Abstract: An implantable cardiac stimulator (10), configured to switch mode of operation between at least one right ventricular stimulation mode in which no control signals triggering left ventricular stimulation pulses are delivered to the left ventricular stimulation unit and a biventricular stimulation mode in alternation. Switching takes place as a function of duration of prevailing QRS signal interval, such that the cardiac stimulator switches to biventricular stimulation mode when comparison of the duration of a prevailing QRS signal interval with a first comparison value reveals the duration of the prevailing QRS signal interval is longer than a first reference value represented by the first comparison value and switches to right ventricular stimulation mode when comparison of the duration of a prevailing QRS signal interval with a second comparison value reveals the duration of the prevailing QRS signal interval is shorter than a second reference value represented by the second comparison value.

Abstract: A medical fixation system for temporary fixation of an implantable medical device such as a short lead pacemaker outside of the heart in a larger blood vessel such as the superior or inferior vena cava. The fixation mechanism or element is temporary in nature in that the fixation holds the implantable medical device in place until the implantable medical device is grown in to the wall of the vessel and the short lead attached to the implantable medical device and implanted in the heart is grown in. The cell tissue surrounding the implantable medical device and the short lead then keeps the implantable medical device in place without the temporary fixation element.

Abstract: An implantable medical device that measures respiration parameters based on transthoracic impedance signals, and converts transthoracic impedance signals into a time series of digital values which is filtered with morphological operators to separate the signal into a respiratory component and a cardiac component. Metrics are generated based on the filtered impedance values such as respiratory rate, I/E ratio, tidal volume and minute ventilation.

Abstract: The present disclosure refers to a heart stimulator comprising a stimulation control unit, a stimulation unit, an impedance measurement unit and an impedance evaluation unit. The stimulation control unit is operatively connected to the stimulation unit to control timing of stimulation pulses by said stimulation unit. The impedance measurement unit is configured to determine an impedance signal reflecting intracardiac impedance. The impedance evaluation unit is operatively connected to the impedance measurement unit and to the stimulation control unit and is configured to evaluate the impedance signal so as to determine an isovolumic contraction time, an isovolumic relaxation time, an ejection time and a filling time from said impedance signal. The stimulation control unit is further configured to control timing of stimulation pulses depending on a performance index.

Abstract: The invention refers to a monitoring device for monitoring and analyzing physiological signals. The monitoring device comprises a transthoracic impedance measurement unit and an evaluation unit connected to the transthoracic impedance measurement unit. The transthoracic impedance measurement unit is adapted to conduct a transthoracic impedance measurement and to generate a transthoracic impedance signal representing a measured transthoracic impedance at consecutive points in time. The evaluation unit being configured to process the transthoracic impedance signal received from the transthoracic impedance measurement unit and to thus generate a respiration signal and to generate therefrom an evaluation signal reflecting at least a diurnal pattern of the respiration rate.

Abstract: Improving the signal-to-noise ratio of electrocardiogram (ECG) measurements facilitates cardiac beat detection in a human or animal patient. ECG signals measured either on the surface of the skin or subcutaneously from pairs of leads may be combined to calculate a differential signal. The measured signal may also be averaged to produce a second estimate. A point-by-point product of the differential signal and the averaged signal is generated if the sample pair has the same polarity. The product signals feature enhanced signal components and reduced noise components, thus improving the signal-to-noise ratio of the to respective input channels. Product signals are then subjected to peak detection through a conventional auto-sensing approach. Preliminary event detection results from the conditional product signals may then be aggregated, and final sense markers for ECG beat detection may be generated by means of a voting algorithm.

Abstract: The invention is directed to a heart stimulator for left-ventricular pacing comprising a left ventricular stimulation pulse generator connected or connectable to a single electrode lead for left ventricular stimulation having one or more electrodes for delivery of stimulation pulses to left ventricular myocardial heart tissue, said stimulation pulse generator being adapted to generate and deliver stimulation pulses of switchable polarity. The heart stimulator further comprises a control unit connected to the stimulation pulse generator for controlling the stimulation pulse generator and to trigger generation and delivery of stimulation pulses having a polarity controlled by said control unit, wherein the control unit is adapted to control said left ventricular stimulation pulse generator so as to deliver at least a pair of suprathreshold stimulation pulses of opposite polarity.

Abstract: Exemplary methods and apparatuses are disclosed that provide for determination of an atrio-ventricular delay on a beat-to-beat basis by determining a P-wave duration from electric signals corresponding to electric potentials in a heart, and determining the atrio-ventricular delay on a beat-to-beat basis such that the atrio-ventricular delay for an individual heart cycle depends on the P-wave duration of a same or an immediately preceding heart cycle.

Abstract: Heart monitor for detecting ectopic beats in an input electrocardiogram signal that includes an electrocardiogram signal input and a morphological signal analyzer connected to the electrocardiogram signal input, the analyzer being adapted to generate a first time series of values representing the input electrocardiogram signal, a second signal analyzer adapted to generate generating a modified time series of values representing a trend of values of the first time series and a comparison stage being adapted to compare the first time series with the modified time series to thus detect ectopic beats.

Abstract: Exemplary versions of the invention include methods and apparatuses for assessing ventricular activation time by determining a point in time t1 of an initial positive deflection on a far-field electrogram and a point in time t2 of a first peak of the negative deflection on a near-field electrogram of a same heart cycle. They also determine a time difference between points in time t1 and t2 said time difference representing the ventricular activation time. A progression of ventricular conduction disorders such as the left bundle branch block (LBBB) and the right bundle branch block (RBBB) can be monitored. Trending analysis of the ventricular activation time provides a means for monitoring the progression of ventricular conduction diseases.

Abstract: Implantable electromedical device or loop recorders or ILRs that solve the problem of very low arrhythmia detection specificities in, i.e., high number of false positives, based on detection and analysis of external noise, specifically muscle noise surrounding the electromedical device. Embodiments generally employ active detection of lead or device movement that induces signal artifacts indicative of external noise. One or more embodiments may detect lead or device movement through use of a piezoelectric transducer, for example located proximally to the device or in the lead of the electromedical.

Abstract: Detects external noise using a motion sensor signal for example to increase the specificity of arrhythmia detections based on active muscle noise detection. Whenever a motion signal is present that is below or above a certain frequency, for example 5 Hz, or within a certain frequency range, for example 1 to 10 Hz, and/or above a certain amplitude, for example greater than 1 mg, or close to a known motion pattern, then the detection of fast ventricular arrhythmia is suspended. For the detection of slow arrhythmia, for example asystole or syncope, an episode is confirmed when a short lasting motion sensor signal occurs. Uses a motion sensor based signal, for example as obtained from an accelerometer on an implantable electrode lead and/or implantable device.

Abstract: A medical fixation system for temporary fixation of an implantable medical device such as a short lead pacemaker outside of the heart in a larger blood vessel such as the superior or inferior vena cava. The fixation mechanism or element is temporary in nature in that the fixation holds the implantable medical device in place until the implantable medical device is grown in to the wall of the vessel and the short lead attached to the implantable medical device and implanted in the heart is grown in. The cell tissue surrounding the implantable medical device and the short lead then keeps the implantable medical device in place without the temporary fixation element.

Abstract: A medical device for processing physiological signals such as electrocardiograms. The processing includes: sampling a physiologic signal in a first channel with a first sampling rate, simultaneously sampling the physiologic signal in a second channel with a higher sampling rate to thus generate pairs of sampling values, forming the difference between two sampling values of each pair, comparing said difference with a threshold, and generating a noise detection indicator whenever said threshold is exceeded.

Abstract: Method for detecting cardiac events, e.g., Atrial Fibrillation (AF) or termination of AF. Based on analysis of the instability observed in heart rate, caused by irregular conduction from the atrium during AF. Change in heart interval is monitored on beat-to-beat basis to recognize instability that indicates presence of AF or Atrial Flutter. A packet of a number of consecutive intervals is evaluated, whether the length of an interval is stable compared with the length of the preceding interval, or whether the length of the subsequent interval has changed. After detection of an instability, instability counter is incremented. The result of the stability test for a packet of intervals is represented by the value of the instability counter. Depending upon whether or not an AF already declared, (indicated by AF status flag), different “X-out-of-Y” criterion are applied. AF status flag set/cleared when declaring AF/termination of AF.

Abstract: A system for heart monitoring comprises an IEGM input for an intracardiac electrocardiogram (IEGM) that is connected to an active filtering stage that is adapted to transform an incoming IEGM into an output ECG signal. The active filtering stage is connected to a filter characterization stage that is adapted to process a recorded, patient specific IEGM template and a corresponding SECG template and to adapt the filter characteristics of said active filtering stage such that the filter characteristics best characterize the input-output relationship between the IEGM template and the corresponding SECG template. As a consequence, the active filtering stage is adapted to transform an incoming IEGM such that the output ECG signal closely resembles a morphology of a corresponding SECG.

Abstract: A method for determining the signal quality of samples in a physiological signal, in particular an electrocardiogram (ECG) signal, is provided. A supra-threshold sample sum, a noise threshold crossing sum, or both are calculated in a noise detection window including the sample to be evaluated, and low signal quality is indicated if either or both of the sums exceed respective values. ECG beat detections can then be labeled as unreliable based on the determination of low signal quality for one or more samples between the detections.

Abstract: An implantable cardiac device, e.g., a pacemaker, defibrillator, cardioverter or biventricular pacing device, that can sense cardiac electrical signals and accurately classify the sensed events. The device provides a template signal and a test signal originated from an electrogram. The device further transforms at least the test signal into a representation of the test signal for example in numerical format where the sample values of the test signal take the form of integers. The device further determines a correlation between the template and test signals, and classifies the sense events based on the correlation. The electrogram may be an intracardiac electrogram (IEGM), atrial electrogram (AEGM), ventricular electrogram (VEGM), surface electrocardiogram (ECG) or subcutaneous electrogram.

Abstract: A device for classifying of supraventricular tachyarrhythmia (SVT) from ventricular tachyarrhythmia (VT) comprising means for providing a template signal and a test signal originated from an electrogram, the template signal and the test signal comprising samples, means for transforming at least the test signal resulting in a representation of the test signal where the sample values of the signal take integers, means for determining a correlation between the template signal and the test signal and means for classifying of SVT from ventricular VT based on the correlation.

Abstract: Heart stimulating system for stimulating at least a ventricle of a heart including: stimulation pulse generator adapted to generate stimulation pulses and connected to a ventricular stimulation electrode for delivering stimulation pulses, atrial sensing stage connected to an electrode for picking up potentials inside an atrium and adapted to sense an excitation or contraction of atrial myocardium, ventricular sensing stage connected to an electrode for picking up potentials inside a ventricle and adapted to sense an excitation or contraction of ventricular myocardium, memory for AV-delay values, a control unit adapted to trigger said stimulation pulse generator to generate ventricular stimulation pulses timed based on AV-delay values stored in said memory and to acquire atrioventricular interval samples, and atrioventricular interval timing analyzing unit for receiving atrioventricular interval samples from said control unit and adapted to generate at least one histogram based on said atrioventricular interva