An implantable antiarrhythmia device which detects and classifies arrhythmias of the human heart, and delivers appropriate therapy. The device employs a method of arrhythmia classification based on a set of prioritized rules, each of the rules defining a plurality of criteria based upon characteristics of sensed depolarizations of heart tissue, each rule being met when the criteria associated with the rule are met. Some rules, when met, trigger delivery of antiarrhythmia therapy. Other rules, when met, inhibit delivery of antiarrhythmia therapy. The rules may be met simultaneously, and if so, the highest priority rule governs the behavior of the device.

Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias

A method of treating cardiovascular disease in a medical patient is provided. The method includes the steps of generating a sensor signal indicative of a fluid pressure within the left atrium of the patient's heart, and delivering an electrical stimulus to a location in the heart. The electrical stimulus is delivered based at least in part on the sensor signal. The method also includes the steps of generating a processor output indicative of a treatment to a signaling device. The processor output is based at least in part on the sensor signal. At least two treatment signals are provided to the medical patient. The treatment signals are distinguishable from one another by the patient, and are indicative of a therapeutic treatment. The treatment signals are based at least in part on the processor output.

System for detecting, diagnosing, and treating cardiovascular disease

Randomized Controlled Trial of an Implantable Continuous Hemodynamic Monitor in Patients With Advanced Heart Failure: The COMPASS-HF Study

An electro-stimulation device includes a pair of electrodes for connection to at least one location in the body that affects or regulates the heartbeat. The electro-stimulation device both electrically arrests the heartbeat and stimulates the heartbeat. A pair of electrodes are provided for connection to at least one location in the body that affects or regulates the heartbeat. The pair of electrodes may be connected to an intravenous catheter for transvenous stimulation of the appropriate nerve. A first switch is connected between a power supply and the electrodes for selectively supplying current from the power supply to the electrodes to augment any natural stimuli to the heart and thereby stop the heart from beating. A second switch is connected between the power supply and the electrodes for selectively supplying current from the power supply to the electrodes to provide an artificial stimulus to initiate heartbeating. In another aspect, the invention is directed to a method for arresting the beat of a heart in a living body comprising the steps of connecting the pair of electrodes to at least one location in the body that affects or regulates the heartbeat and supplying an electrical current to the electrodes of sufficient amplitude and duration to arrest the heartbeat. The device may also serve to still the lungs by input to a respirator or by stimulation of the phrenic nerve during surgical procedures.

Method and device for electronically controlling the beating of a heart

The present invention relates to apparatus and methods for electrically inducing and pharmacologically maintaining cardiac asystole. The present invention combines electrostimulation of the vagus nerve to transiently arrest the heart, and the administration of a pharmaceutical composition that suppresses the tendency of the heart to escape from the induced asystolic state. The present invention provides an apparatus to interrogate the response of a heart to an electric pulse applied to the vagus nerve and to select the optimum location of an electrode and pulse to arrest the heart. The present invention further provides embodiments of catheter and tube electrode devices that incorporate expanding electrodes intended to contact the interior walls of blood vessels or anatomic structures in which the electrode devices are implanted. The present invention also provides cutaneous array electrodes that may be used non-invasively to stimulate the vagus nerve.

Devices and methods for vagus nerve stimulation

An implantable cardioverter/defibrillator provided with method and apparatus for discrimination between ventricular tachycardia and ventricular fibrillation. The device is provided with two pairs of electrodes, each pair of electrodes coupled to processing circuitry for identifying a predetermined fiducal point in the electrical signal associated with a ventricular depolarization. The cumulative beat to beat variability of the intervals separating the two identified fiducal points, over a series of detected depolarizations is analyzed. The result of this analysis is used to distinguish between ventricular tachycardia and ventricular fibrillation.

Method and apparatus for discrimination of ventricular tachycardia from ventricular fibrillation and for treatment thereof

Measurement of pulmonary artery diastolic pressure from the right ventricle

A system and method are provided for determining an index of autonomic nervous system (ANS) or sympathetic nervous system (SNS) activity for use in patient monitoring or therapy delivery control. An ANS or SNS index is calculated as a function of multiple monitored physiological variables that strongly correlate to changes in autonomic or sympathetic tone. These ANS-influenced variables are derived from selected hemodynamic and/or electrical signals and may include variables relating to any of: the maximum rate of pressure rise (dP/dtmax), the maximum rate of pressure decline (dP/dtmin), pulse pressure (PP), pre-ejection time interval (PEI) and/or systolic time interval (STI), heart rate (HR), heart rate variability (HRV), and baro-reflex gain. Changes in the ANS or SNS index may be used to automatically adjust a device delivered therapy.

Method and apparatus to provide diagnostic index and therapy regulated by subject's autonomic nervous system

A barometric pressure sensor (260) for deriving reference pressure data for use in combination with absolute pressure data derived by an implantable medical device (IMD) is disclosed The barometric pressure sensor (260) is located in a sensing module (200) having a module housing (222) enclosing an air chamber (230) which encloses the barometric pressure sensor (260) An air vent (220) extends through the module housing (222) for venting the air chamber (230) to atmospheric pressure outside the housing A protective vent cover (240) extends across the air vent (220) formed of a material capable of air passage and capable of inhibiting passage of moisture, liquids, and particulate contaminants into the air chamber (230) The sensing module (200) is worn or carried by the patient and includes operating circuitry and a power supply for periodically storing sensed atmospheric pressure values as reference pressure data In another embodiment, the sensing module (200) comprises a percutaneous access device (300) which is adapted to be implanted in the skin and subcutaneous tissue layer of the patient

Barometric pressure sensor for use with implantable absolute pressure sensor

Medical device data is transferred using a universal adaptor between an implanted medical device and hospital monitoring systems. The universal adaptor is an interface compatible with various built-in hospital monitoring network comprised of equipment from a variety of manufacturers. The universal adaptor includes a telemetry circuitry, a calibration system for atmospheric pressure and an analog interface. The calibration system relates to barometric correction and includes an external pressure reference system.

Robert T. Taepke

Papers

Method and apparatus for discrimination of ventricular tachycardia from ventricular fibrillation and for treatment thereof

Measurement of pulmonary artery diastolic pressure from the right ventricle

Method and apparatus to provide diagnostic index and therapy regulated by subject's autonomic nervous system

Barometric pressure sensor for use with implantable absolute pressure sensor

Universal interface for implantable medical device data management