公开(公告)号：US20150305642A1

公开(公告)日：2015-10-29

申请号：US14687053

申请日：2015-04-15

Applicant: Medtronic, Inc.

Inventor： James D. REINKE ,  Xusheng ZHANG ,  Vinod SHARMA ,  Vladimir P. NIKOLSKI ,  Michael B. TERRY ,  Scott A. HARELAND ,  Daniel L. HANSEN ,  Donna M. SALMI

IPC: A61B5/0464 ,  A61B5/00 ,  A61B5/04 ,  A61N1/37

CPC classification number: A61B5/0464 ,  A61B5/04017 ,  A61B5/686 ,  A61N1/371 ,  A61N1/3962

Abstract: In situations in which an implantable medical device (e.g., a subcutaneous ICD) is co-implanted with a leadless pacing device (LPD), it may be important that the subcutaneous ICD knows when the LPD is delivering pacing, such as anti-tachycardia pacing (ATP). Techniques are described herein for detecting, with the ICD and based on the sensed electrical signal, pacing pulses and adjusting operation to account for the detected pulses, e.g., blanking the sensed electrical signal or modifying a tachyarrhythmia detection algorithm. In one example, the ICD includes a first pace pulse detector configured to obtain a sensed electrical signal and analyze the sensed electrical signal to detect a first type of pulses having a first set of characteristics and a second pace pulse detector configured to obtain the sensed electrical signal and analyze the sensed electrical signal to detect a second type of pulses having a second set of characteristics.

Abstract translation: 在可植入医疗器械（例如皮下ICD）与无引线起搏器（LPD）共同植入的情况下，皮下ICD知道LPD何时发出起搏，例如抗心动过速起搏 （ATP）。 本文描述了用于利用ICD并基于所感测到的电信号，用于检测起搏脉冲和调整操作以考虑检测到的脉冲的技术，例如消隐感测的电信号或修改快速性心律失常检测算法。 在一个示例中，ICD包括构造成获得感测到的电信号并分析所感测的电信号以检测具有第一组特性的第一类型的脉冲的第一步调脉冲检测器和被配置成获得所感测的电 信号并分析所感测的电信号以检测具有第二组特性的第二类型的脉冲。

公开(公告)号：US20220331600A1

公开(公告)日：2022-10-20

申请号：US17856946

申请日：2022-07-01

Applicant: Medtronic, Inc.

Inventor： Jian CAO ,  Timothy A. EBELING ,  Saul E. GREENHUT ,  Michael W. HEINKS ,  Irving J. SANCHEZ ,  Paul R. SOLHEIM ,  Xusheng ZHANG ,  Gerald P. ARNE

IPC: A61N1/39 ,  A61B5/00 ,  A61B5/287 ,  A61B5/352 ,  A61N1/05

Abstract: An implantable medical device system capable of sensing cardiac electrical signals includes a sensing circuit, a therapy delivery circuit and a control circuit. The sensing circuit is configured to receive a cardiac electrical signal and sense a cardiac event in response to the signal crossing a cardiac event sensing threshold. The therapy delivery circuit is configured to deliver an electrical stimulation therapy to a patient's heart via the electrodes coupled to the implantable medical device. The control circuit is configured to control the sensing circuit to set a starting value of the cardiac event sensing threshold and hold the starting value constant for a sense delay interval. The control circuit is further configured to detect an arrhythmia based on cardiac events sensed by the sensing circuit and control the therapy delivery circuit to deliver the electrical stimulation therapy in response to detecting the arrhythmia.

公开(公告)号：US20190117104A1

公开(公告)日：2019-04-25

申请号：US16221921

申请日：2018-12-17

Applicant: Medtronic, Inc.

Inventor： Robert W. STADLER ,  Xusheng ZHANG ,  Vinod SHARMA ,  James D. REINKE ,  Barbara J. SCHMID

IPC: A61B5/0464 ,  A61B5/00 ,  A61B5/04 ,  A61N1/362 ,  A61N1/372 ,  A61N1/39 ,  A61N1/375

Abstract: An implantable medical device comprises a sensing module configured to obtain electrical signals from one or more electrodes and a control module configured to process the electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia. The control module detects initiation of a pacing train delivered by a second implantable medical device, determines a type of the detected pacing train, and modifies the tachyarrhythmia detection algorithm based on the type of the detected pacing train.

公开(公告)号：US20190111268A1

公开(公告)日：2019-04-18

申请号：US16161534

申请日：2018-10-16

Applicant: Medtronic, Inc.

Inventor： Melissa G.T. CHRISTIE ,  Ronald A. DRAKE ,  Vladimir P. NIKOLSKI ,  Bushan K. PURUSHOTHAMAN ,  Xusheng ZHANG

IPC: A61N1/365 ,  A61N1/38 ,  A61N1/39 ,  A61N1/37

Abstract: In some examples, a medical device system includes an electrode. The medical device system may include impedance measurement circuitry coupled to the electrode, the impedance measurement circuitry may be configured to generate an impedance signal indicating impedance proximate to the electrode. The medical device system may include processing circuitry that may be configured to identify a first component of the impedance signal. The first component of the impedance signal may be correlated to a cardiac event. The processing circuitry may be configured to determine that the cardiac event occurred based on the identification of the first component of the impedance signal.

公开(公告)号：US20190054297A1

公开(公告)日：2019-02-21

申请号：US15677204

申请日：2017-08-15

Applicant: Medtronic, Inc.

Inventor： Xusheng ZHANG ,  Yanina GRINBERG ,  Paul R. SOLHEIM ,  Troy E. JACKSON ,  Timothy A. EBELING ,  Vladimir P. NIKOLSKI

IPC: A61N1/362 ,  A61N1/365 ,  A61N1/39 ,  A61N1/372

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.

公开(公告)号：US20180339164A1

公开(公告)日：2018-11-29

申请号：US16054089

申请日：2018-08-03

Applicant: Medtronic, Inc.

Inventor： Jian CAO ,  Timothy A. EBELING ,  Saul E. GREENHUT ,  Michael W. HEINKS ,  Irving J. SANCHEZ ,  Paul R. SOLHEIM ,  Xusheng ZHANG ,  Gerald P. ARNE

IPC: A61N1/39 ,  A61N1/05 ,  A61B5/0456 ,  A61N1/362 ,  A61N1/365

Abstract: An implantable medical device system capable of sensing cardiac electrical signals includes a sensing circuit, a therapy delivery circuit and a control circuit. The sensing circuit is configured to receive a cardiac electrical signal and sense a cardiac event in response to the signal crossing a cardiac event sensing threshold. The therapy delivery circuit is configured to deliver an electrical stimulation therapy to a patient's heart via the electrodes coupled to the implantable medical device. The control circuit is configured to control the sensing circuit to set a starting value of the cardiac event sensing threshold and hold the starting value constant for a sense delay interval. The control circuit is further configured to detect an arrhythmia based on cardiac events sensed by the sensing circuit and control the therapy delivery circuit to deliver the electrical stimulation therapy in response to detecting the arrhythmia.

公开(公告)号：US20180207437A1

公开(公告)日：2018-07-26

申请号：US15416827

申请日：2017-01-26

Applicant: Medtronic, Inc.

Inventor： Xusheng ZHANG ,  Saul E. GREENHUT ,  Michael W. HEINKS ,  Paul R. SOLHEIM

IPC: A61N1/39 ,  A61N1/362 ,  A61N1/37 ,  A61N1/365 ,  A61N1/08

Abstract: An implantable cardioverter defibrillator (ICD) starts a timer set to a time interval in response to a cardiac electrical signal crossing a noise threshold amplitude and resets the timer to the time interval in response to each crossing of the noise threshold amplitude by the cardiac electrical signal that occurs prior to the time interval expiring. A control circuit of the ICD determines a parameter of the behavior of the timer and identifies a sensed cardiac event as an electromagnetic interference (EMI) event based on the parameter. The ICD may detect EMI in response to the EMI event and withhold a tachyarrhythmia detection or therapy in response to EMI detection.

公开(公告)号：US20180028828A1

公开(公告)日：2018-02-01

申请号：US15655082

申请日：2017-07-20

Applicant: Medtronic, Inc.

Inventor： Jian CAO ,  Saul E. GREENHUT ,  Xusheng ZHANG

IPC: A61N1/39 ,  A61B5/0452 ,  A61B5/042 ,  A61B5/0464 ,  A61B5/04 ,  A61B5/0456

CPC classification number: A61N1/3956 ,  A61B5/04011 ,  A61B5/04017 ,  A61B5/042 ,  A61B5/0452 ,  A61B5/04525 ,  A61B5/0456 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/4836 ,  A61B5/686 ,  A61N1/3925 ,  A61N1/3987

Abstract: A medical device, such as an extra-cardiovascular implantable cardioverter defibrillator (ICD), senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal acquired by a second sensing channel in response to each sensed R-wave. The ICD determines morphology match scores from the stored time segments of the second cardiac electrical signal and, based on the morphology match scores, withholds detection of a tachyarrhythmia episode. In some examples, the ICD detects T-wave oversensing based on the morphology match scores and withholds detection of a tachyarrhythmia episode in response to detecting the T-wave oversensing.

公开(公告)号：US20170312532A1

公开(公告)日：2017-11-02

申请号：US15140802

申请日：2016-04-28

Applicant: Medtronic, Inc.

Inventor： Xusheng ZHANG ,  Jian CAO ,  Saul E. GREENHUT ,  Robert W. STADLER

IPC: A61N1/39 ,  A61B5/0464 ,  A61B5/042

CPC classification number: A61N1/3987 ,  A61B5/042 ,  A61B5/0464 ,  A61N1/3925 ,  A61N1/3956

Abstract: An extra-cardiovascular implantable cardioverter defibrillator senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The ICD determines intervals between successively sensed R-waves and, in response to at least a predetermined number of the intervals being less than a tachyarrhythmia detection interval, analyzes at least a portion of the time segment of the second cardiac electrical signal corresponding to a most recent one of the sensed R-waves to confirm the most recent one of the R-waves. The ICD updates an unconfirmed beat count in response to the most recent one of the R-waves not being confirmed and withholds detection of a tachyarrhythmia episode in response to the unconfirmed beat count being equal to or greater than a rejection threshold.

公开(公告)号：US20170043174A1

公开(公告)日：2017-02-16

申请号：US15334410

申请日：2016-10-26

Applicant: Medtronic, Inc.

Inventor： Saul E. GREENHUT ,  Robert J. NEHLS ,  Walter H. OLSON ,  Xusheng ZHANG ,  Wade M. DEMMER ,  Troy E. JACKSON ,  James D. REINKE

IPC: A61N1/39 ,  A61N1/375 ,  A61N1/365 ,  A61N1/372 ,  A61N1/05 ,  A61N1/362

CPC classification number: A61N1/3962 ,  A61N1/056 ,  A61N1/3621 ,  A61N1/36585 ,  A61N1/37288 ,  A61N1/3756 ,  A61N1/3987

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 translation: 描述了使用皮下植入式心律转复除颤器（SICD）和无引线起搏装置（LPD）监测心律不齐和递送电刺激治疗的技术和系统。 例如，SICD可以检测来自心脏的第一电信号内的快速性心律失常，并且基于快速性心律失常确定将抗心律失常休克疗法递送给患者以治疗所检测到的心律失常。 LPD可以接收来自SICD的通信，请求LPD向心脏提供抗心动过速起搏，并且基于由LPD感测到的心脏的第二电信号确定是否将心动过速（ATP）提供给心脏。 以这种方式，SICD和LPD可以通信以协调ATP和/或心脏复律/除颤疗法。 在另一个示例中，LPD可以被配置为在检测到抗快速性心律失常性休克疗法的递送之后递送后冲击起搏。