47 results about "Ventricular pacing" patented technology

An implantable medical device, comprising a left ventricular, LV, electrode assembly for connection to the myocardium of the left ventricle of a patient's heart and configured for application of left ventricular pacing, LVp, and for left ventricular sensing, LVs, and a control unit, configured to control the LV electrode assembly with respect to an application of LVp at a scheduled LV stimulation time, the control including inhibiting LVp during a left ventricle upper rate interval, LVURI, for T-wave protection, wherein a start of the LVURI is triggered by an LVs or LVp event. The control unit is further configured, if the scheduled LV stimulation time falls into the LVURI, to apply LVp when the LVURI lapses.

A medical device is configured to deliver an atrioventricular nodal stimulation (AVNS) therapy for suppressing atrioventricular node conduction by generating pulse trains according to AVNS control parameters. The medical device may deliver ventricular pacing pulses and determine that a threshold number of ventricular pacing pulses are delivered while the AVNS therapy is being delivered. The medical device may adjust at least one AVNS control parameter in response to determining that the threshold number of ventricular pacing pulses have been delivered.

An intracardiac ventricular pacemaker configured to operate in a selected one of an atrial tracking ventricular pacing mode and a non-atrial tracking ventricular pacing mode. A control circuit of the pacemaker: determines at least one motion signal metric from a motion signal; comparing the at least one motion signal metric to a pacing mode switching criterion; and in response to satisfying the pacing mode switching criterion, switching from a selected one of the non-atrial tracking pacing mode and the atrial tracking pacing mode to the other of the non-atrial tracking pacing mode and the atrial tracking pacing mode, a ventricular pacing pulse is controlled for controlling ventricular pacing pulses delivered by the pacemaker.

Systems and methods are provided for detecting arrhythmias in cardiac activity is provided. The systems and methods include measuring conduction delays between an atria (A) and multiple left ventricular (LV) electrodes to obtain multiple intrinsic A / LV intervals, measuring conduction delays between a right ventricular (RV) and the multiple LV electrodes to obtain multiple intrinsic VV intervals. The systems and methods include calculating a first atrial ventricular (AV) delay based on at least one of the intrinsic A / LV intervals, and calculating a second AV delay based on at least one of the intrinsic VV intervals. The systems and methods include selecting a biventricular (BiV) pacing mode or an LV only pacing mode based on a relation between the first and second AV delays, and delivering a pacing therapy based on the selecting operation.

In some examples, controlling delivery of CRT includes controlling an implantable medical device to deliver ventricular pacing according to a sequence of different values of a CRT parameter and acquire first and second electrograms from respective first and second electrode vectors. For each value of the CRT parameter, a value of a comparison metric of a first activation interval between a first fiducial point of a cardiac cycle detected in the first electrogram and an occurrence of a second fiducial point of the cardiac cycle and a second activation interval between the first fiducial point and the occurrence of the second fiducial point detected in the second electrogram can be determined. A target value of the comparison metric can be identified and an updated value of the CRT parameter determined based on the target value. The system can then control the IMD to deliver ventricular pacing at the updated value of the CRT parameter.

In some examples, a system can be used for delivering cardiac resynchronization therapy (CRT). The system may include a pacing device configured to be implanted within a patient. The pacing device can include a plurality of electrodes, signal generation circuitry configured to deliver ventricular pacing via the plurality of electrodes, and a sensor configured to produce a signal that indicates mechanical activity of the heart. Processing circuitry can be configured to identify one or more features of a cardiac contraction within the signal, and determine whether the contraction was a fusion beat based on the one or more features.

A medical device is configured to deliver atrioventricular junction stimulation (AVNS) therapy for suppressing atrioventricular junction conduction by generating a pulse train in accordance with atrioventricular junction stimulation (AVNS) control parameters. The medical device may deliver ventricular pacing pulses and determine that a threshold number of ventricular pacing pulses are delivered while delivering the AVNS therapy. The medical device may adjust at least one AVNS control parameter in response to determining that the threshold number of ventricular pacing pulses has been delivered.

Dual chamber leadless pacemaker systems comprising an aLP and a vLP, and methods for use therewith, are disclosed. Such systems and methods can detect and terminate pacemaker mediated tachycardia (PMT) even when the implant-to-implant (i2i) communication from the vLP to aLP (V2A) is compromised. The vLP monitors for PMT in response to reception of an i2i communication from the aLP indicating compromised V2A i2i communication and initiates, following detection of a PMT, initiate a PMT PV interval in response to reception of an i2i communication from the aLP indicating an atrial sensed event. The PMT PV interval is shorter than a PV interval that the vLP would otherwise use for ventricular pacing if PMT was not detected. The vLP also delivers a ventricular pacing pulse to the ventricular cardiac chamber in response to the PMT PV interval expiring without an intrinsic ventricular event being detected during the PMT PV interval.

A medical device having a motion sensor is configured to sense a motion signal, generate ventricular pacing pulses in a non-atrial tracking ventricular pacing mode and detect atrial event signals from the motion signal during the non-atrial tracking ventricular pacing mode. The medical device may be configured to determine atrial event intervals from the detected atrial event signals, determine a frequency distribution of the determined atrial event intervals and determine an atrial rate based on the frequency distribution of the detected atrial event intervals.

An implantable medical device system includes an extracardiac sensing device and an intracardiac pacemaker. The sensing device senses a P-wave attendant to an atrial depolarization of the heart via housing-based electrodes carried by the sensing device when the sensing device is implanted outside the cardiovascular system and sends a trigger signal to the intracardiac pacemaker in response to sensing the P-wave. The intracardiac pacemaker detects the trigger signal and schedules a ventricular pacing pulse in response to the detected trigger signal.

Systems and methods for cardiac pacing are described in this document. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to capture a His bundle, and LV pacing (LVP) pulses to capture a left ventricle. A sensing circuit may sense a cardiac activity, such as an atrial or an LV cardiac electrical activity. The system includes a control circuit controlling the delivery of HBP and LVP pulses. The HBP and LVP may be delivered concurrently or sequentially. In an example, the LVP pulses may be delivered based on a His-bundle capture status in response to the HBP pulse. The system may adjust one or more His-bundle stimulation parameters based on the His-bundle capture status.

The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining whether a patient is experiencing atrial fibrillation (AF). If the patient is experiencing AF, the efficacy of CRT is determined. A signal is sensed in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal and a determination is made as to whether the ventricular pacing stimulus evoked a response from the ventricle.

In some examples, a system can be used for delivering cardiac resynchronization therapy (CRT). The system may include a pacing device configured to be implanted within a patient. The pacing device can include a plurality of electrodes, signal generation circuitry configured to deliver ventricular pacing via the plurality of electrodes, and a sensor configured to produce a signal that indicates mechanical activity of the heart. Processing circuitry can be configured to identify one or more features of a cardiac contraction within the signal, and determine whether the contraction was a fusion beat based on the one or more features.

An implantable medical device system includes an extracardiac sensing device and an intracardiac pacemaker. The sensing device senses a P-wave attendant to an atrial depolarization of the heart via housing-based electrodes carried by the sensing device when the sensing device is implanted outside the cardiovascular system and sends a trigger signal to the intracardiac pacemaker in response to sensing the P-wave. The intracardiac pacemaker detects the trigger signal and schedules a ventricular pacing pulse in response to the detected trigger signal.

Systems for detecting potential pacemaker capture loss in a surface electrocardiogram (ECG) signal are provided. In one example, a system includes a plurality of electrodes (RA, LA, RL, LL, V1, V2, V3, V4, V5, V6) configured to measure electrical potentials generated at a patient's skin, an electrode monitor (10) configured to generate an ECG signal from the electrical potentials, an interface (434), a memory (406) storing instructions, and at least one processor (404) configured to execute the instructions to obtain (504) a baseline ECG signal of the patient, obtain (702) a current ECG signal of the patient from the electrode monitor, determine that the patient has an electronic implant performing biventricular pacing based on the baseline ECG signal and / or the current ECG signal, compare (712, 714) the baseline ECG signal of the patient to the current ECG signal based on the determination, and indicate (722) a deterioration condition of the electronic implant through the interface based on the comparison and the determination.

A system and method have at least one implantable lead comprising a right ventricular (RV) electrode and one or more left ventricular (LV) electrodes, at least one processor, and a memory coupled to the at least one processor. The memory stores program instructions. The program instructions are executable by the at least one processor to determine a right ventricular to left ventricular (RV-LV) conduction time representative of a conduction time between a right ventricular (RV) paced event and one or more responsive left ventricular (LV) sensed events, determine a left ventricular to right ventricular (LV-RV) conduction time representative of a conduction time between one or more LV paced event and an RV sensed events, calculate a relation between the RV-LV conduction time and the LV-RV conduction time, and set a pacing mode of an implantable medical device to one of i) a biventricular (BiV) pacing mode and ii) an LV only pacing mode based on the relation between the RV-LV conduction time and the LV-RV conduction time.

A pacemaker is configured to operate in an atrial synchronous ventricular pacing mode and, after expiration of a conduction check time interval, switch to an asynchronous ventricular pacing mode that includes setting a ventricular pacing interval to a base pacing rate interval. The pacemaker is further configured to determine when atrioventricular block detection criteria are satisfied during the asynchronous ventricular pacing mode and, responsive to the atrioventricular block detection criteria being satisfied, switch back to the atrial synchronous ventricular pacing mode.

A processing circuit (50) of a medical system is configured to determine a ventricular activation time metric and determine whether ventricular capture includes left beam branch region pacing or interval pacing based on the ventricular activation time metric. The processing circuitry (50) is further configured to modify an amplitude of the ventricular pacing in response to the ventricular capture comprising interval pacing.

A medical device is configured to sense at least one cardiac electrical signal and generate pacing pulses according to a first pacing therapy by generating pacing pulses for delivery to a first combination of ventricular pacing sites including at least one ventricular conduction system pacing site. The medical device may be configured to determine a ventricular conduction condition based on a QRS signal feature of the sensed cardiac signal during the first pacing therapy. The medical device may change to a second pacing therapy different than the first pacing therapy based on the determined ventricular conduction condition.

A pacemaker is configured to operate in an atrial synchronous ventricular pacing mode and, after expiration of a conduction check time interval, switch to an asynchronous ventricular pacing mode that includes setting a ventricular pacing interval to a base pacing rate interval. The pacemaker is further configured to determine when atrioventricular block detection criteria are satisfied during the asynchronous ventricular pacing mode and, responsive to the atrioventricular block detection criteria being satisfied, switch back to the atrial synchronous ventricular pacing mode.

Methods and systems for delivering cardiac pacing therapy, including sensing a cardiac signal via an electrode of an atrial lead, and determining the occurrence of one of an intrinsic atrial depolarization event and a paced atrial depolarization event for a current cardiac cycle in response to the sensed cardiac signal. In response to the determined occurrence of the depolarization event, delivering a first pacing therapy during the current cardiac cycle, and comparing the amplitude of the cardiac signal after the delivered first pacing therapy in the current cardiac cycle to a predetermined amplitude threshold. In response to the amplitude not being more negative than the predetermined amplitude threshold, delivering a second pacing therapy via a left ventricular lead in the same cardiac cycle and after the delivered first pacing therapy, and in response to the amplitude being more negative than the predetermined amplitude threshold, not delivering the second pacing therapy.

A medical device is configured to determine a rate smoothing pacing interval based on at a ventricular cycle length ending with a ventricular pacing pulse and determine a post-sense ventricular pacing interval based on a ventricular cycle length ending with a sensed ventricular event signal. The medical device may be configured to start a ventricular pacing interval set to the post-sense ventricular pacing interval in response to the sensed ventricular event signal and generate a ventricular pacing pulse in response to the expiration of the post-sense ventricular pacing interval.

Implantable medical device configured to provide for an intra-cardiac pacing includes an electrode arrangement configured to sense a cardiac sense signal and processing circuitry operatively connected to the electrode arrangement. The processing circuitry is configured to start a first timer based on a ventricular sense event; to open an atrial detection window based on a first timer count; to start a second timer based on an atrial sense event; to identify a first timeout based on a comparison of a second timer count and a first pacing delay; to identify a second timeout based on a comparison of the first timer count and a second pacing delay; to identify a third timeout based on a comparison of the first timer count and a basic rate interval; and to trigger a ventricular pace signal based on an identification of at least one of the first, second and third timeouts.

An intraventricular pacemaker includes: a pulse generator for delivering ventricular pacing pulses; an impedance sensing circuit; and a control circuit in communication with the pulse generator and the impedance sensing circuit. The pacemaker is configured to generate an intraventricular impedance signal, detect an atrial systolic event using the intraventricular impedance signal, set an atrioventricular pacing interval in response to detecting the atrial systolic event, and deliver a ventricular pacing pulse in response to the atrioventricular pacing interval expiring.

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.

An intracardiac ventricular pacemaker includes a pulse generator for delivering ventricular pacing pulses, an impedance sensing circuit, and a control circuit in communication with the pulse generator and the impedance sensing circuit. The pacemaker is configured to produce an intraventricular impedance signal, detect an atrial systolic event using the intraventricular impedance signal, set an atrioventricular pacing interval in response to detecting the atrial systolic event, and deliver a ventricular pacing pulse in response to the atrioventricular pacing interval expiring.

A cardiac pacemaker for a patient's heart, for example an ILP which realizes integrated circuit space conservation and simple design that covers many modes of operation even though robust behaviour requires complex dynamic adaptive algorithms. The pacemaker includes a processing unit, a detector and a pacing signal generator, wherein the processing unit, the detector and the pacing signal generator are electrically interconnected, wherein the detector is configured to detect electrical signals of the heart, for example an intracardiac electrogram, and to transmit these signals to the processing unit, wherein the processing unit is configured to perceive an intrinsic ventricular signal and an intrinsic atrial signal from the signals received from the detector, to enable or disable the perception of the intrinsic atrial signal, to produce a ventricular pacing control signal.

A medical device includes a motion sensor for producing a motion signal including cardiac event signals. The medical device generates a ventricular pacing pulse upon expiration of a pacing interval. The medical device determines a synchrony metric from the motion signal after a delivered ventricular pacing pulse and adjusts the pacing interval based on the synchrony metric.

Systems are provided for detecting potential pacemaker lack of capture in surface electrocardiogram (ECG) signals. In one example, a system includes a plurality of electrodes configured to measure electrical potential generated at a skin of a patient, an electrode monitor configured to generate an ECG signal from the electric potential, an interface, a memory storing instructions, and at least one processor configured to execute the instructions to: obtain a baseline ECG signal of the patient, obtain a current ECG signal of the patient from the electrode monitor, determine, based on the baseline ECG signal and / or the current ECG signal, that the patient has an electronic implant carrying out biventricular pacing, compare, based on the determination, the baseline ECG signal to the current ECG signal of the patient, and indicate, through the interface, a degradation condition of the electronic implant based on the comparing and the determination.

A dual chamber LP system (100) includes an aLP (102a) and a vLP (102b) that collectively provide AAI+VVI operation, and selectively transition from the AAI+VVI operation to collectively providing coordinated dual chamber operation (e.g., DDD operation, but not limited thereto), and vice versa. While providing the AAI operation, the aLP (102a) performs atrial pacing when an intrinsic atrial event is not detected within a specified AA interval, performs atrial sensing, and inhibits the atrial pacing when the intrinsic atrial event is detected within the specified AA interval. While providing the VVI operation, the vLP (102b) performs ventricular pacing when an intrinsic ventricular event is not detected within a specified VV interval, performs ventricular sensing, and inhibits the ventricular pacing when the intrinsic ventricular event is detected within the specified VV interval.