Abstract: A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

Abstract: A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

Abstract: Systems and methods for determining the coronary sinus vein branch location of a left ventricle electrode are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart including sensing one or more of the electrical events with the electrode and then analyzing the electrical events to determine the electrode's position. The determination of electrode position may be used to automatically adjust operating parameters of a VRT device. Furthermore, the determination of electrode position may be made in real-time during installation of the electrode and a visual indication of the electrode position may be provided on a display screen.

Abstract: A device for measuring a synchronicity of contraction of a heart to determine if an individual would be a responder to cardiac resynchronization therapy. The device may include a first electrode positioned at a first ventricular wall location to measure movement of the first ventricular wall location and generate a first signal, as well as a second electrode positioned at a second ventricular wall location to measure movement of the second ventricular wall location and generate a second signal. A processing module may process the first and second signals, for example, integrate the signals multiple times, and generate an output based on the processed signals. Based on this output, an individual can be labeled a responder or non-responder to cardiac resynchronization therapy. The electrodes may each include an accelerometer to measure acceleration of the heart wall.

Abstract: A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction-evoking stimulation therapy is delivered from the selected electrode.

Abstract: A cardiac rhythm and function management device configured to automatically adjust stimulation parameters used in delivering cardiac resynchronization therapy. Mechanical contraction intervals are measured using appropriately placed accelerometers and compared with optimum values. The stimulation parameters can then be adjusted accordingly in a manner that moves the mechanical contraction intervals toward their optimum values.

Abstract: A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

Abstract: A cardiac rhythm management device is configured to detect mechanical oscillations in cardiac rhythm. Upon detection of such oscillations, the device may adjust its operating behavior to compensate for the deleterious effects of the condition.

Abstract: A cardiac rhythm management device is configured to detect oscillations in cardiac rhythm by measuring the amplitudes of heart sounds during successive heart beats. Upon detection of acoustic alternans, the device may adjust its operating behavior to compensate for the deleterious effects of the condition.

Abstract: A cardiac rhythm management device is configured to detect oscillations in cardiac rhythm by comparing electrogram signals during successive heart beats. Upon detection of electrical alternans, the device may adjust its operating behavior to compensate for the deleterious effects of the condition.

Abstract: A method and apparatus for selection of one or more ventricular chambers to stimulate for ventricular resynchronization therapy. Intrinsic intracardia electrograms that include QRS complexes, are recorded from a left and right ventricle. A timing relationship between the intrinsic intracardia electrograms recorded from the left and right ventricle is then determined. In one embodiment, the timing relationship is determined using a delay between a left ventricular and a right ventricular sensed intrinsic ventricular depolarizations and a duration interval of one or more QRS complexes. In one embodiment, the duration of QRS complexes is determined from either intracardiac electrograms or from surface ECG recordings. One or more ventricular chambers in which to provide pacing pulses are then selected based on the timing relationship between intrinsic intracardia electrograms recorded from the right and left ventricle, and the duration of one or more QRS complexes.

Abstract: A pacing system for providing optimal hemodynamic cardiac function for parameters such as ventricular synchorny or contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

Abstract: A pacing system for providing optimal hemodynamic cardiac function for parameters such as ventricular synchorny or contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

Abstract: A method and system for setting the operating parameters of a cardiac rhythm management device in which a plurality of parameter optimization algorithms are available. A measured feature of an electrophysiological signal such as QRS width has been shown to be useful in selecting among certain parameter optimization algorithms.

Abstract: An implantable cardiac rhythm/function management device that automatically determines whether or not a pacing stimulus to the ventricles results in capture by detecting propagated depolarizations at stimulating and non-stimulating electrodes. The device of the present invention is suitable for use in either a single or multiple electrode pacing/sensing configuration and may be utilized to verify either atrial or ventricular capture of a heart having either normal or abnormal intrinsic AV conduction.

Abstract: A pacing apparatus and method for providing optimum timing for ventricular pacing without referencing atrial activities. The pacing apparatus includes a processor, at least one sensor and a pulse generator. The pacing method includes the sensing of ventricular depolarization and the identification of an early electrical event, such as a depolarization of the HIS bundle or an onset of a ventricular depolarization (Q*). The system derives the proper timing using this early electrical event which provides a predictable relationship with an optimal ventricular pacing signal.

Abstract: Methods and devices are disclosed for employing mechanical measurements to synchronize contractions of ventricular wall locations. Accelerometers that may be placed within electrode leads are positioned at ventricular wall locations, such as the left ventricle free wall, right ventricle free wall, and the anterior wall/septum wall. The accelerometers produce signals in response to the motion of the ventricular wall locations. A processor may then compare the signals to determine a difference in the synchronization of the ventricular wall location contractions. The difference in synchronization can be determined in various ways such as computing a phase difference and/or amplitude difference between the accelerometer signals. One or more stimulation pulses may be provided per cardiac cycle to resynchronize the contractions as measured by the accelerometers to thereby constantly and automatically optimize the cardiac resynchronization therapy.

Abstract: Systems and methods for detecting and measuring cardiac contractile function of a heart using an acceleration sensor unit inserted within the heart, such as within a vein of the cardiac wall are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart by inserting and positioning an implantable lead having an electrode near a cardiac wall as well as detecting mechanical events within the patient's heart by then inserting and positioning a cardiac motion sensor unit through the inner lumen of the implantable lead. Furthermore, the systems and methods do not require dedicated leads and may be used with preexisting implantable leads.

Abstract: A system and method for automatically selecting among a plurality of pacing modes based upon capture detection. Patients suffering from heart failure may be optimally treated with different resynchronization pacing modes or configurations. By detecting whether capture is being achieved by a particular configuration or mode, a device is able to automatically switch to one that is both optimal in treating the patient and is successful in capturing the heart with pacing pulses.

Abstract: A method and system for operating a cardiac pacemaker which employs pacing therapy to regularize the ventricular rhythm together with biventricular sensing. Biventricular sensing allows the ventricular rate regularization to be accomplished with greater hemodynamic stability.