摘要:
Systems and methods of managing features or functions of an implantable cardiac device involve forming a baseline evoked response template prior to delivery of defibrillation therapy to a patient's heart, and acquiring a post-shock evoked response signal subsequent to defibrillation therapy delivery. The baseline evoked response template is compared to the post-shock evoked response signal. A determination is made whether to enable, disable or adjust a cardiac device feature based on the comparison. The cardiac device feature may be a therapy feature, a monitoring feature, or a diagnostic feature.
摘要:
Systems and methods of managing features or functions of an implantable cardiac device involve forming a baseline evoked response template prior to delivery of defibrillation therapy to a patient's heart, and acquiring a post-shock evoked response signal subsequent to defibrillation therapy delivery. The baseline evoked response template is compared to the post-shock evoked response signal. A determination is made whether to enable, disable or adjust a cardiac device feature based on the comparison. The cardiac device feature may be a therapy feature, a monitoring feature, or a diagnostic feature.
摘要:
Methods and systems involve multi-chamber cardiac capture detection utilizing sensing during a cross-chamber refractory period. First and second pacing pulses are delivered to first and second heart chamber. Capture or non-capture of the second heart chamber is determined. Sensing in the first heart chamber is performed to sense for cross-chamber propagation initiated by the second pacing pulse. Capture of the first chamber is detected if capture of the second heart chamber is detected and if the cross-chamber propagation is not detected.
摘要:
Systems and methods of managing features or functions of an implantable cardiac device involve forming a baseline evoked response template prior to delivery of defibrillation therapy to a patient's heart, and acquiring a post-shock evoked response signal subsequent to defibrillation therapy delivery. The baseline evoked response template is compared to the post-shock evoked response signal. A determination is made whether to enable, disable or adjust a cardiac device feature based on the comparison. The cardiac device feature may be a therapy feature, a monitoring feature, or a diagnostic feature.
摘要:
An embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy.
摘要:
A neurostimulation system senses a signal indicative of a patient's physical state such as posture and/or activity level. In various embodiments, a stored value for each of stimulation parameters controlling delivery of neurostimulation is selected according to the patient's physical state. In various embodiments, values of the stimulation parameters are approximately optimized for each of a number of different physical states, and are stored for later selection.
摘要:
An apparatus comprises a therapy circuit that provides a neural stimulation current, an impedance measurement circuit that measures a value of impedance at the output of the therapy circuit, a supply voltage generating circuit that provides an adjustable supply voltage value to the therapy circuit including a first supply voltage value when in a first mode, and a control circuit communicatively coupled to the therapy circuit, the impedance measuring circuit, and the supply voltage generating circuit. The control circuit, upon receiving an indication to exit the first mode, initiates an impedance measurement by the impedance measurement circuit, determines the second supply voltage value using the impedance measurement, and initiates a change from the first supply voltage value to the second supply voltage value. The second supply voltage value is sufficient to operate the therapy circuit and to provide a specified load current value to the measured impedance.
摘要:
Some embodiments provide a system for delivering neurostimulation. Some system embodiments comprise a lead configured to be implanted in the body, a stimulation output circuit configured to deliver neurostimulation pulses to the vagus nerve through the lead, an EMG sensing circuit configured to use the lead to sense EMG signals from laryngeal muscle activity, and an evoked muscular response detection circuit configured to use the EMG signals sensed by the EMG sensing circuit to detect evoked laryngeal muscle activity evoked by the neurostimulation pulse.
摘要:
A system embodiment for stimulating a neural target comprises a neural stimulator, a pace detector, and a controller. The neural stimulator is electrically connected to at least one electrode, and is configured to deliver a neural stimulation signal through the at least one electrode to stimulate the neural target. The pace detector is configured to use at least one electrode to sense cardiac activity and distinguish paced cardiac activity in the sensed cardiac activity from non-paced cardiac activity in the sensed cardiac activity. The controller is configured to control a programmed neural stimulation therapy using the neural stimulator and using detected paced cardiac activity as an input for the neural stimulation therapy.
摘要:
Various neural stimulator embodiments comprise controller circuitry, neural stimulation output circuitry, sensor circuitry and a memory. The neural stimulation output circuitry is configured to deliver the neural stimulation. The controller circuitry is configured to control stimulation parameters of the neural stimulation delivered by the neural stimulation output circuitry. The sensor circuitry, including at least one sensor, is configured to sense a response to the neural stimulation. The controller is configured to communicate with the sensor circuitry. The memory has instructions stored therein, operable on by the controller circuitry. The instructions include instructions for delivering neural stimulation using the neural stimulation output circuitry, instructions for controlling a titration sweep wherein the titration sweep varies stimulation parameter values, and instructions for monitoring a response to the titration sweep and automatically selecting stimulation parameters that provide an efficacious neural stimulation and provide a desirable safety margin to prevent injury to neural tissue.