Subham Ghosh

Wade M Demmer

Xiaonan Shen

Jeffrey M Gillberg

James D Reinke

Kenneth C Gardeski

Kevin R Seifert

Rick D McVenes

Michael Jay Ebert

Ryan P Lahm

Thomas J Mullen

Jonathan P Roberts

Vincent E Splett

Paul R Solheim

Eric A Schilling

Jay T Rassat

Andrea Jean Asleson

Brian P Colin

Ruth N Klepfer

Lonnie D Ronning

Kaileigh E Rock

Gregory N Nesseth

Jonathan E Baxter

Michael R Leners

Kristin M Johnson

Daniel W Celotta

Brian W Schousek

Alan Cheng

Stephen A Howard

Alexander R Mattson

Robert D Musto

Brett D Atwater

Varun Bhatia

Juan Meng

David L Palkert

John F Beshai

Kendall Emfield

Hongyang Lu

Brett Atwater

Implantable apparatus includes two or more alignable marker elements, and systems and methods for manufacturing such implantable apparatus, and methods to utilize such implantable apparatus. For example, the implantable apparatus may include a first alignable marker element and a second alignable marker element that may be used to ensure proper alignment with a target site.

Lead construction including alignable marker elements

A method of delivering a pacing lead may include locating a potential implantation site adjacent to or within the triangle of Koch region of a patient's heart. The method may include advancing a pacing lead to the potential implantation site. The pacing lead has an elongate body and a fixation element coupled to a distal portion and attachable to the right-atrial endocardium adjacent to or within the triangle of Koch region. The method may include implanting the pacing lead at the potential implantation site to or sense electrical activity of the left ventricle in the basal and/or septal region of the left ventricular myocardium of the patient's heart. The pacing lead may include a lumen configured to receive a guide wire. A sheath of a delivery system used to deliver the pacing lead may include two or more curves to facilitate implanting the pacing lead at the implantation site.

Delivery systems and methods for left ventricular pacing

A method and device for detecting phrenic nerve stimulation (PNS) in, or using, a cardiac medical device. A test signal sensitive to contraction of a diaphragm of a patient may be sensed and signal artifacts of the test signal within each of a first window of the test signal prior to a predetermined cardiac signal and a second window of the test signal subsequent to the predetermined cardiac signal may be determined. The PNS beat criteria may be evaluated, for example, using the test signal, which may be a heart sounds signal.

Sensor-based phrenic nerve stimulation detection

A method includes locating the triangle of Koch region in the right atrium of a patient's heart; securing at least one electrode of an implantable lead or device to cardiac tissue from the triangle of Koch region to deliver ventricle-from-atrium (VfA) cardiac therapy; and testing the location or depth of the at least one electrode to configure VfA cardiac therapy. Locating the target implant region in the triangle of Koch region may include detecting an atrial slow pathway potential (ASP) or atrial pacing output.

VfA delivery and implant region detection

In some examples, controlling delivery of cardiac resynchronization therapy (CRT) includes storing, in a memory of an implantable medical device system and in association with each of a plurality of heart rates, at least one respective value for an interval between an atrial event and a ventricular event. Processing circuitry of the implantable medical device system may determine a heart rate of a patient and select one of the stored values for the interval between the atrial event and the ventricular event associated with the determined heart rate. The processing circuitry may further determine whether to control therapy delivery circuitry of the implantable medical device system to deliver fusion pacing or biventricular pacing, based on the selected one of the stored values for the interval between the atrial event and the ventricular event.

Heart rate based control of cardiac resynchronization therapy

A delivery tool of a system for deploying medical diagnostics and/or therapy includes a deployment member and a sheath. An elastic cantilever element secured to a tubular sidewall of the deployment member, in proximity to a distal opening of a lumen formed by the sidewall, is spring biased to extend outward from the sidewall. When the cantilever element is received within the sheath, a sheath sidewall pushes the cantilever element inward, against the spring bias thereof, and a radius of curvature of the cantilever element approximately conforms to that of an outer surface of the deployment member sidewall. A helical track for receiving passage of a medical device helix fixation element therein may extend around a perimeter of the deployment member lumen, wherein a distal terminal end of the track is located in close proximity to the distal opening and generally opposite a free end of the cantilever element.

Systems for deploying medical diagnostics and/or therapy and delivery tools thereof

Systems, methods, and interfaces are described herein for assisting in a user in configuring cardiac therapy. A projection of a phrenic nerve stimulation map may be projected on a graphical depiction of a portion of a patient's heart. The phrenic nerve stimulation map may indicate to a user the regions of the patient's heart that may have a likelihood of stimulating the patient's phrenic nerve.

Systems, methods, and interfaces for configuring cardiac therapy

A medical device and associated method determine a signal amplitude of a sensor signal produced by a MEMS sensor, compare the signal amplitude to a stiction detection condition, detect stiction of the MEMS sensor in response to the signal amplitude meeting the stiction detection condition, and automatically provide a corrective action in response to detecting the stiction.

Accelerometer integrity alert

A method and medical device for monitoring patient medication compliance that includes a plurality of electrodes to deliver a pacing therapy and a processor configured to determine a pacing threshold in response to the delivered pacing therapy, determine whether there is a change in the pacing threshold, and determine patient medication compliance in response to the determined changes.

Method and apparatus for monitoring of patient medication compliance

Techniques for identifying abnormal cardiac substrate, e.g., scar substrate, may be implemented, as an example, during implantation of a left-ventricular (LV) lead, e.g., for cardiac resynchronization therapy (CRT), which may enable placement of the LV lead to avoid the abnormal cardiac substrate. An example system for identifying abnormal cardiac substrate comprises at least one implantable LV lead comprising at least one bipolar electrode pair configured to sense a LV bipolar cardiac electrogram signal of LV tissue proximate the bipolar electrode pair. The system delivers cardiac pacing pulses to a left ventricle via at least one electrodes of the LV lead, which may be different then the electrodes of the bipolar pair, and which may be spaced at least a threshold distance from the bipolar pair of electrodes. The amplitude of paced depolarizations in the bipolar electrogram indicates whether tissue proximate the bipolar electrode pair comprises abnormal cardiac substrate.

Identification of abnormal cardiac substrate during left-ventricular pacing

A method and medical device for monitoring cardiac function in a patient that includes a plurality of electrodes to deliver cardiac pacing therapy, and a processor configured to determine a pacing threshold in response to initial delivery of the pacing therapy, determine whether there is a change in the pacing threshold during initial delivery of the pacing therapy, adjust a delivery parameter of the pacing therapy in response to determining the change in the pacing threshold during initial delivery of the pacing therapy, determine whether there is an increase in the pacing threshold during delivery of the adjusted pacing therapy, and determine hypokalemia in response to the increase in the pacing threshold during delivery of the adjusted pacing therapy being present.

Method and apparatus for cardiac function monitoring

A method and medical device for monitoring cardiac function in a patient that includes a plurality of electrodes to deliver cardiac pacing therapy, and a processor configured to determine a pacing threshold in response to initial delivery of the pacing therapy, determine whether there is a change in the pacing threshold during initial delivery of the pacing therapy, adjust a delivery parameter of the pacing therapy in response to determining whether there is a change in the pacing threshold during initial delivery of the pacing therapy, determine whether there is a decrease in the pacing threshold during delivery of the adjusted pacing therapy, and determine hyperkalemia in response to the decrease in the pacing threshold during delivery of the adjusted pacing therapy being present.

A medical device system and associated method for controlling a cardiac rhythm management therapy detect extracardiac stimulation. Cardiac pacing pulses are delivered, and a cardiac electrical signal comprising myocardial depolarization and repolarization signals is acquired. A processor is configured to, responsive to the cardiac electrical signal, detect extracardiac capture due to the cardiac pacing pulse.

Detection of extracardiac stimulation by a cardiac rhythm management device

A method for selecting a target vein for left ventricular lead placement for cardiac resynchronization therapy includes determining electrical dispersion for the first coronary vein by calculating the difference between (i) activation time at a location of the vein that has the latest activation time of a plurality of locations in the vein and (ii) activation time at a location that has the earliest activation time of the plurality of locations. The method may further include (ii) determining whether the magnitude of the electrical dispersion for the vein meets or exceeds a predetermined threshold selecting the vein if the vein meets or exceeds the predetermined threshold; or (ii) selecting, among several veins, the vein that has the highest electrical dispersion.

Detection of target vein for CRT therapy

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Shoreview, MN, United States of America

Nathan A Grenz