Rupinder Bharmi

7297114, Nov 20, 2007

Jan 25, 2005

11/043804

Jong Gill - Valencia CA, US
Peter Boileau - Valencia CA, US
Rupinder Bharmi - Stevenson Ranch CA, US
Xiaoyi Min - Thousand Oaks CA, US
Joseph J. Florio - La Canada CA, US
Michael Benser - Valencia CA, US
Gene A. Bornzin - Simi Valley CA, US

Pacesetter, Inc. - Sylmar CA

A61B 5/0452

600365, 600513

Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

7435221, Oct 14, 2008

Nov 10, 2006

11/558819

Rupinder Bharmi - Stevenson Ranch CA, US
Philip de Chazal - Sutton, AU
Gene A. Bornzin - Simi Valley CA, US
Michael E. Benser - Valencia CA, US

Pacesetter, Inc. - Sylmar CA

A61B 5/08
A61B 5/02
A61B 5/04

600484, 600529, 600513, 600509

Techniques are provided for detecting abnormal respiration within a patient based upon intracardiac electrogram (IEGM) signals or other electrical cardiac signals. Briefly, abnormal respiration is detected using a pattern recognition trained to discriminate normal and abnormal respiration based on morphological parameters and interval-based parameters extracted from the IEGM signals. In addition, techniques are described for distinguishing among different cardiac rhythm types within the patient while using one or more pattern classifiers or other pattern recognition devices.

7462150, Dec 9, 2008

Jun 9, 2006

11/450937

Rupinder Bharmi - Stevenson Ranch CA, US

Pacesetter, Inc. - Sylmar CA

A61B 5/00

600300, 600365

Techniques are described for use by a pacemaker or implantable cardioverter/defibrillator (ICD) or other implantable medical device. The techniques are provided for evaluating the likelihood that the patient, in which the device is implanted, has impaired glucose tolerance (IGT) or diabetes mellitus. Briefly, a value representative of sleep quality of the patient is detected and then the likelihood that the patient has IGT or diabetes mellitus is determined based on the sleep quality value. In this regard, it has been found that a decrease in overall sleep quality is associated with an increased likelihood of IGT or diabetes mellitus, which is in turn associated with an increased risk of mortality. Hence, sleep quality may be used as a proxy for evaluating the likelihood that the patient has IGT or diabetes mellitus and for assessing associated mortality risk.

7502644, Mar 10, 2009

Jan 25, 2005

11/043612

Jong Gill - Valencia CA, US
Peter Boileau - Valencia CA, US
Rupinder Bharmi - Stevenson Ranch CA, US
Xiaoyi Min - Thousand Oaks CA, US
Joseph J. Florio - La Canada CA, US
Michael Benser - Valencia CA, US
Gene A. Bornzin - Simi Valley CA, US

Pacesetter, Inc. - Sylmar CA

A61B 5/0468

600516, 600515, 600509

Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

7524287, Apr 28, 2009

May 11, 2005

11/127370

Rupinder Bharmi - Stevenson Ranch CA, US

Pacesetter, Inc. - Sylmar CA

A61B 5/0452

600365, 600517

Techniques are described for detecting and distinguishing among ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. In one technique, these conditions are detected and distinguished based on an analysis of: the interval between the QRS complex and the peak of a T-wave (QTmax), the interval between the QRS complex and the end of a T-wave (QTend), alone or in combination with a change in ST segment elevation. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by cardiac ischemia. In another technique, hyperglycemia and hypoglycemia are predicted, detected and/or distinguished from one another based on an analysis of the amplitudes of P-waves, QRS-complexes and T-waves within the IEGM. Appropriate warning signals are delivered and therapy is automatically adjusted.

7539539, May 26, 2009

Oct 11, 2005

11/248888

Rupinder Bharmi - Stevenson Ranch CA, US

Pacesetter, Inc. - Sylmar CA

A61N 1/365
A61B 5/08

607 20, 607 17, 607 19, 607 42, 600529

A method of providing cardiac stimulation therapy and a device for providing the therapy. A patient's cardiac activity as well as cyclical respiration is monitored. Cardiac stimulation is provided as indicated as therapeutic intervention for a variety of cardiac arrhythmias according to variable timing parameters. One or more of the timing parameters under which cardiac pacing stimulations are provided is varied or modulated with the cyclical variations in respiration. The one or more timing parameters are generally shortened or elongated in concert with the alternating inspiration/exhalation phases of respiration. In certain implementations, the patient's respiration is inferred from cardiac based physiologic signals. The methods and devices for providing cardiac stimulation therapy more accurately emulate natural healthy physiologic activity.

7590443, Sep 15, 2009

Apr 27, 2005

11/117624

Rupinder Bharmi - Stevenson Ranch CA, US

Pacesetter, Inc - Sylmar CA

A61B 5/0205

600509, 600365

Techniques are provided for use with an implantable medical device such as a pacemaker or implantable cardioverter/defibrillator (ICD) for predicting and detecting hypoglycemia. In one example, the device tracks changes in a paced depolarization integral (PDI). A significant increase in PDI over a relatively short period of time indicates the onset of hypoglycemia (this can also be confirmed with QT changes). Upon detection of hypoglycemia, appropriate warning signals are generated to alert the patient. Certain therapies automatically provided by the implantable device may also be controlled in response to hypoglycemia. For example, if the patient is an insulin-dependent diabetic and the implantable device is equipped with an insulin pump capable of delivering insulin directly into the bloodstream, insulin delivery is automatically suspended until blood glucose levels return to acceptable levels. If the device is an ICD, it may be controlled to begin charging defibrillation capacitors upon detection of hypoglycemia so as to permit prompt delivery of a defibrillation shock, which may be needed if hypoglycemia triggers ventricular fibrillation. The detection techniques may be used in conjunction with other hypoglycemia detection techniques to improve detection specificity.

7769436, Aug 3, 2010

Jun 4, 2007

11/757796

Peter Boileau - Valencia CA, US
Jay Snell - Studio City CA, US
Rupinder Bharmi - Stevenson Ranch CA, US
Laleh Jalali - Moorpark CA, US
Gene A. Bornzin - Simi Valley CA, US

Pacesetter, Inc. - Sylmar CA

A61B 5/04
A61B 5/0402
A61B 5/0452

600509, 600517

Techniques are described for adaptively adjusting detection thresholds for use in detecting cardiac ischemia and other abnormal physiological conditions based on morphological parameters derived from intracardiac electrogram (IEGM) signals, impedance measurements, or other signals. In one example, where ST segment elevation is used to detect cardiac ischemia, default detection thresholds are determined in advance from an examination of variations in ST segment elevations occurring within a population of patients. Thereafter, an individual pacemaker or other implantable medical device uses the default thresholds during an initial learning period to detect ischemia within the patient in which the device is implanted. During the initial learning period, the pacemaker also collects data representative of the range of variation in ST segment elevations occurring within the patient. The pacemaker then adaptively adjusts the thresholds based on the range of variation so as to improve detection specificity within the patient.