Abstract: The invention is directed to techniques for providing cardiac resynchronization therapy by synchronizing delivery of pacing pulses to the left ventricle with intrinsic right ventricular depolarizations. An implantable medical device measures an interval between an atrial depolarization and an intrinsic ventricular depolarization is measured. In various embodiments, the intrinsic ventricular depolarization may be an intrinsic right or left ventricular depolarization. The implantable medical device delivers pacing pulses to the left ventricle to test a plurality of pacing intervals. The pacing intervals tested may be within a range around the measured interval between the atrial depolarization and the intrinsic ventricular depolarization. One of the pacing intervals is selected based on a measured characteristic of an electrogram that indicates ventricular synchrony. For example, the pacing interval may be selected based on measured QRS complex widths and/or Q-T intervals.

Abstract: An implantable medical device and associated method deliver cardiac resynchronization therapy in a patient having right bundle branch block by measuring an interval between a right atrial depolarization and a first heart sound and selecting a right atrial-ventricular (AV) pacing interval in response to the measured interval. Pacing pulses are delivered to the right ventricle of a patient's heart at the selected right AV pacing interval to synchronize the right ventricle with an intrinsic left ventricle depolarization.

Abstract: A method for use in an implantable medical device system, comprising: selecting a first sensing electrode operatively disposed in a first heart chamber; setting a first sensing window corresponding to cardiac electrical events occurring in a second heart chamber; enabling a first sense amplifier coupled to the first sensing electrode during the first sensing window; sensing a first signal corresponding to cardiac electrical events occurring in the second heart chamber during the first sensing window using the first sensing electrode; and transmitting the first signal from an implantable medical device to an external monitor.

Abstract: A method for use in an implantable medical device system, comprising: selecting a first sensing electrode operatively disposed in a first heart chamber; setting a first sensing window corresponding to cardiac electrical events occurring in a second heart chamber; enabling a first sense amplifier coupled to the first sensing electrode during the first sensing window; sensing a first signal corresponding to cardiac electrical events occurring in the second heart chamber during the first sensing window using the first sensing electrode; and transmitting the first signal from an implantable medical device to an external monitor.

Abstract: Techniques for stabilizing the rate of a ventricle, during conducted atrial fibrillation for example, adjust the escape interval of an implantable medical device to increase or decrease the pacing rate. In some embodiments, the escape interval is adjusted to achieve and maintain a percentage of pacing. In other embodiments, the stability of the ventricular rate is quantified as a function of measured R-R intervals, and the escape interval is adjusted to achieve and maintain a level of stability. In still other embodiments, a mean compensatory pause length is determined, and the escape interval is adjusted as a function of the mean compensatory pause length, to maintain the escape interval at or near the mean compensatory pause length.

Abstract: In general, the invention is directed to techniques for detecting and addressing pacemaker syndrome. When a pacemaker detects a risk of pacemaker syndrome, the pacemaker paces one or more chambers of the heart to reduce the risk of pacemaker syndrome. One pacing technique is to apply ventricular paces, thereby reducing the delay between the atrial activation and the ventricular activation. Another technique, available to a patient who receives atrial pacing, is to decrease the atrial pacing rate.

Abstract: The invention is directed to techniques for providing cardiac resynchronization therapy by synchronizing delivery of pacing pulses to the left ventricle with intrinsic right ventricular depolarizations. An implantable medical device measures an interval between an atrial depolarization and an intrinsic ventricular depolarization is measured. In various embodiments, the intrinsic ventricular depolarization may be an intrinsic right or left ventricular depolarization. The implantable medical device delivers pacing pulses to the left ventricle to test a plurality of pacing intervals. The pacing intervals tested may be within a range around the measured interval between the atrial depolarization and the intrinsic ventricular depolarization. One of the pacing intervals is selected based on a measured characteristic of an electrogram that indicates ventricular synchrony. For example, the pacing interval may be selected based on measured QRS complex widths and/or Q-T intervals.

Abstract: Myocardial performance is assessed using a combination of electrical and mechanical criteria. More specifically, this assessment may be based on a QT interval based on electrogram (EGM) readings and on first and second heart sounds. The timing relationships between the QT interval and the first and second heart sounds can be used to evaluate certain systolic, diastolic, and systolic/diastolic parameters relating to myocardial performance. In addition, these parameters may be used to automatically drive therapies. For example, myocardial performance parameters obtained from the QT interval and from the timing of the first and second heart sounds may be used to optimize the AV delay and to optimize multisite pacing.

Abstract: Techniques for stabilizing the rate of a ventricle, during conducted atrial fibrillation for example, adjust the escape interval of an implantable medical device to increase or decrease the pacing rate. In some embodiments, the escape interval is adjusted to achieve and maintain a percentage of pacing. In other embodiments, the stability of the ventricular rate is quantified as a function of measured R-R intervals, and the escape interval is adjusted to achieve and maintain a level of stability. In still other embodiments, a mean compensatory pause length is determined, and the escape interval is adjusted as a function of the mean compensatory pause length, to maintain the escape interval at or near the mean compensatory pause length.

Abstract: Myocardial performance is assessed using a combination of electrical and mechanical criteria. More specifically, this assessment may be based on a QT interval based on electrogram (EGM) readings and on first and second heart sounds. The timing relationships between the QT interval and the first and second heart sounds can be used to evaluate certain systolic, diastolic, and systolic/diastolic parameters relating to myocardial performance. In addition, these parameters may be used to automatically drive therapies. For example, myocardial performance parameters obtained from the QT interval and from the timing of the first and second heart sounds may be used to optimize the AV delay and to optimize multisite pacing.

Abstract: The device senses Natural Heart Acceleration (NHA), isolating at least one segment (t) thereof corresponding to an isovolumetric phase, such as isovolumetric contraction (P1, P2) and/or isovolumetric relaxation (P3, P4). Preferentially, the action of isolation of the aforesaid segment is made starting from the electrocardiogram (ECG) signal. Among other things, the device may be used to carry out pacing functions (pacemaker, defibrillator, pacer cardioverter defibrillator) and/or to pick up, possibly by telemetry, data on the myocardial function and/or also to control a system of drug administration.

Abstract: A device for controlling therapeutic means acting on a patient comprises means for detecting the sympatho-vagal balance of the patient and processor means for generating a control signal for the therapeutic means combined in a circuit assembly which allows the device to be implanted in the body of said patient.

Abstract: The device senses Natural Heart Acceleration (NHA), isolating at least one segment (t) thereof corresponding to an isovolumetric phase, such as isovolumetric contraction (P1, P2) and/or isovolumetric relaxation (P3, P4). Preferentially, the action of isolation of the aforesaid segment is made starting from the electrocardiogram (ECG) signal. Among other things, the device may be used to carry out pacing functions (pacemaker, defibrillator, pacer cardioverter defibrillator) and/or to pick up, possibly by telemetry, data on the myocardial function and/or also to control a system of drug administration.

Abstract: The device senses Natural Heart Acceleration (NHA), isolating at least one segment (t) thereof corresponding to an isovolumetric phase, such as isovolumetric contraction (P1, P2) and/or isovolumetric relaxation (P3, P4). Preferentially, the action of isolation of the aforesaid segment is made starting from the electrocardiogram (ECG) signal. Among other things, the device may be used to carry out pacing functions (pacemaker, defibrillator, pacer cardioverter defibrillator) and/or to pick up, possibly by telemetry, data on the myocardial function and/or also to control a system of drug administration.

Abstract: A cardiostimulator device includes an accelerometric sensor positioned on the electrode or cathetar intended to be inserted in the cardiac mass, possibly being associated with a stimulating or sensing electrode. In this way, it is possible to regulate the frequency (and in general all the methods) of stimulation in dependence on the so-called natural heart acceleration correlated to the physical activity of the patient.