Abstract: A method, system, and apparatus for performing a lead condition assessment and/or a lead orientation determination associated with an implantable medical device (IMD). A first impedance is determined. The first impedance relates to the impedance relative to a first electrode and a portion of the IMD. A second impedance is determined. The second impedance relates to the impedance relative to a second electrode and the portion of the IMD. The first impedance is compared with the second impedance to determine an impedance difference. A determination is made whether the impedance difference is outside a predetermined tolerance range. Furthermore, artifact measured during impedance measurements or test pulses may be compared to assess lead orientation. An indication of a lead condition error is provided in response to determining that the impedance difference is outside the predetermined tolerance range.

Abstract: Example techniques involve generating test stimulation programs based upon specific patient feedback to guide the programming process for stimulation therapy. The patient describes positive effects and adverse effects of the test stimulation by listing and/or rating specific types of effects, both positive and adverse, and the location of each effect. In this manner, a programming device, i.e. a programmer, uses the feedback to generate subsequent test stimulation programs. Initially, programs with unipolar electrode configurations are tested, but the programmer may generate bipolar electrode configurations to test if the patient rates the unipolar electrode combinations poorly. After the stimulation programs are tested and rated, the programmer sorts the tested programs based upon the feedback and presents the tested programs to the user. The user selects the best tested program to use for chronic stimulation therapy.

Abstract: A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

Abstract: A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.

Abstract: Telemetry signal strength is used for positioning a primary recharge coil of a recharging unit at a location proximate to an Implantable Medical Device (IMD) in preparation to recharge a rechargeable power source of the IMD. An antenna of the recharging unit is positioned proximate to the IMD, a telemetry session is initiated between the two devices, and a value indicative of the telemetry signal strength is obtained. Using a known correspondence between telemetry signal strength and recharge coupling efficiency for the IMD/recharging unit pair, the telemetry signal strength value is used to determine whether adequate recharge coupling may be achieved between the pair of devices. If so, a recharge session may be established. Otherwise, the antenna is repositioned and the process is repeated. The correspondence between telemetry signal strength and recharge coupling efficiency for the device pair may be developed empirically or using modeling.

Abstract: A cardiac rhythm management system provides for the trending of a third heart sound (S3) index. The S3 index is a ratio, or an estimate of the ratio, of the number of S3 beats to the number of all heart heats, where the S3 beats are each a heart beat during which an occurrence of S3 is detected. An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including S3. An S3 detector detects occurrences of S3 from the acoustic signal. A heart sound processing system trends the S3 index on a periodic basis to allow continuous monitoring of the S3 activity level, which is indicative of conditions related to heart failure.

Abstract: Techniques for detecting tachyarrhythmia and also for preventing T-wave oversensing use signals filtered by a narrowband bradycardia filter in combination with signals filtered by a narrowband tachycardia filter. A separate wideband filter may also be used.

Abstract: A method of treating an upper airway of a patient. The method may include displacing a tongue of the patient while observing a response of the upper airway. The method may further include treating the upper airway based on the observed response, wherein treating the upper airway includes positioning an electrode adjacent a nerve innervating an upper airway muscle and delivering an electrical stimulation to the nerve to activate the upper airway muscle.

Abstract: An anchor for an implantable medical device, anchor delivery tools, kits, and methods, all directed to securing a therapy delivery element at a target location in a patient. An anchor for a therapy delivery element having an outer surface about which the anchor is disposable. The anchor includes a body portion having elastomeric properties, a first opening, a second opening, and a non-linear lumen extending though the body portion from the first opening to the second opening in a relaxed state. The non-linear lumen becomes a linear lumen in a stretched state. The linear lumen of the body portion is adapted to receive the therapy delivery element and the non-linear lumen frictionally engages the outer surface of the therapy delivery element in the relaxed state.

Abstract: A diaphragm pacing stimulatory method and a system to implement the method are provided to improve respiratory function and the quality of sleep in patients whose sleep is compromised by poor respiration. The diaphragm pacing method includes adaptations that make it particularly compatible with the onset of sleep and sustaining sleep. Embodiments of the method are operated independently of breathing effort the patient may make during sleep. Patients for whom the invention is appropriate include those with a neuromuscular disease, such as amyotrophic lateral sclerosis (ALS). System elements include an external electrical stimulator coupled to one or more implanted electrodes that stimulate diaphragm contraction. The system and method provide for a pacing of the diaphragm, improved breathing, and improved sleep. Features of improved sleep include longer sleep time, an increased amount of REM sleep, and fewer episodes of wakefulness and restlessness.

Abstract: An apparatus includes a flexible lead body extending from a proximal end to a distal end, an expandable electrode coupled proximate the distal end, the expandable electrode having an expanded diameter dimensioned to abut a wall of a pulmonary artery, and an implantable pulse generator electrically coupled to the expandable electrode. The expandable electrode includes a plurality of electrode zones. The plurality of zones can be tested to determine which zone delivers the best baroreflex response. At least one of the electrode zones can be selected to deliver a stimulation signal based on the testing. The implantable pulse generator is adapted to deliver a baroreflex stimulation signal to a baroreceptor in the pulmonary artery via the electrode.

Abstract: An electronic low-frequency pulse patch of a one-piece structure comprises a flexible top cover body, a hollow supporting enclosure, a circuit control unit, a power supply unit, a base and a coupling output conductive flexible film. Flexible top cover body is coupled to the coupling output conductive flexible film with hollow supporting enclosure located therebetween. Circuit control unit and the power supply unit are coupled to the base for providing respective low-frequency electric pulses. Electrical conduction is accomplished by electrically connecting the first and the second conductive ends of the base to respective conductive contact lugs of the coupling output conductive flexible film. At either side of which, first and second low-frequency pulse output regions are disposed, such that the electronic low-frequency pulse patch is bendable for conforming to curvature at different locations of the human body without using screw or other means.

Abstract: An improved implantable pulse generator (IPG) containing improved telemetry circuitry is disclosed. The IPG includes a telemetry coil within the conductive IPG case, not in the non-conductive header as is typical, which simplifies IPG design. The improved resonant circuit of which the coil is a part does not include a discrete tuning resistor with the coil, which tuning resistor was traditionally used to increase communication bandwidth of the coil to render it suitable for FSK telemetry. In lieu of the tuning resistor, the coil is intentionally inductively coupled to the case by positioning the coil a certain distance away from the case. Such coupling decreases the effective inductance and increases the effective series resistance in the improved resonant circuit, both of which increase the communication bandwidth. As such, suitable FSK telemetry can be achieved, even though the improved resonant circuit without the case would not on its own have suitable bandwidth.

Abstract: An assembly includes a medical implantable lead adapted to be attached with a distal end of the lead to an organ inside a human or animal body, the medical implantable lead being formed with an inner lumen extending along essentially the entire length of the lead. The assembly also includes a support core that has a desirable stiffness and a suitably cross sectional dimension such that it is insertable into the lumen (7) in order to increase the stiffness of the lead along its length during its working life when being implanted into a body. A method for implanting a medical implantable lead into a human or animal body makes use of such an assembly.

Abstract: An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate.

Abstract: Described herein are methods and systems for improving or adapting a breathing pattern of a patient with disordered breathing toward a more helpful state, as well as systems and devices for adapting breathing. These methods and systems may be used for improving sleep in patients with sleep disordered breathing and a system by which to implement devices for performing these methods.

Abstract: A medical, implantable electrode device, in particular a cardiological electrode device, comprises an elongate electrode body (2) having a proximal and a distal end (1) for insertion into the body of the patient and multiple strut-like anchoring elements (4), which are attached laterally to the electrode body (2) before the distal end (1) for fixing the electrode device in the patient and are distributed around the circumference, which each project having their longitudinal axis (SL) at an acute angle (W1) opening in the direction of the proximal end in relation to the electrode body axis (KL). The anchoring elements have a preferred direction around the circumference in such a way that upon engagement of the anchoring elements (4) in a body part of the patient, a rotation of the electrode body (2) is opposed by a greater resistance in one rotational direction than in the opposite direction.

Abstract: A device comprises a medical implant and an actively deployable clip attached to the medical implant that operates to restrict movement of the medical implant once the actively deployable clip is deployed within a body of a patient. In some embodiments, the medical implant is an electrical lead for electrical stimulation. The actively deployable clip is operable to fixate the medical implant to a body tissue once deployed, such that the actively deployable clip performs a similar function to a suture. In this manner, embodiments of the invention may provide a medical implant that requires few or even no sutures to properly fixate the implant within the patient.

Abstract: An implantable tissue-stimulating device, such as a cochlear implant, having a resiliently flexible elongate member (11) having a plurality of electrodes (12) positioned thereon. The elongate member (11) provides a means of delivering at least one bio-active substance to the implantee following implantation of the elongate member (11). The delivery means can comprise a lumen 21 containing the bio-active substance in a liquid form. The bio-active substance can comprise a steroid or can perform a function of reducing the resting neuron potential of neurons within the cochlea.

Abstract: In implantable medical devices such a pacemaker or cardioverter/defibrillators (ICDs) and systems including such a device and an external programmer a measure of a hemodynamic parameter such as the cardiac output, the stroke volume, or the contractility of a patient is used to trend heart failure or in an AV/VV optimization scheme. The implantable medical device is adapted to measure the cardiac impedance and the cardiac impedance data is used to determine impedance morphology curves, which, in turn, are used to compute a measure of the hemodynamic parameter.