Abstract:
Systems and methods are described herein for evaluation and adjustment of a left ventricular assist device (LVAD). The systems and methods may utilize at least a plurality of external electrodes to monitor cardiac electrical activity before and during LVAD therapy. The cardiac electrical activity as well as other information such cardiac sound information may be used to determine and adjust one or more LVAD output parameters such as pump speed.
Abstract:
Techniques for determining paced cardiac depolarization waveform morphological templates are described. For example, an implantable medical device (IMD) may sense a cardiac electrogram of a heart, identify cardiac depolarizations within the cardiac electrogram, and determine that the cardiac depolarizations are paced cardiac depolarizations resulting from delivery of a pacing pulse to the heart by another IMD without detecting the pacing pulse and without communicating with the other IMD. The IMD may identify paced cardiac depolarization waveforms of the paced cardiac depolarizations, determine a paced cardiac depolarization waveform morphological template based on the identified paced cardiac depolarization waveforms, determine a normal cardiac depolarization waveform morphological template based on the paced cardiac depolarization waveform morphological template, and compare the normal cardiac depolarization waveform morphological template to subsequent cardiac depolarization waveforms. The IMD may detect a cardiac tachyarrhythmia based on the above comparison.
Abstract:
An implantable medical device comprises therapy delivery circuitry and processing circuitry. The therapy delivery circuitry is configured to deliver anti-tachycardia pacing (ATP) therapy to a heart of a patient. The ATP therapy includes one or more pulse trains and each of the one or more pulse trains includes a plurality of pacing pulses. The processing circuitry is configured to, for at least one of the plurality of pacing pulses of at least one of the one or more pulse trains, determine at least one latency metric of an evoked response of the heart to the pacing pulse. The processing circuitry is further configured to modify the ATP therapy based on the at least one latency metric.
Abstract:
A medical device and associated method for detecting and treating tachyarrhythmias acquires a cardiac signal using electrodes coupled to a sensing module. Cardiac events are sensed from the cardiac signal and a processing module computes a first morphology metric for each sensed cardiac event occurring during a time segment of the cardiac signal. The first morphology metrics corresponding to an event originating in a ventricular chamber are counted. The first processing module computes a second morphology metric for the time segment of the cardiac signal in response to the count of the first morphology metrics meeting a threshold number of events. The time segment is classified as a shockable segment in response to the second morphology metric meeting a detection criterion.
Abstract:
A medical device comprises therapy delivery circuitry and processing circuitry. The therapy delivery circuitry is configured to deliver anti-tachycardia pacing (ATP) therapy to a heart of a patient. The ATP therapy includes one or more pulse trains and each of the one or more pulse trains includes a plurality of pacing pulses. The processing circuitry is configured to, for at least one of the plurality of pacing pulses of at least one of the one or more pulse trains, determine at least one latency metric of an evoked response of the heart to the pacing pulse. The processing circuitry is further configured to modify the ATP therapy based on the at least one latency metric.
Abstract:
A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes monitoring one or more parameters in response to a delivered cardiac remodeling pacing, determining whether the cardiac remodeling pacing has an effect on cardiac normalization in response to the monitoring, and adjusting the cardiac remodeling pacing in response to the determined effect on cardiac normalization. The method and device may also perform short-term monitoring of one or more parameters in response to the delivered cardiac remodeling pacing, monitor one or more long-term parameter indicative of a long-term effect of the delivered cardiac remodeling pacing, determine the long-term effect of the delivered cardiac remodeling pacing on cardiac normalization in response to the monitoring, and adjust the cardiac remodeling pacing in response to one or both of the short-term monitoring and the determined long-term effect on cardiac normalization.
Abstract:
Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.
Abstract:
An extra-cardiovascular implantable cardioverter defibrillator (ICD) system receives a cardiac electrical signal by an electrical sensing circuit via an extra-cardiovascular sensing electrode vector and senses cardiac events from the cardiac electrical signal. The ICD system detects tachycardia from the cardiac electrical signal and determines a tachycardia cycle length from the cardiac electrical signal. The ICD system determines an ATP interval based on the tachycardia cycle length and sets an extended ATP interval that is longer than the ATP interval. The ICD delivers ATP pulses to a patient's heart via an extra-cardiovascular pacing electrode vector different than the sensing electrode vector. The ATP pulses include a leading ATP pulse delivered at the extended ATP interval after a cardiac event is sensed from the cardiac electrical signal and a second ATP pulse delivered at the ATP interval following the leading ATP pulse.
Abstract:
An example medical device system includes memory configured to store information relating to an occurrence of a cardiac event in a patient and processing circuitry configured to determine the occurrence of the cardiac event in the patient. The processing circuitry is configured to determine at least one of a fall of the patient, a slumping posture of the patient, or a change from an upright posture to a non-upright posture of the patient and that the cardiac event is associated therewith in time. The processing circuitry is configured to, in response to determining that the cardiac event and the at least one of the fall of the patient, the slumping posture of the patient, or the change from the upright posture to the non-upright posture of the patient are associated in time, modulate a response to the cardiac event.
Abstract:
An implantable medical device system is configured to detect a tachyarrhythmia from a cardiac electrical signal and start an ATP therapy delay period. The implantable medical device determines whether the cardiac electrical signal received during the ATP therapy delay period satisfies ATP delivery criteria. A therapy delivery module is controlled to cancel the delayed ATP therapy if the ATP delivery criteria are not met and deliver the delayed ATP therapy if the ATP delivery criteria are met.