摘要:
A leadless intra-cardiac medical device (LIMD) includes multiple electrodes that allow for stimulation and sensing of the right ventricle (RV) and sensing of the right atrium (RA), even though it is entirely located in the RV. The LIMD includes a housing having a proximal end configured to engage local tissue in the local chamber and electrodes located at multiple locations along the housing. Sensing circuitry is configured to define a far field (FF) channel between a first combination of the electrodes to sense FF signals occurring in the adjacent chamber. The sensing circuitry is configured to define a near field (NF) channel between a second combination of the electrodes to sense NF signals occurring in the local chamber. A controller is configured to analyze the NF and FF signals to determine whether the NF and FF signals collectively indicate that a validated event of interest occurred in the adjacent chamber.
摘要:
A leadless intra-cardiac medical device includes a housing that is configured to be implanted entirely within a single local chamber of the heart. A first electrode is provided on the housing at a first position such that when the housing is implanted in the local chamber, the first electrode engages the local wall tissue at a local activation site within the conduction network of the local chamber. An intra-cardiac extension is coupled to the housing and configured to extend from the local chamber into an adjacent chamber of the heart. A stabilization arm of the intra-cardiac extension engages the adjacent chamber. A second electrode on the intra-cardiac extension engages distal wall tissue at a distal activation site within the conduction network of the adjacent chamber.
摘要:
A system for implanting an implantable medical device (IMD) within a patient may include a main handle assembly having proximal and distal ends, a device-connection control handle connected to the proximal end of the main handle assembly, an introducer connected to the distal end of the main handle assembly, and a connection tool extending from the introducer. The connection tool may include a device-engaging member configured to change at least one of shape or orientation to selectively connect to and disconnect from the IMD. The device-connection control handle may be operatively connected to the device-engaging member and the device-connection control handle may be configured to manipulate the device-engaging member between connected and disconnected states by changing the at least one of the shape or orientation.
摘要:
A stimulation device that includes a housing, a neuro lead configured to be coupled to the housing and to be located proximate to a neurostimulation site of interest, a neuro pulse generator, in the housing, configured to generate multi-polar neuro modulation (NM) pulses for delivery by the lead to the neuromodulation site of interest and the neuro pulse generator generating the NM pulses utilizing a waveform, with the frequency components of the ICMD compatible waveform in a range of 0 to 225 Hz having substantially limited NM energy content to avoid interference with sensing operation of the ICMD. A method for managing a neuromodulation (NM) device to avoid interference with an implantable medical device (ICMD) providing an ICMD having electrodes configured based on ICMD sensing parameters that define an ICMD sensing frequency range, providing an NM device having NM electrodes to be located proximate a region of interest, the NM electrodes delivering NM pulses based on NM pulse parameters, setting at least one NM pulse parameter in a manner that limits an amount of NM energy content that propagates beyond an active area surrounding the site of interest within the ICMD sensing frequency range.
摘要:
Techniques are described for overdrive pacing the heart using a pacemaker wherein the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
摘要:
A leadless intra-cardiac medical device senses cardiac activity from multiple chambers and applies cardiac stimulation to at least one cardiac chamber and/or generates a cardiac diagnostic indication. The leadless device may be implanted in a local cardiac chamber (e.g., the right ventricle) and detect near-field signals from that chamber as well as far-field signals from an adjacent chamber (e.g., the right atrium).
摘要:
Disclosed herein is an implantable medical device including an antimicrobial layer. The antimicrobial layer may include a first distinct size of silver nanoparticles, a second distinct size of silver nanoparticles, and a third distinct size of silver nanoparticles. The antimicrobial layer extends over a surface of the implantable medical device, and, in some instances, the surface of the implantable medical device may serve as a substrate on which the antimicrobial layer is deposited.
摘要:
A process for determining whether the location of a stimulation electrode meets a selected heart performance criteria includes providing stimulation to the heart through the electrode and obtaining an impedance measurement during stimulation delivery using an impedance sensing vector formed by electrodes that do not include the stimulation electrode. The impedance measurements are processed, either alone or in combination with an electrogram, also obtained during stimulation, to obtain a measure of hemodynamic performance.
摘要:
A method and apparatus for reducing the incidence of atrial arrhythmias by using an overdrive algorithm to determine the application of overdrive stimulation pulses to a patient's heart, e.g., in the atria. In a first aspect of the invention, the apparatus first determines an overdrive pacing rate and then applies pairs of temporally spaced (staggered) pacing pulses, i.e., primary and secondary pacing pulses, at the determined overdrive pacing rate. In a further aspect of the invention, the pairs of pacing pulses are applied at the overdrive pacing rate to multiple spatially spaced electrodes, i.e., electrodes distributed among multiple sites in a patient's heart, e.g., in the atria. In accordance with a first preferred embodiment, the electrodes may be distributed within a single atrium, e.g., the right atrium, of the patient's heart. Alternatively, a first electrode may be placed in the right atrium and a second electrode may be placed in the coronary sinus or the left atrium or multiple electrodes may be placed proximate to the left atrium. Furthermore, the invention relates to techniques for controlling overdrive pacing to multiple sites in a patient's heart so as to achieve and maintain a target degree of pacing and thus suppress tachycardias.