Abstract: Systems and methods provide for ambulatorily sensing pulmonary artery pressure from within a patient, and producing a pulmonary artery pressure measurement from the sensed pulmonary artery pressure. Power is ambulatorily provided within the patient to facilitate sensing of the pulmonary artery pressure and producing of the pulmonary artery pressure measurement. Acute pulmonary embolism is detected based on a change or rate of change in the pulmonary artery pressure measurement. An alert is preferably generated in response to detecting pulmonary embolism.

Abstract: A method of optimizing cardiac resynchronization therapy delay over a patient's full range of activity for use in operating an implantable cardiac pacing device and such a device are disclosed. The method includes measuring selected conduction time between selected sites in the heart for a plurality of beats and logging the values on a periodic repeating programmable basis to produce cumulative data and constructing a current template of conduction time in relation to one or more other sensed parameters of interest over a desired range of patient activity levels. The current template is used to derive suggested optimum pacing timing.

Abstract: Systems and methods provide for ambulatorily sensing pulmonary artery pressure from within a patient, and producing a pulmonary artery pressure measurement from the sensed pulmonary artery pressure. Power is ambulatorily provided within the patient to facilitate sensing of the pulmonary artery pressure and producing of the pulmonary artery pressure measurement. Acute pulmonary embolism is detected based on a change or rate of change in the pulmonary artery pressure measurement. An alert is preferably generated in response to detecting pulmonary embolism.

Abstract: Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals.

Abstract: Systems and methods provide for ambulatorily sensing pulmonary artery pressure from within a patient, and producing a pulmonary artery pressure measurement from the sensed pulmonary artery pressure. Power is ambulatorily provided within the patient to facilitate sensing of the pulmonary artery pressure and producing of the pulmonary artery pressure measurement. Acute pulmonary embolism is detected based on a change or rate of change in the pulmonary artery pressure measurement. An alert is preferably generated in response to detecting pulmonary embolism.

Abstract: Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals.

Abstract: An evaluation of heart failure status is provided based on a disordered breathing index. Patient respiration is sensed and a respiration signal is generated. Disordered breathing episodes are detected based on the respiration signal. A disordered breathing index is determined based on the disordered breathing episodes. The disordered breathing index is trended and used to evaluate heart failure status. The disordered breathing index may be combined with additional information and/or may take into account patient activity, posture, sleep stage, or other patient information.

Abstract: An evaluation of heart failure status is provided based on a disordered breathing index. Patient respiration is sensed and a respiration signal is generated. Disordered breathing episodes are detected based on the respiration signal. A disordered breathing index is determined based on the disordered breathing episodes. The disordered breathing index is trended and used to evaluate heart failure status. The disordered breathing index may be combined with additional information and/or may take into account patient activity, posture, sleep stage, or other patient information.

Abstract: Systems and methods provide for ambulatorily sensing pulmonary artery pressure from within a patient, and producing a pulmonary artery pressure measurement from the sensed pulmonary artery pressure. Power is ambulatorily provided within the patient to facilitate sensing of the pulmonary artery pressure and producing of the pulmonary artery pressure measurement. Acute pulmonary embolism is detected based on a change or rate of change in the pulmonary artery pressure measurement. An alert is preferably generated in response to detecting pulmonary embolism.

Abstract: Disordered breathing events may be classified as central, obstructive or a combination of central an obstructive in origin based on patient motion associated with respiratory effort. Central disordered breathing is associated with disrupted respiration with reduced respiratory effort. Obstructive disordered breathing is associated with disrupted respiration accompanied by respiratory effort. A disordered breathing classification system includes a disordered breathing detector and a respiratory effort motion sensor. Components of the disordered breathing classification system may be fully or partially implantable.

Abstract: Systems and methods provide for determining blood gas saturation based on one or more measured respiration parameters. A parameter of respiration is measured implantably over a duration of time. The measured respiratory parameter is associated with a blood gas saturation level. Blood gas saturation is determined based on the measured respiration parameter. At least one of associating the measured respiratory parameter and determining blood gas saturation is preferably preformed implantably.

Abstract: Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals.

Abstract: This document discusses, among other things, systems, devices, and methods measure an impedance and, in response, adjust an atrioventricular (AV) delay or other cardiac resynchronization therapy (CRT) parameter that synchronizes left and right ventricular contractions. A first example uses parameterizes a first ventricular volume against a second ventricular volume during a cardiac cycle, using a loop area to create a synchronization fraction (SF). The CRT parameter is adjusted in closed-loop fashion to increase the SF. A second example measures a septal-freewall phase difference (PD), and adjusts a CRT parameter to decrease the PD. A third example measures a peak-to-peak volume or maximum rate of change in ventricular volume, and adjusts a CRT parameter to increase the peak-to-peak volume or maximum rate of change in the ventricular volume.

Abstract: This patent document discusses systems, devices, and methods for increasing a sensitivity or specificity of thoracic fluid detection in a subject and differentiating between pleural effusion and pulmonary edema. In one example, a thoracic impedance measurement circuit senses a thoracic impedance signal. In another example, a processor receives the thoracic impedance signal and determines whether such thoracic impedance signal is “significant.” A significant thoracic impedance signal indicates the presence of thoracic fluid and may be recognized by comparing the thoracic impedance signal (or variation thereof) to a thoracic impedance threshold. When a significant thoracic impedance signal is recognized, the processor is adapted to detect one or both of: a pleural effusion indication and a pulmonary edema indication using one or a combination of: physiologic information, patient symptom information, and posture information.

Abstract: Methods and systems involve adjusting cardiac pacing based on information acquired via a respiratory therapy device. A medical system includes a respiratory therapy device having one or more sensors and a therapy delivery unit. The one or more sensors are configured to sense respiration cycles. The therapy delivery unit is configured to deliver an external respiratory therapy to the patient. The medical system also includes a pulse generator configured to deliver cardiac pacing pulses to the patient. A controller is coupled to the one or more sensors and the pulse generator. The control unit configured to adjust a cardiac pacing rate based on the patient's respiration cycles.

Abstract: A cardiac rhythm management system for coordination therapy includes a pulse generator to generate pacing and discharging of recharge pulses. A pulse delivery controller coupled to the pulse generator, times the delivery of the pacing and discharging of recharge pulses in a desired sequence. A therapy circuit coupled to the pulse delivery controller, receives the timed pulses from the pulse delivery controller and delivers the timed pulses to one or more electrodes disposed in or around a heart to communicate the timed pacing and discharging of recharge pulses to different sites of a heart, to avoid any interactions resulting from the electric fields surrounding the electrodes during a multiple site pacing required by the coordination therapy.

Abstract: Systems and methods obtain information that allows detection of whether a patient suffers from congestion by monitoring a response of the patient to a recumbent position of the patient's body. The patient may be monitored to determine a respiration pattern for a non-recumbent position such as standing and a respiration pattern for a recumbent position such as lying down. The two patterns may be compared, either by a processing device or a physician, to determine a difference in the two respiration patterns. Furthermore, the congestion may be inferred from detecting an amount of time that the patient spends in a recumbent position or from detecting the recumbent angle that the patient obtains, either of which is presumed to indicate whether a recumbent position presents discomfort to the patient due to the presence of congestion.

Abstract: A method for operating a cardiac pacemaker in which the mode of operation of the pacemaker is altered in response to detecting an episode of atrial tachycardia. In accordance with the invention, the pacemaker's pacing mode is altered in a manner that attempts to maintain hemodynamic stability during the atrial tachycardia. Such a mode switch is particularly applicable to pacemaker patients suffering from some degree of congestive heart failure.

Abstract: A physiological sensor is located within the airway of the subject's body, such as for measuring barometric pressure and communicating this value to a blood pressure or other monitoring device, which can derive gauge pressure using the barometric pressure and a measured absolute pressure within the body. The physiological sensor may also detect one or more other physiological parameters such as air flow, sound, or a chemical property. It may be anchored within the airway with the ability to communicate wirelessly to one or more other medical devices, such as an implanted cardiac function management device. Methods of use are also described.

Abstract: A medical device programmer and a method of operation in which a first data value is received and used in the execution of one or more algorithms. One or more suggested pulse generator settings are calculated from the one or more algorithms based on the first data value, and the one or more suggested pulse generator settings are displayed on an interactive display screen of the medical device programmer. In one embodiment, the first data value is a duration interval of a QRS complex. From the duration interval, suggestions are made as to one or more ventricular chambers in which to provide pacing pulses. Additionally, pacing intervals for an AV delay are suggested based on measured P-R intervals, or pacing intervals for an LV offset are suggested based on a measured duration interval of a V-V-interval between a right ventricular event and a left ventricular event.