Cardiac Pacemakers, Inc.

Data Sciences International, Inc.

Paul Allan Haefner

Imad Libbus

Anthony V Caparso

Scott A Meyer

Haris Sih

Marina V Brockway

Yi Zhang

Aaron R McCabe

Darrell Orvin Wagner

Apurv Ullas Kamath

Kent Lee

Kristofer J James

Jonathan T Kwok

Yachuan Pu

Jaeho Kim

Joseph M Bocek

M Jason Brooke

Alok S Sathaye

Mark A Stockburger

William J Linder

Jeffrey E Stahmann

Andrew P Kramer

Julio Cesar Spinelli

Rene H Wentkowski

Zhengnian Tang

Qingsheng Zhu

David J Ternes

Jason Alan Shiroff

Gary Thomas Seim

Michael J Lyden

Adam W Cates

Wondimeneh Tesfayesus

Loell Boyce Moon

Curtis Charles Lindstrom

Mark Gryzwa

Scot C Boon

Ron Heil

Wondimeneh Tesfavesus

Darrel Orvin Wagner

Gary Pritchard

Scott R Tiesma

Steve Hachtman

Haris J Sih

Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein.

Closed loop neural stimulation synchronized to cardiac cycles

A cardiac monitoring and/or stimulation system includes a housing coupled to a plurality of electrodes configured for subcutaneous non-intrathoracic sensing. A signal processor receives a plurality of composite signals associated with a plurality of sources, separates a signal from the plurality of composite signals, and identifies the separated signal as a cardiac signal using information derived from a non-electrophysiologic sensor, such as an accelerometer or acoustic transducer. The signal processor may iteratively correlate separated signals from the plurality of composite signals with a non-electrophysiologic sensor signal until the cardiac signal is identified.

Subcutaneous cardiac signal discrimination employing non-electrophysiologic signal

Methods and devices for classifying a cardiac pacing response involve using a first electrode combination for pacing and a second electrode combination for sensing a cardiac signal following pacing. The cardiac response to pacing may be classified using the sensed cardiac signal. One process involves using the sensed cardiac signal to detect the cardiac response as a fusion/pseudofusion beat. Another process involves using the sensed cardiac signal to classify the cardiac response to pacing as one of at least three cardiac response types.

Cardiac response classification using multisite sensing and pacing

A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system detects apnea and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected apnea.

Method and apparatus for controlling neural stimulation during disordered breathing

A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder.

Method and apparatus for neural stimulation with respiratory feedback

Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.

Subcutaneous cardiac sensing and stimulation system

Methods and devices for classifying a cardiac response to pacing involve establishing a plurality of classification windows relative to and following a pacing pulse. One or more characteristics of a cardiac signal sensed following the pacing pulse are detected within one or more particular classification windows. The characteristics may be compared to one or more references. Classification of the cardiac response may be performed based on the comparison of the one or more characteristics to the one or more references and the particular classification windows in which the one or more characteristics are detected.

Cardiac response classification using multiple classification windows

A method embodiment comprises generating a neural stimulation signal for a neural stimulation therapy. The signal is generated during a duty cycle of a stimulation period to provide the neural stimulation therapy with an intensity at a therapy level for a portion of the duty cycle. In various embodiments, a ramp up protocol is implemented to begin the duty cycle, a ramp down protocol is implemented to end the duty cycle, or both the ramp up protocol and the ramp down protocol are implemented. The ramp up protocol includes ramping up the intensity from a non-zero first subthreshold level for the neural stimulation therapy at the beginning of the duty cycle to the therapy level. The ramp down protocol includes ramping down the intensity from the therapy intensity level to a non-zero second subthreshold level for the neural stimulation therapy at the end of the duty cycle.

Systems and methods for providing neural stimulation transitions

Inhalation measurement systems and methods enable, during inhalant exposure, substantially real-time respiratory measurements of a test subject using techniques that obtain measurements of respiration directly from that test subject, instead of from inhalation chamber parameter measurements. Direct test subject respiratory measurements may be, by way of example only, impedance measurements. These respiratory measurements taken directly from the test subject may be transmitted, wirelessly for example, for processing during the course of the test to a processing system to determine a cumulative volume of inhalant inspired by the test subject. From that, a cumulative amount of inhalant (or dose) inspired by the test subject may be determined during the course of the inhalation compound test. In addition, a calibration procedure may be performed before the inhalant exposure to provide correlation needed to translate chest and/or abdominal wall expansion measurements, made during the test, into lung volume measurements.

Respiration measurements and dosimetry control in inhalation testing systems

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Circle Pines, MN, United States of America

Paul Allan Haefner