Treating Or Preventing Abnormally High Heart Rate Patents (Class 607/14)
  • Patent number: 8255049
    Abstract: Various system embodiments comprise at least one sensor input adapted to receive at least one sensed signal associated with a tachyarrhythmia, a feature set extractor adapted to extract at least two features from the at least one sensed signal associated with the tachyarrhythmia, a feature set generator adapted to form a feature set using the at least two features extracted by the feature set extractor, at least one generator adapted for use to selectively apply an anti-tachycardia pacing (ATP) therapy and a neural stimulation (NS) therapy, and a controller adapted to respond to the feature set. The controller is adapted to initiate the NS therapy when the feature set corresponds to criteria for applying the NS therapy to modify the tachyarrhythmia, and initiate the ATP therapy to terminate the modified tachyarrhythmia. Other aspects and embodiments are provided herein.
    Type: Grant
    Filed: May 8, 2006
    Date of Patent: August 28, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventor: Dan Li
  • Publication number: 20120215269
    Abstract: The present invention provides both methods and devices for termination of arrhythmias, such as ventricular or atrial tachyarrhythmias. The device and method involves application of alternating current (AC) for clinically significant durations at selected therapeutic frequencies through the cardiac tissue to a subject experiencing arrhythmia. Methods are also provided to minimize or eliminate pain during defibrillation.
    Type: Application
    Filed: September 3, 2010
    Publication date: August 23, 2012
    Inventors: Harikrishna Tandri, Ronald David Berger, Seth Weinberg, Leslie Tung, Natalia Trayanova
  • Publication number: 20120215273
    Abstract: An implantable medical device delivers anti-tachyarrhythmia therapies including anti-tachycardia pacing (ATP). If a detected tachyarrhythmia is classified as a type suitable for treatment using ATP, the implantable medical device selects one of an atrial ATP (A-ATP) mode, a ventricular ATP (V-ATP) mode, and a concurrent atrio-ventricular ATP (concurrent AV-ATP) mode according to the characteristics of the detected tachyarrhythmia. The concurrent ATP mode is an ATP mode during which the atrial pacing pulses and the ventricular pacing pulses are delivered concurrently. In one embodiment, the concurrent AV-ATP mode includes a synchronized atrio-ventricular ATP (synchronized AV-ATP) mode during which atrial and ventricular pacing pulses are delivered synchronously and an independent atrio-ventricular ATP (independent AV-ATP) mode during which atrial and ventricular pacing pulses are delivered concurrently but timed independently.
    Type: Application
    Filed: April 27, 2012
    Publication date: August 23, 2012
    Inventors: Dan Li, Jaeho Kim, Joseph M. Bocek
  • Patent number: 8249705
    Abstract: Described here are devices, systems, and methods for improving left ventricular function in a patient with systolic heart failure with left ventricular dysfunction using baroreflex activation therapy. In general the systems have at least one electrode and a control system in communication with the electrode, the control system including a processor and memory, wherein the memory includes software defining a stimulus regime configured to effect improvement in left ventricular function. The methods for improving left ventricular function in a subject typically include identifying a patient in need of left ventricular function improvement and stimulating a baroreceptor with a baroreceptor activation device to improve left ventricular function.
    Type: Grant
    Filed: March 6, 2008
    Date of Patent: August 21, 2012
    Assignee: CVRx, Inc.
    Inventors: Robert S. Kieval, Martin Rossing
  • Patent number: 8249704
    Abstract: Method and apparatus for preventing heart rhythm disturbances by recording cardiac electrical activity, measuring beat-to-beat variability in the morphology of electrocardiographic waveforms, and using the measured beat-to-beat variability to control the delivery of electrical impulses to the heart during the absolute refractory period.
    Type: Grant
    Filed: July 26, 2006
    Date of Patent: August 21, 2012
    Assignee: Massachusetts Institute of Technology
    Inventors: Antonis A. Armoundas, Richard J. Cohen
  • Publication number: 20120209343
    Abstract: Methods and apparatus for a three-stage atrial cardioversion therapy that treats atrial arrhythmias within pain tolerance thresholds of a patient. An implantable therapy generator adapted to generate and selectively deliver a three-stage atrial cardioversion therapy and at least two leads, each having at least one electrode adapted to be positioned proximate the atrium of the patient. The device is programmed for delivering a three-stage atrial cardioversion therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of an atrial arrhythmia. The three-stage atrial cardioversion therapy includes a first stage for unpinning of one or more singularities associated with an atrial arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities delivered via the near-field configuration of the electrodes.
    Type: Application
    Filed: January 12, 2012
    Publication date: August 16, 2012
    Inventors: Igor R. Efimov, Wenwen Li, Ajit Janardhan
  • Patent number: 8244348
    Abstract: An implantable cardioverter/defibrillator (ICD) includes a tachyarrhythmia detection and classification system that classifies tachyarrhythmias based on a morphological analysis of arrhythmic waveforms and a template waveform. Correlation coefficients each computed between morphological features of an arrhythmic waveform and morphological features of the template waveform provide for the basis for classifying the tachyarrhythmia. In one embodiment, a correlation analysis takes into account the uncertainty associated with the production of the template waveform by using a template band that includes confidence intervals.
    Type: Grant
    Filed: September 8, 2008
    Date of Patent: August 14, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventor: Dan Li
  • Patent number: 8244353
    Abstract: An implantable cardiac stimulator includes a cardioversion/defibrillation unit connected to at least one electrode pair for generation and delivery of cardioversion or defibrillation shocks; an atrial sensing unit detecting atrial contraction, and outputting an atrial sensing signal indicating a atrial event when an atrial contraction is detected; a ventricular sensing unit detecting ventricular contraction, and outputting a ventricular sensing signal when a ventricular contraction is detected; a tachycardia detection unit connected to the atrial and ventricular sensing units and detecting a tachycardia, and classifying it as a ventricular tachycardia (VT) or as a supraventricular tachycardia (SVT); and a treatment control unit designed to trigger at least one atrial cardioversion shock when a ventricular rhythm detected by the ventricular sensing unit is faster than a programmed frequency limit, and the tachycardia detection unit classifies an SVT as an atrial fibrillation (AFib).
    Type: Grant
    Filed: June 1, 2009
    Date of Patent: August 14, 2012
    Assignee: Biotronik CRM Patent AG
    Inventor: Thomas Doerr
  • Patent number: 8244354
    Abstract: An implantable pacing system with single, double and triple chamber pacing capabilities, provided individually or in concert on a conditional or continuous basis depending upon ongoing analyses of atrial rhythm status, atrioventricular conduction status and ventricular rate. A mode is selected to reduce the occurrence of any ventricular pacing in favor of intrinsic atrioventricular and ventricular conduction. If excessively long PR intervals are occurring too frequently or atrioventricular conduction is unreliable or absent, the implantable pulse generator is operated in a conditional triple chamber pacing mode that provides atrial-synchronous biventricular pacing in every cardiac cycle for a period of time as necessary to restore and maintain AV synchrony, while minimizing ventricular asynchrony otherwise associated with monochamber RV pacing as in conventional dual chamber pacing systems.
    Type: Grant
    Filed: February 26, 2010
    Date of Patent: August 14, 2012
    Assignee: Medtronic, Inc.
    Inventors: Michael O. Sweeney, Todd J. Sheldon
  • Patent number: 8239011
    Abstract: An apparatus comprises an implantable impedance sensing circuit configured to sense an atrial impedance signal when coupled to a plurality of implantable electrodes, and an impedance signal analyzer circuit configured to detect a sudden change in a characteristic of the sensed atrial impedance signal that indicates atrial tachyarrhythmia. The impedance signal analyzer circuit classifies the atrial tachyarrhythmia indication as ST when the detected sudden change satisfies an ST threshold value of the characteristic, classifies the atrial tachyarrhythmia indication as AT when the detected sudden change satisfies an AT threshold value of the characteristic that is different from the ST threshold value, classifies the atrial tachyarrhythmia indication as AF when the detected sudden change satisfies an AF threshold value of the characteristic that is different from the ST and AT amplitude threshold values, and provides a classification of the tachyarrhythmia to a user or process.
    Type: Grant
    Filed: April 9, 2010
    Date of Patent: August 7, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventor: Dan Li
  • Patent number: 8239021
    Abstract: A cardiac pacing system preventing short-long-short pacing sequences. The system providing pacing pulses where necessary. The system having dynamic event window generation to adapt to changes in heart rate. The event window adaptable to process a number of intervals. The system including provisions for other inputs, such as sensor and morphology detection. The system adaptable for single mode and dual mode applications. The system also applicable to long pause prevention in atrial pacing and ventricular pacing.
    Type: Grant
    Filed: June 15, 2010
    Date of Patent: August 7, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventor: Eric G. Lovett
  • Publication number: 20120197328
    Abstract: High frequency cardiac arrhythmias and fibrillations are terminated by electric field pacing pulses having an order of magnitude less energy than a conventional cardioversion or defibrillation energy. The frequency and number of the pulses are selected based on a frequency analysis of a present high frequency cardiac arrhythmia or fibrillation. The energy of the pulses is selected from 1/400 to ½ of the conventional defibrillation energy, and the amplitude of the electric field pacing pulses are selected such as to activate a multitude of effective pacing sites in the heart tissue per each pacing electrode. The number and locations of the effective pacing sites in the heart tissue are regulated by the amplitude of the electric field pacing pulses, and by an orientation of the electric field of the pulses.
    Type: Application
    Filed: February 17, 2012
    Publication date: August 2, 2012
    Inventors: Stefan Luther, Valentin Krinski, Eberhard Bodenschatz
  • Patent number: 8233980
    Abstract: Techniques are provided for detecting atrial events that might be hidden due to the operation of a post-ventricular atrial blanking (PVAB) interval or other atrial channel blanking interval. In one example, candidate atrial events are identified within signals occurring during the PVAB interval. Then, a determination is made as to whether the candidate atrial event is a true atrial event based on a comparison of characteristics of the candidate atrial event with characteristics of prior known atrial events within the patient. By comparing the characteristics of the “hidden” event with the characteristics of prior known atrial events within the patient, a quick and accurate determination can be made whether the event should be counted as a P-wave. In this manner, hidden atrial arrhythmias can be detected and mode switch oscillations can be reduced or eliminated.
    Type: Grant
    Filed: May 7, 2008
    Date of Patent: July 31, 2012
    Assignee: Pacesetter, Inc.
    Inventor: Xing Pei
  • Patent number: 8233982
    Abstract: In various method embodiments, a supraventricular arrhythmia event is detected, and a supraventricular arrhythmia treatment, including neural stimulation to elicit a sympathetic response, is delivered in response to a detected supraventricular arrhythmia event. Some embodiments detect a precursor for a supraventricular arrhythmia episode, and deliver prophylactic neural stimulation to avoid the supraventricular arrhythmia event. Some embodiments detect a supraventricular arrhythmia episode, and deliver therapeutic neural stimulation for the supraventricular arrhythmia event.
    Type: Grant
    Filed: February 21, 2007
    Date of Patent: July 31, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventor: Imad Libbus
  • Publication number: 20120191154
    Abstract: An implantable medical device includes a lead configured to be located proximate to the left ventricle (LV) of the heart, the lead including multiple LV electrodes to sense cardiac activity at multiple LV sensing sites. The a detection module to detect an arrhythmia that represents at least one of a tachycardia and fibrillation based at least in part on the cardiac activity sensed at the multiple LV sensing sites. The ATP therapy module to identify at least one of an ATP configuration or an ATP therapy site based on the cardiac sensed activity at the LV sensing sites, the ATP therapy module to control delivery of antitachycardia pacing (ATP) therapy at the ATP therapy site.
    Type: Application
    Filed: January 24, 2011
    Publication date: July 26, 2012
    Applicant: PACESETTER, INC.
    Inventors: Kyungmoo Ryu, Stuart Rosenberg, Allen Keel, Taraneh Ghaffari Farazi, Richard Williamson, Mark Carlson
  • Patent number: 8229561
    Abstract: Methods and systems for classifying cardiac responses to pacing stimulation and/or preventing retrograde cardiac conduction are described. Following delivery of a pacing pulse to an atrium of the patient's heart during a cardiac cycle, the system senses in the atrium for a retrograde P-wave. The system classifies the atrial response to the pacing pulse based on detection of the retrograde P-wave. The system may also sense for an atrial evoked response and utilize the atrial evoked response in classifying the cardiac pacing response. If capture is not detected, the system may deliver additional atrial pacing pulses to reduce atrial retrograde conduction. A backup pace may be delivered to prevent the atrial retrograde conduction if an atrial evoked response is not detected during a cardiac cycle. Alternatively, retrograde management may involve delaying a next scheduled pace may be until expiration of an atrial effective refractory period.
    Type: Grant
    Filed: December 15, 2004
    Date of Patent: July 24, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventors: Geng Zhang, Ankur Garg
  • Patent number: 8229563
    Abstract: Devices configured to perform an adaptive method for initiating charging of high power capacitors and delivering therapy to a patient after the patient experiences a non-sustained arrhythmia. The adaptive methods adjust persistence criteria used to analyze an arrhythmia prior to initiating a charging sequence to deliver therapy.
    Type: Grant
    Filed: January 25, 2005
    Date of Patent: July 24, 2012
    Assignee: Cameron Health, Inc.
    Inventors: Jay A. Warren, Gust H. Bardy
  • Publication number: 20120185008
    Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.
    Type: Application
    Filed: January 19, 2012
    Publication date: July 19, 2012
    Inventors: Xiaohong Zhou, Robert Stadler, Richard Cornelussen, Lillian Kornet, Paul D. Ziegler, Karen J. Kleckner, Alberto Della Scala
  • Publication number: 20120185009
    Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.
    Type: Application
    Filed: January 19, 2012
    Publication date: July 19, 2012
    Inventors: Lilian Kornet, Richard N.M. Cornelussen, Paul D. Ziegler, Xiaohong Zhou, Eduardo Warman, Karen J. Kleckner, Lucy Nichols, Alberto Della Scala
  • Patent number: 8224444
    Abstract: Apparatus is provided including an electrode device, adapted to be coupled to a site of a subject; and a control unit, adapted to drive the electrode device to apply a current to the site intermittently during alternating “on” and “off” periods, each of the “on” periods having an “on” duration equal to between 1 and 10 seconds, and each of the “off” periods having an “off” duration equal to at least 50% of the “on” duration. Other embodiments are also described.
    Type: Grant
    Filed: October 19, 2007
    Date of Patent: July 17, 2012
    Assignee: Bio Control Medical (B.C.M.) Ltd.
    Inventors: Tamir Ben-David, Omry Ben-Ezra, Ehud Cohen, Shai Ayal
  • Publication number: 20120179220
    Abstract: Validated atrial and/or ventricular interval decreases are used to discriminate between VT and SVT. Atrial and/or ventricular intervals are monitored in order to detect decreases in such intervals (which are indicative in increases in rate). The atrial intervals can be, e.g., AA intervals, and the ventricular intervals can be, e.g., VV intervals. A detected atrial and/or ventricular interval decrease can be a decrease that is greater than an interval decrease threshold. Detected atrial and/or ventricular interval decreases can be validated by examining atrial and/or ventricular intervals before and after a detected atrial and/or ventricular interval decrease. The use of the validated atrial and/or ventricular interval decreases to classify an arrhythmia as SVT or VT can be called arrhythmia initiation analysis, since it is believed to determine whether the initiation of the arrhythmia is in an atrium or a ventricle.
    Type: Application
    Filed: January 10, 2011
    Publication date: July 12, 2012
    Applicant: PACESETTER, INC.
    Inventor: Carolyn Lall
  • Patent number: 8214038
    Abstract: A cardiac rhythm management device is configured to discriminate between ventricular and supraventricular tachycardias (referred to as SVT/VT discrimination) by utilizing a morphology criterion in which the morphology of electrogram waveforms during ventricular beats are analyzed to determine if the beats are normally conducted. After the delivery of a cardioversion/defibrillation shock, however, the intraventricular conduction system is left in a modified state which alters the subsequently generated electrogram signal. Use of the morphology criterion for SVT/VT discrimination is discontinued after delivery of such a shock and resumed after a predetermined minimum number of normally conducted ventricular beats has been detected.
    Type: Grant
    Filed: August 1, 2011
    Date of Patent: July 3, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventors: Jaeho Kim, Joseph M. Bocek, Eric G. Lovett
  • Publication number: 20120165811
    Abstract: A medical device system and associated method for guiding ablation therapy sense cardiac signals using implantable electrodes and detect spontaneous cardiac events from the sensed cardiac signals. Pacing pulses are delivered and a return cycle length is measured in response to the plurality of pacing pulses. The spontaneous cardiac event is clustered with a previously detected cardiac event in response to the measured return cycle length, and a targeted ablation site is estimated in response to the measured return cycle length. A transit time interval, corresponding to a distance traversed by a depolarization associated with a last one of the plurality of pacing pulses when a reset condition occurs, is computed using the return cycle length, and the ablation site is estimated in response to the computed transit time interval.
    Type: Application
    Filed: April 5, 2011
    Publication date: June 28, 2012
    Inventors: Jeffrey M. Gillberg, Mark L. Brown, Christopher J. Gennaro
  • Patent number: 8209005
    Abstract: Constant voltage or current is applied to high-voltage leads to determine impedance across medical device leads. Thyristors are used for upper switching components in an H-bridge. Current is sourced into a thyristor's gate from a ground-referenced source. This current then passes from the gate to the cathode and out to the patient. By keeping the current sufficiently low, the thyristors will not conduct from the anode to the cathode. Current passes through the thyristor, lead and patient and is sensed as it returns from the other lead. The sensed current is used to regulate the injected current. Pulses of constant current on the order of tens of milliamperes can be injected and the resulting voltage can be measured. Alternatively, a constant voltage can be applied and the resulting current can be measured to determine lead impedance.
    Type: Grant
    Filed: October 31, 2006
    Date of Patent: June 26, 2012
    Assignee: Pacesetter, Inc.
    Inventors: J. Christopher Moulder, George I. Isaac, Sergiu Silvian
  • Patent number: 8204592
    Abstract: Techniques are described for generating diagnostic information to aid in determining whether cardiac ischemia within a patient is clinically actionable. In one example, a pacemaker or implantable cardioverter/defibrillator (ICD) detects information pertaining to arrhythmia precursors and to episodes of sustained arrhythmias, as well as information pertaining to episodes of cardiac ischemia. The implanted device then correlates the arrhythmia precursors and the sustained arrhythmias with the episodes of cardiac ischemia so as to generate diagnostics permitting a physician reviewing the diagnostics to determine whether the ischemia is clinically actionable. In some implementations, the diagnostics are instead generated by an external system based on raw data provided by the implanted device. In some implementations, the device itself determines whether the ischemia is clinically actionable and automatically controls therapy or generates warning signals accordingly.
    Type: Grant
    Filed: December 3, 2007
    Date of Patent: June 19, 2012
    Assignee: Pacesetter, Inc.
    Inventors: Eliot L. Ostrow, Jay Snell, Xiaoyi Min
  • Patent number: 8204591
    Abstract: A method is provided, including identifying that a subject is at risk of suffering from atrial fibrillation (AF). Responsively to the identifying, a risk of an occurrence of an episode of the AF is reduced by applying an electrical current to a site of the subject selected from the group consisting of: a vagus nerve, a sinoatrial (SA) node fat pad, a pulmonary vein, a carotid artery, a carotid sinus, a coronary sinus, a vena cava vein, a jugular vein, an azygos vein, an innominate vein, and a subclavian vein, and configuring the current to stimulate autonomic nervous tissue in the site. Other embodiments are also described.
    Type: Grant
    Filed: January 24, 2007
    Date of Patent: June 19, 2012
    Assignee: Bio Control Medical (B.C.M.) Ltd.
    Inventors: Tamir Ben-David, Omry Ben-Ezra, Ehud Cohen
  • Patent number: 8195293
    Abstract: Sensing ventricular noise artifacts in an active implantable medical device for pacing, resynchronization and/or defibrillation of the heart. This device concerns sensing heart rhythm through an endocardial electrode collecting the depolarization potentials, and detecting the myocardium contractions through an endocardial acceleration sensor. The device searches for ventricular noise artifacts (X, Y) by correlating the signals representative of successive ventricular and atrial depolarizations (P, R) with the signals representative of successive acceleration peaks (PEA I). In case of a lack of correlation, a signal of suspicion of ventricular noise is delivered, which temporarily modifies the sensing sensitivity (S) of the sensing circuit.
    Type: Grant
    Filed: May 18, 2007
    Date of Patent: June 5, 2012
    Assignee: Sorin CRM S.A.S
    Inventors: Marcel Limousin, Elodie Vincent
  • Patent number: 8190257
    Abstract: Various aspects of the present subject matter provide devices and methods to treat AV-conducted ventricular tachyarrhythmia (AVCVT). According to various embodiments of the method, an AVCVT is sensed, an IVC-LA fat pad is stimulated when the AVCVT is sensed to block AV conduction, and bradycardia support pacing is provided while the IVC-LA fat pad is stimulated. Other aspects and embodiments are provided herein.
    Type: Grant
    Filed: May 28, 2009
    Date of Patent: May 29, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventors: Julia Moffitt, Andrew P. Kramer, Imad Libbus
  • Patent number: 8185200
    Abstract: An apparatus comprises an electrical stimulation circuit, a ventricular sensing circuit, a ventricular sensing timer, and an atrial pacing timer. The ventricular sensing circuit detects an intrinsic ventricular tachyarrhythmia depolarization. The ventricular sensing timer initiates timing of a lowest tachy rate (LTR) zone interval and also a ventricular pace interval that is calculated using a lower rate limit (LRL). The atrial pacing timer calculates an atrial pace interval to follow the intrinsic ventricular depolarization using the ventricular pace interval less a paced atrioventricular (AV) delay interval, delays generation of the atrial pace until after expiration of the LTR zone interval by decreasing the paced AV delay interval when the calculated atrial pace interval is within the LTR zone interval, and disables decreasing of the paced AV delay interval when the LRL interval less the paced AV delay interval at the LRL is less than the LTR zone interval.
    Type: Grant
    Filed: December 1, 2008
    Date of Patent: May 22, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventor: David L. Perschbacher
  • Publication number: 20120123488
    Abstract: The present invention, in illustrative embodiments, includes devices for analyzing cardiac signals in an implantable cardiac stimulus system. Within the analysis, a threshold may be defined related to a cardiac event rate. If the cardiac event rate does not exceed the threshold, filtering of captured cardiac signals occurs, including attenuating T-waves. If the cardiac event rate does exceed the threshold, circuitry for analog filtering or programming for digital filtering is bypassed to avoid attenuating low frequency components of the captured cardiac signals.
    Type: Application
    Filed: January 25, 2012
    Publication date: May 17, 2012
    Inventor: Alan H. Ostroff
  • Patent number: 8180439
    Abstract: An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.
    Type: Grant
    Filed: July 29, 2010
    Date of Patent: May 15, 2012
    Assignee: Pacesetter, Inc.
    Inventors: Jong Gill, Peter Boileau, Gene A. Bornzin, Joseph J. Florio, Mohssen Fard
  • Publication number: 20120116473
    Abstract: An exemplary method includes delivering a cardiac pacing therapy that includes an atrio-ventricular delay and an interventricular delay, providing a paced propagation delay associated with delivery of a stimulus to a ventricle, delivering a stimulus to the ventricle, sensing an event in the other ventricle caused by the stimulus, determining an interventricular conduction delay value based on the delivering and the sensing, determining a interventricular delay (?Sur) based on the interventricular conduction delay and the paced propagation delay and determining an atrio-ventricular delay based at least in part on the interventricular delay (?Sur). Other exemplary methods, devices, systems, etc., are also disclosed.
    Type: Application
    Filed: January 17, 2012
    Publication date: May 10, 2012
    Applicant: PACESETTER, INC.
    Inventor: Xiaoyi Min
  • Patent number: 8175705
    Abstract: Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a baroreflex stimulator and a controller. The baroreflex stimulator is adapted to generate a stimulation signal to stimulate a baroreflex. The controller is adapted to communicate with the baroreflex stimulator and implement a baroreflex stimulation protocol to vary an intensity of the baroreflex stimulation provided by the stimulation signal to abate baroreflex adaptation. According to various embodiments, the controller is adapted to implement the baroreflex stimulation protocol to periodically modulate the baroreflex stimulation to produce an effect that mimics an effect of pulsatile pressure. Other aspects are provided herein.
    Type: Grant
    Filed: October 12, 2004
    Date of Patent: May 8, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventor: Imad Libbus
  • Patent number: 8175702
    Abstract: A method for extinguishing a cardiac arrhythmia utilizes destructive interference of the passing of the reentry wave tip of an anatomical reentry through a depolarized region created by a relatively low voltage electric field in such a way as to effectively unpin the anatomical reentry. Preferably, the relatively low voltage electric field is defined by at least one unpinning shock(s) that are lower than an expected lower limit of vulnerability as established, for example, by a defibrillation threshold test. By understanding the physics of the electric field distribution between cardiac cells, the method permits the delivery of an electric field sufficient to unpin the core of the anatomical reentry, whether the precise or estimated location of the reentry is known or unknown and without the risk of inducting ventricular fibrillation. A number of embodiments for performing the method are disclosed.
    Type: Grant
    Filed: November 3, 2005
    Date of Patent: May 8, 2012
    Assignee: The Washington University
    Inventors: Igor R. Efimov, Valentin I. Krinski, Vladimir P. Nikolski
  • Patent number: 8175706
    Abstract: An example implantable medical device (IMD), such as an implantable cardioverter defibrillator, may be configured to store a ventricular tachycardia zone, wherein the ventricular tachycardia zone specifies ventricular depolarization rates indicative of ventricular tachycardia, and to deliver pacing pulses to at least one ventricle of a heart in response to detecting intrinsic atrial depolarizations at rates within the ventricular tachycardia zone. The IMD may further store a maximum ventricular tracking rate that is greater than a lower bound of the ventricular tachycardia zone, and be further configured to deliver the pacing pulses to the at least one ventricle in response to detecting intrinsic atrial depolarizations at rates up to the maximum ventricular rate. In this manner, the IMD may be configured with overlapping pacing and tachyarrhythmia detection zones.
    Type: Grant
    Filed: June 29, 2009
    Date of Patent: May 8, 2012
    Assignee: Medtronic, Inc.
    Inventor: Theodore Chow
  • Patent number: 8170668
    Abstract: A system comprising an implantable medical device (IMD) that includes a tachyarrhythmia detector, a baroreflex detector to obtain baroreflex information, and a processor in communication with the tachyarrhythmia detector and the baroreflex detector. The processor adjusts at least one of a tachyarrhythmia detection parameter of the IMD or a tachyarrhythmia therapy parameter of the IMD using the baroreflex information.
    Type: Grant
    Filed: July 14, 2006
    Date of Patent: May 1, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventors: Benjamin Ettori, Dan Li, Imad Libbus
  • Publication number: 20120101539
    Abstract: A pacing output circuit can be configured to generate a ventricular pacing signal configured to be delivered to an electrode near the His bundle in a right ventricle of a heart to pace the right and left ventricles and improve synchronization of at least one of the ventricles relative to intrinsic activity. In an example, the ventricular pacing signal can include first and second signal components in opposite polarity from each other with respect to a reference component, the first and second signal components having substantially identical duration and magnitude.
    Type: Application
    Filed: December 18, 2009
    Publication date: April 26, 2012
    Inventors: Qingsheng Zhu, Daniel Felipe Ortega, Julio Cesar Spinelli
  • Patent number: 8165675
    Abstract: Techniques are described for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT) using an implantable medical device capable of multi-site ventricular sensing. In one example, ventricular depolarization events are detected within a patient by the implantable device during a tachyarrhythmia, at both a left ventricular sensing site and a right ventricular sensing site. Ventricular event timing differences are then ascertained. The device compares the ventricular event timing differences detected during the tachyarrhythmia with predetermined supraventricular event timing differences for the patient, such as event timing differences previously detected within the patient during sinus rhythm or extrapolated from sinus rhythm values. The device then distinguishes VT from SVT based on the comparison of the event timing differences detected during the tachyarrhythmia with the predetermined supraventricular event timing differences.
    Type: Grant
    Filed: October 29, 2009
    Date of Patent: April 24, 2012
    Assignee: Pacesetter, Inc.
    Inventors: Hanbiao Wang, Bonian Dai, Xing Pei
  • Patent number: 8150514
    Abstract: A spectral fingerprint technique is disclosed that allows an ICD to eliminate unnecessary shocks to the heart.
    Type: Grant
    Filed: August 21, 2009
    Date of Patent: April 3, 2012
    Inventor: Michael E. Mollerus
  • Patent number: 8145301
    Abstract: Systems and methods are described for classifying a cardiac rhythm. A cardiac rhythm is classified using a classification process that includes a plurality of cardiac rhythm discriminators. Each rhythm discriminator provides an independent classification of the cardiac rhythm. The classification process is modified if the modification is likely to produce enhanced classification results. The rhythm is reclassified using the modified classification process.
    Type: Grant
    Filed: September 30, 2010
    Date of Patent: March 27, 2012
    Assignee: Cardiac Pacemakers, Inc.
    Inventors: Jaeho Kim, Joseph M. Bocek, Julie A. Thompson, Eric G. Lovett
  • Publication number: 20120071942
    Abstract: Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.
    Type: Application
    Filed: September 20, 2011
    Publication date: March 22, 2012
    Inventors: Apurv Kamath, Paul Haefner, Darrell Orvin Wagner, Marina Brockway
  • Patent number: 8140153
    Abstract: Cardiac treatment methods and devices providing templates representative of past tachyarrhythmia events, each template associated with a therapy. A cardiac waveform is detected, and if it corresponds to a particular template associated with a previous therapy that was satisfactory in terminating a past event, the previous therapy is delivered again. If unsatisfactory, the previous therapy is eliminated as an option. If, for example, the previous therapy was an antitachycardia pacing therapy unsatisfactory in terminating the past tachyarrhythmia event, delivery of the antitachycardia pacing therapy is eliminated as an option. Instead of ATP therapy, one or more of a cardioversion, defibrillation, or alternate anti-tachycardia pacing therapy may be associated with the particular template.
    Type: Grant
    Filed: April 30, 2010
    Date of Patent: March 20, 2012
    Assignee: Cardiac Pacemakers Inc.
    Inventor: Shelley M. Cazares
  • Publication number: 20120053507
    Abstract: An implantable electronic therapy device, having a therapy unit, a heart rate capturing unit, a contractility determination unit, and an evaluation and control unit. The therapy unit delivers an antitachycardiac therapy. The heart rate capturing unit determines a ventricular heart rate from an input signal, and the contractility determination unit generates from an input signal, a contraction signal reflecting a contractility of a ventricle. The evaluation and control unit is connected to the therapy unit, the heart rate capturing unit, and the contractility determination unit actuates the therapy unit to administer an antitachycardiac therapy when the heart rate capturing unit detects an increase in the heart rate above a specified threshold value and the contractility determination unit supplies a contraction signal which is not physiologically adequate for the increase in the heart rate.
    Type: Application
    Filed: August 1, 2011
    Publication date: March 1, 2012
    Inventor: Thomas Doerr
  • Patent number: 8126553
    Abstract: Electrical noise may be discriminated from sensed heart signals based on cardiovascular pressure. A plurality of detected cardiovascular pressure values are respectively associated with a plurality of detected tachyarrhythmia events. In some examples, a variance in the cardiovascular pressure, e.g., above a threshold range, may indicate that the detected tachyarrhythmia events are at least partially attributable to electrical noise. In some examples, stimulation therapy to a heart of a patient may be controlled based on the detection of a tachyarrhythmia episode and a variability in the cardiovascular pressure values that are associated with the tachyarrhythmia episode. In other examples, a sensing integrity indication may be generated upon determining that a tachyarrhythmia episode was associated with a variable cardiovascular pressure.
    Type: Grant
    Filed: July 25, 2008
    Date of Patent: February 28, 2012
    Assignee: Medtronic, Inc.
    Inventor: Mark J. Mayotte
  • Publication number: 20120046707
    Abstract: Systems and methods for sensing external magnetic fields in implantable medical devices are provided. One aspect of this disclosure relates to an apparatus for sensing magnetic fields. An apparatus embodiment includes a sensing circuit with at least one inductor having a magnetic core that saturates in the presence of a magnetic field having a prescribed flux density. The apparatus embodiment also includes an impedance measuring circuit connected to the sensing circuit. The impedance measuring circuit is adapted to measure impedance of the sensing circuit and to provide a signal when the impedance changes by a prescribed amount. According to an embodiment, the sensing circuit includes a resistor-inductor-capacitor (RLC) circuit. The impedance measuring circuit includes a transthoracic impedance measurement module (TIMM), according to an embodiment. Other aspects and embodiments are provided herein.
    Type: Application
    Filed: October 27, 2011
    Publication date: February 23, 2012
    Inventors: Karl Gauglitz, Thomas M. Bocek, Mark Rutzer, Lorin W. Matthews, William E. Reagor, Blair Erbstoeszer
  • Patent number: 8116867
    Abstract: The present invention, in illustrative embodiments, includes methods and devices for analyzing cardiac signals in an implantable cardiac stimulus system. Within the analysis, a threshold may be defined related to a cardiac event rate. If the cardiac event rate does not exceed the threshold, filtering of captured cardiac signals occurs, including attenuating T-waves. If the cardiac event rate does exceed the threshold, circuitry for analog filtering or programming for digital filtering is bypassed to avoid attenuating low frequency components of the captured cardiac signals.
    Type: Grant
    Filed: August 4, 2005
    Date of Patent: February 14, 2012
    Assignee: Cameron Health, Inc.
    Inventor: Alan H. Ostroff
  • Publication number: 20120035492
    Abstract: Methods and systems are directed to detecting atrial tachyarrhythmia. A plurality of A-A intervals is detected. The detected A-A intervals are selected and used to detect atrial tachyarrhythmia. Selecting A-A intervals may be based on determining that A-A intervals are qualified. Qualified A-A intervals may be determined if a duration of the particular A-A interval falls outside a predetermined duration range, for example. Qualified A-A intervals may also be determined based on events occurring between consecutively sensed atrial events of the particular A-A interval, and whether the duration of the particular A-A interval falls within the predetermined duration range, for example.
    Type: Application
    Filed: October 18, 2011
    Publication date: February 9, 2012
    Inventors: Jaeho Kim, Joseph M. Bocek, Anthony S. Harrington, Harley G. White
  • Publication number: 20120035491
    Abstract: An apparatus comprises an implantable cardiac signal sensing circuit and a controller circuit. The implantable cardiac signal sensing circuit provides a sensed depolarization signal from a ventricle and a sensed depolarization signal from an atrium. The controller circuit includes a one-to-one detector circuit and a tachyarrhythmia discrimination circuit. The one-to-one detector circuit measures cardiac depolarization intervals of the atrium and the ventricle and determines whether a relationship of atrial depolarizations to ventricular depolarizations is substantially one-to-one. The tachyarrhythmia discrimination circuit increments a counter when detecting a shortening or prolonging of a V-V interval that immediately precedes the same shortening or prolonging of an A-A interval, classifies the episode as VT according to the counter, and provides the classification of the tachyarrhythmia episode to a user or process.
    Type: Application
    Filed: August 2, 2011
    Publication date: February 9, 2012
    Inventors: Deepa Mahajan, Yanting Dong, David L. Perschbacher
  • Publication number: 20120035679
    Abstract: Apparatus and methods are described including identifying a subject as suffering from a condition selected from the group consisting of congestive heart failure, diastolic heart failure, acute myocardial infarction, and hypertension. In response to the identifying, an electrode is placed on the subject's aorta at an aortic site that is between a bifurcation of the aorta with the subject's left subclavian artery and a bifurcation of the aorta with the subject's fifth intercostal artery. The subject is treated by electrically stimulating the aortic site by driving a current into the aortic site, via the electrode. Other applications are also described.
    Type: Application
    Filed: August 16, 2011
    Publication date: February 9, 2012
    Applicant: RAINBOW MEDICAL LTD.
    Inventors: Amir Dagan, Yotam Reisner, Offer Glasberg, Nitai Hanani, Gal Ariav
  • Publication number: 20120029586
    Abstract: This disclosure is directed toward techniques for classifying a tachycardia as supraventricular tachycardia or ventricular tachycardia. A method comprises detecting a tachycardia based on at least one value of a cardiac interval, delivering vagal stimulation in response to the detection of the tachycardia, sensing a physiological parameter other than the cardiac interval during or subsequent to delivering the vagal stimulation, and classifying the tachycardia as supraventricular or ventricular based on the sensed physiological parameter. In some examples, the method includes sensing a response of a physiological parameter other than cardiac rate to the vagal stimulation, such as pressure or a morphological characteristic of the cardiac electrical waveform. The method may include providing an indication to a user based on the classification of supraventricular tachycardia, or delivery of appropriate electrical therapy based on the classification of ventricular tachycardia or ventricular fibrillation.
    Type: Application
    Filed: July 28, 2010
    Publication date: February 2, 2012
    Applicant: Medtronic, Inc.
    Inventors: Arun Kumar, Shailesh Kumar Vishnu Musley