Abstract: A haptic system for a minimally invasive, hand-held surgical instrument and the system's various parts including a graphical user haptic interface, one or more haptic interfaces associated with a hand-held handle used to control a sensorized end-effector of the surgical instrument or inserted catheters, associated hardware, and an operating system. The system enables users to acquire, read, modify, store, write, and download sensor-acquired data in real time. The system can provide: an open, universally compatible platform capable of sensing or acquiring physiological signals/data in any format; processing of the sensor acquired data within an operating system; and outputting the processed signals to hardware which generates tangible sensations via one or more haptic interfaces. These tangible sensations can be modified by the user in real time as the system ensures the temporal relationship of sensed fiducial events are not altered or shifted relative to the generated and displayed haptic signals.

Abstract: Provided herein are implantable systems that include an implantable photoplethysmography (PPG) sensor, which can be used to obtain an arterial PPG waveform. In an embodiment, a metric of a terminal portion of an arterial PPG waveform is determined, and a metric of an initial portion of the arterial PPG waveform is determined, and a surrogate of mean arterial pressure is determined based on the metric of the terminal portion and the metric of the initial portion. In another embodiment, a surrogate of diastolic pressure is determined based on a metric of a terminal portion of an arterial PPG waveform. In a further embodiment, a surrogate of cardiac afterload is determined based on a metric of a terminal portion of an arterial PPG waveform.

Abstract: A haptic system for a minimally invasive, hand-held surgical instrument and the system's various parts including a graphical user haptic interface, one or more haptic interfaces associated with a hand-held handle used to control a sensorized end-effector of the surgical instrument or inserted catheters, associated hardware, and an operating system. The system enables users to acquire, read, modify, store, write, and download sensor-acquired data in real time. The system can provide: an open, universally compatible platform capable of sensing or acquiring physiological signals/data in any format; processing of the sensor acquired data within an operating system; and outputting the processed signals to hardware which generates tangible sensations via one or more haptic interfaces. These tangible sensations can be modified by the user in real time as the system ensures the temporal relationship of sensed fiducial events are not altered or shifted relative to the generated and displayed haptic signals.

Abstract: An implantable cardiac therapy device and methods of using a device including an implantable stimulation pulse generator, one or more implantable leads defining sensing and stimulation circuits adapted to sense and deliver therapy in at least one right side heart chamber, and an implantable controller in communication with the stimulation pulse generator and the one or more patient leads so as to receive sensed signals indicative of a patient's physiologic activity and deliver indicated therapy. The controller is adapted to monitor at least one indicator of cardiac dysynchrony and to compare the at least one indicator to a determined dysynchrony threshold. The threshold is determined for indications that the patient be further evaluated for cardiac resynchronization therapy. The controller is further adapted to set an alert when the at least one indicator exceeds the threshold to indicate to a clinician that evaluation for bi-ventricular pacing might be indicated.

Abstract: A method of determining pacing therapy for an individual patient including determining representative electromechanical physiologic characteristics for a plurality of normal patients having a range of anatomical dimensions and developing a plurality of normal templates. Each template indicates the representative electromechanical physiologic characteristics of a group of normal patients having similar anatomical dimensions.

Abstract: Cardiac tissue motion characteristics acquired by novel cardiac sensors are analyzed and processed for the derivation of physiological indices. The indices are output to a hand held local or remote volumetric haptic display and enable an operator to obtain motion related dynamic characteristics of cardiac tissues. The ability to tactually sense the motion of cardiac tissue and the affect on such motion from inserted cardiovascular instrumentation enhances the operator's performance of procedures including the positioning and placement of implanted catheters/sensors, extraction of permanently implanted leads and delivery of cardiovascular therapies. Optimal haptic rendering is achieved by using computational techniques to reconstruct the physically and perceptually relevant aspects of acquired signals and bridge the gap between the inserted catheter and operator's hand/catheter handle.

Abstract: A family of minimally-invasive surgical (MIS) cardiac interventional tools with tactile feedback based upon cardiac mechanical data and physiologic parameters derived from sensors positioned upon the tools are configurable for optimal placement of an end-effector to provide acute cardiac resuscitation and/or remote cardiovascular intervention for a subject. A haptic interface (e.g., a haptic handle, haptic glove or a simulated haptic heart) provides a clinician with real, not virtual, interaction with the cardiovascular anatomy (including intrathoracic organs) of the subject to optimize end-effector placement. The MIS tools optionally include webbed blade portions for exploration of extracardiac or intrathoracic spaces.

Abstract: Cardiac tissue motion characteristics acquired by novel cardiac sensors are analyzed and processed for the derivation of physiological indices. The indices are output to a hand held local or remote volumetric haptic display and enable an operator to obtain motion related dynamic characteristics of cardiac tissues. The ability to tactually sense the motion of cardiac tissue and the affect on such motion from inserted cardiovascular instrumentation enhances the operator's performance of procedures including the positioning and placement of implanted catheters/sensors, extraction of permanently implanted leads and delivery of cardiovascular therapies. Optimal haptic rendering is achieved by using computational techniques to reconstruct the physically and perceptually relevant aspects of acquired signals and bridge the gap between the inserted catheter and operator's hand/catheter handle.

Abstract: Cardiac tissue motion characteristics acquired by novel cardiac sensors are analyzed and processed for the derivation of physiological indices. The indices are output to a hand held local or remote volumetric haptic display and enable an operator to obtain motion related dynamic characteristics of cardiac tissues. The ability to tactually sense the motion of cardiac tissue and the affect on such motion from inserted cardiovascular instrumentation enhances the operator's performance of procedures including the positioning and placement of implanted catheters/sensors, extraction of permanently implanted leads and delivery of cardiovascular therapies. Optimal haptic rendering is achieved by using computational techniques to reconstruct the physically and perceptually relevant aspects of acquired signals and bridge the gap between the inserted catheter and operator's hand/catheter handle.

Abstract: A haptic system for a minimally invasive, hand-held surgical instrument and the system's various parts including a graphical user haptic interface, one or more haptic interfaces associated with a hand-held handle used to control a sensorized end-effector of the surgical instrument or inserted catheters, associated hardware, and an operating system. The system enables users to acquire, read, modify, store, write, and download sensor-acquired data in real time. The system can provide: an open, universally compatible platform capable of sensing or acquiring physiological signals/data in any format; processing of the sensor acquired data within an operating system; and outputting the processed signals to hardware which generates tangible sensations via one or more haptic interfaces. These tangible sensations can be modified by the user in real time as the system ensures the temporal relationship of sensed fiducial events are not altered or shifted relative to the generated and displayed haptic signals.

Abstract: Embodiments of this invention include hand-held handles and systems for balloon-tipped catheter interventions that enable a user to appreciate a combination of palpable sensations as though his or her hand is actual anatomic tissue in situ in real time. The system may include a haptic handle coupled to the proximal end of the catheter where the haptic handle includes a balloon-shaped haptic interface that exhibits geometric characteristics reflecting an anatomy of the interventional balloon and provides tangible sensations representative of tissues surrounding the interventional balloon. Multiple sensors and actuators may be used to create a non-virtual, transparent experience communicated to a user with a three dimensional, volumetric haptic display.

Abstract: Provided herein are implantable systems that include an implantable photoplethysmography (PPG) sensor, which can be used to obtain an arterial PPG waveform. In an embodiment, a metric of a terminal portion of an arterial PPG waveform is determined, and a metric of an initial portion of the arterial PPG waveform is determined, and a surrogate of mean arterial pressure is determined based on the metric of the terminal portion and the metric of the initial portion. In another embodiment, a surrogate of diastolic pressure is determined based on a metric of a terminal portion of an arterial PPG waveform. In a further embodiment, a surrogate of cardiac afterload is determined based on a metric of a terminal portion of an arterial PPG waveform.

Abstract: Cardiac tissue motion characteristics acquired by novel cardiac sensors are analyzed and processed for the derivation of physiological indices. The indices are output to a hand held local or remote volumetric haptic display and enable an operator to obtain motion related dynamic characteristics of cardiac tissues. The ability to tactually sense the motion of cardiac tissue and the affect on such motion from inserted cardiovascular instrumentation enhances the operator's performance of procedures including the positioning and placement of implanted catheters/sensors, extraction of permanently implanted leads and delivery of cardiovascular therapies. Optimal haptic rendering is achieved by using computational techniques to reconstruct the physically and perceptually relevant aspects of acquired signals and bridge the gap between the inserted catheter and operator's hand/catheter handle.

Abstract: The cross-correlation of corresponding signals facilitates the development of sensor nanotechnologies including a catheter for performing ablation of cardiac arrhythmias and a biocompatible electrical interface with monitoring capabilities. Cross-correlation of data acquired with differing techniques enables system calibration and design, as well as, validation of the data acquired with next generation sensors. In a preferred mode of the invention, novel cardiac nanosensors enable an operator to differentiate one individual patient's cardiac tissue mechanical properties from others by using a sense of touch much as clinicians today use auditory cues with a stethoscope.

Abstract: A method of determining pacing therapy for an individual patient including determining representative electromechanical physiologic characteristics for a plurality of normal patients having a range of anatomical dimensions and developing a plurality of normal templates. Each template indicates the representative electromechanical physiologic characteristics of a group of normal patients having similar anatomical dimensions.

Abstract: A method of determining pacing therapy for an individual patient including determining representative electromechanical physiologic characteristics for a plurality of normal patients having a range of anatomical dimensions and developing a plurality of normal templates. Each template indicates the representative electromechanical physiologic characteristics of a group of normal patients having similar anatomical dimensions.

Abstract: A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.

Abstract: A system with an implantable cardiac stimulation device having an implantable stimulation generator, at least one implantable lead adapted for connection to the implantable stimulation generator and further adapted for at least one of sensing physiologic activity and delivery of therapy, memory, and a controller in communication with the memory and with the at least one implantable lead and stimulation generator. The controller is configured to automatically evaluate a patient's physiologic status and selectively induce delivery of therapeutic stimulation under variable timing parameters. The system also has a measurement system adapted to measure at least one of strain and velocity of myocardial tissue and is adapted to evaluate strain and/or velocity measures and adjust the variable timing parameters of the implantable stimulation device to increase mechanical synchrony of the myocardial tissue.

Abstract: An exemplary method includes delivering stimulation energy via a right ventricular site; sensing an evoked response caused by the delivered stimulation energy at the right ventricular site; calculating a paced propagation delay for the right ventricular site (PPDRV); delivering stimulation energy via a left ventricular site; sensing an evoked response caused by the delivered stimulation energy at the left ventricular site; calculating a paced propagation delay for the left ventricular site (PPDLV); and determining an interventricular delay time (VV) for delivery of a bi-ventricular pacing therapy based in part on the paced propagation delay for the right ventricular site (PPDRV) and the paced propagation delay for the left ventricular site (PPDLV). Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.