Pacesetter, Inc.

Yun Qiao

Wenwen Li

Jan O Mangual-Soto

Luke C McSpadden

Xiaoyi Min

Kyungmoo Ryu

Jan Mangual

Nima Badie

Aditya Goil

Fujian Qu

Fady Dawoud

Avi Fischer

Carin Folman

Chaoyi Kang

Stuart Rosenbeg

Luke C Mcspadden

System and methods are provided herein and include a HIS electrode configured to be located proximate to a HIS bundle and to at least partially define a HIS sensing vector. They system includes memory to store program instructions and cardiac activity (CA) signals for a series of beats utilizing a candidate sensing configuration. The candidate sensing configuration is defined by i) the HIS sensing vector and ii) a sensing channel that utilizes sensing circuitry configured to operate based on one or more sensing settings to detect near field and far field activity. The system includes one or more processors that, when executing the program instructions, are configured to analyze the CA signals to obtain an atrial (A) feature of interest (FOI) and a ventricular (V) FOI for the corresponding beats within the series of beats and identify a V-A FOI relation between the A FOIs and the V FOIs across the series of beats. The system adjusts the candidate sensing configuration and repeat the obtain, analyze and identify operations to obtain a collection of V-A FOI relations for a corresponding collection of candidate sensing configurations and selects a resultant sensing configuration from the collection of candidate sensing configurations based on one or more criteria, the resultant sensing configuration to be utilized to manage HIS bundle pacing during an atrial arrhythmia.

Method and device for managing his bundle pacing in a non-tracking mode during AF/AT

Certain embodiments of the present technology described herein relate to detecting atrial oversensing, characterizing atrial oversensing, determining when atrial oversensing is likely to occur, and or reducing the chance of atrial oversensing occurring. Some such embodiments characterize and/or avoid atrial oversensing.

Implantable medical systems and methods used to detect, characterize or avoid atrial oversensing within an IEGM

Described herein are implantable medical devices and systems, and methods for use therewith, for reducing T-wave oversensing and arrhythmia undersensing that occur due to inappropriate filtering of a signal indicative of cardiac electrical activity. A method includes obtaining a signal indicative of cardiac electrical activity, and using a first bandpass filter to produce a first filtered version thereof, using a second bandpass filter to produce a second filtered version thereof, wherein the first bandpass filter passes frequencies within a first frequency range, and the second bandpass filter passes frequencies within a second frequency range that is wider than the first frequency range. The method also includes selectively changing from using the first filtered version of the signal to monitor for a VS event, to using the second filtered version of the signal to monitor for a VS event, based on first criteria, and vice versa, based on second criteria.

Implantable medical devices, systems and methods for reducing T-wave oversensing and arrhythmia undersensing

A system is provided that includes one or more processors, and a memory coupled to the one or more processors. The memory stores program instructions, and the program instructions are executable by the one or more processors. When executed, the one or more processors obtain cardiac activity (CA) signals for a series of beats, and identify whether a characteristic of interest (COI) from a first segment of the CA signals exceeds a COI limit. The one or more processors also analyze morphology of the CA signals for the series of beats responsive to the first segment of the CA signals exceeding the COI limit, and based on the analyze operation, identify a premature ventricular contraction (PVC) within the series of beats.

System for identifying premature ventricular contractions

A system and a method include an implantable medical device (IMD) having one or more inputs configured to receive one or more sensed signals from one or more electrodes. A plurality of filters are configured to filter the one or more sensed signals and output a plurality of filtered signals. Memory is configured to store program instructions. A processor, when executing the program instructions, is configured to receive the plurality of filtered signals, and analyze the plurality of filtered signals to determine a desired one of the plurality of filters.

Method and system for optimizing filter settings of an implantable medical device

Methods and systems for dynamically modifying pacing timing and backup pacing delivery in cardiac stimulation devices include applying pacing impulses, measuring corresponding responses, and, based on such responses, automatically modifying timing or operational settings of the stimulation device to improve pacing functionality. Among other things, the approaches described herein reduce unnecessary backup pacing impulses in HIS bundle pacing applications, facilitate fusion in bundle branch block applications, and automatically enable or disable backup pacing in response to achieving QRS complex correction.

Systems and methods for improved his bundle and backup pacing timing

A system is provided that includes a first electrode configured to be located within a septal wall, and a second electrode configured to be located outside of the septal wall. The system also includes an impedance circuit configured to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes. One or more processors are also provided that are configured to obtain impedance data indicative of an impedance along the IM vector with the first electrode located at different depths within the septal wall, the impedance data including a set of data values associated with different depths of the first electrode within the septal wall. The one or more processors are also configured to determine when the first electrode is located at a target depth within the septal wall based on the impedance data.

Method and system for implanting a septal wall electrode

A system and method are provided for managing atrial-ventricular (AV) delay adjustments. An AV interval is measured that corresponds to an interval between an atrial paced (Ap) event or an atrial sensed (As) event and a sensed ventricular (Vs) event. A candidate AV delay is set based on the AV interval and a bundle branch adjustment (BBA) value. A QRS characteristic of interest (COI) is measured while utilizing the candidate AV delay in connection with delivering a pacing therapy. The BBA value is adjusted and the candidate AV delay is reset based on the BBA value as adjusted. A collection of QRS COIs and corresponding candidate AV delays are obtained and one of the candidate AV delays is selected as a BBA AV delay. The pacing therapy is managed, based on the BBA AV delay.

Systems and methods for managing atrial-ventricular delay adjustments

Certain embodiments of the present technology described herein relate to detecting atrial oversensing in a His intracardiac electrogram (His IEGM), characterizing atrial oversensing, determining when atrial oversensing is likely to occur, and or reducing the chance of atrial oversensing occurring. Some such embodiments characterize and/or avoid atrial oversensing within a His IEGM. Other embodiments of the present technology described herein relate to determining whether atrial capture occurs in response to His bundle pacing (HBP). Still other embodiments of the present technology described herein relate to determining whether AV node capture occurs in response to HBP.

Implantable medical systems and methods used to detect, characterize or avoid atrial oversensing within a His IEGM

A system and method are provided. The system includes a HIS electrode configured to be located proximate to a HIS bundle. A pulse generator is coupled to the HIS electrode and is configured to deliver HIS bundle pacing (HBP), a right atrial (RA) electrode is located in a right atrium, a sensing circuitry coupled to the RA electrode and defines an RA sensing channel that does not utilize the HIS electrode. The system includes a memory including program instructions. The system includes a processor is configured to collect cardiac activity (CA) signals over the RA sensing channel utilizing the RA electrode. The CA signals include a far field (FF) component associated with a ventricular event (VE). The processor analyzes the FF component to identify first and second FF component (FFC) characteristics of interest (COI) of the ventricular event and utilizes the first FFC COI to apply a first capture class (CC) discriminator to distinguish between first and second capture classes. The first capture class includes first and second capture types. The processor utilizes the second FFC COI to apply a second CC discriminator to distinguish between at least one of i) the first and second capture types within the first capture class, or ii) third and fourth capture classes and manages HIS bundle pacing based on distinctions by the first and second CC discriminators.

Implantable medical systems and methods for use therewith that detect atrial capture and AV node capture responsive to his bundle pacing

A computer implemented method and system for detecting premature ventricular contractions (PVCs) are provided. The method is under control of one or more processors configured with specific executable instructions. The method obtains a cycle length (CL) distribution metric that plots a series of cardiac beats into one of a set of transition types based on R-R interval (RRI) difference pairs associated with the cardiac beats. The CL distribution metric plots the cardiac beats based on a comparison between combinations of the RRI difference pairs for corresponding combinations of the cardiac beats. The method calculates a distribution characteristic for the cardiac beats, from the series of cardiac beats that exhibit a first transition type from the set of transition types and calculates a discrimination score based on the distribution characteristic of the cardiac beats across the CL distribution metric. The method designates the CA signals to include a predetermined level of PVC burden based on the discrimination score.

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Valencia, CA, United States of America

Yun Qiao