Medtronic, Inc.

University of Minnesota

Medronic, Inc.

Allina Health System

Subham Ghosh

Jeffrey M Gillberg

Robert W Stadler

Karen J Kleckner

Zhongping C Yang

Juan Du

Berthold Stegemann

Trent M Fischer

Thomas A Anderson

Lilian Kornet

Richard N Cornelussen

Brian P Colin

Ruth N Klepfer

William J Clemens

D'Anne E Kudlik

Jean J Rutten

Todd Jon Sheldon

Saul E Greenhut

Jian L Cao

Xiaohong Zhou

Troy Edward Jackson

John D Wahlstrand

Aleksandre T Sambelashvili

Eric A Schilling

Michael T Hemming

Tarek D Haddad

Vincent E Splett

Michael F Hess

Teresa A Whitman

Michael W Heinks

Elizabeth A Schotzko

Yanina Grinberg

Nathan A Grenz

Michael L Hudziak

Manfred Justen

Ya-Jian Cheng

Jean E Hudson

Anthony W Schrock

Melissa Rhodes

Richard M T Lu

Joshua J Blauer

Maurice T I Verbeek

Toine Camps

Marc C Steckler

Jordyn Reich

Keelia Doyle

Kushagr Gupta

Joeri Heynens

Alfonso Aranda Hernandez

Stefan Kracker

Daniel S Flo

Alan J Bank

Ryan M Gage

Kevin V Burns

Antonia E Curtin

Sean Farrell

Andrea Grammatico

Sarah Meloni

Irah-Vanesa H Comia

Brandon K Hoglund

Richard MT Lu

Melissa M Rhodes

Maurice TI Verbeek

Jean Rutten

Sean R Farrell

Yonk K Cho

Richard Cornelussen

A cardiac pacemaker that delivers cardiac pacing therapy that includes delivering the cardiac pacing therapy from a cardiac pacing device, sensing a pacing event from a plurality of electrodes of the pacing device, and sensing an electromechanical signal from an electromechanical sensor of the pacing device. A pre-ejection period is determined in response to the sensed electromechanical signal, and a left ventricular ejection time is determined in response to the sensed electromechanical signal. The pacemaker device performs one or both of adjusting a pacing parameter setting and generating an alert in response to the determined pre-ejection period and the determined left ventricular ejection time.

Determining heart failure using diagnostic metrics

Systems and methods are described herein for detecting disturbances in cardiac signals. An electrode apparatus includes a plurality of external electrodes to be disposed proximate a patient's skin. A computing apparatus includes processing circuitry. The computing apparatus is operably coupled to the electrode apparatus. The computing apparatus is configured to monitor electrical activity from tissue of a patient using a plurality of external electrodes to generate a plurality of electrical signals. At least one of the electrical signals of the plurality of electrical signals is filtered. At least one disturbance in the at least one electrical signal is detected using the at least one filtered signal. A temporal location of the at least one disturbance in the at least one electrical signal is determined based on a time that the at least one filtered signal crosses a predetermined threshold.

Disturbance detection and removal in cardiac signals

Methods and related systems and devices for cardiac therapy use pseudo-electric vectors (PEVs) for characterizing and representing the electrical forces generated by a patient's heart in a three-dimensional (3D) manner. PEVs may be used to predict whether a patient will respond to pacing therapy prior to implant, during implant, or in the follow-up after implant. Various cardiac therapy systems and devices, such as an electrocardiogram (ECG) belt or vest, which may include a plurality of external electrodes, may be used to obtain electrical activity information to generate the PEVs. One or more spatio-temporal PEVs may be determined using one or more sensors at one or more points in time. Spatial representation data may be determined based on the PEVs.

Propagation patterns method and related systems and devices

Systems, interfaces, and methods are described herein for evaluation and adjustment cardiac therapy. The systems, interfaces, and methods may utilize, or include, a graphical user interface to display various information with respect to a plurality of external electrodes and electrical activity monitored using such external electrodes and to allow a user to adjust what information to display.

Systems, methods, and interfaces for use in cardiac evaluation

An implantable medical system may provide atrioventricular synchronous pacing using the ventricular septal wall. The system may include a ventricular electrode coupled to an intracardiac housing or a first medical lead implantable in the ventricular septal wall of the patient's heart to deliver cardiac therapy to or sense electrical activity of the left ventricle of the patient's heart and a right atrial electrode coupled to a leadlet or second medical lead to deliver cardiac therapy to or sense electrical activity of the right atrium of the patient's heart. A right ventricular electrode may be coupled to the intracardiac housing or the first medical lead and implantable in the ventricular septal wall of the patient's heart to deliver cardiac therapy to or sense electrical activity of the right ventricle of the patient's heart.

AV synchronous septal pacing

Systems and methods are described herein related to the evaluation and adjustment of left bundle branch (LBB) pacing therapy. Evaluation of the LBB pacing therapy may utilize electrical activity monitored from a plurality of external electrodes. The electrical activity may be used to provided one or more metrics of dispersion of surrogate cardiac electrical activation times, which may then be used to evaluate, and potentially adjust the LBB pacing therapy.

Evaluation and adjustment of left bundle branch (LBB) pacing therapy

In a medical device system, a computer apparatus is configured to receive body surface electrical signals from an electrode apparatus including multiple external electrodes. The computing apparatus generates electrical dyssynchrony data from the body surface electrical signals during delivery of His bundle pacing pulses and identifies effective His bundle capture based on the electrical dyssynchrony data. The computing apparatus generates an indication of His bundle capture in response to identifying the effective His bundle capture.

Medical device system and method for determining His bundle pacing capture

An implantable medical device includes a plurality of electrodes to detect electrical activity, a motion detector to detect mechanical activity, and a controller to determine at least one electromechanical interval based on at least one of electrical activity and mechanical activity. The activity detected may be in response to delivering a pacing pulse according to an atrioventricular (AV) pacing interval using the second electrode. The electromechanical interval may be used to adjust the AV pacing interval. The electromechanical interval may be used to determine whether cardiac therapy is acceptable or whether atrial or ventricular remodeling is successful.

VFA cardiac resynchronization therapy using accelerometer

Systems and methods are described herein for use in synchronizing electrical activity monitored by a plurality of external electrodes with supplemental cardiac data for use in evaluating a patient's cardiac condition and configuring cardiac therapy. The supplemental cardiac data may include one or more markers indicative of the occurrence of cardiac events and/or data representative of representative of at least one of cardiac electrical signals, cardiac sounds, cardiac pressures, blood flow, and an estimated instantaneous flow waveform provided by a left ventricular assist device.

Synchronizing external electrical activity

Ventricle-from-atrium (VfA) cardiac therapy may utilize a tissue-piercing electrode implanted in the left ventricular myocardium of the patient's heart from the right atrium through the right atrial endocardium and central fibrous body. The exemplary devices and methods may determine whether the tissue-piercing electrode is achieving effective left ventricular capture. Additionally, one or more pacing parameters, or paced settings, may be adjusted in view of the effective left ventricular capture determination.

Capture in ventricle-from-atrium cardiac therapy

Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.

Assessing intra-cardiac activation patterns

An electrode apparatus includes a portable amplifier and a plurality of external electrodes to be disposed proximate a patient's skin. A portable computing apparatus is operably coupled to the electrode apparatus. The portable computing apparatus is configured to monitor electrical activity from tissue of a patient using the plurality of external electrodes to generate a plurality of electrical signals over time. The portable computing apparatus is configured to perform at least one of optimizing at least one parameter of the of the implantable pacing device based on the plurality of electrical signals and determining cardiac synchrony based on the plurality of electrical signals.

ECG belt systems to interoperate with IMDs

Systems and methods are described herein for generating representative cardiac information. The representative cardiac information may be based on a plurality of electrode signals monitored, or measured, over a plurality of cardiac cycles or heart beats. The systems and methods may remove unqualified cardiac cycles, remove invalid electrode signals, remove inconsistent cardiac cycles, and removing uncorrelated cardiac cycles, and then generate representative cardiac information based on the remaining cardiac cycles and electrode signals.

Generating representative cardiac information

The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining whether a patient is experiencing atrial fibrillation (AF). If the patient is experiencing AF, the efficacy of CRT is determined. A signal is sensed in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal and a determination is made as to whether the ventricular pacing stimulus evoked a response from the ventricle.

Modulate pacing rate to increase the percentage of effective ventricular capture during atrial fibrillation

Systems and methods are described herein for determining whether cardiac conduction system pacing therapy may be beneficial and/or determining how proximal or distal a cardiac conduction system block may be using external cardiac signals. To do so, one or more left-sided metrics of electrical heterogeneity information may be generated based on left-sided surrogate cardiac electrical measured using a plurality of left external electrodes.

Cardiac conduction system therapy benefit determination

Growing community of inventors

Blaine, MN, United States of America

Subham Ghosh