WO2001032260A1 - Implantable cardiac rhythm management device for assessing status of chf patients - Google Patents
Implantable cardiac rhythm management device for assessing status of chf patients Download PDFInfo
- Publication number
- WO2001032260A1 WO2001032260A1 PCT/US2000/019230 US0019230W WO0132260A1 WO 2001032260 A1 WO2001032260 A1 WO 2001032260A1 US 0019230 W US0019230 W US 0019230W WO 0132260 A1 WO0132260 A1 WO 0132260A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- rate
- patient
- minute ventilation
- tidal volume
- respiratory
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36585—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by two or more physical parameters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
Definitions
- This invention relates generally to an apparatus and method for treating and assessing the efficacy of such treatment of CHF patients, and more particularly to an improved cardiac rhythm management device incorporating circuitry for sensing respiratory, heart rate and/or activity-related parameters.
- Cardiac Pacemakers and “Cardiac Rhythm Management”(CRM) devices are both used as generic terms for pacemakers and defibrillators.
- CRMs have long been used in the treatment of bradycardia and tachycardia, but only more recently CRMs have been specifically designed to enhance the hemodynamic performance of the heart for patients suffering from CHF.
- Pacemakers designed for treatment of bradycardia have incorporated a variety of physiologic sensors whereby the pacing rate of the pacemaker can be made to vary automatically with changes in physiologic demand.
- the Hauck et al. Patent 5,318,597 describes a rate adaptive pacemaker in which the pacing rate is adjusted in accordance with changes in a patient's minute ventilation.
- Means are provided in the CRM for measuring variations in transthoracic impedance and for processing of the impedance signal to extract a minute ventilation signal that is used to vary the pacing rate of an implantable pacemaker between lower and upper programmed rate limit values in that there is a direct correlation between a patient's minute ventilation and the body's hemodynamic demand.
- rate adaptive CRMs have incorporated some form of an activity sensor, such as an accelerometer, for developing a control signal that varies with a patient's level of physical activity. This control signal is then used to vary the pacing rate of a rate adaptive CRM device to maintain an appropriate pacing rate for the level of exercise being exerted.
- an activity sensor such as an accelerometer
- the present invention constitutes a departure from the related art in that even though the apparatus employed incorporates circuitry for implementing impedance plethysmography in generating a signal component relating to minute ventilation and an accelerometer responsive to patient activity, the information derived from these sensors is used to monitor a CHF patient's status so that the efficacy of a change in pacing therapy or drug therapy can be read from the implanted device periodically for review and analysis by a medical professional.
- the apparatus involved may further include an activity sensor connected to the microprocessor for deriving a plurality of physiologic parameters based upon the signal output of the activity sensor.
- the activity sensor derived parameters may also be telemetered to the external monitor for display or for further processing and display.
- Meaningful ratios that serve as CHF status indicators include: ventilatory tidal volume to respiratory rate (V RR); ventilatory tidal volume to inspiratory time
- V,/T ventilatory tidal volume to expiratory time
- V/T e minute ventilation to carbon dioxide output
- MV VCO minute ventilation to carbon dioxide output
- RR/MV respiratory rate to minute ventilation
- V,/MV tidal volume to minute ventilation
- the present invention takes advantage of such high correlation, providing a way in which a particular pacing or drug therapy affects the status of CHF patients in whom the present invention is utilized.
- the present invention provides a method and apparatus for monitoring a patient's status of congestive heart failure.
- the method is carried out by first implanting in the patient an electronic device capable of measuring transthoracic impedance and for sensing a level of physical activity.
- the transthoracic impedance signal is then processed such that an estimate is derived of the patient's minute ventilation, respiratory rate and tidal volume.
- the oxygen uptake (VO 2 ) and carbon dioxide production values (VCO 2 ) are estimated from the accelerometer measured activity. It has been found that by calculating a ratio of tidal volume to respiratory rate, a first CHF status indicator is obtained. Also, once tidal volume information from a patient is arrived at, his or her inspiratory time can also be derived.
- the ratio of tidal volume to inspiratory time is found to comprise a second congestive heart failure status indicator that is meaningful.
- the ratio of minute ventilation to carbon dioxide production can be derived as a third congestive heart failure status indicator.
- the ratio of oxygen uptake to heart rate is found to be a further CHF status indicator.
- the invention also contemplates the use of the CHF status indicators (ratios) in the closed-loop control of a CRM device that for example may adjust a pacing parameter to optimize the benefit afforded by the pacing therapy.
- FIG. 1 is a block diagram representation of a CRM device configured in accordance with the present invention.
- the present invention is applicable to a monitoring a variety of conditions of the heart.
- the invention is generally described in the context of an implantable cardiac rhythm management device configured to monitor chronic heart failure (CHF) patients for illustrative purposes only.
- CHF chronic heart failure
- FIG. 1 there is illustrated by means of an electrical schematic block diagram the hardware platform to carry out the method of the present invention can be.
- a CRM device having electrodes 12 and 14 disposed thereon.
- Electrode 12 may comprise an uninsulated portion of the metal, typically titanium, hermetically sealed housing while electrode 14 may be disposed on the device's header.
- CRM device 10 is adapted to be coupled to a patient's heart via an electrical lead assembly 16 comprising an body member 18 having a distal tip electrode 20 and a ring electrode 22 affixed to the surface thereof.
- Body member 18 is typically a flexible elongated and tubular and composed of a biocompatible material. Extending the length of the lead are electrical conductors 24 that connect through electrical contacts in the lead barrel to the internal circuitry of the CRM device.
- a R-wave sensing amplifier 26 that picks up and amplifies ventricular depolarization signals picked up by the electrode 20.
- the output from the sense amplifier is applied as an input to a microprocessor circuit 28 by way of conductor 30.
- the microprocessor following a stored program, provides a control signal on line 32 to a pulse generator 34 whose output signal is applied over one of the conductors 24 to the tip electrode 20 for stimulating and thereby evoking a paced response from the heart.
- circuitry is also provided for measuring impedance changes within at least one chamber of the heart due to the influx and outflow of blood.
- an oscillator 36 which, when activated, produces an alternating current of a predetermined frequency, typically in a range of from about 2000 Hz to 5000 Hz and of an amplitude below about 10 microamperes, which insures that the output from the oscillator will not stimulate heart tissue.
- This signal is preferably applied between the indifferent electrode 12 on the implanted CRM device and the ring electrode 22 on the lead and comprises an AC carrier signal that is modulated by the influx and outflow blood from the right ventricle.
- the modulated carrier signal is developed between the tip electrode 20 and the indifferent electrode 14 on the device's header and is amplified by sense amplifier 38 and then demodulated by demodulator circuit 40 to remove the modulating envelope from the carrier.
- the envelope signal is a measure of instantaneous impedance as a function of time.
- the impedance vs. time (Z vs. t) analog signal is converted to a digital format by A/D converter 41 and is then applied to a signal processing circuit 42 which comprises a peak/ valley /zero cross detector.
- the circuit 42 calculates the preceding peak-to-valley amplitude and issues an interrupt signal to the microprocessor 28.
- the microprocessor fetches the peak-to-valley amplitude from the signal processing circuit 42 and sums the absolute values of the peak-to-valley amplitudes over an eight-second interval. This eight-second sum of the peak-to-valley amplitudes comprises the sensor input that is used in establishing the minute ventilation delta signal fed over line 32 to the pulse generator 34 for adjusting the rate at which the pulse generator issues cardiac stimulating pulses to the heart.
- the aforereferenced Hauck et al. '597 patent hereby incorporated by reference, describes a system for developing a delta rate signal for a rate adaptive pacemaker based upon variations in minute ventilation index.
- This patent describes, in detail, how a transthoracic impedance waveform can be signal processed to derive respiratory related factors including respiratory rate (RR), tidal volume (V t ) inspiratory time (T,), expiratory time (T e ) and minute ventilation (MV) and need not be repeated here.
- RR respiratory rate
- V t tidal volume
- T expiratory time
- MV minute ventilation
- the CRM device 10 also includes an activity sensor in the form of an integrated silicon accelerometer 44 that is bonded to a ceramic circuit board contained within the housing of the CRM device.
- the accelerometer includes a mass suspended by four leaf spring elements from a frame.
- the springs each include a piezoresistive element forming the four legs of a Wheatstone bridge which becomes unbalanced from displacement of the mass due to acceleration forces in a direction perpendicular to the frame.
- the Wheatstone bridge is energized in a pulse mode where a predetermined voltage is applied across it for only a short period of time, typically 15 microseconds, and at a repetition rate of about 146 Hz.
- the raw accelerometer output from device 44 is then amplified by amplifier 46 before being applied to a switched capacitor bandpass filter 48.
- the pass band of the filter 48 effectively excludes motion artifacts due to external noise sources while allowing passage of signal components whose frequencies are related to body motion due to exercise.
- the output from the bandpass filter 48 is converted to a digital quantity by A/D converter 52 and then signal processed by circuits before being applied to the microprocessor 28.
- the CRM device 10 further includes a telemetry circuit 54 of known construction which allows information stored in the microprocessor's RAM memory banks to be read out transcutaneously to an external monitor 56 for viewing by a medical professional.
- the telemetry link 58 allows programmable operands of the pacemaker to be altered following implantation of the CRM device.
- a CRM device which, when implanted in a patient, provides for the read-out of both respiratory data and activity data, whereby a physician or other caregiver can compute, as ratios, a number of features indicative of CHF patient status.
- RR/MV respiratory rate to minute ventilation
- T/MV tidal volume to minute ventilation
- HR/MV heart rate to minute ventilation
- HR WR heart rate to work rate
- MV/VO 2 minute ventilation to oxygen uptake
- MV/WR minute ventilation to work rate
- Other computed ratios such as tidal volume to inspiratory time (V/T,). tidal volume to expiratory time (V/T e ). minute ventilation to CO, production (MV/CO 2 ) and tidal volume to respiratory rate (V/RR) also prove meaningful and the factors are readily obtained from a state-of-the-art rate-adaptive pacemaker incorporating an accelerometer and impedance measuring circuits.
- the ratio of oxygen uptake to heart rate could also be used wherein oxygen uptake could be measured with an accelerometer and heart rate being measured by the CRM device.
- a factor indicative of the patient ' s body mass index BMI
- the HR/MV ratio is detected following a change in therapy, it is indicative of worsening of CHF and suggests that the therapy was ineffective.
- the V/RR ratio decrease, it suggests that the patient's condition has worsened and that the therapy should be modified accordingly.
- the V/T, ratio is a good indicator of change in CHF status. An increase in this ratio following a change in pacing therapy or drug therapy is indicative that the change was counter-productive.
- the MV/VCO 2 ratio or slope increases as a patient's CHF condition worsens.
- the slope for normal persons is about 0.025 while a typical CHF patient will exhibit a slope of 0.035 or higher at rest and at relatively low levels of exercise.
- the RR/MV ratio gives the percentage of current MV due to increases or decreases in respiratory rate. An increase in this ratio would be indicative of a CHF patient ' s worsening condition.
- V/MV ratio gives the percentage of current MV due to increases or decreases in tidal volume. A decrease in this ratio would be indicative of a CHF patient ' s worsening condition.
- ratios are listed for exemplary purposes. Those skilled in the art will recognize that other ratios derived from the above listed variables and derivatives of those variables will also be indicative of a CHF patient ' s condition. It can be seen that by data logging accelerometer data (activity) and transthoracic impedance within an implanted CRM device for subsequent readout and processing, valuable information on CHF patient condition can be stored over a prolonged period of time and then telemetered to a healthcare professional via the implanted device's telemetry link. Alternatively, one or more of the derived ratios can be compared to corresponding ratio(s) previously computed and stored to determined whether a change in therapy has proven beneficial or has resulted in a worsening of the patient's CHF status.
- a programmable parameter of the CRM can be adjusted accordingly in either a closed-loop (automatic) or open-loop (manual) fashion.
- This invention has been described in considerable detail to provide those skilled in the art with the information needed to make and use the invention. However, it is to be understood that the invention can be carried out by specifically different ratios, equipment and devices, and that various modifications, both as to the ratios, equipment and operating procedures, can be accomplished without departing from the scope of the invention itself.
Abstract
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Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002390016A CA2390016C (en) | 1999-11-04 | 2000-07-13 | Implantable cardiac rhythm management device for assessing status of chf patients |
DE60036396T DE60036396T2 (en) | 1999-11-04 | 2000-07-13 | IMPLANTABLE DEVICE FOR CONTROLLING HEART RYTHM THROUGH DETERMINING THE CONDITION OF CHF PATIENTS |
EP00945392A EP1225954B1 (en) | 1999-11-04 | 2000-07-13 | Implantable cardiac rhythm management device for assessing status of chf patients |
AU59343/00A AU5934300A (en) | 1999-11-04 | 2000-07-13 | Implantable cardiac rhythm management device for assessing status of chf patients |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/434,009 | 1999-11-04 | ||
US09/434,009 US6275727B1 (en) | 1999-11-04 | 1999-11-04 | Implantable cardiac rhythm management device for assessing status of CHF patients |
US09/547,519 US6459929B1 (en) | 1999-11-04 | 2000-04-12 | Implantable cardiac rhythm management device for assessing status of CHF patients |
US09/547,519 | 2000-04-12 |
Publications (1)
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WO2001032260A1 true WO2001032260A1 (en) | 2001-05-10 |
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Application Number | Title | Priority Date | Filing Date |
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PCT/US2000/019230 WO2001032260A1 (en) | 1999-11-04 | 2000-07-13 | Implantable cardiac rhythm management device for assessing status of chf patients |
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Country | Link |
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US (1) | US6459929B1 (en) |
EP (1) | EP1225954B1 (en) |
AT (1) | ATE372808T1 (en) |
AU (1) | AU5934300A (en) |
CA (1) | CA2390016C (en) |
DE (1) | DE60036396T2 (en) |
WO (1) | WO2001032260A1 (en) |
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US7207947B2 (en) | 2003-01-10 | 2007-04-24 | Pacesetter, Inc. | System and method for detecting circadian states using an implantable medical device |
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US7794404B1 (en) | 2006-03-31 | 2010-09-14 | Pacesetter, Inc | System and method for estimating cardiac pressure using parameters derived from impedance signals detected by an implantable medical device |
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---|---|---|---|---|
US6076015A (en) * | 1998-02-27 | 2000-06-13 | Cardiac Pacemakers, Inc. | Rate adaptive cardiac rhythm management device using transthoracic impedance |
US6718198B2 (en) | 1999-08-24 | 2004-04-06 | Cardiac Pacemakers, Inc. | Arrhythmia display |
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US20040133079A1 (en) * | 2003-01-02 | 2004-07-08 | Mazar Scott Thomas | System and method for predicting patient health within a patient management system |
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US7720541B2 (en) | 2003-08-18 | 2010-05-18 | Cardiac Pacemakers, Inc. | Adaptive therapy for disordered breathing |
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US7757690B2 (en) * | 2003-09-18 | 2010-07-20 | Cardiac Pacemakers, Inc. | System and method for moderating a therapy delivered during sleep using physiologic data acquired during non-sleep |
US7591265B2 (en) | 2003-09-18 | 2009-09-22 | Cardiac Pacemakers, Inc. | Coordinated use of respiratory and cardiac therapies for sleep disordered breathing |
US7510531B2 (en) * | 2003-09-18 | 2009-03-31 | Cardiac Pacemakers, Inc. | System and method for discrimination of central and obstructive disordered breathing events |
EP1670547B1 (en) | 2003-08-18 | 2008-11-12 | Cardiac Pacemakers, Inc. | Patient monitoring system |
US7887493B2 (en) | 2003-09-18 | 2011-02-15 | Cardiac Pacemakers, Inc. | Implantable device employing movement sensing for detecting sleep-related disorders |
US7662101B2 (en) | 2003-09-18 | 2010-02-16 | Cardiac Pacemakers, Inc. | Therapy control based on cardiopulmonary status |
US7668591B2 (en) | 2003-09-18 | 2010-02-23 | Cardiac Pacemakers, Inc. | Automatic activation of medical processes |
US7468040B2 (en) | 2003-09-18 | 2008-12-23 | Cardiac Pacemakers, Inc. | Methods and systems for implantably monitoring external breathing therapy |
US7320675B2 (en) | 2003-08-21 | 2008-01-22 | Cardiac Pacemakers, Inc. | Method and apparatus for modulating cellular metabolism during post-ischemia or heart failure |
US7392084B2 (en) | 2003-09-23 | 2008-06-24 | Cardiac Pacemakers, Inc. | Demand-based cardiac function therapy |
US7286872B2 (en) * | 2003-10-07 | 2007-10-23 | Cardiac Pacemakers, Inc. | Method and apparatus for managing data from multiple sensing channels |
US7572226B2 (en) | 2003-10-28 | 2009-08-11 | Cardiac Pacemakers, Inc. | System and method for monitoring autonomic balance and physical activity |
US7319900B2 (en) | 2003-12-11 | 2008-01-15 | Cardiac Pacemakers, Inc. | Cardiac response classification using multiple classification windows |
US20060247693A1 (en) | 2005-04-28 | 2006-11-02 | Yanting Dong | Non-captured intrinsic discrimination in cardiac pacing response classification |
US7774064B2 (en) | 2003-12-12 | 2010-08-10 | Cardiac Pacemakers, Inc. | Cardiac response classification using retriggerable classification windows |
US8521284B2 (en) | 2003-12-12 | 2013-08-27 | Cardiac Pacemakers, Inc. | Cardiac response classification using multisite sensing and pacing |
US7471980B2 (en) * | 2003-12-22 | 2008-12-30 | Cardiac Pacemakers, Inc. | Synchronizing continuous signals and discrete events for an implantable medical device |
US7431699B2 (en) * | 2003-12-24 | 2008-10-07 | Cardiac Pacemakers, Inc. | Method and apparatus for third heart sound detection |
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US20050215884A1 (en) * | 2004-02-27 | 2005-09-29 | Greicius Michael D | Evaluation of Alzheimer's disease using an independent component analysis of an individual's resting-state functional MRI |
US7094207B1 (en) | 2004-03-02 | 2006-08-22 | Pacesetter, Inc. | System and method for diagnosing and tracking congestive heart failure based on the periodicity of cheyne-stokes respiration using an implantable medical device |
US7070568B1 (en) * | 2004-03-02 | 2006-07-04 | Pacesetter, Inc. | System and method for diagnosing and tracking congestive heart failure based on the periodicity of Cheyne-Stokes Respiration using an implantable medical device |
US7627366B1 (en) | 2004-05-17 | 2009-12-01 | Pacesetter, Inc. | Analysis of polarization information |
US7260431B2 (en) * | 2004-05-20 | 2007-08-21 | Cardiac Pacemakers, Inc. | Combined remodeling control therapy and anti-remodeling therapy by implantable cardiac device |
US7764995B2 (en) * | 2004-06-07 | 2010-07-27 | Cardiac Pacemakers, Inc. | Method and apparatus to modulate cellular regeneration post myocardial infarct |
US7747323B2 (en) | 2004-06-08 | 2010-06-29 | Cardiac Pacemakers, Inc. | Adaptive baroreflex stimulation therapy for disordered breathing |
US7706866B2 (en) | 2004-06-24 | 2010-04-27 | Cardiac Pacemakers, Inc. | Automatic orientation determination for ECG measurements using multiple electrodes |
US7729761B2 (en) | 2004-07-14 | 2010-06-01 | Cardiac Pacemakers, Inc. | Method and apparatus for controlled gene or protein delivery |
US7480528B2 (en) * | 2004-07-23 | 2009-01-20 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities |
US7269458B2 (en) * | 2004-08-09 | 2007-09-11 | Cardiac Pacemakers, Inc. | Cardiopulmonary functional status assessment via heart rate response detection by implantable cardiac device |
US7389143B2 (en) * | 2004-08-12 | 2008-06-17 | Cardiac Pacemakers, Inc. | Cardiopulmonary functional status assessment via metabolic response detection by implantable cardiac device |
US7828711B2 (en) | 2004-08-16 | 2010-11-09 | Cardiac Pacemakers, Inc. | Method and apparatus for modulating cellular growth and regeneration using ventricular assist device |
US7387610B2 (en) | 2004-08-19 | 2008-06-17 | Cardiac Pacemakers, Inc. | Thoracic impedance detection with blood resistivity compensation |
US7567841B2 (en) | 2004-08-20 | 2009-07-28 | Cardiac Pacemakers, Inc. | Method and apparatus for delivering combined electrical and drug therapies |
US7457664B2 (en) | 2005-05-09 | 2008-11-25 | Cardiac Pacemakers, Inc. | Closed loop cardiac resynchronization therapy using cardiac activation sequence information |
US7797036B2 (en) | 2004-11-30 | 2010-09-14 | Cardiac Pacemakers, Inc. | Cardiac activation sequence monitoring for ischemia detection |
US7917196B2 (en) | 2005-05-09 | 2011-03-29 | Cardiac Pacemakers, Inc. | Arrhythmia discrimination using electrocardiograms sensed from multiple implanted electrodes |
US7890159B2 (en) | 2004-09-30 | 2011-02-15 | Cardiac Pacemakers, Inc. | Cardiac activation sequence monitoring and tracking |
US7805185B2 (en) | 2005-05-09 | 2010-09-28 | Cardiac Pacemakers, In. | Posture monitoring using cardiac activation sequences |
US7509170B2 (en) | 2005-05-09 | 2009-03-24 | Cardiac Pacemakers, Inc. | Automatic capture verification using electrocardiograms sensed from multiple implanted electrodes |
US7418293B2 (en) * | 2004-11-09 | 2008-08-26 | Cardiac Pacemakers, Inc. | Multiple pulse defibrillation for subcutaneous implantable cardiac devices |
US7155281B1 (en) | 2004-12-03 | 2006-12-26 | Pacesetter, Inc. | Complimentary activity sensor network for disease monitoring and therapy modulation in an implantable device |
US8818504B2 (en) | 2004-12-16 | 2014-08-26 | Cardiac Pacemakers Inc | Leadless cardiac stimulation device employing distributed logic |
US8060219B2 (en) | 2004-12-20 | 2011-11-15 | Cardiac Pacemakers, Inc. | Epicardial patch including isolated extracellular matrix with pacing electrodes |
US7981065B2 (en) | 2004-12-20 | 2011-07-19 | Cardiac Pacemakers, Inc. | Lead electrode incorporating extracellular matrix |
US7996072B2 (en) * | 2004-12-21 | 2011-08-09 | Cardiac Pacemakers, Inc. | Positionally adaptable implantable cardiac device |
US7386345B2 (en) * | 2005-01-27 | 2008-06-10 | Cardiac Pacemakers, Inc. | Apparatus and method for temporary treatment of acute heart failure decompensation |
US7680534B2 (en) | 2005-02-28 | 2010-03-16 | Cardiac Pacemakers, Inc. | Implantable cardiac device with dyspnea measurement |
US7392086B2 (en) | 2005-04-26 | 2008-06-24 | Cardiac Pacemakers, Inc. | Implantable cardiac device and method for reduced phrenic nerve stimulation |
US8391990B2 (en) | 2005-05-18 | 2013-03-05 | Cardiac Pacemakers, Inc. | Modular antitachyarrhythmia therapy system |
US7922669B2 (en) | 2005-06-08 | 2011-04-12 | Cardiac Pacemakers, Inc. | Ischemia detection using a heart sound sensor |
US20070021678A1 (en) * | 2005-07-19 | 2007-01-25 | Cardiac Pacemakers, Inc. | Methods and apparatus for monitoring physiological responses to steady state activity |
US7927284B2 (en) * | 2005-09-16 | 2011-04-19 | Cardiac Pacemakers, Inc. | Quantifying hemodynamic response to drug therapy using implantable sensor |
US7731663B2 (en) * | 2005-09-16 | 2010-06-08 | Cardiac Pacemakers, Inc. | System and method for generating a trend parameter based on respiration rate distribution |
US7775983B2 (en) * | 2005-09-16 | 2010-08-17 | Cardiac Pacemakers, Inc. | Rapid shallow breathing detection for use in congestive heart failure status determination |
US20070073352A1 (en) * | 2005-09-28 | 2007-03-29 | Euler David E | Method and apparatus for regulating a cardiac stimulation therapy |
US8046060B2 (en) | 2005-11-14 | 2011-10-25 | Cardiac Pacemakers, Inc. | Differentiating arrhythmic events having different origins |
US20070118180A1 (en) * | 2005-11-18 | 2007-05-24 | Quan Ni | Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection |
US8108034B2 (en) | 2005-11-28 | 2012-01-31 | Cardiac Pacemakers, Inc. | Systems and methods for valvular regurgitation detection |
US7766840B2 (en) | 2005-12-01 | 2010-08-03 | Cardiac Pacemakers, Inc. | Method and system for heart failure status evaluation based on a disordered breathing index |
US7662105B2 (en) * | 2005-12-14 | 2010-02-16 | Cardiac Pacemakers, Inc. | Systems and methods for determining respiration metrics |
US8204585B2 (en) * | 2005-12-20 | 2012-06-19 | Cardiac Pacemakers, Inc. | Bio-impedance sensor and sensing method |
US9155896B2 (en) * | 2005-12-22 | 2015-10-13 | Cardiac Pacemakers, Inc. | Method and apparatus for improving cardiac efficiency based on myocardial oxygen consumption |
US20070173728A1 (en) * | 2006-01-25 | 2007-07-26 | Yachuan Pu | Cyclic variation of heart rate detection and treatment |
US20070190028A1 (en) * | 2006-02-13 | 2007-08-16 | Jihong Qu | Method and apparatus for heat or electromagnetic control of gene expression |
US7713213B2 (en) * | 2006-03-13 | 2010-05-11 | Cardiac Pacemakers, Inc. | Physiological event detection systems and methods |
US7819816B2 (en) | 2006-03-29 | 2010-10-26 | Cardiac Pacemakers, Inc. | Periodic disordered breathing detection |
US7780606B2 (en) | 2006-03-29 | 2010-08-24 | Cardiac Pacemakers, Inc. | Hemodynamic stability assessment based on heart sounds |
US8005543B2 (en) | 2006-05-08 | 2011-08-23 | Cardiac Pacemakers, Inc. | Heart failure management system |
US8000780B2 (en) | 2006-06-27 | 2011-08-16 | Cardiac Pacemakers, Inc. | Detection of myocardial ischemia from the time sequence of implanted sensor measurements |
US7599741B2 (en) * | 2006-06-29 | 2009-10-06 | Cardiac Pacemakers, Inc. | Systems and methods for improving heart rate kinetics in heart failure patients |
US8527048B2 (en) | 2006-06-29 | 2013-09-03 | Cardiac Pacemakers, Inc. | Local and non-local sensing for cardiac pacing |
US8209013B2 (en) | 2006-09-14 | 2012-06-26 | Cardiac Pacemakers, Inc. | Therapeutic electrical stimulation that avoids undesirable activation |
US7963924B2 (en) * | 2006-10-25 | 2011-06-21 | Sorin Crm Sas | Heart simulator |
US20080119749A1 (en) | 2006-11-20 | 2008-05-22 | Cardiac Pacemakers, Inc. | Respiration-synchronized heart sound trending |
US8096954B2 (en) | 2006-11-29 | 2012-01-17 | Cardiac Pacemakers, Inc. | Adaptive sampling of heart sounds |
US9968266B2 (en) | 2006-12-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Risk stratification based heart failure detection algorithm |
US9022930B2 (en) * | 2006-12-27 | 2015-05-05 | Cardiac Pacemakers, Inc. | Inter-relation between within-patient decompensation detection algorithm and between-patient stratifier to manage HF patients in a more efficient manner |
US8768718B2 (en) * | 2006-12-27 | 2014-07-01 | Cardiac Pacemakers, Inc. | Between-patient comparisons for risk stratification of future heart failure decompensation |
US7629889B2 (en) | 2006-12-27 | 2009-12-08 | Cardiac Pacemakers, Inc. | Within-patient algorithm to predict heart failure decompensation |
US7736319B2 (en) | 2007-01-19 | 2010-06-15 | Cardiac Pacemakers, Inc. | Ischemia detection using heart sound timing |
US8052611B2 (en) | 2007-03-14 | 2011-11-08 | Cardiac Pacemakers, Inc. | Method and apparatus for management of heart failure hospitalization |
US7853327B2 (en) | 2007-04-17 | 2010-12-14 | Cardiac Pacemakers, Inc. | Heart sound tracking system and method |
US8209033B2 (en) * | 2007-05-14 | 2012-06-26 | Cardiac Pacemakers, Inc. | Method and apparatus for regulating blood volume using volume receptor stimulation |
US8271080B2 (en) | 2007-05-23 | 2012-09-18 | Cardiac Pacemakers, Inc. | Decongestive therapy titration for heart failure patients using implantable sensor |
US9037239B2 (en) | 2007-08-07 | 2015-05-19 | Cardiac Pacemakers, Inc. | Method and apparatus to perform electrode combination selection |
US8265736B2 (en) | 2007-08-07 | 2012-09-11 | Cardiac Pacemakers, Inc. | Method and apparatus to perform electrode combination selection |
US20090287094A1 (en) * | 2008-05-15 | 2009-11-19 | Seacrete Llc, A Limited Liability Corporation Of The State Of Delaware | Circulatory monitoring systems and methods |
US8636670B2 (en) | 2008-05-13 | 2014-01-28 | The Invention Science Fund I, Llc | Circulatory monitoring systems and methods |
US8280484B2 (en) | 2007-12-18 | 2012-10-02 | The Invention Science Fund I, Llc | System, devices, and methods for detecting occlusions in a biological subject |
US9672471B2 (en) | 2007-12-18 | 2017-06-06 | Gearbox Llc | Systems, devices, and methods for detecting occlusions in a biological subject including spectral learning |
US9717896B2 (en) | 2007-12-18 | 2017-08-01 | Gearbox, Llc | Treatment indications informed by a priori implant information |
US20090287120A1 (en) | 2007-12-18 | 2009-11-19 | Searete Llc, A Limited Liability Corporation Of The State Of Delaware | Circulatory monitoring systems and methods |
WO2009094335A1 (en) | 2008-01-22 | 2009-07-30 | Cardiac Pacemakers, Inc. | Respiration as a trigger for therapy optimization |
CN101939051B (en) | 2008-02-14 | 2013-07-10 | 心脏起搏器公司 | Method and apparatus for phrenic stimulation detection |
US8147415B2 (en) | 2008-05-07 | 2012-04-03 | Cardiac Pacemakers, Inc. | System and method for detection of pulmonary embolism |
US8372013B2 (en) | 2008-09-19 | 2013-02-12 | Medtronic, Inc. | Method and apparatus for determining a respiration parameter in a medical device |
WO2010049931A1 (en) * | 2008-10-29 | 2010-05-06 | Ai Medical Semiconductor Ltd. | Optimal cardiac pacing with q learning |
WO2010109448A1 (en) | 2009-03-22 | 2010-09-30 | Ai Medical Semiconductor Ltd. | Optimal deep brain stimulation therapy with q learning |
JP5469251B2 (en) | 2009-10-19 | 2014-04-16 | カーディアック ペースメイカーズ, インコーポレイテッド | Cardiorenal electrical stimulation system |
WO2011103020A1 (en) * | 2010-02-16 | 2011-08-25 | Cardiac Pacemakers, Inc. | Kinetics of physiological response to activity during activities of daily living |
US8975900B2 (en) * | 2010-04-08 | 2015-03-10 | Disney Enterprises, Inc. | System and method for sensing human activity by monitoring impedance |
US9341659B2 (en) * | 2010-04-08 | 2016-05-17 | Disney Enterprises, Inc. | User interactive living organisms |
US8639324B2 (en) * | 2011-02-02 | 2014-01-28 | Cardiac Pacemakers, Inc. | Respiratory parameters for arrhythmia detection and therapy |
US9743889B2 (en) | 2013-08-05 | 2017-08-29 | Cardiac Pacemakers, Inc. | System and method for detecting worsening of heart failure based on rapid shallow breathing index |
EP3092034B1 (en) | 2014-01-10 | 2019-10-30 | Cardiac Pacemakers, Inc. | Systems for detecting cardiac arrhythmias |
ES2661718T3 (en) | 2014-01-10 | 2018-04-03 | Cardiac Pacemakers, Inc. | Methods and systems to improve communication between medical devices |
US9526909B2 (en) | 2014-08-28 | 2016-12-27 | Cardiac Pacemakers, Inc. | Medical device with triggered blanking period |
EP3253449B1 (en) | 2015-02-06 | 2018-12-12 | Cardiac Pacemakers, Inc. | Systems for safe delivery of electrical stimulation therapy |
EP3827877A1 (en) | 2015-02-06 | 2021-06-02 | Cardiac Pacemakers, Inc. | Systems for treating cardiac arrhythmias |
US10046167B2 (en) | 2015-02-09 | 2018-08-14 | Cardiac Pacemakers, Inc. | Implantable medical device with radiopaque ID tag |
WO2016141046A1 (en) | 2015-03-04 | 2016-09-09 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US10050700B2 (en) | 2015-03-18 | 2018-08-14 | Cardiac Pacemakers, Inc. | Communications in a medical device system with temporal optimization |
WO2016149262A1 (en) | 2015-03-18 | 2016-09-22 | Cardiac Pacemakers, Inc. | Communications in a medical device system with link quality assessment |
CN108136186B (en) | 2015-08-20 | 2021-09-17 | 心脏起搏器股份公司 | System and method for communication between medical devices |
US10357159B2 (en) | 2015-08-20 | 2019-07-23 | Cardiac Pacemakers, Inc | Systems and methods for communication between medical devices |
US9968787B2 (en) | 2015-08-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Spatial configuration of a motion sensor in an implantable medical device |
US9956414B2 (en) | 2015-08-27 | 2018-05-01 | Cardiac Pacemakers, Inc. | Temporal configuration of a motion sensor in an implantable medical device |
US10226631B2 (en) | 2015-08-28 | 2019-03-12 | Cardiac Pacemakers, Inc. | Systems and methods for infarct detection |
US10159842B2 (en) | 2015-08-28 | 2018-12-25 | Cardiac Pacemakers, Inc. | System and method for detecting tamponade |
US10137305B2 (en) | 2015-08-28 | 2018-11-27 | Cardiac Pacemakers, Inc. | Systems and methods for behaviorally responsive signal detection and therapy delivery |
WO2017044389A1 (en) | 2015-09-11 | 2017-03-16 | Cardiac Pacemakers, Inc. | Arrhythmia detection and confirmation |
US10065041B2 (en) | 2015-10-08 | 2018-09-04 | Cardiac Pacemakers, Inc. | Devices and methods for adjusting pacing rates in an implantable medical device |
US10183170B2 (en) | 2015-12-17 | 2019-01-22 | Cardiac Pacemakers, Inc. | Conducted communication in a medical device system |
US10905886B2 (en) | 2015-12-28 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device for deployment across the atrioventricular septum |
WO2017127548A1 (en) | 2016-01-19 | 2017-07-27 | Cardiac Pacemakers, Inc. | Devices for wirelessly recharging a rechargeable battery of an implantable medical device |
US10350423B2 (en) | 2016-02-04 | 2019-07-16 | Cardiac Pacemakers, Inc. | Delivery system with force sensor for leadless cardiac device |
CN108883286B (en) | 2016-03-31 | 2021-12-07 | 心脏起搏器股份公司 | Implantable medical device with rechargeable battery |
US10668294B2 (en) | 2016-05-10 | 2020-06-02 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker configured for over the wire delivery |
US10328272B2 (en) | 2016-05-10 | 2019-06-25 | Cardiac Pacemakers, Inc. | Retrievability for implantable medical devices |
CN109414582B (en) | 2016-06-27 | 2022-10-28 | 心脏起搏器股份公司 | Cardiac therapy system for resynchronization pacing management using subcutaneous sensing of P-waves |
WO2018009569A1 (en) | 2016-07-06 | 2018-01-11 | Cardiac Pacemakers, Inc. | Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10426962B2 (en) | 2016-07-07 | 2019-10-01 | Cardiac Pacemakers, Inc. | Leadless pacemaker using pressure measurements for pacing capture verification |
US10688304B2 (en) | 2016-07-20 | 2020-06-23 | Cardiac Pacemakers, Inc. | Method and system for utilizing an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10391319B2 (en) | 2016-08-19 | 2019-08-27 | Cardiac Pacemakers, Inc. | Trans septal implantable medical device |
US10870008B2 (en) | 2016-08-24 | 2020-12-22 | Cardiac Pacemakers, Inc. | Cardiac resynchronization using fusion promotion for timing management |
US10780278B2 (en) | 2016-08-24 | 2020-09-22 | Cardiac Pacemakers, Inc. | Integrated multi-device cardiac resynchronization therapy using P-wave to pace timing |
US10758737B2 (en) | 2016-09-21 | 2020-09-01 | Cardiac Pacemakers, Inc. | Using sensor data from an intracardially implanted medical device to influence operation of an extracardially implantable cardioverter |
EP3515553B1 (en) | 2016-09-21 | 2020-08-26 | Cardiac Pacemakers, Inc. | Leadless stimulation device with a housing that houses internal components of the leadless stimulation device and functions as the battery case and a terminal of an internal battery |
US10994145B2 (en) | 2016-09-21 | 2021-05-04 | Cardiac Pacemakers, Inc. | Implantable cardiac monitor |
WO2018081275A1 (en) | 2016-10-27 | 2018-05-03 | Cardiac Pacemakers, Inc. | Multi-device cardiac resynchronization therapy with timing enhancements |
US10413733B2 (en) | 2016-10-27 | 2019-09-17 | Cardiac Pacemakers, Inc. | Implantable medical device with gyroscope |
JP7038115B2 (en) | 2016-10-27 | 2022-03-17 | カーディアック ペースメイカーズ, インコーポレイテッド | Implantable medical device with pressure sensor |
WO2018081237A1 (en) | 2016-10-27 | 2018-05-03 | Cardiac Pacemakers, Inc. | Use of a separate device in managing the pace pulse energy of a cardiac pacemaker |
US10561330B2 (en) | 2016-10-27 | 2020-02-18 | Cardiac Pacemakers, Inc. | Implantable medical device having a sense channel with performance adjustment |
US10758724B2 (en) | 2016-10-27 | 2020-09-01 | Cardiac Pacemakers, Inc. | Implantable medical device delivery system with integrated sensor |
CN109890456B (en) | 2016-10-31 | 2023-06-13 | 心脏起搏器股份公司 | System for activity level pacing |
WO2018081721A1 (en) | 2016-10-31 | 2018-05-03 | Cardiac Pacemakers, Inc | Systems for activity level pacing |
WO2018089311A1 (en) | 2016-11-08 | 2018-05-17 | Cardiac Pacemakers, Inc | Implantable medical device for atrial deployment |
EP3538213B1 (en) | 2016-11-09 | 2023-04-12 | Cardiac Pacemakers, Inc. | Systems and devices for setting cardiac pacing pulse parameters for a cardiac pacing device |
US10881869B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Wireless re-charge of an implantable medical device |
CN109963618B (en) | 2016-11-21 | 2023-07-04 | 心脏起搏器股份公司 | Leadless cardiac pacemaker with multi-mode communication |
WO2018093605A1 (en) | 2016-11-21 | 2018-05-24 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker providing cardiac resynchronization therapy |
US10639486B2 (en) | 2016-11-21 | 2020-05-05 | Cardiac Pacemakers, Inc. | Implantable medical device with recharge coil |
US11147979B2 (en) | 2016-11-21 | 2021-10-19 | Cardiac Pacemakers, Inc. | Implantable medical device with a magnetically permeable housing and an inductive coil disposed about the housing |
US11207532B2 (en) | 2017-01-04 | 2021-12-28 | Cardiac Pacemakers, Inc. | Dynamic sensing updates using postural input in a multiple device cardiac rhythm management system |
US10737102B2 (en) | 2017-01-26 | 2020-08-11 | Cardiac Pacemakers, Inc. | Leadless implantable device with detachable fixation |
WO2018140623A1 (en) | 2017-01-26 | 2018-08-02 | Cardiac Pacemakers, Inc. | Leadless device with overmolded components |
EP3573706A1 (en) | 2017-01-26 | 2019-12-04 | Cardiac Pacemakers, Inc. | Intra-body device communication with redundant message transmission |
US10905872B2 (en) | 2017-04-03 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device with a movable electrode biased toward an extended position |
AU2018248361B2 (en) | 2017-04-03 | 2020-08-27 | Cardiac Pacemakers, Inc. | Cardiac pacemaker with pacing pulse energy adjustment based on sensed heart rate |
WO2018200470A1 (en) | 2017-04-29 | 2018-11-01 | Cardiac Pacemakers, Inc. | Heart failure event rate assessment |
US10918875B2 (en) | 2017-08-18 | 2021-02-16 | Cardiac Pacemakers, Inc. | Implantable medical device with a flux concentrator and a receiving coil disposed about the flux concentrator |
WO2019036600A1 (en) | 2017-08-18 | 2019-02-21 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
CN111107899B (en) | 2017-09-20 | 2024-04-02 | 心脏起搏器股份公司 | Implantable medical device with multiple modes of operation |
US11185703B2 (en) | 2017-11-07 | 2021-11-30 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker for bundle of his pacing |
EP3717060B1 (en) | 2017-12-01 | 2022-10-05 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with reversionary behavior |
CN111417433A (en) | 2017-12-01 | 2020-07-14 | 心脏起搏器股份公司 | Method and system for detecting atrial contraction timing reference during ventricular filling from a ventricular implanted leadless cardiac pacemaker |
EP3717059A1 (en) | 2017-12-01 | 2020-10-07 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials within a search window from a ventricularly implanted leadless cardiac pacemaker |
EP3717063B1 (en) | 2017-12-01 | 2023-12-27 | Cardiac Pacemakers, Inc. | Systems for detecting atrial contraction timing fiducials and determining a cardiac interval from a ventricularly implanted leadless cardiac pacemaker |
CN111556773A (en) | 2018-01-04 | 2020-08-18 | 心脏起搏器股份公司 | Dual chamber pacing without beat-to-beat communication |
US11529523B2 (en) | 2018-01-04 | 2022-12-20 | Cardiac Pacemakers, Inc. | Handheld bridge device for providing a communication bridge between an implanted medical device and a smartphone |
CN111886046A (en) | 2018-03-23 | 2020-11-03 | 美敦力公司 | AV-synchronized VFA cardiac therapy |
CN111936046A (en) | 2018-03-23 | 2020-11-13 | 美敦力公司 | VFA cardiac therapy for tachycardia |
WO2019183512A1 (en) | 2018-03-23 | 2019-09-26 | Medtronic, Inc. | Vfa cardiac resynchronization therapy |
EP3856331A1 (en) | 2018-09-26 | 2021-08-04 | Medtronic, Inc. | Capture in ventricle-from-atrium cardiac therapy |
US11951313B2 (en) | 2018-11-17 | 2024-04-09 | Medtronic, Inc. | VFA delivery systems and methods |
US11679265B2 (en) | 2019-02-14 | 2023-06-20 | Medtronic, Inc. | Lead-in-lead systems and methods for cardiac therapy |
US11697025B2 (en) | 2019-03-29 | 2023-07-11 | Medtronic, Inc. | Cardiac conduction system capture |
US11213676B2 (en) | 2019-04-01 | 2022-01-04 | Medtronic, Inc. | Delivery systems for VfA cardiac therapy |
US11712188B2 (en) | 2019-05-07 | 2023-08-01 | Medtronic, Inc. | Posterior left bundle branch engagement |
US11305127B2 (en) | 2019-08-26 | 2022-04-19 | Medtronic Inc. | VfA delivery and implant region detection |
US11813466B2 (en) | 2020-01-27 | 2023-11-14 | Medtronic, Inc. | Atrioventricular nodal stimulation |
US11911168B2 (en) | 2020-04-03 | 2024-02-27 | Medtronic, Inc. | Cardiac conduction system therapy benefit determination |
US11813464B2 (en) | 2020-07-31 | 2023-11-14 | Medtronic, Inc. | Cardiac conduction system evaluation |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0510456A1 (en) * | 1991-04-26 | 1992-10-28 | Pacesetter AB | Implantable medical apparatus |
US5318597A (en) | 1993-03-15 | 1994-06-07 | Cardiac Pacemakers, Inc. | Rate adaptive cardiac rhythm management device control algorithm using trans-thoracic ventilation |
US5800471A (en) | 1997-10-20 | 1998-09-01 | Cardiac Pacemakers, Inc. | Method for optimizing cardiac performance by determining the optimal pacing mode-AV delay from a transient heart rate signal for use in CHF, brady, and tachy/brady therapy devices |
US5931858A (en) * | 1998-01-12 | 1999-08-03 | Cardiac Pacemakers, Inc. | Implantable device for monitoring aerobic capacity of patients |
Family Cites Families (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE68927447T2 (en) * | 1988-02-17 | 1997-04-03 | Stuart Charles Webb | Frequency-sensitive pacemaker |
-
2000
- 2000-04-12 US US09/547,519 patent/US6459929B1/en not_active Expired - Lifetime
- 2000-07-13 AU AU59343/00A patent/AU5934300A/en not_active Abandoned
- 2000-07-13 EP EP00945392A patent/EP1225954B1/en not_active Expired - Lifetime
- 2000-07-13 DE DE60036396T patent/DE60036396T2/en not_active Expired - Lifetime
- 2000-07-13 CA CA002390016A patent/CA2390016C/en not_active Expired - Fee Related
- 2000-07-13 WO PCT/US2000/019230 patent/WO2001032260A1/en active IP Right Grant
- 2000-07-13 AT AT00945392T patent/ATE372808T1/en not_active IP Right Cessation
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0510456A1 (en) * | 1991-04-26 | 1992-10-28 | Pacesetter AB | Implantable medical apparatus |
US5318597A (en) | 1993-03-15 | 1994-06-07 | Cardiac Pacemakers, Inc. | Rate adaptive cardiac rhythm management device control algorithm using trans-thoracic ventilation |
US5800471A (en) | 1997-10-20 | 1998-09-01 | Cardiac Pacemakers, Inc. | Method for optimizing cardiac performance by determining the optimal pacing mode-AV delay from a transient heart rate signal for use in CHF, brady, and tachy/brady therapy devices |
US5931858A (en) * | 1998-01-12 | 1999-08-03 | Cardiac Pacemakers, Inc. | Implantable device for monitoring aerobic capacity of patients |
Cited By (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2002007814A1 (en) * | 2000-07-21 | 2002-01-31 | Cardiac Pacemakers, Inc. | An estimate of efficiency using acceleration - heart rate ratio |
WO2003077991A1 (en) * | 2002-03-12 | 2003-09-25 | Lidco Group Plc | Method and apparatus for the setting or adjustment of a cardiac pacemaker |
US7231250B2 (en) | 2002-03-12 | 2007-06-12 | Lidco Group Plc | Method and apparatus for the setting or adjustment of a cardiac pacemaker |
US7207947B2 (en) | 2003-01-10 | 2007-04-24 | Pacesetter, Inc. | System and method for detecting circadian states using an implantable medical device |
US8306623B2 (en) | 2006-03-31 | 2012-11-06 | Pacesetter, Inc. | Tissue characterization using intracardiac impedances with an implantable lead system |
US8712519B1 (en) | 2006-03-31 | 2014-04-29 | Pacesetter, Inc. | Closed-loop adaptive adjustment of pacing therapy based on cardiogenic impedance signals detected by an implantable medical device |
US9107585B1 (en) | 2006-03-31 | 2015-08-18 | Pacesetter, Inc. | Tissue characterization using intracardiac impedances with an implantable lead system |
US7925349B1 (en) | 2006-03-31 | 2011-04-12 | Pacesetter, Inc. | Tissue characterization using intracardiac impedances with an implantable lead system |
US7794404B1 (en) | 2006-03-31 | 2010-09-14 | Pacesetter, Inc | System and method for estimating cardiac pressure using parameters derived from impedance signals detected by an implantable medical device |
US7945326B1 (en) | 2006-03-31 | 2011-05-17 | Pacesetter, Inc. | Tissue characterization using intracardiac impedances with an implantable lead system |
US8010196B1 (en) | 2006-03-31 | 2011-08-30 | Pacesetter, Inc. | Tissue characterization using intracardiac impedances with an implantable lead system |
US8065005B1 (en) | 2006-03-31 | 2011-11-22 | Pacesetter, Inc. | Tissue characterization using intracardiac impedances with an implantable lead system |
US8600497B1 (en) | 2006-03-31 | 2013-12-03 | Pacesetter, Inc. | Systems and methods to monitor and treat heart failure conditions |
US9066662B2 (en) | 2007-04-04 | 2015-06-30 | Pacesetter, Inc. | System and method for estimating cardiac pressure based on cardiac electrical conduction delays using an implantable medical device |
US9113789B2 (en) | 2007-04-04 | 2015-08-25 | Pacesetter, Inc. | System and method for estimating electrical conduction delays from immittance values measured using an implantable medical device |
EP2152362A1 (en) * | 2007-05-28 | 2010-02-17 | St. Jude Medical AB | Implantable medical device for monitoring lung deficiency |
EP2152362A4 (en) * | 2007-05-28 | 2010-09-15 | St Jude Medical | Implantable medical device for monitoring lung deficiency |
US9730601B2 (en) | 2008-07-31 | 2017-08-15 | Medtronic, Inc. | Using multiple diagnostic parameters for predicting heart failure events |
US8255046B2 (en) | 2008-07-31 | 2012-08-28 | Medtronic, Inc. | Detecting worsening heart failure based on impedance measurements |
US10299693B2 (en) | 2008-07-31 | 2019-05-28 | Medtronic, Inc. | Using multiple diagnostic parameters for predicting heart failure events |
US9713701B2 (en) | 2008-07-31 | 2017-07-25 | Medtronic, Inc. | Using multiple diagnostic parameters for predicting heart failure events |
US8632473B2 (en) | 2009-01-30 | 2014-01-21 | Medtronic, Inc. | Detecting worsening heart failure based on fluid accumulation with respiratory confirmation |
US9247883B2 (en) | 2009-01-30 | 2016-02-02 | Medtronic, Inc. | Detecting worsening heart failure based on fluid accumulation with respiratory confirmatoin |
WO2011053723A1 (en) * | 2009-10-30 | 2011-05-05 | Medtronic, Inc. | Detecting worsening heart failure |
US8271072B2 (en) | 2009-10-30 | 2012-09-18 | Medtronic, Inc. | Detecting worsening heart failure |
US10952686B2 (en) | 2016-08-02 | 2021-03-23 | Medtronic, Inc. | Mobile application to prompt physical action to measure physiologic response in implantable device |
US11717186B2 (en) | 2019-08-27 | 2023-08-08 | Medtronic, Inc. | Body stability measurement |
US11602313B2 (en) | 2020-07-28 | 2023-03-14 | Medtronic, Inc. | Determining a fall risk responsive to detecting body position movements |
US11737713B2 (en) | 2020-07-28 | 2023-08-29 | Medtronic, Inc. | Determining a risk or occurrence of health event responsive to determination of patient parameters |
Also Published As
Publication number | Publication date |
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DE60036396D1 (en) | 2007-10-25 |
EP1225954B1 (en) | 2007-09-12 |
US6459929B1 (en) | 2002-10-01 |
EP1225954A1 (en) | 2002-07-31 |
CA2390016A1 (en) | 2001-05-10 |
DE60036396T2 (en) | 2008-05-29 |
CA2390016C (en) | 2006-05-09 |
ATE372808T1 (en) | 2007-09-15 |
AU5934300A (en) | 2001-05-14 |
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