Abstract: An implantable medical device and associated method provide atrial pacing and measure an atrial ventricular (AV) delay. An autonomic function index is computed using the AV delay. The autonomic function index may be compiled in a medical report. In some embodiments, the autonomic function index is used to adjust atrial pacing control parameters.

Abstract: Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

Abstract: Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

Abstract: A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.

Abstract: Techniques for adjusting pacing therapy based on ventriculo-atrial delay are described herein. These techniques may be used to control ventricular filling times during the delivery of pacing therapy. In some examples, a device or system delivers pre-excitation fusion pacing therapy to a ventricular chamber, determines a ventriculo-atrial delay interval for the ventricular chamber for at least one cardiac cycle, and adjusts the pacing therapy delivered by the implantable medical device to compensate for decreased ventricular filling time when the ventriculo-atrial delay interval is less than a threshold. In some examples, the device or system may adjust the pacing therapy by decreasing a pacing rate of the implantable medical device, increasing a pre-excitation interval for pacing of the ventricular chamber, and/or switching from a fusion pacing mode to a biventricular pacing mode.

Abstract: A medical device and associated method for controlling a cardiac pacing therapy sense a first cardiac signal including events corresponding to cardiac electrical events and a second cardiac signal including events corresponding to cardiac hemodynamic events. A processor is enabled to measure a cardiac conduction time interval using the first cardiac signal and control a signal generator to deliver a pacing therapy. A pacing control parameter is adjusted to a plurality of settings during the pacing therapy delivery. A hemodynamic parameter value is measured from the second cardiac signal during application of each of the control parameter settings. The processor identifies an optimal setting from the plurality of settings and solves for a patient-specific equation defining the pacing control parameter as a function of the cardiac conduction time interval.

Abstract: A hood that mounts around an outlet of a catch basin with a cover having a proximal end and distal end; the proximal end being pivotally attached to the hood. The cover pivots between a closed sealed position that substantially prevents water born contaminants from passing through the access opening and an open position that allows access to the access opening. The cover is made from a flexible material to allow the cover to be lifted from the closed sealed position in a substantially vertical path that allows access to the outlet of a catch basin.

Abstract: Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

Abstract: A medical device for monitoring a patient condition includes a sensor capable of being advanced transvascularly to be positioned along a volume of tissue, the sensor including a first combination of a light source and a light detector to emit light into a volume of tissue and to detect light scattered by the volume of tissue and to generate a first output signal corresponding to an intensity of the detected light. A control module is coupled to the light source to control the light source to emit light at least four spaced-apart light wavelengths, and a monitoring module is coupled to the light detector to receive the output signal and compute a measure of tissue oxygenation using the light detector output signal.

Abstract: A method of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. In the event that the AV conduction test reveals an AV conduction block condition then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.

Abstract: A method and apparatus are used to provide therapy to a patient experiencing ventricular dysfunction or heart failure. At least one electrode is located in a region associated with nervous tissue, such as nerve bundles T1-T4, in a patient's body. Electrical stimulation is applied to the at least one electrode to improve the cardiac efficiency of the patient's heart. One or more predetermined physiologic parameters of the patient are monitored, and the electrical stimulation is adjusted based on the one or more predetermined physiologic parameters.

Abstract: A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.

Abstract: Methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles) and delivering fusion pacing using a decremented value of the intrinsic PR interval.

Abstract: A medical device for monitoring a patient condition includes a first combination of a light source and a light detector to emit light into a volume of tissue, detect light scattered by the volume of tissue, and provide a first output signal corresponding to an intensity of the detected light. A control module is coupled to the light source to control the light source to emit light at least four spaced-apart light wavelengths, and a monitoring module is coupled to the light detector to receive the output signal, compute a measure of tissue oxygenation in response to the light detector output signal, and detect tissue hypoxia using the measure of tissue oxygenation.

Abstract: The implantable medical device (IMD) system disclosed here utilizes one or more cardiac sensors that measure mechanical characteristics of the heart, such as left ventricular acceleration or right ventricular pressure. The raw sensor data is collected and processed by the IMD, which derives one or more mechanical event marker signals from features, traits, and characteristics of the sensor data waveforms. The mechanical event marker signals are wirelessly transmitted to an external monitor device for display.

Abstract: A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.

Abstract: A method of delivering phrenic nerve stimulation in a medical device system that includes detecting an activation event, delivering phrenic nerve stimulation therapy in response to the detected activation event, sensing a heart sound signal, in response to the delivered phrenic nerve stimulation therapy, monitoring a portion of the sensed heart sound signal, the portion defined by a predetermined window ocurring after the delivered phrenic nerve stimulation therapy, and determining whether the delivered phrenic nerve stimulation therapy was successful in response to the monitoring.

Abstract: Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time at least two subsequent V2 sensing events decremented by the adjusted PEI.

Abstract: A medical device and method for determining a parameter for delivery of a predetermined pacing therapy that includes a plurality of electrodes to deliver a pacing therapy, including the predetermined pacing therapy, and a control unit to control the timing of the delivery of the pacing therapy, including the predetermined pacing therapy, by the electrodes. A processor generates a first template in response to the pacing therapy being delivered to only one of a right ventricle and a left ventricle, and a second template in response to the pacing therapy being delivered to only the other of the right ventricle and the left ventricle, and determines the parameter in response to a comparing of subsequently delivered pacing therapy to the first template and the second template.

Abstract: A hood that mounts around an outlet of a catch basin with a cover having a proximal end and distal end; the proximal end being pivotally attached to the hood. The cover pivots between a closed sealed position that substantially prevents water born contaminants from passing through the access opening and an open position that allows access to the access opening. The cover is made from a flexible material to allow the cover to be lifted from the closed sealed position in a substantially vertical path that allows access to the outlet of a catch basin.