Abstract: A defibrillator for providing both defibrillating energy and pacing energy to a patient is described. In delivering the defibrillating energy, electrical energy is stored by a charge capacitor and the stored energy is then coupled to the patient to provide a defibrillating pulse. To deliver pacing energy to a patient, an electrical energy circuit generates electrical energy that is filtered by the charge capacitor and delivered to the patient as pacing energy. The magnitude of the pacing energy delivered to the patient is monitored by a controller, which adjusts the generation of the electrical energy based on the magnitude of the pacing energy in order to provide adequate pacing energy to the patient.

Abstract: Compositions and methods are provided for modulating the growth, development and repair of bone, cartilage or other connective tissue. Devices and stimulus waveforms are provided to differentially modulate the behavior of osteoblasts, chondrocytes and other connective tissue cells to promote proliferation, differentiation, matrix formation or mineralization for in vitro or in vivo applications. Continuous-mode and pulse-burst-mode stimulation of cells with charge-balanced signals may be used. Bone, cartilage and other connective tissue growth is stimulated in part by nitric oxide release through electrical stimulation and may be modulated through co-administration of NO donors and NO synthase inhibitors. Bone, cartilage and other connective tissue growth is stimulated in part by release of BMP-2 and BMP-7 in response to electrical stimulation to promote differentiation of cells.

Abstract: In one embodiment, a method electrically stimulates an area in a spinal disc. The method comprises: implanting at least one steerable lead at a placement site for stimulating a spinal disc such that the lead is disposed exterior and immediately adjacent to and circumferentially along an annulus of the spinal disc, the at least one lead including a plurality of electrodes distributed along a majority of a circumference of the annulus; connecting the lead to a signal generator; and generating electrical stimulation pulses using the generator to stimulate targeted portions of the spinal disc, wherein the stimulation of the targeted portion of the spinal disc sufficiently stimulates nerve tissue within the spinal disc to prevent communication of pain signals originating in the spinal disc without damaging tissue of the spinal disc.

Abstract: Implantable systems, and method for use therewith, are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments, as will be described below, are for use with an implantable device that include one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering AATP and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.

Abstract: A method and device for delivering ventricular resynchronization pacing therapy in conjunction with electrical stimulation of nerves which alter the activity of the autonomic nervous system is disclosed. Such therapies may be delivered by an implantable device and are useful in preventing the deleterious ventricular remodeling which occurs as a result of a heart attack or heart failure. The device may perform an assessment of cardiac function in order to individually modulate the delivery of the two types of therapy.

Abstract: An active implantable medical device, notably for pacing, resynchronization, defibrillation and/or cardioversion of the heart, or for diagnosis of a patient's condition, able to produce a predictive alert in response to a detected degradation of the patient's clinical status. The device measures and analyses (56) a parameter representative of the patient's metabolic needs, such as minute ventilation (MV), and a physical activity parameter, such as acceleration (G). It further diagnoses heart failure by evaluating an index of the patient's clinical status through applying a set of status criteria (S1, S2). It further measures and analyzes (56) a hemodynamic parameter such as endocardial acceleration (PEA) or intracardiac impedance, representative of the patient's myocardium contractility. An index of cardiac contractility is created and evaluated through applying a set of contractility criteria (S?1, S?2).

Abstract: A biological pacemaker composition for implantation into cardiac tissue includes an effective amount of interstitial cells of Cajal (ICC) to produce or conduct pacing stimuli and thereby modulate cardiac contraction. The biological pacemaker may be included as part of a heart pacing system that includes an implantable electric pacemaker for producing backup pacing stimuli if the at least one biological pacemaker is unable to modulate cardiac contraction at a predetermined pacing rate. Methods for preventing cardiac pacing or conduction dysfunction in a heart include implanting the biological pacemaker or the heart pacing system into the heart.

Abstract: A method and apparatus are provided for controlling interrogation of an implantable device such as a pacemaker, an implantable cardioverter, or a defibrillator utilizing an external device in a home environment. The method controls how frequently a patient can retrieve status information from the implantable device based on a time period elapsed since a last interrogation and a power level of a battery.

Abstract: An electrode lead for implantation into a small heart vessel, especially into a coronary sinus, is provided with an elongated outer insulating lead body (1), having a proximal end (2), a distal end (3) and at least one electrode pole (4) at the distal end (3). At least one electrical conductor unit (6, 6?) leads to said electrode pole (4), each of said electrical conductor units (6, 6?) having a conductor core (7) and a separate insulating sheath (8) surrounding said conductor core (7). A lumen (9) is provided in said insulating lead body (1), being defined by a tubular envelope (10), to accommodate a guide wire means (11). The at least one electrical conductor unit (6, 6?) and the envelope (10) of the lumen (9) are each slidable relative to each other along their longitudinal direction (L) and fixed relative to each other at least in the vicinity of the distal end (3) of the lead body (1).

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.

Abstract: A method and apparatus are provided for controlling interrogation of an implantable device such as a pacemaker, an implantable cardioverter, or a defibrillator utilizing an external device in a home environment. The method controls how frequently a patient can retrieve status information from the implantable device based on a time period elapsed since a last interrogation and a power level of a battery.

Abstract: In a method and system for processing an electrocardiogram (ECG), digital ECG data are received. The digital ECG data evinces a plurality of a patient's heartbeats detected during an ECG. Digital annotation data are generated representing marking to be shown on an ECG tracing of the plurality of heartbeats. An annotated ECG tracing image is produced using the digital ECG data and the digital annotation data.

Abstract: Cardiac systems and methods provide for discriminating between supraventricular tachyarrhythmia and ventricular tachyarrhythmia based on a determination that the patient's supraventricular rhythm exhibits rate dependency. One approach involves determining if a patient's supraventricular rhythm exhibits rate dependent morphology. If the patient's supraventricular rhythm is determined to exhibit rate dependent morphology, an implantable device classifies a detected tachyarrhythmia episode based on one or more templates selected from a plurality of rate-indexed templates stored in the device. Determining if the supraventricular rhythm exhibits rate dependent morphology may also include determining one or more rates at which the rate dependent morphology occurs.

Abstract: The invention relates to a method and a device for improved imaging by means of ECG triggering. A first trigger time A and a second trigger time B, as well as a threshold value for the heart rate variability is determined with the method according to the invention. The heart rate variability is subsequently calculated. Trigger time A is used as long as the threshold value is exceeded. Trigger time B is used when the threshold value is reached or exceeded.

Abstract: A cardiac medical device used for delivering anti-tachycardia pacing in both the atrial and ventricular regions in a simultaneous manner, while preventing potential of inducing atrial arrhythmia. The pacing pulses may be synchronized in a gradual manner so that simultaneous delivery of the pulses is ultimately achieved at reduced risk of inducing atria arrhythmia. The pacing pulses may also be synchronized immediately after a determination is made whether simultaneous pacing purses will be delivered in the vulnerable regions of the cardiac cycle.