Medtronic, Inc.

Cprx Inc.

Advanced Circulatory Systems, Inc.

Medtronics, Inc.

Woodstream Corporation

Todd M Zielinski

Douglas A Hettrick

Shantanu Sarkar

Keith G Lurie

Yong Kyun Cho

Eduardo N Warman

Xusheng Zhang

Robert Patterson

Wolfgang Voelckel

Vinod Sharma

Jonathan L Kuhn

Brian Bruce Lee

Tom Dean Bennett

Mattias Rouw

James W Biondi

Paul A Sobotka

Scott McKnite

Kevin P Vincent

Nemer Samniah

Karl Lindner

Vern Menk

John E Burnes

James Kevin Carney

Can Cinbis

Tommy Dean Bennett

David A Anderson

Mark K Erickson

Richard J O'Brien

Zhendong Song

Thomas J Daly, Jr

David G Benditt

Peter Koziar, Jr

Charles P Sperling

Wolfgang Voeckel

Donald J Hefner

Gene Scharenbroich

Nicole M Campbell

Amber L Jaeger

Daniel J Wanninger

Kalyan C Jinnuri

In some examples, determining a heart failure status includes using an implantable medical device configured for subcutaneous implantation and comprising a plurality of electrodes and an optical sensor. Processing circuitry of a system comprising the device may determine, for a patient, a current tissue oxygen saturation value based on a signal received from the at least one optical sensor, a current tissue impedance value based on a subcutaneous tissue impedance signal received from the electrodes, and a current pulse transit time value based on a cardiac electrogram signal received from the electrodes and at least one of the signal received from the optical sensor and the subcutaneous tissue impedance signal. The processing circuitry may further compare the current tissue oxygen saturation value, current tissue impedance value, and current pulse transit time value to corresponding baseline values, and determine the heart failure status of the patient based on the comparison.

Sensing for heart failure management

Systems and methods include differential diagnosis for acute heart failure to provide treatment to a patient including determining whether the patient has cardiac volume overload, determining whether the patient has decreased abdominal venous system volume, and providing the appropriate treatment in response to the determinations. A multi-sensor system may be used to determine cardiac volume and abdominal venous system volume. Fluid redistribution treatment may be provided when cardiac volume overload is accompanied by a decrease in abdominal venous system volume. Fluid accumulation treatment may be provided when cardiac volume overload is not accompanied by a decrease in abdominal venous system volume.

Acute heart failure monitoring and treatment

A medical device is configured to generate fluid status signal data of a patient by determining impedance metrics from an impedance signal, determining cardiac electrical signal amplitudes from a cardiac electrical signal and determining a calibration relationship between the impedance metrics and cardiac electrical signal amplitudes. The medical device generates a fluid status signal data by adjusting cardiac electrical signal amplitudes according to the determined calibration relationship. The fluid status signal data may be displayed or monitored for detecting a change in the patient's fluid status.

Fluid status detection from a cardiac electrical signal and impedance signal

In some examples, determining a heart failure status of a patient using a medical device comprising a plurality of electrodes includes determining an estimated arterial pressure waveform of the patient based on an arterial impedance signal received from at least two of the plurality of electrodes. The estimated arterial pressure waveform may comprise a plurality of arterial pressure cycles. Each of the plurality of arterial pressure cycles may correspond to a different cardiac cycle of a plurality of cardiac cycles of the patient. At least one value of an intrinsic frequency of the corresponding arterial pressure cycle may be determined for at least some of the plurality of cardiac cycles and the heart failure status of the patient may be determined based on the at least one value of the intrinsic frequency.

A system and method is provided to measure intrathoracic complex impedance and to identify and indicate disease conditions based on the impedance measurements. Multiple impedance vectors may be taken into account, and an optimal vector may be selected to provide the most useful impedance measurement for the identification and indication of disease conditions.

Multi-frequency impedance monitoring system

The exemplary systems and methods may monitor one or more signals to be used to assess the hemodynamic status of a patient. The one or more signals may be used to calculate, or determine, a plurality of pulse transit times. The plurality of pulse transit times may be used to determine hemodynamic status values that may be indicative of a patient's aggregate hemodynamic status.

Systems and methods for monitoring hemodynamic status

Methods and/or devices used in delivering cardiac resynchronization therapy based on a plurality of device parameters (e.g., A-V delay, V-V delay, etc.) are optimized by setting a device parameter based on selection data. The selection data may be acquired by acquiring temporal fiducial points (e.g., heart sounds) associated with at least a part of a systolic portion of at least one cardiac cycle and/or temporal fiducial points associated with at least a part of a diastolic portion of the at least one cardiac cycle for each of a plurality of electrode vector configurations, and extracting measurements from the intracardiac impedance signal acquired for each of a plurality of electrode vector configurations based on the temporal fiducial points. The acquired selection data may be scored and used to optimize the device parameter.

Cardiac resynchronization therapy optimization based on intracardiac impedance and heart sounds

Methods and/or devices are disclosed herein for monitoring cardiac impedance signal and delivering therapy to a patient's heart based upon the monitored cardiac impedance.

Cardiac therapy based upon impedance signals

An implantable medical device and associated method to determine an optimal control parameter setting for controlling a cardiac therapy that includes a therapy delivery module to deliver cardiac pacing signals at a plurality of pacing rates, and an admittance measurement module to determine admittance signals associated with each of the plurality of pacing rates. A control unit determines metrics of hemodynamic performance corresponding to each of the plurality of pacing rates in response to the determined admittance signals, identifies pacing rates of the plurality of pacing rates as rejected rates in response to the determined metrics of hemodynamic performance, and determines a pacing rate of the plurality of pacing rates as an optimal rate for delivering the cardiac therapy in response to the identified pacing rates.

Method to assess hemodynamic performance during cardiac resynchronization therapy optimization using admittance waveforms and derivatives

Cardiac resynchronization therapy optimization based on intracardiac impedance

Techniques for estimating a cardiac chamber or vascular pressure based upon impedance are described. A device or system may measure an impedance between at least two electrodes implanted within or proximate to a cardiovascular system. The device or system may estimate a pressure of an element of the cardiovascular system based on a relationship between impedance and volume of the element, and based on a empirical relationship between the volume and the pressure. The device or system may also estimate the dimension of the element based on the impedance-volume relationship, or other characteristics based on the impedance. Because the impedance measurements may be obtained, in some examples, by using electrodes and leads implanted within the cardiovascular system and coupled to an implantable medical device, a practical estimation of a cardiovascular pressure can be obtained on a chronic basis without requiring the use other invasive sensors, such as micronanometer transducers.

Estimating cardiovascular pressure and volume using impedance measurements

A medical device and associated method for delivery of a cardiac therapy that includes determining a first impedance signal along a thoracic electrode vector extending within a portion of a thoracic cavity, determining a second impedance signal along an extra-thoracic electrode vector extending outside the thoracic cavity, comparing first amplitude measurements corresponding to the first impedance signals and second amplitude measurements corresponding to the second impedance signals, comparing first slope measurements corresponding to the first impedance signals and second slope measurements corresponding to the second impedance signals, and determining delivery of the cardiac therapy in response to the comparing.

Use of thoracic and extra-thoracic impedance for diagnostic monitoring

Growing community of inventors

Ham Lake, MN, United States of America

Todd M Zielinski