Abstract: Adaptive methods for initiating charging of the high power capacitors of an implantable medical device for therapy delivery after the patient experiences a non-sustained arrhythmia, and devices that perform such methods. The adaptive methods and devices adjust persistence criteria used to analyze an arrhythmia prior to initiating a charging sequence to deliver therapy. Some embodiments apply a specific sequence of X-out-of-Y criteria, persistence criteria, and last event criteria before starting charging for therapy delivery.

Abstract: Methods, systems, and devices for signal analysis in an implantable cardiac device such as an implantable cardioverter defibrillator. In illustrative examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. Analysis of the apparent width of detected events is used to determine whether overdetection is occurring. If overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data.

Abstract: Methods, implantable medical devices and systems configured to perform analysis of captured signals from implanted electrodes to identify cardiac arrhythmias. In an illustrative embodiment, signals captured from two or more sensing vectors are analyzed, where the signals are captured with a patient in at least first and second body positions. Analysis is performed to identify primary or default sensing vectors and/or templates for event detection.

Abstract: Self-correlation enhancements and implementations are described. In particular, certain examples demonstrate the use of a peak selector to identify peaks of a self-correlation function which serve as candidate cardiac rates for an implantable medical device. The approach may enable an alternative calculation of cardiac rate in an implantable medical device as a stand-alone rate detector or as a double-check of other rate calculations.

Abstract: Automated pre-implant screening for candidate recipients of implantable medical devices. A set of cutaneous electrodes placed on a patient transcutaneously capture a cardiac signal using a screening device coupled to the electrodes. A first beat rate may be determined by identifying individual R-waves, QRS complexes or cardiac cycles from the captured cardiac signal using the cutaneous electrodes. A second beat rate may be calculated using one of several different methods, for example, by optical measurement, by monitoring heart sounds, by a second electric cardiac signal analysis, or by using an implanted device. The rates are compared to one another and, if a match is identified, the patient is deemed well suited to receive a particular device.

Abstract: In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameters such as rate, QRS pulse width, cardiac QRS slew rate, amplitude and stability measures of these parameters from the filtered cardiac signal information are measured, processed and integrated to determine if the cardioverter/defibrillator needs to initiate therapeutic action.

Abstract: New and/or alternative designs for implantable leads that have fixation structures to keep leads at a desired location after implant. Fixation structure may take several forms that create distally located fixation for use primarily in subcutaneous implantation. Some examples include new and/or alternative methods of implanting such leads. Some examples also include fixation structures, such as a suture sleeve, that can be attached to a lead for fixation thereof. Some further examples show methods of implanting a subcutaneous lead, and others include methods of extracting implanted subcutaneous leads.

Abstract: The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.

Abstract: Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In illustrative examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. New methods for organizing the use of morphology and rate analysis in an overall architecture for rhythm classification and cardiac signal analysis are also discussed.

Abstract: Methods, systems, and devices for signal analysis in an implantable cardiac device such as an implantable cardioverter defibrillator. In illustrative examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. Analysis of the apparent width of detected events is used to determine whether overdetection is occurring. If overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data.

Abstract: Devices and methods for single therapy pulse (STP) therapy for tacharrythmia are disclosed. The STP therapy can be delivered from a far-field position to allow a “global” capture approach to pacing. Due to the global capture in STP, a series of pulses, which is indicative of conventional anti-tachycardia pacing (ATP) delivered by transvenous systems, becomes unnecessary. One to four pulses at most are needed for STP, and after delivery of the one to four pulses, therapy delivery can be interrupted to determine whether the previously delivered therapy has been successful.

Abstract: Self-correlation enhancements and implementations are described. In particular, certain examples demonstrate the use of a tracking mechanism to identify and/or confirm cardiac rate using data from iterative self-correlation performed at intervals over time. This may enable the interpolation of cardiac rate in an implantable medical device when data is insufficient, and may provide confidence in cardiac rate analyses.

Abstract: Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In illustrative examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. New methods for organizing the use of morphology and rate analysis in an overall architecture for rhythm classification and cardiac signal analysis are also discussed.

Abstract: Signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In some examples, detected events are analyzed to identify changes in detected event amplitudes. When detected event amplitudes are dissimilar from one another, a first set of detection parameters may be invoked, and, when detected event amplitudes are similar to one another, a second set of detection parameters may be invoked. Additional examples determine whether the calculated heart rate is “high” or “low,” and then may select a third set of detection parameters for use when the calculated heart rate is high.

Abstract: Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In some examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. Several examples emphasize the use of morphology analysis using correlation to static templates and/or inter-event correlation analysis.

Abstract: Devices and methods for single therapy pulse (STP) therapy for tachyarrythmia are disclosed. The STP therapy can be delivered from a far-field position to allow a “global” capture approach to pacing. Due to the global capture in STP, a series of pulses, which is indicative of conventional anti-tachycardia pacing (ATP) delivered by transvenous systems, becomes unnecessary. One to four pulses at most are needed for STP, and after delivery of the one to four pulses, therapy delivery can be interrupted to determine whether the previously delivered therapy has been successful.

Abstract: Methods and devices providing multiple criteria for use in arrhythmia identification. Based on inputs including defined rules or parameters, one of a more conservative or more aggressive set of arrhythmia identification parameters can be selected. One or the other of the selectable sets of arrhythmia identification parameters may also be adaptive or modifiable during the use of the system, for example, in response to identified nonsustained episodes, the more conservative set of arrhythmia identification parameters can be modified to become still more conservative. Such modification of arrhythmia identification criteria allows reduced time to therapy when indicated, while allowing more deliberate decisions in other circumstances.

Abstract: Methods, implantable medical devices and systems configured to perform analysis of captured signals from implanted electrodes to identify cardiac arrhythmias. In an illustrative embodiment, signals captured from two or more sensing vectors are analyzed, where the signals are captured with a patient in at least first and second body positions. Analysis is performed to identify primary or default sensing vectors and/or templates for event detection.

Abstract: Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In some illustrative examples, detected events are analyzed to identify changes in detected event amplitudes. When detected event amplitudes are dissimilar from one another, a first set of detection parameters may be invoked, and, when detected event amplitudes are similar to one another, a second set of detection parameters may be invoked. Additional methods determine whether the calculated heart rate is “high” or “low,” and then may select a third set of detection parameters for use when the calculated heart rate is high.

Abstract: Implantable systems and methods directed toward improved accuracy in cardiac signal analysis. An impedance waveform is captured and used to confirm the analysis performed by the system on electrical signals or electrocardiogram. A detected heart beat from the electrocardiogram is either confirmed or identified as a misdetection depending on whether the impedance waveform shows likely correct or incorrect detection. Identified misdetection can then be corrected or otherwise mitigated.