Abstract: The present invention is related to implantable cardiac devices such as pacemakers and defibrillators that deliver cardiac resynchronization therapy (CRT), and to a method of optimizing acquisition of multi-vector impedance signals from electrodes present on implanted lead systems. Acquired impedance signals associated with dynamic intracardiac impedance are related to specific time frames of the cardiac cycle as to derive indices representative of systolic and diastolic cardiac performance. The impedance signals are further adjusted by non-dynamic or static impedance signals associated with pulmonary impedance as to derive composite indices representative of cardiac performance and pulmonary vascular congestion. The pulmonary impedance signals are preferably obtained during relative periods of apnea in a patient.

Abstract: The present invention is related to implantable cardiac devices such as pacemakers and defibrillators that deliver cardiac resynchronization therapy (CRT), and to a method of optimizing acquisition of impedance signals between electrodes present on implanted lead systems. This system then automatically determines which electrodes or electrode combinations acquire impedance waveforms that have the best signal to noise ratio (highest fidelity) and characterize data most representative of dysynchronous electromechanical events. Using closed loop algorithms which provide electrograms and a variety of impedance data reflective of the patient's clinical status, the system autonomously modifies interval timing within the CRT device.

Abstract: External or internal monitoring equipment is used to automatically determine optimal programming parameters for a CRT based on externally or internally derived measurements of cardiac performance, anisotropic myocardial deformation (AMD) or both. The ideal programming parameter, operational parameter, represents optimal interval timing between multiple electrodes within the CRT, and is generated by such a closed loop control system. The closed loop system may be semi-automatic and implement connectivity to external ultrasound equipment or externally derived measurements of transthoracic impedance. Preferably, the operational parameter is determined by a closed loop system using internally derived intracardiac and intrathoracic electrograms and impedance measurements that describe cardiac performance and electromechanical dysynchrony in real time. Such a CRT has a control system that automatically optimizes performance by a system of checks and balance.

Abstract: The present invention describes methods and algorithms for processing a plurality of clinically relevant signals/data/genotypes intrinsic to a given patient and/or signals/data derived from external diagnostic equipment. The intrinsic signals can be acquired from device-based sensors and analogous extrinsic data can be obtained from imaging equipment. These signals/data are input into software algorithms that use digital signal processing in order to output informational data sets of clinical and technical relevance after comparisons are made to patients with access to this technology whose outcome under varying treatments is known. This data is used to define prognosis, guide clinical decision-making, make treatment suggestions, and direct programming of cardiac devices. Evaluation of an implanted device using such technology will confirm appropriately programmed settings within such a device.

Abstract: The present invention is related to implantable cardiac devices such as pacemakers and defibrillators that deliver cardiac resynchronization therapy (CRT), and to a method of optimizing acquisition of impedance signals between electrodes present on implanted lead systems. This system then automatically determines which electrodes or electrode combinations acquire impedance waveforms that have the best signal to noise ratio (highest fidelity) and characterize data most representative of dysynchronous electromechanical events. Using closed loop algorithms which provide electrograms and a variety of impedance data reflective of the patient's clinical status, the system autonomously modifies interval timing within the CRT device.