Pacesetter, Inc.

Siew Bee Er

Quang Ly

Paul A Levine

Euljoon Park

Laurence S Sloman

Melinda A Endaya

Robert E Smith, Jr

Qiuju Huang

James E Tyler

A method and system for programming an implantable therapeutic stimulation device sensing from and delivering therapeutic stimulations to multiple sites within a patient under a plurality of programmable parameters. The method includes automatically determining which parameters need to be programmed, graphically indicating specific parameters that need to be programmed in a spatial correspondence to the affected sites in the patient and/or displaying a waveform corresponding to expected physiological activity with the programming, and providing control inputs to program the specific parameters. The method can also include automatically evaluating the programmed parameters, and if errors exist in the programming, indicating the errors and awaiting corrective input, else programming the implantable device. The method can also include automatically determining a number of sensing and stimulation electrodes connected to the device.

Method and system to graphically display programming parameters for multi-chamber devices

An implantable medical device, such as a pacemaker, stores information pertaining to a variety of events detected and/or triggered by the medical device for subsequent transmission to an external programmer device. The external programmer device displays graphical representations of the information under the control of a physician operating the programmer device. Examples of information stored by the pacemaker include information pertaining to operations triggered within the pacemaker as a result of the condition of the patient, such as an auto-mode switching event automatically triggered as a result of conditions detected within the heart, or as a result of the condition of the pacemaker itself, such as a battery test operation. Still other examples of information recorded by the pacemaker include information pertaining to programmer operations triggered by a remote programmer device, such as a heart base rate programming operation triggered by an external programmer.

Method and apparatus for implementing operating changes and displaying operating change information for an implantable medical device

A pacemaker or other implantable medical device stores diagnostic information pertaining to a variety of events detected pacemaker for subsequent transmission to an external programmer. The external programmer displays graphical representations of the diagnostic information under the control of a physician operating the programmer. In one example, the pacemaker senses events occurring within the heart during a refractory period following generation of a stimulation signal, stores diagnostic information pertaining to those events as &ldquo;event records&rdquo; within the pacemaker, and ultimately transmits the event records to the external programmer for display in various graphical formats. The events occurring during the refractory period include events such as a P-wave detected during a relative post-ventricular atrial refractory period not followed by a ventricular pulse or an R-wave detected during a relative ventricular refractory period or a P-wave detected during an atrial refractory period during an AV/PV interval. Other examples of diagnostic information stored by the pacemaker include information pertaining to operations triggered within the pacemaker as a result of the condition of the patient, such as an auto-mode switching event, or as a result of the condition of the pacemaker itself, such as a battery test operation. Still other examples of diagnostic information recorded by the pacemaker and displayed by the external programmer include information pertaining to programming signals received from the external programmer, such as a heart base rate and rest rate re-programming signals.

Method and apparatus for displaying programming events detected by an implantable medical device

A pacemaker, or other implantable medical device, connected to heart tissue, detects atrial and ventricular electrical signals. The pacemaker analyzes the signals to determine whether the signals are representative of P-waves or R-waves according to atrial and ventricular sensitivity threshold values. Signals determined to be P-waves or R-waves are identified as sensed signals. Otherwise the signals are identified as not-sensed signals. The pacemaker further determines whether the sensed signals were detected during a refractory period or an alert period and its current tracking mode (e.g., VDD, DDD vs. DDI, VVI). Information pertaining to these atrial and ventricular signals is transmitted to an external programmer which generates representative histograms. The histograms present the number of counts detected within each of a set of high pass filtered amplitude ranges and further indicate the relative numbers of sensed vs. not-sensed counts. For the sensed counts, the histogram may further indicate the relative numbers of counts detected during refractory periods and alert periods. The histograms additionally show the applicable atrial or ventricular sensitivity threshold values to visually assist a physician in determining whether the threshold values are set properly. An auto-sensitivity adjustment system is also provided to determine optimal sensitivity threshold values.

Method and apparatus for detecting and displaying P-wave and R-wave histograms for an implant medical device

An implantable stimulation device is interrogated by an external programmer, operated by a medical practitioner, to determine whether a recommended replacement time indicator in the device is set to an active state. If the recommended replacement time indicator is active, the programmer displays the active indicator and an accompanying message explaining various causes that may result in the indicator being set to the active state. The programmer then retrieves battery diagnostic data, which may include, but is not limited to battery test rate, battery voltage, battery current, and battery impedance, and optionally generates a battery longevity prediction graph. The battery diagnostic data and the prediction graph are then displayed by the programmer to the medical practitioner. The medical practitioner may then analyze the battery diagnostic data and the prediction graph to determine whether the recommended replacement time indicator was properly set by the implantable stimulation device to the active state. Finally, the medical practitioner can use the programmer to reset an improperly set recommended replacement time indicator to the inactive state.

System and method for verification of recommended replacement time indication in an implantable cardiac stimulation device

An implantable medical device, such as a pacemaker, stores diagnostic information pertaining to a variety of events detected by the medical device for subsequent transmission to an external programmer device. The external programmer device displays graphical representations of the diagnostic information under the control of a physician operating the programmer device. In one example, wherein the implantable medical device is a pacemaker coupled to the heart of a patient, the pacemaker senses events occurring within the heart during a refractory period following generation of a stimulation signal, stores diagnostic information pertaining to those events as 'event records' within the pacemaker, and ultimately transmits the event records to the external programmer device for display thereon in various graphical formats. The events occurring during the refractory period include events such as a P-wave detected during a relative post-ventricular atrial refractory period not followed by a ventricular pulse or an R-wave detected during a relative ventricular refractory period or a P-wave detected during an atrial refractory period during an AV/PV interval.

Method and apparatus for detecting and displaying diagnostic information

A pacemaker generates and transmits real-time intracardiac electrogram signals to an external display device for display thereon. Simultaneously, the pacemaker senses a variety of events occurring either within the heart tissue or within the pacemaker itself and transmits signals representative of those events for display, using appropriate marker icons, along with the intracardiac electrograms. In this manner, a physician viewing the intracardiac electrograms is simultaneously apprised of the various events. In one example, events displayed along with the intracardiac electrograms include the detection of atrial and ventricular events occurring within the heart during a non-absolute refractory period following generation of a stimulation signal. Other examples of events displayed along with the intracardiac electrograms include operations triggered within the pacemaker as a result of the condition of the patient, such as an auto-mode switching event, or operations triggered within the pacemaker as a result of the condition of the pacemaker itself, such as a battery test operation. Still other examples of events include pacemaker programming operations triggered using a remote programming device by a physician. Such events include an electrophysiological artificially-induced arrhythmia operation. In the described example, the external display device also presents surface electrocardiograms along with the intracardiac electrograms and the event marker icons.

A real-time impedance monitoring system is provided for use with an implantable medical device having an implantable electrical lead. The impedance monitoring system includes components for determining the electrical impedance of the lead as a function of time, with the determination being made substantially in real-time, and components for graphically displaying the electrical impedance of the lead as a function of time, with the display also being generating substantially in real-time. In one specific example described herein, the implantable medical device is a pacemaker and the impedance monitoring system is within an external programmer device separate from the pacemaker. The programmer device includes a computer display screen or a computer printout device for presenting real-time graphical displays of the lead impedance. The programmer may alternatively generate graphical displays of lead impedance as a function of time based upon pre-recorded data.

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Newhall, CA, United States of America

Siew Bee Er