Medtronic, Inc.

Other

Pierre Andre Grandjean

Chester L Struble

Antoine N Camps

Philip H Lee

David E Francischelli

Robert Leinders

Ivan M Bourgeois

Nicolaas M Lokhoff

Kendra K Gealow

Gary M Johnson

Willem J Van Driel

Johann J Neisz

Koen J Weijand

David K Peterson

Volkert A Zeijlemaker

Karel F A A Smits

Frits W Prinzen

Barbro M Kjellstrom

Lambert Muhlenberg

Chrit W Dreessen

Martinus A G M Bakx

John Hammargren

Michael W Polz

Chester W Struble

Ilaria Vicini

A method and apparatus concerning the retrieval and storage of status information obtained from patients having implantable medical devices (IMDs). When patients are having episodes during which symptoms are experienced relating to their medical condition, the collection of the patient's status information can be helpful to the patient's physician for diagnostic purposes. Telemetered signals recorded by the IMD can be transmitted from the IMD to a programmer. Such programmer is portable and sized so as to be carried by the patient. As such, mechanisms added to such programmers for use in retrieving and storing patient status information can provide more convenience for patients.

Portable programmer for providing patient status information

A method for pacing a left ventricle of a heart includes delivering a pacing pulse via a first electrode to activate a first papillary muscle and another pacing pulse via a second electrode to activate a second papillary muscle.

Papillary muscle stimulation

A method and apparatus for adjusting the electrogram (EGM) sensitivity level of an implantable medical device using intracardiac pressure data. An EGM is monitored to detect electrical events and intracardiac pressure is monitored to detect pressure waves. The electrical waves and pressure waves are analyzed to determine the presence of a one-to-one correlation, with the absence of a one-to-one correlation indicating the need to adjust the sensitivity level.

Method and apparatus for adjusting sensitivity using intracardiac pressure data

The invention is directed to techniques for electrode placement around a heart. A harness having one or more attachment sites may be secured around the heart, and electrodes may be secured at the attachment sites as desired by the physician for the patient. The electrodes may be, for example, pacing and sensing electrodes, defibrillation electrodes, or any combination thereof. The harness holds the electrodes in place and also impedes the progress of ventricular dilation. The electrodes attached to the harness may be used for any of several purposes, such as cardiac resynchronization, selective defibrillation, measurement of impedance, pacing and cardioversion.

Cardiac restraint with electrode attachment sites

The hemodynamic operation of certain heart disease patient can be improved using pressure regulated atrio-ventricular delay. The pressure regulated atrio-ventricular delay involves recording atrial activation and ventricle activation, identifying a maximum diastolic pressure, identifying a declination pressure, calculating a percent decrease, and adjusting atrio-ventricular delay. The declination pressure occurs at the beginning of an isovolumetric contraction. The percent decrease is calculated between the maximum diastolic pressure and the declination pressure. The atrio-ventricular delay is adjusted according to the percent decrease between the maximum diastolic pressure and the declination pressure.

Pressure regulated atrio-ventricular delay for multi-site pacing

A plurality of sensors are disposed in and around the heart of a patient to collect data such as various electrical parameters, pressure parameters and temperature parameters. The data collected via the sensors may be organized and stored according to cardiac rhythm type. The organization of data according to cardiac rhythm type allows the patient's physician to be better able to monitor how the various parameters are related to the various cardiac rhythm types. In a typical embodiment, one or more of the sensors may be deployed on a single lead implanted in the heart.

Organizing data according to cardiac rhythm type

In a system that provides bi-atrial and/or bi-ventricular pacing, the system adjusts an interval between paces delivered to the atria, and/or an interval between paces delivered to the ventricles, as a function of pressure data from the heart. In an exemplary embodiment, the system uses the pressure data from the ventricles to identify the times that each ventricle begins ejection of blood. The system may adjust the interval between paces to cause the ventricles to begin ejection at the same time, or to cause one ventricle to commence blood ejection prior to the other ventricle with a desired time offset. The system may further adjust the interval in response to changing conditions, such as a changing heart rate.

Cardiac resynchronization with adaptive A1-A2 and/or V1-V2 intervals

An improved pacemaker has a hysteresis feature that activates accelerated pacing during periods of sinus arrest and/or extreme bradycardia. When the patient's intrinsic heart rate drops below a hysteresis rate, the pacemaker reverts to a programmable accelerated rate or to the average cardiac rate. Accelerated pacing is delivered for a programmable period of time, after which the pacing rate is gradually reduced toward a lower rate. If a desirable intrinsic rate is not attained after the pacing rate is reduced to the lower rate, the intervention cycle repeats.

Hysteresis activation of accelerated pacing

In a system that provides bi-atrial and/or bi-ventricular pacing, the system adjusts an interval between paces delivered to the atria, and/or an interval between paces delivered to the ventricles, as a function of heart rate. By adjusting the interval between paces as a function of heart rate, the atria and/or ventricles may be activated in a more synchronous and more hemodynamically efficient fashion.

There is provided a system and method for continually monitoring the occurrence of contraction during stimulation of skeletal muscle which is employed in a cardiac assist-type system. During delivery of a periodic burst, or train of stimulus pulses, the impedance of the muscle between the electrodes through which the pulses are delivered is monitored, and evaluated to determine whether or not stimulation has been achieved. In a particular embodiment, the impedance and impedance derivative values are accumulated throughout the burst, and assessed to determine whether the impedance change corresponded to a full muscle contraction. In the event of failure to stimulate the muscle to contraction, the system can automatically adjust the pulse output parameters to achieve reliable contraction.

System and method of determining skeletal muscle contraction by serial lead impedance measurements

A cardiac assist device having muscle augmentation during confirmed arrhythmia. In particular the present invention operates, in a first embodiment, to sense a cardiac event, next it determines whether the cardiac event is a cardiac arrhythmia, if the event is not a cardiac arrhythmia the devices delivers stimulation to a skeletal muscle grafted about a heart, but if the event is a cardiac arrhythmia the device inhibits delivery of skeletal muscle stimulation and once the arrhythmia is confirmed, then delivers therapeutic stimulation to the heart. In a second embodiment the present invention operates to re-initiate skeletal muscle stimulation once the arrhythmia is confirmed but prior to the delivery of the therapeutic stimulation to the heart.

Cardiac assist device having muscle augmentation prior to defibrillation

A medical electrical lead having active fixation which readily flexes within the cardiac tissue through a fixation mechanism which is temporarily rigid. In a preferred embodiment, the medical electrical lead features a fixation helix constructed from an absorbable material, such as mannitol. In an alternate embodiment a medical electrical lead is disclosed which features a fixation mechanism having a multi-layer construction. In that embodiment the fixation mechanism is fashioned of a first, rigid and absorbable, material and a second, readily pliable and nonabsorbable, material. Through such a construction the lead may be fixed in the tissue such that over time the first material is absorbed by the body and the second material is left in position to flexibly fix the lead in place. In one embodiment the second material is conductive and is used to achieve an electrical coupling to the body tissue.

Medical electrical lead having temporarily rigid fixation

A device and algorithm for a combined cardiomyostimulator and a cardiac pacer-cardioverter-defibrillator. In particular the present device operates, in a first embodiment, to deliver stimulation to a skeletal muscle grafted about a heart; sense depolarizations of a patient's heart; measure the intervals separating successive depolarizations of the patient's heart; define first and second interval ranges; determine the number of the measured intervals falling within the first and second interval ranges; inhibit the delivery of stimulation to a skeletal muscle grafted about a heart upon the sensing of a depolarization within the first or second interval range; detect the occurrence of a first type of arrhythmia when the number of the measured intervals falling within the first interval range equals a first predetermined value; detect the occurrence of a second type of an arrhythmia when the number of the intervals falling within the second interval range equals a second predetermined value; deliver a first type of arrhythmia therapy in response to the detection of the first arrhythmia; and deliver a second type of arrhythmia therapy in response to the detection of the second arrhythmia, the second type of arrhythmia therapy having a cardiac stimulation component and a skeletal muscle component.

Device and algorithm for a combined cardiomyostimulator and a cardiac

An end-of-life (EOL) indicator for an implantable pulse generator (IPG)--especially of the neuromuscular stimulation variety--indicates an approaching battery EOL condition via an electrocardiogram (ECG) by changing the nature of the muscle stimulation burst signals. IPG internal circuitry detects an approaching EOL condition and modifies the burst signals by, for example, decreasing the number of pulses in a burst, increasing the heart contraction-to-powering-muscle contraction ratio, or alternating between two numbers of pulses in successive burst cycles. The approaching battery EOL condition can be easily ascertained via trans-telephonic monitoring by analyzing a transmitted ECG alone, for the above-mentioned burst signal changes. By observing the patterns in the ECG caused by the burst signal changes, a clinician could be aware of an approaching EOL without having known the original muscle stimulation burst signal parameters.

End-of-life indication system for implantable pulse generator

An intramuscular lead for the electrical stimulation of muscle tissue. The improved lead has a needle connected to a strand of suture, a coiled conductor coupled to the strand by a tapered section of the coiled conductor, an insulative cover covers part of the coiled conductor, and a terminal connector coupled to the coiled conductor provides a connection to a pulse generator. Through such a construction the lead may be more readily introduced through muscle tissue.

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Warsage, Belgium

Pierre Andre Grandjean