摘要:
Systems and method for assessing a patient's myocardial electrical stability by pacing a patient's heart using a pacing sequence that includes at least two different types of pacing pulses. The pacing rate used is preferably only slightly above the patient's intrinsic heart rate. A degree of alternans, in a signal (e.g., IEGM or ECG) that is indicative of cardiac activity in response to the pacing sequence, is determined. The degree of alternans can be determined by comparing portions of the signal that are indicative of cardiac activity in response to the first type of pacing pulses to portions of the signal that are indicative of cardiac activity in response to the second type of pacing pulses. The patient's myocardial electrical stability is assessed based on the determined degree of alternans.
摘要:
A glycemic condition is indicated based on variance of a feature derived from cardiac electrogram data. Neurostimulation is then used to counteract a cardiac-related autonomic response to the glycemic condition. For example, stimulation of parasympathetic innervation may be used to counteract an autonomic sympathetic response that is associated with hypoglycemia or hyperglycemia. In addition, stimulation of sympathetic innervation may be used to counteract an autonomic parasympathetic response that is associated with hypoglycemia or hyperglycemia.
摘要:
Embodiments of the present invention relate to monitoring a patient's atrial stretch, heart failure (HF) condition, and/or risk of atrial fibrillation (AF), as well as methods for estimating a change in at least one of a patient's left atrial pressure (LAP), pulmonary capillary wedge pressure (PCWP), and right pulmonary artery pressure (RPAP). Embodiments of the present invention also relate to selecting a pacing energy level. Such embodiments involve determining atrial evoked response metrics when a patient's atrium is paced, and monitoring changes in such metrics.
摘要:
Methods and system are provided for monitoring a patients venous blood oxygen saturation (SvO2). At least one signal indicative of electrical activity of a patient's heart is obtained. Such a signal can be, e.g., an IEGM or ECG signal. In specific embodiments, such a signal(s) can be obtained from implanted electrodes, and thus, embodiments of the present invention can be implemented by an implantable system. Additionally, there are measurements of at least one metric of cardiac cycles represented in the at least one signal indicative of electrical activity of the patient's heart, where the metric changes with changes in SvO2. Examples of such metric include T-wave metrics and PR intervals. SvO2, and changes therein, are monitored based on the measured metric(s).
摘要:
Provided herein are implantable systems, and methods for use therewith, for characterizing a tachycardia and/or selecting treatment for a tachycardia using results of a dominant frequency analysis. One or more electrogram (EGM) signal(s) indicative of cardiac electrical activity are obtained. For at least one of the EGM signal(s) a dominant frequency (DF) analysis is performed, and the results of the DF analysis are used to characterize a tachycardia and/or to select treatment for a tachycardia.
摘要:
Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.
摘要:
Systems and methods are provided for estimating a patient's ventricular defibrillation threshold (VDFT). Stimulation pulses, which are of at least three different energy levels up to 2 Joules, are delivered to the patient's right ventricle during a window defined between an R-wave and a vulnerable period that follows the R-wave. Voltage potentials, induced in response to the delivered RV stimulation pulses, are measured at a location of the patient's left ventricle (LV) where it is predicted that potential gradients induced in response to RV stimulation pulses will be lowest. Potential gradients are computed using the measured voltage potentials. The patient's VDFT can then be estimated by estimating, based on the computed potential gradients, the RV stimulation energy level that would be required to achieve a minimum acceptable potential gradient at the location of the patient's LV where it is predicted that potential gradients induced in response to RV stimulation pulses will be lowest.
摘要:
Provided herein are implantable systems, and methods for use therewith, for characterizing a tachycardia and/or selecting treatment for a tachycardia using results of a fractionation analysis. One or more electrogram (EGM) signal(s) indicative of cardiac electrical activity are obtained. At least one of the EGM signal(s) is analyzed to determine whether the EGM signal is fractionated, and the results of the analyzing are used to characterize a tachycardia and/or to select treatment for a tachycardia.
摘要:
Embodiments of the present invention relate to monitoring a patient's atrial stretch, heart failure (HF) condition, and/or risk of atrial fibrillation (AF), as well as methods for estimating a change in at least one of a patient's left atrial pressure (LAP), pulmonary capillary wedge pressure (PCWP), and right pulmonary artery pressure (RPAP). Embodiments of the present invention also relate to selecting a pacing energy level. Such embodiments involve determining atrial evoked response metrics when a patient's atrium is paced, and monitoring changes in such metrics.
摘要:
Provided herein are implantable systems, and methods for use therewith, for characterizing a tachycardia and/or selecting treatment for a tachycardia using results of a fractionation analysis. One or more electrogram (EGM) signal(s) indicative of cardiac electrical activity are obtained. At least one of the EGM signal(s) is analyzed to determine whether the EGM signal is fractionated, and the results of the analyzing are used to characterize a tachycardia and/or to select treatment for a tachycardia.