Abstract: Systems and methods for resolving catheter rendering issues are provided. A system includes a catheter including a plurality of electrodes and a plurality of catheter pins, each catheter pin corresponding to an associated electrode. The system further includes a mapping system communicatively coupled to the catheter, the mapping system including a pin box including a plurality of sockets, a display device configured to render the catheter, and an electronic control unit (ECU). The ECU is configured to determine that the catheter is being rendered incorrectly on the display device, determine a number of electrodes that are being rendered incorrectly on the display device, identify at least one particular electrode of the plurality of electrodes that is being rendered incorrectly on the display device, and attempt to resolve the incorrect rendering of the catheter based on the determined number of electrodes and the at least one particular electrode.

Abstract: Computer implemented methods and systems are provided for automatically determining capture thresholds for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole left ventricular (LV) lead. The methods and systems measures a base capture threshold for a base pacing vector utilizing stimulation pulses varied over at least a portion of an outer test range. The base pacing vector is defined by a first LV electrode provided on the LV lead and a second electrode located remote from an LV chamber. The methods and systems designate a secondary pacing vector that includes the first LV electrode and a neighbor LV electrode provided on the LV lead. The methods and systems further define an inner test range having secondary limits based on the base capture threshold, wherein at least one of the limits for the inner test range differs from a corresponding limit for the outer test range.

Abstract: Methods and devices are provided for, under control of one or more processors within an implantable medical device (IMD), delivering cardiac resynchronization therapy (CRT) at one or more pacing sites. The processors obtain cardiac signals, associated with a candidate beat, from multi-site left ventricular (MSLV) electrodes distributed along a left ventricle and analyze the cardiac signals to collect at least one of a MSLV conduction pattern or a MSLV morphology. The processors compare at least one of the MSLV conduction pattern or MSLV morphology to one or more associated templates. The processors then label the candidate beat as a pseudo-fusion beat based on the comparing and adjust the CRT based on the labeling.

Abstract: Methods and devices are provided that collect intra-cardiac electrogram (EGM) signals over first and second sensing channels (channel-1 and channel-2 EGM signals, respectively) associated with an event of interest that includes a right ventricle (RV) and a left ventricle (LV), determine first, second and third global characteristics (GC) from the channel-1 and channel-2 EGM signals, and define a QRS start time within at least one of the EGM signals; and determine a threshold crossing. The methods and systems compare at least one of the first, second and third GC to the threshold crossing, select one of the first, second and third GC based on the comparing; defining a QRS end time, within at least one of the channel-1 and channel-2 EGM signals based on the one of the first, second and third GC selected, and calculate a QRS duration based on the QRS start time and QRS end time.

Abstract: Systems and methods for resolving catheter rendering issues are provided. A system includes a catheter including a plurality of electrodes and a plurality of catheter pins, each catheter pin corresponding to an associated electrode. The system further includes a mapping system communicatively coupled to the catheter, the mapping system including a pin box including a plurality of sockets, a display device configured to render the catheter, and an electronic control unit (ECU). The ECU is configured to determine that the catheter is being rendered incorrectly on the display device, determine a number of electrodes that are being rendered incorrectly on the display device, identify at least one particular electrode of the plurality of electrodes that is being rendered incorrectly on the display device, and attempt to resolve the incorrect rendering of the catheter based on the determined number of electrodes and the at least one particular electrode.

Abstract: Systems and methods for measuring transmural activation times between an endocardial surface and an epicardial surface are provided. A system includes at least one catheter including at least one electrode, the at least one catheter configured to acquire electrogram data and positioning data proximate at least one of the endocardial surface and the epicardial surface. The system further includes a computing device communicatively coupled to the at least one catheter, the computing device configured to determine transmural activation times based on the acquired electrogram data and positioning data.

Abstract: Disclosed herein is a catheter for delivering an implantable medical lead to an implantation site near an ostium leading to a proximal region of a coronary sinus. The catheter includes a distal end, a proximal end opposite the distal end, a tubular body extending between the distal and proximal ends, an atraumatic fixation structure defining a distal termination of the distal end, and a lead receiving lumen. The atraumatic fixation structure is configured to enter the ostium and passively pivotally anchor with the proximal region of the coronary sinus. The lead receiving lumen extends along the tubular body from the proximal end to an opening defined in a side of the tubular body near the distal end and proximal the atraumatic fixation structure.

Abstract: Methods and devices are provided that collect intra-cardiac electrogram (EGM) signals over first and second sensing channels (channel-1 and channel-2 EGM signals, respectively) associated with an event of interest that includes a right ventricle (RV) and a left ventricle (LV), determine first, second and third global characteristics (GC) from the channel-1 and channel-2 EGM signals, and define a QRS start time within at least one of the EGM signals; and determine a threshold crossing. The methods and systems compare at least one of the first, second and third GC to the threshold crossing, select one of the first, second and third GC based on the comparing; defining a QRS end time, within at least one of the channel-1 and channel-2 EGM signals based on the one of the first, second and third GC selected, and calculate a QRS duration based on the QRS start time and QRS end time.

Abstract: Methods and devices are provided for, under control of one or more processors within an implantable medical device (IMD), delivering cardiac resynchronization therapy (CRT) at one or more pacing sites. The processors obtain cardiac signals, associated with a candidate beat, from multi-site left ventricular (MSLV) electrodes distributed along a left ventricle and analyze the cardiac signals to collect at least one of a MSLV conduction pattern or a MSLV morphology. The processors compare at least one of the MSLV conduction pattern or MSLV morphology to one or more associated templates. The processors then label the candidate beat as a pseudo-fusion beat based on the comparing and adjust the CRT based on the labeling.

Abstract: Methods and devices are provided comprising an implantable lead having electrodes configured to be located proximate to a heart, the electrodes defining a sensing vector through a region of interest in the heart. The method and system collect an intra-cardiac electrogram (EGM) signal associated with an event of interest and determining an global amplitude characteristic (GAC) and a global slope characteristic (GSC) from the EGM signal under control of one or more processors within an implantable medical device (IMD). A QRS start time is defined, within the EGM signal, based on the GSC and determining a local amplitude characteristic (LAC) for a segment of the EGM signal within a search window of the GAC under control of one or more processors within an implantable medical device (IMD) A QRS end time is defined, within the EGM signal, based on the LAC; and calculating a QRS duration based on the QRS start time and QRS end time under control of one or more processors within an implantable medical device (IMD).

Abstract: Methods and devices are provided for, under control of one or more processors within an implantable medical device (IMD), delivering cardiac resynchronization therapy (CRT) at one or more pacing sites. The processors obtain cardiac signals, associated with a candidate beat, from multi-site left ventricular (MSLV) electrodes distributed along a left ventricle and analyze the cardiac signals to collect at least one of a MSLV conduction pattern or a MSLV morphology. The processors compare at least one of the MSLV conduction pattern or MSLV morphology to one or more associated templates. The processors then label the candidate beat as a pseudo-fusion beat based on the comparing and adjust the CRT based on the labeling.

Abstract: Computer implemented methods and systems are provided for automatically determining capture thresholds for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole left ventricular (LV) lead. The methods and systems measures a base capture threshold for a base pacing vector utilizing stimulation pulses varied over at least a portion of an outer test range. The base pacing vector is defined by a first LV electrode provided on the LV lead and a second electrode located remote from an LV chamber. The methods and systems designate a secondary pacing vector that includes the first LV electrode and a neighbor LV electrode provided on the LV lead. The methods and systems further define an inner test range having secondary limits based on the base capture threshold, wherein at least one of the limits for the inner test range differs from a corresponding limit for the outer test range.

Abstract: Methods and devices are provided for, under control of one or more processors within an implantable medical device (IMD), delivering cardiac resynchronization therapy (CRT) at one or more pacing sites. The processors obtain cardiac signals, associated with a candidate beat, from multi-site left ventricular (MSLV) electrodes distributed along a left ventricle and analyze the cardiac signals to collect at least one of a MSLV conduction pattern or a MSLV morphology. The processors compare at least one of the MSLV conduction pattern or MSLV morphology to one or more associated templates. The processors then label the candidate beat as a pseudo-fusion beat based on the comparing and adjust the CRT based on the labeling.

Abstract: Methods and devices are provided comprising an implantable lead having electrodes configured to be located proximate to a heart, the electrodes defining a sensing vector through a region of interest in the heart. The method and system collect an intra-cardiac electrogram (EGM) signal associated with an event of interest and determining an global amplitude characteristic (GAC) and a global slope characteristic (GSC) from the EGM signal under control of one or more processors within an implantable medical device (IMD). A QRS start. time is defined, within the EGM signal, based on the GSC and determining a local amplitude characteristic (LAC) for a segment of the EGM signal within a search window of the GAC under control of one or more processors within an implantable medical device (IMD) A QRS end time is defined, within the EGM signal, based on the LAC; and calculating a QRS duration based on the QRS start time and QRS end time under control of one or more processors within an implantable medical device (IMD).

Abstract: Computer implemented methods and systems are provided for automatically determining capture thresholds for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole left ventricular (LV) lead. The methods and systems measures a base capture threshold for a base pacing vector utilizing stimulation pulses varied over at least a portion of an outer test range. The base pacing vector is defined by a first LV electrode provided on the LV lead and a second electrode located remote from an LV chamber. The methods and systems designate a secondary pacing vector that includes the first LV electrode and a neighbor LV electrode provided on the LV lead. The methods and systems further define an inner test range having secondary limits based on the base capture threshold, wherein at least one of the limits for the inner test range differs from a corresponding limit for the outer test range.

Abstract: Disclosed herein is a catheter for delivering an implantable medical lead to an implantation site near an ostium leading to a proximal region of a coronary sinus. The catheter includes a distal end, a proximal end opposite the distal end, a tubular body extending between the distal and proximal ends, an atraumatic fixation structure defining a distal termination of the distal end, and a lead receiving lumen. The atraumatic fixation structure is configured to enter the ostium and passively pivotally anchor with the proximal region of the coronary sinus. The lead receiving lumen extends along the tubular body from the proximal end to an opening defined in a side of the tubular body near the distal end and proximal the atraumatic fixation structure.

Abstract: A method of performing a cardiac electrophysiology procedure includes using a magnetically-localizable catheter to generate a cardiac model and then removing the catheter from the patient's heart. An electrophysiology catheter, such as a multi-electrode, non-contact mapping catheter, is then inserted into the heart. The electrophysiology catheter is also magnetically-localizable, and therefore can be localized within the model. The electrophysiology catheter is used to perform the electrophysiology procedure, such as electrophysiological mapping or ablation. Advantageously, because the electrophysiology catheter is magnetically-localizable, it can move during the electrophysiology procedure, either deliberately or inadvertently, without invalidating any previously-collected data or requiring recreation of the cardiac model.

Abstract: A method and system for selecting at least one left ventricular (LV) pacing site for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole LV lead are provided. The method and system include sensing LV activation events at multiple LV sensing sites. The arrival times of the LV activation events for corresponding LV sensing sites are measured. The method and system further include calculating differences between the arrival times for combinations of the LV sensing sites to obtain inter-site arrival delays between the combinations of the LV sensing sites. When at least one of the inter-site arrival delays exceeds a threshold, the method and system include designating the LV sensing site from the corresponding combination that has a later arrival time as a first LV pacing site from which to deliver LV pacing pulses using the implantable medical device.