Abstract: The currently claimed invention is for a method of placement of certain medical devices, and in particular, to the placement of electrodes in the field biopotential or electrophysiological monitoring. More particularly, it provides a new method for marking the skin of a subject where medical electrodes are to be placed including the placement of an electrode harness containing these electrodes. The method for accurate placement of electrodes of the currently claimed invention provides a quick, efficient method of electrode placement and replacement. This method further allows homecare providers or even the patient themself to accurately place and replace electrodes for home health care or outpatient monitoring.

Abstract: A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).

Abstract: Described are apparatus and methods for electrically modulating a nerve in a mammal. An electrical signal that includes a signal intensity pattern and a signal frequency pattern is delivered to a nerve. The combination of the signal intensity pattern and the signal frequency pattern is effective to result in weight loss, fat loss, and/or lean-mass gain, in a mammal. In some embodiments the nerve is modulated in response to a physiological parameter. In some embodiments, the physiological parameter is measured by a sensor.

Abstract: Methods and apparatus are provided for determining a defibrillation treatment protocol in an external defibrillator whereby a user may override a CPR-first default protocol. The method includes following steps configured in a defibrillator controller of issuing an inquiry; waiting for a response to the inquiry for a set time; ordering a CPR treatment protocol if no response is received within the set time; analyzing a response; ordering a CPR treatment protocol upon receiving a non-affirmative response to the inquiry; and ordering a shock treatment protocol upon receiving an affirmative response to the inquiry. Upon selecting a shock treatment protocol, the defibrillator performs a shock analysis under the shock treatment protocol, and either orders a CPR treatment protocol if shock treatment is not indicated by the shock analysis or provides a defibrillation shock if shock treatment is indicated by the shock analysis. Queries may be presented to a user in visual, audible, or both visual and audible format.

Abstract: A method of activating at least two electrodes in a multichannel electrode array using channel specific sampling sequences is presented. A channel specific sampling sequence is defined for each electrode, the sequence having a particular duration, pulse amplitude distribution, and number of pulses. A weighting factor is applied to the channel specific sampling sequence. Each electrode in the multichannel electrode array is then simultaneously activated using sign-correlated pulses, the sign-correlated pulses based on parameters of spatial channel interaction reflecting geometric overlapping of electrical fields from each electrode, non-linear compression, and each electrode's weighted channel specific sampling sequence.

Abstract: A method is described for the treatment of obesity or other disorders, by electrical activation or inhibition of the sympathetic nervous system. This activation or inhibition can be accomplished by electrically stimulating the greater splanchnic nerve or other portion of the sympathetic nervous system using an implantable pulse generator. This nerve activation can result in reduced food intake and increased energy expenditure. Reduced food intake may occur through a variety of mechanisms that reduce appetite and cause satiety. Increased adrenal gland hormone levels will result in increased energy expenditure. Fat and carbohydrate metabolism, which are also increased by sympathetic nerve activation, will accompany the increased energy expenditure.

Abstract: An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a p-wave, ADI/R pacing resumes to monitor ventricular response.

Abstract: A cardiac transvenous defibrillation lead has a continuous coil conductor within a layer of insulation. A portion of the coil conductor is exposed as a defibrillation electrode. In order to enhance fluoroscopic visualization of the exposed electrode during implant, the end of the exposed electrode is marked with a radiopaque element. The element may be in the form of an adhesive filled with radiopaque material that is used to backfill under the layer of insulation. Alternatively, a tube made of radiopaque material may be installed between the layer of insulation and the coil conductor.

Abstract: A stimulation system including a stimulator having a multi-channel electrode array utilizing a monopolar electrode configuration. A processor is operatively coupled to the stimulator. The processor is configured to determine a channel interaction (CI) sequence using simultaneous, sign-correlated pulses and channel interaction compensation. The CI sequence has a CI pulse rate and a CI mean pulse amplitude, and produces resulting potentials that are substantially equal to desired potentials at given positions relative to the multi-channel array. The CI sequence may include temporal gaps between pulses, wherein the processor may be configured to increase the CI pulse rate, such that the temporal gap between pulses is decreased. Furthermore, the processor may be configured to reduce the pulse amplitude of the CI sequence while increasing pulse phase duration, such that charge per pulse remains substantially unchanged and the temporal gap between pulses is decreased.

Abstract: An implantable medical device (IMD) delivers neurostimulation therapy to a patient according to a parameter set, which may consist of a number of programs that are delivered substantially simultaneously. When programming the IMD, a clinician programmer may maintain a session log for the patient that includes a listing of programs delivered to the patient and rating information provided by a clinician and the patient for programs of the list. The listing may be ordered according to the rating information in order to facilitate the selection of programs for a parameter set. A program library that may include particularly effective programs organized according to a directory structure may be stored in a memory. The IMD and/or a patient programmer may store usage information that provides an objective assessment of therapy use by the patient, and allows a clinician to later improve the therapy based on the usage information.

Abstract: A device for stimulating the osteogenesis of a traumatized bone is mounted on a bone stabilizing implant. The device comprises a first component part comprising a first electrode, an isolating element, which is mounted at the first component part and a second component part comprising a second electrode. The second component part is mounted at the isolating element such that the first electrode and the second electrode are electrically isolated from each other. The power generation unit is electrically coupled both to the first electrode and to the second electrode. The first component part is designed to be attached to the implant in such a manner that the second component part intrudes in a region defined by a trauma within the bone.

Abstract: An implantable medical electrode lead for stimulation of bodily tissue. The lead is adapted for use with a needle lumen diameter of not greater than 0.05 inch, and includes a lead body and a tine assembly. The lead body has a distal section forming at least one exposed electrode surface. The tine assembly includes a plurality of tines each having a base end coupled to an exterior of the lead body immediately adjacent the exposed electrode surface and a free end that is movable relative to the lead body to inhibit axial migration of the lead body upon implantation into a patient. In one embodiment, the lead body is a PNE lead and provides two electrode surfaces for bipolar operation.

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 general includes longer intervals between subsequent attempts. A maximum interval is provided such that conduction checks are not repeated sequentially at the same time of day when at this maximum interval.

Abstract: A method for use in an implantable medical device, comprising: sensing a signal corresponding to ventricular wall acceleration; and determining a metric of atrial function using the ventricular wall acceleration signal. The method includes sensing the ventricular wall acceleration signal during at least during a sensing window corresponding to a ventricular filling phase.

Abstract: An implantable medical device having an implantable power source such as a rechargeable lithium ion battery. The implantable medical device includes a recharge module that regulates the recharging process of the implantable power source using closed-loop feedback control. The recharge module includes a recharge regulator, a recharge measurement device monitoring at least one recharge parameter, and a recharge regulation control unit for regulating the recharge energy delivered to the power source in response to the recharge measurement device. The recharge module adjusts the energy provided to the power source to ensure that the power source is being recharged under safe levels.

Abstract: Devices, systems and methods by which the blood pressure, nervous system activity, and neurohormonal activity may be selectively and controllably reduced by activating baroreceptors. A baroreceptor activation device is positioned near a baroreceptor, for example a baroreceptor in the carotid sinus. A control system may be used to modulate the baroreceptor activation device. The control system may utilize an algorithm defining a stimulus regimen which promotes long term efficacy and reduces power requirements/consumption.

Abstract: The present invention relates to a neural stimulation delivery device to deliver electrical and/or chemical stimulation to target sites in the central and peripheral nervous system. The device generally includes a tubular body defining a plurality of ports along the longitudinal axis thereof, a plurality of delivery structures insertable in the body, and a control mechanism in communication with the plurality of delivery structures to independently move each of the plurality of delivery structures through a respective one of the plurality of ports with respect to each other of the plurality of delivery structures. The ability of each delivery structure to be independently moveable through a respective port allows each delivery structure to be selectively advanced or retracted independent of the movement of another delivery structure.

Abstract: An interface device capable of communicating with a computer running a simulation program, such as a surgical simulation program, comprises an instrument capable of being manipulated by a user. The instrument is receivable within an orifice in an instrument receiving member, the instrument receiving member comprising a capture member engageable with the instrument and a sensor to sense a position of the instrument. The position of the instrument is then used by the computer to control a graphic image related to the simulation. In one version, the simulation is a simulation of a surgical instrument insertion procedure, such as an endoscopy procedure.

Abstract: A rechargeable implantable medical device with an external recharging coil carried on the medical device proximal face. The recharging coil can be attached to the medical device housing physically, or chemically, or a combination of both physically and chemically. The recharging coil electrically couples through housing electrical feedthroughs to electronics configured to perform a therapy and a rechargeable power source both carried inside the medical device housing. Additionally methods for attaching the external recharging coil to an implantable medical device are disclosed. The rechargeable implantable medical device can be a medical devices such as a neuro stimulators, drug delivery pumps, pacemakers, defibrillators, diagnostic recorders, cochlear implants, and the like.

Abstract: Implantable medical devices having two or more leads can utilize digital signal processing to sample and filter the acquired data. The processed data is utilized to identify electrical activity in cardiac tissue remote from the lead location. An atrial lead and a ventricular lead are used to acquire data and the data is processed to indicated electrical timing within the HIS bundle.