Abstract: A system and method for storing and processing physiological data in a medical recording device that allows continuous data collection and storage of such data in multiple time-resolved levels are provided. The method includes: sampling one or more physiological signals at a selected sampling rate; deriving physiological parameter values from the sampled signal; storing the parameter values as they are determined in a temporary memory buffer for a predetermined storage interval; determining a statistical aspect of the stored parameter values upon expiration of the storage interval; and writing the statistical aspect to a long-term memory buffer. A number of long-term memory buffers may be designated for storing a statistical aspect of a physiological parameter at uniquely different time resolutions. The resolution of each long-term memory buffer is determined by the storage interval defined for an associated temporary memory buffer, which stores parameter values from which statistical aspects are computed.

Abstract: In some embodiments, a method for optimizing cardiac resynchronization therapy (CRT) may include one or more of the following steps: (a) conducting a baseline measurement of a physical parameter of a patient before initiating CRT, (b) performing an implantation process including implanting a pacing device and pacing leads in the patient, the pacing device and pacing leads for providing the CRT, (c) initiating CRT on the patient, (d) measuring the physical parameter of the patient after initiation of the CRT, (e) comparing the measured physical parameter after initiation of the CRT to the baseline measure of the physical parameter to analyze the patient's response to the CRT, (f) adjusting the CRT during the implantation process to try and improve the patient's response to the CRT, and (g) repositioning at least one of the patient leads during the implantation process to try and improve the patient's response to the CRT.

Abstract: An implantable medical device provides ventricular pacing capabilities and optimizes AV intervals for multiple purposes. In general, intrinsic conduction is promoted by determining when electromechanical systole (EMS) ends and setting an AV interval accordingly. EMS is determined utilizing various data including QT interval, sensor input, and algorithmic calculations.

Abstract: A medical therapy delivery device that includes a shaft formed by an outer layer and a deflectable tip that includes a tapered portion. A manipulator wire extends through the shaft to adjust deflection of a second portion of the shaft relative to a first portion. The outer layer forms a single shaft lumen having a first lumen portion positioned about a thru lumen tubing and a second lumen portion, offset from and in fluid communication with the first lumen portion, the second lumen portion having a first side wall, a second side wall and a bottom wall extending between the first side wall and the second side wall. The thru lumen tubing, first side wall, the second side wall and the bottom wall position the manipulator wire within the second lumen portion.

Abstract: A connector assembly for detachably connecting an electrical lead to an implantable medical device for emitting electrical pulses is provided. One or more deflectable connector clips are positioned inside or partially inside a compact housing that is designed to deflect the connector clips in a partially loaded state so that insertion of the terminal pin of an electrical lead causes a minor deflection of the spring clip, but results in high retention force. The positioning of the connector clip in the housing in a partially loaded state results in a relatively flat force deflection curve. The one or more connector clips are preferably electrically conducting metal and may be formed into a U-shape. The connector clips are generally positioned to provide multiple contact points with an inserted terminal pin of a lead.

Abstract: A communications device facilitates communication between a medical device and a wireless communications network and comprises a telemetry circuit configured to wirelessly communicate with one or more medical devices, and a computer network communication interface configured to wirelessly communicate directly with a wireless computer network. The communications device also comprises a peripheral device communication interface configured to communicate with a wireless peripheral device and a processor being in operable communication with, and configured to control operations of, the telemetry circuit, the network communication interface, and the peripheral device communication interface.

Abstract: A sensor is disposed within a pin portion of a feedthrough assembly. The feedthrough assembly provides a hermetically sealed enclosure that protects the sensor. In one embodiment, the sensor is a temperature sensor and the feedthrough assembly thermally isolates the sensor from the surrounding housing or enclosure.

Abstract: Embodiments of the invention include channel selection and mapping for medical device communication. The communication system can implement a two-stage listen before talk protocol to choose a channel for communication. The first stage samples the interference of each channel for a relatively short time and chooses the best signal. The second stage samples the channel selected by the first stage and samples it for a relatively longer time to confirm the channel selected by the first stage is the best channel for communication.

Abstract: A voltage compensation unit reduces the effects of induced voltages upon a device having a single wire line. The single wire line has balanced characteristic impedance. The voltage compensation unit includes a tunable compensation circuit connected to the wire line. The tunable compensation circuit applies supplemental impedance to the wire line. The supplemental impedance causes the characteristic impedance of the wire line to become unbalanced, thereby reducing the effects of induced voltages caused by changing magnetic fields.

Abstract: Waveform analysis is used to identify and distinguish components of a sensed input signal, such as P-wave and Far Field R-wave signal components present in a sensed cardiac signal, even when the components are so closely spaced in time that the overlap to create a distorted input signal. A set of composite waveforms are generated by superimposing waveform templates of the signal components with different time delays or degree of overlap. Form parameters for each composite waveform are derived and mapped in a multidimensional map, from which form parameter boundaries are derived. Waveform data is collected from an input signal during a sensed event time window, and form parameters for the input signal waveform are derived. An output identifying the signal component of interest (e.g., a P-wave) and its location within the sensed event time window is produced based upon the set of form parameters of the input signal waveform and the form parameter boundaries.

Abstract: Undersensing of an evoked response during an automatically initiated search of the stimulation threshold in a stimulation channel of an IMD, e.g., the pacing threshold in a pacing channel of a pacing system, is minimized by repeating the search using the sense amplifier of the stimulation channel configured in bipolar and unipolar sensing configurations. A failure to sense an evoked response in the search in one sensing configuration can be confirmed, and stimulation energy set to a high output, if an evoked response is not sensed in an alternate sensing configuration or refuted if an evoked response is sensed in the alternate sensing configuration. If the failure is refuted, the alternate sensing configuration is employed until the next search.

Abstract: An implantable medical device having a prioritized multiplexor sensing circuit used for monitoring the condition or status of a patient. The device includes patient parameter sensors, such as electrodes, that are monitored for indications of significant events. Sensors indicating the presence of significant events may then be monitored more often than the other sensors.

Abstract: An electromagnetic shield has a first patterned or apertured layer having non-conductive materials and conductive material and a second patterned or apertured layer having non-conductive materials and conductive material. The conductive material may be a metal, a carbon composite, or a polymer composite. The non-conductive materials in the first patterned or apertured layer may be randomly located or located in a predetermined segmented pattern such that the non-conductive materials in the first patterned or apertured layer are located in a predetermined segmented pattern with respect to locations of the non-conductive materials in the second patterned or apertured layer.

Abstract: A cardiac rhythm management system includes an implantable medical device capable of delivering cardiac therapy and sensing an EGM. The implantable medical device undergoes threshold testing and transmits testing data to a computer via a remote monitor.

Abstract: A pacing protocol is provided that reduces or minimizes ventricular pacing in favor of intrinsic conduction. When operating in a mode that provides ventricular pacing, a series of conduction checks are performed to determine if intrinsic conduction has returned. These conduction checks occur according to a predetermined pattern that generally includes longer intervals between subsequent attempts. The AV interval provided for dual chamber based pacing is modulated and generally moves from a larger value to a nominal value as the interval between unsuccessful conduction checks increases.

Abstract: An improved medical lead assembly and method of use is provided. The lead assembly includes a lead body, and a spring member positioned adjacent to the lead body. The spring member may be deployed a selectable amount to maintain the lead body in a fixed location within a patient's body. The spring member may be an expandable coil, a mesh structure that is similar to a stent, or any other similar device that may be positioned in a low-profile state during a lead implant procedure. After the lead is positioned at a target destination, the spring member may be deployed an amount that is selected based on the characteristics of the surrounding tissue, including vessel size. According to one aspect of the invention, the lead assembly may provide means for facilitating chronic lead extraction.

Abstract: In general, the invention is directed to techniques for delivery of pacing in response to a premature atrial contraction (PAC) to prevent atrial arrhythmia, i.e., delivery of post-PAC pacing pulses. The techniques may involve monitoring the success rate of prior post-PAC pacing sequences, and adjusting the number of post-PAC pacing pulses delivered subsequent post-PAC pacing sequences based on a success rate. In addition, the techniques may involve adjusting the post-PAC pacing interval based on the success rate.

Abstract: A method and apparatus for providing positive fixation of medical components to a portion of pericardial tissue via both vacuum- and/or mechanically-assisted means. A source of vacuum couples via a lumen to a recessed portion of a body structure deployed into the pericardial space. The recessed portion is adapted to form a seal around its periphery with adjacent pericardial tissue so that when the recessed portion is evacuated, the tissue is drawn into the recessed portion. Then, a sharpened instrument, such as a stylet, is deployed through the lumen and pierces the tissue, thus anchoring the body structure. A source of fluid may also be included for delivery to the pericardial space (e.g., contrast media; saline solution; biological, genetic and pharmaceutical substances and the like).

Abstract: Ventricular arrhythmias are monitored and classified based upon various criteria. One criterion is PR dissociation which is determined by comparing the PR interval in a current RR cycle to a median PR value. If the current PR interval varies too far from the median, then dissociation is indicated. Often, there are multiple atrial events in a given RR interval and the PR value has been based upon the last atrial event in the cycle. An algorithm determines whether to use the last atrial event in a cycle or whether an earlier atrial event occurred and would provide a more accurate PR value.

Abstract: This disclosure provides for methods and apparatus for preventing an early recurring atrial fibrillation and atrial flutter (AF) episode (herein “ERAF”). Some aspects of the foregoing involve commencing atrial overdrive pacing therapy delivery at an overdrive pacing rate upon detection of one of: (i) an AF episode and (ii) a relatively long pause between successive sensed P-waves during an AF episode. The AF episode typically has a cycle length interval of between about 100 ms and 300 ms, and the relatively long pause has a duration of between about 40 ms and 100 ms longer than the cycle length of the AF episode. Atrial overdrive pacing is delivered for a relatively short period of time after successful termination of the AF episode. Subsequently, the atrial pacing rate is rapidly decreased until either normal sinus rhythm or a lower programmed pacing rate is reached.