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154 results about "Cardiac resynchronization therapy" patented technology

Cardiac resynchronisation therapy (CRT or CRT-P) is the insertion of electrodes in the left and right ventricles of the heart, as well as on occasion the right atrium, to treat heart failure by coordinating the function of the left and right ventricles via a pacemaker, a small device inserted into the interior chest wall.

Electric tomography

Methods for evaluating motion of a tissue, such as of a cardiac location, e.g., heart wall, via electrical field tomography are provided. In the subject methods, an sensing element is stably associated with a tissue location of interest. Signals obtained from the sensing element are obtained to evaluate movement of the tissue location. Also provided are systems and devices for practicing the subject methods. In addition, innovative data displays and systems for producing the same are provided. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.
Owner:PROTEUS DIGITAL HEALTH INC

Method and apparatus for optimizing cardiac resynchronization therapy based on left ventricular acceleration

A system and method for monitoring left ventricular cardiac contractility and for optimizing a cardiac therapy based on left ventricular lateral wall acceleration (LVA) are provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with an acceleration sensor. The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of LVA during isovolumic contraction. A therapy optimization method evaluates the LVA during varying therapy settings and selects the setting(s) that correspond to a maximum LVA during isovolumic contraction. In one embodiment, the optimal inter-ventricular pacing interval for use in cardiac resynchronization therapy is determined as the interval corresponding to the highest amplitude of the first LVA peak during isovolumic contraction.
Owner:MEDTRONIC INC

Devices and methods for accelerometer-based characterization of cardiac synchrony and dyssynchrony

Systems and methods according to the invention employ an acceleration sensor to characterize the synchrony or dyssynchrony of the left ventricle. Patterns of acceleration related to myocardial contraction can be used to assess synchrony or dyssynchrony. Time-frequency transforms and coherence are derived from the acceleration. Information and numerical indices determined from the acceleration time frequency transforms and coherence can be used to find the optimal pacing location for cardiac resynchronization therapy. Similarly, the information can be used to optimize timing intervals including V to V and A to V timing.
Owner:CARDIOSYNC

External continuous field tomography

Methods for evaluating tissue motion of a tissue location, e.g., a cardiac location, via external continuous field tomography are provided. Aspects of the methods include generating at least one substantially linear continuous field gradient across the tissue location of interest, and using a resultant signal from a sensing element stably associated with the tissue location to evaluate motion of the tissue location. Also provided are systems, devices and related compositions for practicing the subject methods. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.
Owner:PROTEUS DIGITAL HEALTH INC

Implantable pressure sensor with pacing capability

Devices and methods for left ventricular or biventricular pacing plus left ventricular pressure measurement. For example, a pacing lead having a combined electrode and pressure sensor assembly may be used for left ventricular (LV) pacing and pressure measurement. The assembly may include one or more electrodes, a pressure sensor, and a pressure transmission catheter. Such a pacing lead is particularly suitable for biventricular pacing and may be incorporated into a cardiac resynchronization therapy (CRT) system, for example.
Owner:TRANSOMA MEDICAL

Optimization method for cardiac resynchronization therapy

ActiveUS6978184B1Shortening of pre-ejection periodIncrease in rate of contractionInternal electrodesHeart stimulatorsAccelerometerLeft ventricular size
The patterns of contraction and relaxation of the heart before and during left ventricular or biventricular pacing are analyzed and displayed in real time mode to assist physicians to screen patients for cardiac resynchronization therapy, to set the optimal A-V or right ventricle to left ventricle interval delay, and to select the site(s) of pacing that result in optimal cardiac performance. The system includes an accelerometer sensor; a programmable pace maker, a computer data analysis module, and may also include a 2D and 3D visual graphic display of analytic results, i.e. a Ventricular Contraction Map. A feedback network provides direction for optimal pacing leads placement. The method includes selecting a location to place the leads of a cardiac pacing device, collecting seismocardiographic (SCG) data corresponding to heart motion during paced beats of a patient's heart, determining hemodynamic and electrophysiological parameters based on the SCG data, repeating the preceding steps for another lead placement location, and selecting a lead placement location that provides the best cardiac performance by comparing the calculated hemodynamic and electrophysiological parameters for each different lead placement location.
Owner:HEART FORCE MEDICAL +1

Cardiac resynchronization therapy optimization using mechanical dyssynchrony and shortening parameters from realtime electrode motion tracking

Therapy optimization includes tracking electrode motion using an electroanatomic mapping system and generating, based on tracked electrode motion, one or more mechanical dyssynchrony metrics to thereby guide a clinician in therapy optimization (e.g., via optimal electrode sites, optimal therapy parameters, etc.). Such a method may include a vector analysis of electrode motion with respect to factors such as times in cardiac cycle, phases of a cardiac cycle, and therapy conditions, e.g., pacing sites, pacing parameters and pacing or no pacing. Differences in position-with-respect-to-time data for electrodes may also be used to provide measurements of mechanical dyssynchrony.
Owner:PACESETTER INC

Continuous field tomography

InactiveUS20080183072A1Easy to measureEasily propagate through tissueCatheterHeart stimulatorsMedicineSubject matter
Methods for evaluating motion of a tissue, such as of a cardiac location, e.g., heart wall, via continuous field tomography are provided. In the subject methods, a continuous field (e.g., an electrical, mechanical, electro-mechanical, or other field) sensing element is stably associated with the tissue location. A property of the applied continuous field is detected with the sensing element to evaluate movement of the tissue location. Also provided are systems, devices and related compositions for practicing the subject methods. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.
Owner:PROTEUS DIGITAL HEALTH INC

Cardiac Motion Characterization by Strain Measurement

Methods for evaluating motion of a cardiac tissue location, e.g., heart wall, are provided. In the subject methods, timing of a signal obtain from a strain gauge stably associated with the tissue location of interest is employed to evaluate movement of the cardiac tissue location. Also provided are systems, devices and related compositions for practicing the subject methods. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.
Owner:PROTEUS DIGITAL HEALTH INC

Implantable Devices and Methods for Stimulation of Cardiac or Other Tissues

An implantable stimulation system is provided for stimulation of the heart, phrenic nerve, gastric system, or other tissue structures accessible via a patient's upper gastrointestinal system or airway. The stimulation system includes an implantable controller housing including a pulse generator; at least one electrical lead attachable to the pulse generator; and at least one electrode carried by the electrical lead that is positionable and fixable within the upper gastrointestinal tract or airway. The controller housing may be adaptable for subcutaneous implantation, or within the upper gastrointestinal tract or airway, wherein the controller housing is proportioned to substantially permit fluid and solid flow through the upper gastrointestinal tract or airway about the controller housing. The pulse generator may be operable to deliver one or more electrical pulses effective in cardiac pacing, cardiac defibrillation, cardioversion, cardiac resynchronization therapy, diaphragm pacing, phrenic nerve stimulation, gastric electrical stimulation, or a combination thereof.
Owner:E PACING

Method and System for Patient Specific Planning of Cardiac Therapies on Preoperative Clinical Data and Medical Images

A method and system for patient-specific planning of cardiac therapy, such as cardiac resynchronization therapy (CRT), based on preoperative clinical data and medical images, such as ECG data, magnetic resonance imaging (MRI) data, and ultrasound data, is disclosed. A patient-specific anatomical model of the left and right ventricles is generated from medical image data of a patient. A patient-specific computational heart model, which comprises cardiac electrophysiology, biomechanics and hemodynamics, is generated based on the patient-specific anatomical model of the left and right ventricles and clinical data. Simulations of cardiac therapies, such as CRT at one or more anatomical locations are performed using the patient-specific computational heart model. Changes in clinical cardiac parameters are then computed from the patient-specific model, constituting predictors of therapy outcome useful for therapy planning and optimization.
Owner:SIEMENS HEATHCARE GMBH

Method and apparatus for optimizing stroke volume during DDD resynchronization therapy using adjustable atrio-ventricular delays

InactiveUS7158830B2Convenient timeMaximizes ventricular performanceHeart stimulatorsSystoleHemodynamics
A pacing system for providing optimal hemodynamic cardiac function for parameters such as ventricular synchorny or contractility (peak left ventricle pressure change during systole or LV+dp / dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.
Owner:CARDIAC PACEMAKERS INC

Closed loop cardiac resynchronization therapy using cardiac activation sequence information

Cardiac monitoring and / or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and / or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.
Owner:CARDIAC PACEMAKERS INC

Self-referencing communication in implantable devices

InactiveUS8055345B2Convenient treatmentReliable information transmissionElectrotherapyDuration/width modulated pulse demodulationEngineeringSelf-clocking signal
Various aspects of the present invention enable robust, reliable control functionality for effectors present on intraluminal, e.g., vascular leads, as well as other types of implantable devices. Aspects of the invention include implantable integrated circuits that have self-referencing and self-clocking signal encoding, and are capable of bidirectional communication. Also provided by the invention are effector assemblies that include the integrated circuits, as well as implantable medical devices, e.g., pulse generators that include the same, as well as systems and kits thereof and methods of using the same, e.g., in pacing applications, including cardiac resynchronization therapy (CRT) applications.
Owner:PROTEUS DIGITAL HEALTH INC

Method and apparatus for optimizing cardiac resynchronization therapy

A method and apparatus for optimizing cardiac resynchronization therapy are provided. An iterative optimization procedure is performed to test the systolic hemodynamic effects of varying A-V-V timing schemes. The hemodynamic effect is assessed based on a surrogate of stroke volume. The stroke volume surrogate is derived from a sensor signal proportional to the blood pressure in the aorta or a major artery. The A-V-V timing scheme corresponding to the greatest stroke volume, as indicated by the stroke volume surrogate, is identified and automatically programmed to maintain optimal A-V-V settings acutely and chronically.
Owner:MEDTRONIC INC

Implantable integrated circuit

Embodiments of the present invention enable robust, reliable control functionality for effectors present on intraluminal, e.g., vascular leads, as well as other types of implantable devices. Embodiments of the invention enable the required functionality for accurate long term control of effectors units, even ones present on multiplex carrier configurations, while provide for low power consumption. Aspects of the invention include implantable integrated circuits that have power extraction; energy storage; communication; and device configuration functional blocks, where these functional blocks are all present in a single integrated circuit on an intraluminal-sized support. Also provided by the invention are effector assemblies that include the integrated circuits, as well as implantable medical devices, e.g., pulse generators that include the same, as well as systems and kits thereof and methods of using the same, e.g., in pacing applications, including cardiac resynchronization therapy (CRT) applications.
Owner:PROTEUS DIGITAL HEALTH INC

Evaluating ventricular synchrony based on phase angle between sensor signals

InactiveUS20050038481A1Reduce, or possibly eliminate, ventricular dysynchronyHeart stimulatorsFundamental frequencyCRTS
An implantable medical device evaluates ventricular synchrony by determining a phase angle between at least two sensor signals that reflect mechanical contraction of the ventricles. In exemplary embodiments, two intracardiac impedance signals associated with the right and left ventricles, respectively, with two points within either of the left and right ventricles, or with both the left and right ventricles relative to a reference point, are processed. In such embodiments, fundamental frequency phases of each of the impedance signals may be compared to determine the phase angle between the signals. In some embodiments, the signals are used to dynamically adjust one or more timing intervals, such as a V-V timing interval, for delivery of cardiac resynchronization therapy (CRT) pacing. In such embodiments, the one or more timing intervals are periodically adjusted to reduce or possibly eliminate ventricular dysynchrony as indicated by the phase angle between the sensor signals.
Owner:MEDTRONIC INC

Monitoring hf exacerbation and cardiac resynchronization therapy performance

An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay parameter and an interventricular delay parameter, measuring an atrio-ventricular conduction delay, measuring an interventricular conduction delay, assessing heart failure and / or cardiac resynchronization therapy performance based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay and determining at least one of an atrio-ventricular delay parameter value and an interventricular delay parameter value based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay. Other exemplary technologies are also disclosed.
Owner:PACESETTER INC

Method and apparatus for optimizing ventricular synchrony during DDD resynchronization therapy using adjustable atrio-ventricular delays

A pacing system for providing optimal hemodynamic cardiac function for parameters such as ventricular synchorny or contractility (peak left ventricle pressure change during systole or LV+dp / dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.
Owner:CARDIAC PACEMAKERS INC

Closed loop cardiac resynchronization therapy using cardiac activation sequence information

Cardiac monitoring and / or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track, and / or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.
Owner:CARDIAC PACEMAKERS INC

Cardiac resynchronization therapy optimization using cardiac activation sequence information

Systems and methods provide for pacing a heart to improve pumping efficiency of the heart, such as by producing a cardiac fusion response for patient's subject to cardiac resynchronization therapy. A pacing parameter, such as an A-V delay, V-V delay, lead / electrode configuration or vector, is adjusted and a cardiac signal vector representative of all or a portion of one or more cardiac activation sequences is monitored during pacing parameter adjustment. A change in a characteristic of the cardiac signal vector is detected in response to an adjusted pacing parameter, the change indicative of a cardiac fusion response. A pacing therapy may be delivered to produce the cardiac fusion response using the adjusted pacing parameter.
Owner:CARDIAC PACEMAKERS INC

Bi-ventricular ventricular capture management in cardiac resyncronization therapy delivery devices

The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., “CRT”). The invention also provides ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the stimulus captured. If a loss-of-capture (LOC) signal results from the capture management testing, then the applied pacing pulses are modified and the conduction test repeated. If LOC, an alert message can issue. Other aspects include: use of a trend of A-RV / LV and LV-RV timing intervals to monitor changes in the patient's heart conduction properties; bi-ventricular verification test and search—while still pacing BiV by detecting latent sense; single-V pacing threshold search, use of timing of sense in other V chamber to establish capture and LOC windows; (iv) use of a premature V pace rather than short AV interval if VV cannot be discriminated from AV; (v) option to run a threshold search only if the Bi-ventricular verification test fails.
Owner:MEDTRONIC INC

Confirming sensed atrial events for pacing during resynchronization therapy in a cardiac medical device and medical device system

A medical device and medical device system for controlling delivery of therapeutic stimulation pulses that includes a sensing device to sense a cardiac signal and emit a trigger signal in response to the sensed cardiac signal, a therapy delivery device to receive the trigger signal and deliver therapy to the patient in response to the emitted trigger signal, and a processor positioned within the sensing device, the processor configured to determine whether the sensed cardiac signal exceeds a possible P-wave threshold, compare a portion of the sensed cardiac signal to a P-wave template having a sensing window having a length less than a width of the P-wave, confirm an occurrence of a P-wave signal in response to the comparing, emit the trigger signal in response to the occurrence of a P-wave signal being confirmed, and inhibit delivery of the emitting signal in response to the occurrence of a P-wave signal not being confirmed.
Owner:MEDTRONIC INC

Closed loop impedance-based cardiac resynchronization therapy systems, devices, and methods

This document discusses, among other things, systems, devices, and methods measure an impedance and, in response, adjust an atrioventricular (AV) delay or other cardiac resynchronization therapy (CRT) parameter that synchronizes left and right ventricular contractions. A first example uses parameterizes a first ventricular volume against a second ventricular volume during a cardiac cycle, using a loop area to create a synchronization fraction (SF). The CRT parameter is adjusted in closed-loop fashion to increase the SF. A second example measures a septal-freewall phase difference (PD), and adjusts a CRT parameter to decrease the PD. A third example measures a peak-to-peak volume or maximum rate of change in ventricular volume, and adjusts a CRT parameter to increase the peak-to-peak volume or maximum rate of change in the ventricular volume.
Owner:CARDIAC PACEMAKERS INC

Trending of conduction time for optimization of cardiac resynchronization therapy in cardiac rhythm management system

A method of optimizing cardiac resynchronization therapy delay over a patient's full range of activity for use in operating an implantable cardiac pacing device and such a device are disclosed. The method includes measuring selected conduction time between selected sites in the heart for a plurality of beats and logging the values on a periodic repeating programmable basis to produce cumulative data and constructing a current template of conduction time in relation to one or more other sensed parameters of interest over a desired range of patient activity levels. The current template is used to derive suggested optimum pacing timing.
Owner:CARDIAC PACEMAKERS INC

Implantable accelerometer-based cardiac wall position detector

InactiveUS20060161211A1Beneficial to patientQuality improvementHeart stimulatorsAccelerometerCardiac wall
Methods for evaluating motion of a cardiac tissue location, e.g., heart wall, are provided. In the subject methods, timing of a signal obtain from a accelerometer stably associated with the tissue location of interest is employed to evaluate movement of the cardiac tissue location. Also provided are systems, devices and related compositions for practicing the subject methods. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.
Owner:PROTEUS DIGITAL HEALTH INC
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