Abstract: Methods and systems are provided for generating a virtual venous image. The methods and systems utilize an intravascular mapping tool configured to be inserted into a venous structure of an object of interest. The methods and systems further acquire a plurality of position data points at predetermined intervals corresponding to a position of the intravascular mapping tool within the venous structure, and adjust each position data point based on at least one of a cardiac motion or a respiratory motion of the object of interest. The methods and systems also display a travelled path of the intravascular mapping tool on the display based on the adjusted position data points.

Abstract: An exemplary method for optimizing pacing configuration includes providing distances between electrodes of a series of three or more ventricular electrodes associated with a ventricle; selecting a ventricular electrode from the series; delivering energy to the ventricle via the selected ventricular electrode, the energy sufficient to cause an evoked response; acquiring signals of cardiac electrical activity associated with the evoked response via non-selected ventricular electrodes of the series; based on signals of cardiac electrical activity acquired via the non-selected ventricular electrodes and the distances, determining conduction velocities; based on the conduction velocities, deciding if the selected ventricular electrode is an optimal electrode for delivery of a cardiac pacing therapy; and, if the selected ventricular electrode comprises an optimal electrode for delivery of the cardiac pacing therapy, calling for delivery of the cardiac pacing therapy using the selected ventricular electrode.

Abstract: Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays.

Abstract: An exemplary method for optimizing pacing configuration includes providing distances between electrodes of a series of three or more ventricular electrodes associated with a ventricle; selecting a ventricular electrode from the series; delivering energy to the ventricle via the selected ventricular electrode, the energy sufficient to cause an evoked response; acquiring signals of cardiac electrical activity associated with the evoked response via non-selected ventricular electrodes of the series; based on signals of cardiac electrical activity acquired via the non-selected ventricular electrodes and the distances, determining conduction velocities; based on the conduction velocities, deciding if the selected ventricular electrode is an optimal electrode for delivery of a cardiac pacing therapy; and, if the selected ventricular electrode comprises an optimal electrode for delivery of the cardiac pacing therapy, calling for delivery of the cardiac pacing therapy using the selected ventricular electrode.

Abstract: Evaluation of an implanted electrical lead condition includes comparing electrogram template features with test electrogram features. The evaluating also includes determining the implanted electrical lead condition based solely on the electrogram comparison. The compared test electrogram features and template electrogram features may be atrial amplitudes and ventricular amplitudes. The sensing may be with a quad polar lead. The compared test electrogram features and electrogram template features may account for different patient postures and/or may account for respiration modulation.

Abstract: A method and system are provided to measure cardiac motion data using a cardiovascular navigation system. The method and system position a patient reference sensor (PRS) on a patient, wherein the PRS determines a position of the patient relative to a reference point. The method and system determine a reference orientation matrix based on an orientation of the PRS relative to a reference point and determining a normalization time based on an electrical signal. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates a three dimensional trajectory that occurs at the corresponding map point on a wall of a heart of the patient during at least one cardiac cycle. Further the method and system compensate the PS motion data based on the PRS.

Abstract: A method and system are provided for analyzing motion data collected by a cardiovascular navigation system to determine a level of dyssynchrony exhibited by a heart. The method and system comprise obtaining a motion data (MD) set that includes a plurality of map point specific motion data (PSMD) collections of motion data. The motion data in each PSMD collection includes information indicating an amount and direction of motion that occurred at a corresponding map point on a wall of the heart during a select period of time, such as during at least one cardiac cycle. The method and system divide the PSMD collections of data into sectors which may be associated with corresponding phases of the cardiac cycle, and analyze the sectors of the PSMD collections to determine at least one of a slope, a magnitude and a direction of motion at the corresponding map point of the wall of the heart during the associated sector.

Abstract: A method and system are provided that provide feedback regarding lead stability for a candidate target vessel, and provide guidance on a type of lead to be used. The method and system utilize a surgical navigation system and information regarding patient anatomy to predict lead stability within the patient anatomy. The method and system provide patient-specific force measurements for one or more vessels of a patient.

Abstract: Pacing related timing is determined for an implantable medical device (IMD) by pacing at an RV pacing site, a first LV pacing site and a second LV pacing site in accordance with a first site, a second site and a third site pacing order, and further in accordance with a first inter-electrode pacing delay between pacing at the first site and pacing at the second site and a second inter-electrode pacing delay between pacing at the second site and pacing at the third site. At least one of a sensed event or a paced event is detected for at each of the second site and the third site. The first inter-electrode pacing delay and the second inter-electrode pacing delay are adjusted to avoid sensed events in favor of paced events at each of the second site and the third site. An atrio-ventricular delay may also be adjusted to avoid sensed events or lack of capture due to possible fusion at the first site, in favor of paced events at the first site.

Abstract: Specific embodiments of the present invention determine a range of a physiologic property, for each of a plurality of periods of time, and monitor changes in the patient's heart disease based on changes in the range. Other embodiments determine a minimum of a physiologic property, for each of a plurality of periods of time, and monitor changes in the patient's heart disease based on changes in the minimum. Still other embodiments determine a maximum of the physiologic property, for each of a plurality of periods of time, and monitor changes in the patient's heart disease based on changes in the maximum.

Abstract: A method and system is provided for calculating a strain from characterization motion data. The method and system utilize an intravascular mapping tool configured to be inserted into at least one of the endocardial or epicardial space. The mapping tool is maneuvered to select locations proximate to surfaces of the heart, while collecting map points at the select locations to form a point cloud data set during at least one cardiac cycle. The method and system further include automatically assigning segment identifiers (IDs) to the map points based on a position of the map point within the point cloud data set. The method and system further select a first and second reference from a group of map points. Further, the method and system calculate a linear strain based on an instantaneous distance and a reference distance between the first and second references.

Abstract: A method and system are provided that provide feedback regarding lead stability for a candidate target vessel, and provide guidance on a type of lead to be used. The method and system utilize a surgical navigation system and information regarding patient anatomy to predict lead stability within the patient anatomy. The method and system provide patient-specific force measurements for one or more vessels of a patient.

Abstract: Specific embodiments of the present invention determine a range of a physiologic property, for each of a plurality of periods of time, and monitor changes in the patient's heart disease based on changes in the range. Other embodiments determine a minimum of a physiologic property, for each of a plurality of periods of time, and monitor changes in the patient's heart disease based on changes in the minimum. Still other embodiments determine a maximum of the physiologic property, for each of a plurality of periods of time, and monitor changes in the patient's heart disease based on changes in the maximum.

Abstract: The present disclosure provides systems and methods for neurostimulation. The method includes applying electrical stimulation to a patient using a paddle lead that includes a plurality of electrodes, acquiring local impedances associated with at least some of the plurality of electrodes, wherein the local impedances are indicative of electrode-tissue contact and effectiveness of the electrical stimulation, transmitting the local impedances data to a computing device, and processing the local impedances data using the computing device to adjust the amplitude of stimulations and electrode configurations, and monitor electrode-tissue contact status over time.

Abstract: An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.

Abstract: A method of identifying potential driver sites for cardiac arrhythmias includes acquiring a plurality of electrograms from a plurality of locations on at least a portion of a patient's heart. Using the acquired electrograms, at least one electrical activity map is generated. Desirable electrical activity maps include complex fractionated electrogram standard deviation and mean maps, dominant frequency maps, peak-to-peak voltage maps, and activation sequence maps. Using one or more of these maps (e.g., by analyzing one or more electrogram morphological characteristics represented by these maps), at least one potential driver site can be detected.

Abstract: Various embodiments of the present invention are directed to, or are for use with, an implantable system including a lead having multiple electrodes implantable in a patient's left ventricular (LV) chamber. In accordance with an embodiment, the patient's LV chamber is paced at first and second sites within the LV chamber using a programmed LV1-LV2 delay, wherein the LV1-LV2 delay is a programmed delay between when first and second pacing pulses are to be delivered respectively at the first and second sites within the LV chamber. Evoked responses to the first and second pacing pulses are monitored for, and one or more LV pacing parameter is/are adjusted and/or one or more backup pulse is/are delivered based on results of the monitoring.

Abstract: Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination based on activation times. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in the left atrial (LA) chamber, the right atrial (RA) chamber, and at least one ventricular chamber of a patient's heart. For each of a plurality of cardiac cycles, there is a determination, based on the plurality of obtained IEGMs, of an LA activation time, an RA activation time, and a ventricular activation time. Arrhythmia discrimination is then performed based on the determined activation times.

Abstract: A method and system are provided to measure cardiac motion data using a cardiovascular navigation system. The method and system position a patient reference sensor (PRS) on a patient, wherein the PRS determines a position of the patient relative to a reference point. The method and system determine a reference orientation matrix based on an orientation of the PRS relative to a reference point and determining a normalization time based on an electrical signal. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates a three dimensional trajectory that occurs at the corresponding map point on a wall of a heart of the patient during at least one cardiac cycle. Further the method and system compensate the PS motion data based on the PRS.