Medtronic, Inc.

Peter Oosterhoff

Mattias Rouw

Peter M Van Dam

Harry Bernardus Antonius Kerver

Henricus W M De Bruyn

Diederick M Keizer

Suzanne Mouton

An implantable medical device and associated method perform ECG morphology monitoring. A subcutaneous ECG signal and a posture signal are sensed in a patient. A cardiac condition is detected in response to the ECG signal and the posture signal. In one embodiment, multiple ECG morphology templates corresponding to each of a number of different patient postures are acquired and stored for use in detecting a cardiac condition.

Template matching method for monitoring of ECG morphology changes

Methods and devices for identification of intrinsic ventricular activity occurring within a ventricular signal. Ventricular signal morphology is analyzed to determine if the signal contains intrinsic ventricular activity while delivering pacing pulses separated by nearly constant time intervals. Furthermore, an extension of a pacing interval is specified based on whether or not the signal contains autonomous intrinsic ventricular activity. In this manner, the pacing interval is only extended when it is likely for autonomous intrinsic ventricular activity to occur.

Dynamic pacing interval extension for detection of intrinsic ventricular activity

The invention is directed to methods and apparatus for automatically changing from bi-ventricular pacing, in which an implantable medical device (IMD) applies pacing stimuli to both ventricles of a heart during a cardiac cycle, to single-ventricle pacing, in which the IMD paces one ventricle and inhibits pacing of the other. An IMD applying the techniques of the invention automatically changes from bi-ventricular pacing to single-ventricle pacing, or vice versa, as a function of the reliability of left ventricular pacing. Exemplary techniques for determining the reliability of left ventricular pacing include impedance measurement, capture testing, capture threshold testing, or any combination thereof.

Bi-ventricular and single-ventricle pacing

A medical device is directed to techniques for removing polarization artifacts from electrical activity signals in order to detect presence of an evoked response. More specifically, a medical device receives a signal that represents electrical activity within a heart of a patient following delivery of a stimulation pulse to the heart and reconfigures a filter state of a filter from an initial filter state to remove the polarization artifact from the electrical activity signal in order to determine whether a cardiac event, such as an evoked response has occurred. The medical device may, for example, when the filter of the medical device is a digital filter, recalculate the values of digital filter components using the present input value of the electrical activity signal as a direct current (DC) input value of the digital filter.

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Zutphen, Netherlands

Peter Oosterhoff