Medtronic, Inc.

Medtronic, Inc. (cvg)

Other

Medtronic Cryocath LP

Medtronics, Inc.

Medronic, Inc.

Xusheng Zhang

Robert W Stadler

Saul E Greenhut

Jian L Cao

Raja N Ghanem

Jeffrey M Gillberg

James D Reinke

Troy Edward Jackson

Paul R Solheim

Yuanzhen Liu

Karen J Kleckner

Vinod Sharma

Timothy A Ebeling

Vladimir Pavlovich Nikolski

Michael W Heinks

Wade M Demmer

Paul Gordon Krause

Paul J Degroot

Gerald P Arne

Walter H Olson

Robert J Nehls

Mark L Brown

Thomas J Mullen

Yanina Grinberg

Yong Kyun Cho

Douglas A Hettrick

Scott A Hareland

Michael B Terry

Daniel L Hansen

Donna M Salmi

Barbara J Schmid

Irving J Sanchez

Todd M Zielinski

Ronald A Drake

David A Anderson

Melissa G T Christie

Teresa A Whitman

Aleksandre T Sambelashvili

Nathan A Grenz

Bushan K Purushothaman

Todd Jon Sheldon

Eduardo N Warman

Zhendong Song

Scott A Ransom

Xin Zhang

Alfonso Aranda Hernandez

Jeffrey M Huston

Veerdhaval Mahajan

Kevin L Dehmer

Gavin M Mischler

James A Vander Heyden

A medical device processor is configured to receive a first cardiac electrical signal sensed from a first sensing electrode vector, receive a second cardiac electrical signal sensed from a second sensing electrode vector different than the first sensing electrode vector, and construct a third cardiac electrical signal from the first cardiac electrical signal and the second cardiac electrical signal. In some examples, the system determines sensed cardiac events according to at least one setting of a cardiac event sensing threshold control parameter from at least the third cardiac electrical signal and may determine at least one acceptable setting of a sensing control parameter based on the determined sensed cardiac events. The processor may generate an output representative of the determined sensed cardiac events.

Device and method for determining a cardiac sensing control parameter

A medical device is configured to sense event signals from a cardiac electrical signal and determine maximum amplitudes of cardiac electrical signal segments associated with sensed event signals. The medical device is configured to determine at least one tachyarrhythmia metric based on at least a greatest one of the determined maximum amplitudes. The medical device may determine when the at least one tachyarrhythmia metric does not meet true tachyarrhythmia evidence and, in response, determine when the maximum amplitudes meet suspected noise criteria. The medical device may withhold a tachyarrhythmia detection and tachyarrhythmia therapy when suspected noise criteria are met.

Medical device and method for detecting electrical signal noise

A method and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a first sensing vector and a second sensing vector, identifying the cardiac event as one of a shockable event and a non-shockable event in response to first processing of a first interval sensed along the first sensing vector during a predetermined sensing window and a second interval simultaneously sensed along the second sensing vector, performing second processing of the first interval and the second interval, different from the first processing, in response to the cardiac event being identified as a shockable event, and determining whether to delay identifying the cardiac event being shockable in response to the second processing of the first interval and the second interval.

Method and apparatus for discriminating tachycardia events in a medical device

Techniques are described for discriminating SVT and, in particular, rapidly conducting AF. The techniques include detecting an onset of a fast rate of ventricular events sensed from a cardiac electrical signal and detecting a pause in the fast rate of ventricular sensed events. A threshold number of ventricular event intervals required to detect a ventricular tachyarrhythmia is detected with each of the threshold number of ventricular event intervals being less than a tachyarrhythmia detection interval. Detection of the ventricular tachyarrhythmia and an electrical stimulation therapy for treating the ventricular tachyarrhythmia are withheld in response to at least the pause being detected.

Supraventricular tachyarrhythmia discrimination

An implantable medical device comprises a sensing module configured to obtain electrical signals from one or more electrodes and a control module configured to process the electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia. The control module detects initiation of a pacing train delivered by a second implantable medical device, determines a type of the detected pacing train, and modifies the tachyarrhythmia detection algorithm based on the type of the detected pacing train.

Implantable cardioverter-defibrillator (ICD) tachyarrhythmia detection modifications responsive to detected pacing

An implantable medical device system capable of sensing cardiac electrical signals includes a sensing circuit, a therapy delivery circuit and a control circuit. The sensing circuit is configured to receive a cardiac electrical signal and sense a cardiac event in response to the signal crossing a cardiac event sensing threshold. The therapy delivery circuit is configured to deliver an electrical stimulation therapy to a patient's heart via the electrodes coupled to the implantable medical device. The control circuit is configured to control the sensing circuit to set a starting value of the cardiac event sensing threshold and hold the starting value constant for a sense delay interval. The control circuit is further configured to detect an arrhythmia based on cardiac events sensed by the sensing circuit and control the therapy delivery circuit to deliver the electrical stimulation therapy in response to detecting the arrhythmia.

Multi-threshold sensing of cardiac electrical signals in an extracardiovascular implantable cardioverter defibrillator

A medical device is configured to sense an electrical signal and determine that signal to noise criteria are met based on electrical signal segments stored in response to sensed electrophysiological events. The medical device is configured to determine an increased gain signal segment from one of the stored electrical signal segments in response to determining that the signal to noise criteria are met. The medical device determines a noise metric from the increased gain signal segment. The stored electrical signal segment associated with the increased gain signal segment may be classified as a noise segment in response to the noise metric meeting noise detection criteria.

A medical device, such as an extra-cardiovascular implantable cardioverter defibrillator (ICD), senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal acquired by a second sensing channel in response to each sensed R-wave. The ICD determines morphology match scores from the stored time segments of the second cardiac electrical signal and, based on the morphology match scores, withholds detection of a tachyarrhythmia episode. In some examples, the ICD detects T-wave oversensing based on the morphology match scores and withholds detection of a tachyarrhythmia episode in response to detecting the T-wave oversensing.

Cardiac electrical signal morphology and pattern-based T-wave oversensing rejection

An extra-cardiovascular implantable cardioverter defibrillator senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The ICD determines intervals between successively sensed R-waves and, in response to at least a predetermined number of the intervals being less than a tachyarrhythmia detection interval, analyzes at least a portion of the time segment of the second cardiac electrical signal corresponding to a most recent one of the sensed R-waves to confirm the most recent one of the R-waves. The ICD updates an unconfirmed beat count in response to the most recent one of the R-waves not being confirmed and withholds detection of a tachyarrhythmia episode in response to the unconfirmed beat count being equal to or greater than a rejection threshold.

System and method for sensing and detection in an extra-cardiovascular implantable cardioverter defibrillator

An implantable medical device system is configured to sense cardiac events in response to a cardiac electrical signal crossing a cardiac event sensing threshold. A control circuit is configured to determine a drop time interval based on a heart rate and control a sensing circuit to hold the cardiac event sensing threshold at a threshold value during the drop time interval.

Multi-threshold sensing of cardiac electrical signals in an implantable medical device

Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

Systems and methods for leadless pacing and shock therapy

In situations in which an implantable medical device (e.g., a subcutaneous ICD) is co-implanted with a leadless pacing device (LPD), it may be important that the subcutaneous ICD knows when the LPD is delivering pacing, such as anti-tachycardia pacing (ATP). Techniques are described herein for detecting, with the ICD and based on the sensed electrical signal, pacing pulses and adjusting operation to account for the detected pulses, e.g., blanking the sensed electrical signal or modifying a tachyarrhythmia detection algorithm. In one example, the ICD includes a first pace pulse detector configured to obtain a sensed electrical signal and analyze the sensed electrical signal to detect a first type of pulses having a first set of characteristics and a second pace pulse detector configured to obtain the sensed electrical signal and analyze the sensed electrical signal to detect a second type of pulses having a second set of characteristics.

Pace pulse detector for a medical device

A method and device for detecting phrenic nerve stimulation (PNS) in, or using, a cardiac medical device. A test signal sensitive to contraction of a diaphragm of a patient may be sensed and signal artifacts of the test signal within each of a first window of the test signal prior to a predetermined cardiac signal and a second window of the test signal subsequent to the predetermined cardiac signal may be determined. The PNS beat criteria may be evaluated, for example, using the test signal, which may be a heart sounds signal.

Sensor-based phrenic nerve stimulation detection

An implantable cardioverter defibrillator (ICD) performs a method that includes determining whether first criteria for detecting a ventricular tachyarrhythmia are met by a cardiac electrical signal. The ICD determines features from cardiac signal segment of a group of cardiac signal segments and determines whether a first portion of the features satisfy monomorphic waveform criteria and determines whether a second portion of the features satisfy supraventricular beat criteria. The ICD determines whether second criteria for detecting the ventricular tachyarrhythmia are met and withholds detecting of the ventricular tachyarrhythmia in response to the monomorphic waveform criteria and the supraventricular beat criteria being met.

Growing community of inventors

Shoreview, MN, United States of America

Xusheng Zhang