26 results about "Conducting system" patented technology

An implantable lead for use with an implantable medical device (IMD) includes a tubular lead body having a proximal portion including a proximal end, a distal portion including a distal end opposite the proximal end, and an intermediate portion between the proximal portion and the distal portion. A helical electrode extends distally from the distal end of the tubular lead body. At least one atrial electrode is disposed in the intermediate portion of the tubular lead body. At least one electrical conductor extends through the tubular lead body and is mechanically and electrically coupled to the helical electrode and the at least one atrial electrode. The intermediate portion may have a pre-formed bend configured to urge the at least one atrial electrode against a surface of the right atrium when the lead is implanted. A distal pre-formed bend located in the distal portion of the tubular lead body may be configured to bias a plurality of pacing / sensing electrodes towards a surface of a right ventricle. A distal pre-formed bend located in the distal portion of the tubular lead body may be configured to bias the helical electrode and at least one pacing / sensing against a surface of a right ventricle.

A medical device is configured to deliver His-Purkinje pacing pulses according to multiple settings of a pacing control parameter and determine an electromechanical time delay from a ventricular electrical event to a fiducial point of the pressure signal for each of the pacing control parameter settings. The medical device may be configured to select an operating pacing control parameter from the pacing control parameter settings based on a determined electromechanical time delay being less than a threshold interval. The medical device may deliver pacing pulses to the His-Purkinje conduction system according to the selected operating pacing control parameter.

In some examples, a method comprises sensing one or more left-ventricular activations via one or more electrodes of a left-ventricular lead, wherein each of the one or more left-ventricular activations are in response to delivery of an electrical stimulation to a heart of a patient; determining one or more left-ventricular activation metrics based on the sensed one or more left-ventricular activations; and determining whether the electrical stimulation provided conduction system pacing based on the one or more ventricular activation metrics.

Antitachycardia pacing (ATP) therapy may be delivered to the cardiac conduction system using cardiac conduction system pacing therapy. An initial cardiac conduction system ATP pulse set including three or less cardiac conduction system ATP pulses may be delivered to the patient's cardiac conduction system. A first cardiac conduction system ATP pulse of the initial cardiac conduction system ATP pulse set may be delivered at an interval configured to provide maximal capture of the cardiac conduction system.

An implantable medical device includes a plurality of implantable electrodes for sensing and pacing a heart of a patient. The plurality of electrodes includes cardiac conduction system electrodes positionable proximate a portion of a cardiac conduction system of a patient. A computing device includes processing circuitry and is operably coupled to a plurality of implantable electrodes. A computing device monitors a precardiac ejection (HS-PEP) of a heart of a patient. A change in the HS-PEP is determined based on the monitoring. A change in HS-PEP is determined to be greater than or equal to a specified threshold. Delivery of cardiac conduction system pacing therapy to the cardiac conduction system of the patient using the cardiac conduction system electrode is initiated based on the HS-PEP being greater than or equal to a specified threshold.

This article describes systems and methods for determining whether cardiac conduction system pacing therapy may be beneficial and / or for determining how close or far a cardiac conduction system block may be using external cardiac signals. For this purpose, one or more left-sided measures can be generated based on left-sided alternative cardiac electrical activity measured using multiple left external electrodes to produce information on electrical heterogeneity.

A system includes a medical device including therapy delivery circuitry configured to deliver conduction system pacing to a heart of a patient via a first one or more of a plurality of electrodes disposed on an implantable medical lead coupled to the medical device and deliver anodal stimulation pacing via a second one or more of the plurality of electrodes disposed on the implantable medical lead; and sensing circuitry configured to sense one or more cardiac electrograms (EGMs) of the patient responsive to the delivery of the anodal stimulation pacing; and processing circuitry configured to: control the delivery of the anodal stimulation pacing by the therapy delivery circuitry on a periodic schedule; determine the implantable medical lead has migrated based on the one or more cardiac EGMs; and output an alert indicating the implantable medical lead has migrated to a user.

Illustrative systems, devices, and methods monitor cardiac morphology during delivery of cardiac conduction system pacing therapy to determine effective cardiac conduction system pacing therapy. If effective cardiac conduction system pacing therapy is not determined, one or both of the cardiac conduction system pacing vector and atrioventricular delay may be adjusted until the monitored cardiac morphology indicates effective cardiac conduction system pacing therapy.

A method of operating a cardiac rhythm management (CRM) system includes: measuring a baseline PR interval of cardiac depolarization; measuring one or both of the heart sound and the heart depolarized QRS width; delivering pacing stimulation according to atrial sensing of a ventricular pacing interval (AsVp interval), and measuring one or both of a heart sound and a QRS width of the AsVp interval, where the pacing stimulation is delivered using a conducted system pacing (CSP) vector comprising electrodes positioned in the interventricular septum; delivering a pacing stimulus according to an atrial pacing to ventricular pacing interval (ApVp interval) and measuring one or both of a heart sound and a QRS width of the ApVp interval; and generating a recommended atrial-to-ventricular delay setting for the CSP based on one or both of the measured heart sound and the QRS width.

In some examples, a method comprises sensing one or more left-ventricular activations via one or more electrodes of a left-ventricular lead, wherein each of the one or more left-ventricular activations are in response to delivery of an electrical stimulation to a heart of a patient; determining one or more left-ventricular activation metrics based on the sensed one or more left-ventricular activations; and determining whether the electrical stimulation provided conduction system pacing based on the one or more ventricular activation metrics.

Described herein are systems, methods, and apparatuses for determining capture of a cardiac conduction system by a ventricular to atrial (VfA) therapy. A VfA therapy can be delivered at a plurality of different A-V delays while the electrical activity of a patient is monitored. The electrical activity can then be utilized to determine whether the cardiac conduction system of the patient has been captured by the VfA therapy.

An implantable medical system includes an implantable catheter advanceable into a coronary sinus of a patient's heart. A guide element and an implantable lead receivable in the side lumen is advanceable through an angled opening of the catheter to be deflected laterally away from the catheter at the deflection angle to position the at least one testing electrode or at least one pacing electrode, respectively, in a myocardium of the patient's heart when the distal portion of the catheter is positioned in the coronary sinus.

Antibodies which bind selectively to cardiac conduction system (CCS) cells, imaging and / or diagnostic reagents and compositions visualizing the CCS cells and therapeutic products and compositions comprising one or more of the antibodies. Methods for delivering therapeutic agents to the CCS cells. The disclosure further provides methods for visualizing the CCS cells in vivo in real time, including in a subject undergoing a cardiothoracic surgery or other cardiac intervention. Compositions and methods for isolation, purification, analyses and / or transplantation of the CCS cells, including pluripotent stem cell (hiPSC)-derived or human embryonic stem cell (hESC)-derived CCS cells.

The invention provides a simulated jellyfish-based plateau environment systolic function model, which comprises a jellyfish-shaped framework and a cardiac muscle tissue layer cultured on the jellyfish-shaped framework, and is used for simulating the systolic function of the heart through spontaneous or rhythmic systole; the pacing point and conduction system consists of a patterned myocardial cell layer and is used for generating and / or conducting an electric signal to stimulate rhythmic contraction / relaxation of a myocardial tissue layer; the balance weight is arranged at the bottom of the center of the jellyfish-shaped frame and used for enabling the gravity borne by the simulated jellyfish in the culture solution to be larger than the buoyancy borne by the simulated jellyfish. The invention also provides a simulated jellyfish-based plateau environment systolic function simulation and detection system, and the simulated jellyfish-based plateau environment systolic function model is used as a bionic simulator and is used for analyzing the motion state, tissue pathology and metabolism conditions of the bionic simulator in a body blood component culture solution in a simulated plateau environment. And evaluating the influence of the culture solution on the heart function.

An implantable lead for use with an implantable medical device (IMD) includes a tubular lead body having a proximal portion including a proximal end, a distal portion including a distal end opposite the proximal end, and an intermediate portion between the proximal portion and the distal portion. A helical electrode extends distally from the distal end of the tubular lead body. At least one atrial electrode is disposed in the intermediate portion of the tubular lead body. At least one electrical conductor extends through the tubular lead body and is mechanically and electrically coupled to the helical electrode and the at least one atrial electrode.

A method of operating a cardiac rhythm management (CRM) system includes transmitting a list of electrodes from a programming device for a mobile medical device (AMD) to the AMD of the CRM system, the electrode list including types of electrodes available for the AMD and locations of the electrodes; sending to the AMD a selection of one or more capture acknowledgement criteria for acknowledging pacing capture; performing, by the AMD, an automatic pacing threshold test on all potential pacing vectors including electrodes in the electrode list; collecting data for each pacing confirmed to be captured according to the selected one or more capture confirmation criteria in the pacing threshold test; transmitting the collected data to a programming device; and presenting the collected data relative to the at least one selected capture confirmation criterion and a trend resulting in the captured pacing stimulation energy.

A medical device (50) is configured to obtain, by processing circuitry of the medical device (50), at least a first electrocardiogram (ECG) signal. The processing circuitry may determine a ventricular activation time (VAT) using the first ECG signal for each one of multiple pacing pulses and detect a threshold difference between a first VAT associated with a first pacing pulse of the plurality of pacing pulses and a second VAT associated with a second pacing pulse of the plurality of pacing pulses. The medical device (50) may be configured to display the determined VATs.

Adaptive cardiac conduction system pacing therapy may monitor electrical activity of a patient's heart and select a cardiac conduction system pacing therapy pacing mode based on the monitored electrical activity. For instance, one or more metrics such as P-wave-to-R-wave interval and QRS complex width may be determined based on the monitored electrical activity, and one of an inhibited pacing mode, a ventricular fusion pacing mode, an atrioventricular synchronous pacing mode, and an atrial fibrillation pacing mode may be selected based on the determined one or more metrics.

The present disclosure relates to pacing of the cardiac conduction system, and to delivery of an implantable medical device (IMD). A delivery catheter may be configured to deliver the IMD, the delivery catheter including a deployment tube, a handle, a cup, and a sleeve. The deployment tube can define a curve along a portion of a length of the deployment tube, the curve comprising a first shape. The handle can be coupled to the proximal end of the deployment tube and used to control the delivery device. The cup can be coupled to the distal end of the deployment tube and configured to house a leadless implantable medical device. The sleeve can be disposed around the perimeter of the deployment tube, the sleeve configured to move from a first undeployed position to a second deployed position and manipulate the curve from the first shape to a second shape.

A medical device includes a sensing circuit configured to sense at least one cardiac electrical signal, a therapy delivery circuit configured to deliver pacing pulses and a memory configured to store CSP capture criteria. The medical device includes a control circuit configured to perform an evoked response capture test including controlling the therapy delivery circuit to deliver a first test pacing pulse at an evoked response capture test output, detecting an evoked response following the first test pacing pulse from the at least one cardiac electrical signal and selecting a conduction system capture test output for performing a conduction system capture test after the evoked response capture test.

A method of machine-assisted setting up of a procedure for tricuspid valve implantation in a patient with a heart, comprising: (a) identifying a conduction system location on an image data set of said heart, said image acquired using data collection from outside the heart; and (b) providing machine-assisted guidance of a tricuspid valve implantation and / or selection based on a risk to the conduction system from valve implantation.

A medical device system is configured to obtain a cardiac electrical signal episode sensed during a conduction system capture management test and determine capture test data from the cardiac electrical signal episode. The medical device system may be configured to detect an alert condition of the conduction system capture management test indicating a change in the capture test data compared to a previous conduction system capture management test and generate an output in response to detecting the alert condition. The generated output may be stored in memory of the medical device system. The medical device system may display data in a user interface based on the generated output.

A method of machine-assisted setting up of a procedure for conduction system pacing in a patient with a heart, comprising: (a) identifying a conduction system location on an image data set of said heart, said image acquired using data collection from outside the heart; and (b) providing machine-assisted guidance of a pacemaker electrode placement to a target location associated with a portion of said conduction system in said heart, said target location suitable for capture of said conduction system by pacing with a pacing pulse from said lead.

A medical device is configured to receive a conductive system pacing therapy command, which may correspond to one of a first conductive system pacing therapy command or a second conductive system pacing therapy command. A medical device may determine an atrioventricular (AV) pacing interval according to a first method in response to receiving a first conductive system pacing therapy command. The medical device may determine an AV pacing interval according to a second method different from the first method in response to receiving the second conductive system pacing therapy command. The medical device may schedule conduction system pacing pulses for delivery at the determined AV pacing interval.

A medical device system delivers ventricular pacing pulses as conduction system pacing (CSP) pulses in at least one example. The medical device system senses at least one cardiac electrical signal and obtains at least one post-pace T-wave from the at least one cardiac electrical signal sensed following a delivered CSP pulse. The medical device system may determine at least one T-wave match metric between the at least one post-pace T-wave and at least one T-wave template and determine that effective CSP criteria corresponding to capture of at least a portion of a cardiac conduction system are not met based on the at least one T-wave match metric.

The present invention relates to a nerve conduit system for connecting two nerve ends end-to-end. In particular, the present invention relates to a nerve conduit system that supports the repair of nerve injuries by facilitating proper placement and orientation of the nerve ends and allowing the connection of nerve ends having the same or different diameters. Accordingly, a nerve conduit system (10) for connecting two nerve ends end-to-end is provided. The nerve conduction system (10) comprises a first portion (12) and a second portion (14), each portion (12, 14) having an insertion portion (16, 26) adapted to receive one of two nerve ends and a connection portion (22, 24), each portion (12, 14) including through holes (20, 30) defined by at least the respective insertion portion (16, 26) and extending between the longitudinally opposing ends of the respective portion (12, 14), the connection portions (22, 24) configured to engage with each other and arranged such that in a connected state, i.e., when the connection portions (22, 24) of the first portion (12) and the second portion (14) are engaged, the through holes (20, 30) are in fluid communication with each other.