Abstract: A technique of controlling operation of a user-adjustable cardiac pacemaker, or a software model thereof, in a training mode is described. A method implementation of the technique comprises generating at least one cardiac event by a feedback-based heart simulator, wherein the cardiac event includes a pulse parameter set defining at least a pulse amplitude. The method further comprises transmitting the at least one cardiac event, or a first signal representation derived therefrom, to an electro cardiogram, ECG, generator configured to generate ECG graphics triggering a user to perform, in the training mode, one or more user adjustments at the cardiac pacemaker or its software model. Further still, the method comprises transmitting the at least one cardiac event, or a second signal representation derived therefrom, to the cardiac pacemaker or its software model, and acquiring stimulus information on one or more stimuli generated by the cardiac pacemaker or its software model.

Abstract: For cardiac rhythm management, a combination of cardiac pacing and a noninvasive heart monitoring is proposed for the determination of a set of programmable pacing parameters hemodynamically beneficial to the patient. The apparatus incorporates a cardiac pacemaker and a thoracic electrical bioimpedance (TEB) heart monitor. This combination allows the creation of a closed-loop system that obtains pacing parameter settings providing hemodynamically beneficial pacing therapy to the patient as determined by measuring and recording of stroke volume (SV), cardiac output (CO), and other indices of ventricular performance by the heart monitor during an optimization cycle automatically employing different permutations of values of pacing parameters such as atrioventricular delays, inter-atrial delay, inter-ventricular delay, or heart rate, that are sequentially programmed to the pacemaker.

Abstract: For cardiac rhythm management, a combination of cardiac pacing and a noninvasive heart monitoring is proposed for the determination of a set of programmable pacing parameters hemodynamically beneficial to the patient. The apparatus incorporates a cardiac pacemaker and a thoracic electrical bioimpedance (TEB) heart monitor. This combination allows the creation of a closed-loop system that obtains pacing parameter settings providing hemodynamically beneficial pacing therapy to the patient as determined by measuring and recording of stroke volume (SV), cardiac output (CO), and other indices of ventricular performance by the heart monitor during an optimization cycle automatically employing different permutations of values of pacing parameters such as atrioventricular delays, inter-atrial delay, inter-ventricular delay, or heart rate, that are sequentially programmed to the pacemaker.

Abstract: Methods and apparatus for digital demodulation of signals obtained in the measurement of electrical bioimpedance or bioadmittance of an object. One example comprises: generating an excitation signal of known frequency content; applying the excitation signal to the object; sensing a response signal of the object; sampling and digitizing the response signal to acquire a digitized response signal representing the response signal with respect to frequency content, amplitude and phase; correlating, for each frequency fAC of the excitation signal applied, digitized samples of the response signal, with discrete values representing the excitation signal; calculating, using the correlated signals for each frequency fAC of the excitation signal applied, complex values for the bioimpedance Z(fAC); providing, over time, a set of digital bioimpedance waveforms Z(fAC,t)); separating the base bioimpedance Z0(fAC), from the waveforms; and separating the changes of bioimpedance ?Z(fAC,t), from the waveforms.

Abstract: In order to reliably determine the left-ventricular ejection time TLVE of a heart of a subject, at least two different measuring methods are employed. This includes in any case the derivation of a first waveform related to thoracic electrical bioimpedance or bioadmittance. A second waveform can be determined by using pulse oximetry, Doppler velocimetry, measurement of arterial blood pressure and measurement of peripheral electrical bioimpedance or bioadmittance. Depending on signal quality, the results obtained by each method are weighted and then averaged. The weighted average for left-ventricular ejection time is used as an input variable for cardiovascular monitoring methods, which determine objective measurements of cardiovascular function and performance. Such measurements include, but are not limited to, left ventricular ejection fraction, stroke volume, cardiac output, systolic time ratio, and indices of ventricular contractility.

Abstract: For cardiac rhythm management a combination of cardiac pacing and a noninvasive heart monitoring is proposed for the determination of a set of programmable pacing parameters hemodynamically most beneficial to the patient. The apparatus incorporates a cardiac pacemaker (130) and a thoracic electrical bioimpedance (TEB) heart monitor (120). This combination allows the creation of a closed-loop system that conveniently and effectively obtains pacing parameter settings providing hemodynamically optimal pacing therapy to the patient as determined by measuring and recording of stroke volume (SV), cardiac output (GO), and other indices of ventricular performance by the heart monitor during an optimization cycle automatically employing different permutations of values of pacing parameters such as atrioventricular delays, inter-atrial delay, inter-ventricular delay, or heart rate, that are sequentially programmed to the pacemaker.