Abstract: A method and medical system for operating two leads disposed adjacent tissue of a patient. A first one of a pair of electrodes respectively carried by the two leads is activated to generate an electrical field within the tissue. An electrical parameter in response to the generated electrical field is measured at a second one of the pair of electrodes. A reference electrical parameter is measured in response to the generated electrical field at a reference electrode carried by the same one of the two leads that carries the first electrode. A reference distance between the first electrode and the reference electrode is known prior to the generation of the electrical field. The ratio between the measured electrical parameter and the measured reference electrical parameter is computed, and the distance between the pair of electrodes is computed as a function of the computed ratio and the reference distance.

Abstract: At least one of a plurality of disorders of a patient characterized at least in part by vagal activity innervating at least one of a plurality of organs of the patient is treated by a method that includes positioning an electrode on a vagus nerve. An electrical signal is applied to the electrode to modulate vagal activity by an amount selected to treat the disorder. In some embodiments, the disorder is gastroparesis. The signal may be a blocking or a stimulation signal. In some embodiments, the signal is selected to a) at least in part, upregulate neural activity on the vagus nerve without triggering muscular contractility, and, b) increase pancreobilliary output.

Abstract: An apparatus for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling.

Abstract: A method and apparatus for treatment of hypertension and heart failure by increasing secretion of endogenous atrial hormones by pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in premature atrial contraction that does not result in ventricular contraction. Pacing results in the atrial wall stress, peripheral vasodilation, ANP secretion. Concomitant reduction of the heart rate is monitored and controlled as needed with backup pacing.

Abstract: A system for monitoring a fetus during gestation comprises an input for receiving a plurality of electric signals measured on a surface of a maternal body; and a processor for providing a fetal electrocardiogram based on the received electric signals and based on an orientation of the fetus, wherein the fetal electrocardiogram represents a projection of a fetal cardiac potential vector according to a predetermined projection direction that is fixed with respect to the fetus. The fetal vector electrocardiogram is projected according to the projection direction. An at least partial representation of a fetal vector electrocardiogram is provided in dependence on the plurality of electric signals and indicative of a time path of an electrical field vector generated by a fetal heart of the fetus.

Abstract: Implantable systems, and methods for use therewith, enable the monitoring of a patient's electromechanical delay (EMD) and arterial blood pressure. Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient's EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal. The value indicative of EMD can be used to more accurately determine metrics indicative of pulse arrival time (PAT), which can be used to estimate arterial blood pressure.

Abstract: Anchoring methods, systems and devices anchor an intravascular implantable device within a vessel that is located superior to the heart, i.e. above the heart in a direction toward the head of a patient. A method of providing an intravascular device and instructions for implanting the intravascular device, includes providing an intravascular device having an elongate device body with a proximal end and a distal end that is adapted for chronic implantation within the vasculature of a patient and that includes a distal portion of the intravascular device proximate the distal end of the elongate device body, and providing instructions for chronically implanting the intravascular device substantially wholly within the vasculature of a patient in a target vessel superior to the heart of the patient.

Abstract: A lead system may include a cuff electrode configured to be implanted on a nerve and including a cylindrical cuff body having a plurality of electrode contacts. The cylindrical cuff body may include a first side with a first longitudinal edge and a second side with a second longitudinal edge. The cylindrical cuff body may also have a proximalmost end surface and a distalmost end surface, wherein the first longitudinal edge includes a proximalmost end and a distalmost end, and the second longitudinal edge includes a proximalmost end and a distalmost end. The lead system may also include first and second lead portions having generally serpentine configurations and a first anchor interposed between the first and second lead portions and configured to be secured relative to a non-nerve body structure. The lead system may also include a connector extending proximally from the second lead portion and configured to electrically connect to an implantable pulse generator.

Abstract: An implantable medical device (IMD) may include at least two separate lead connection assemblies, each with electrical connectors for connecting implantable leads to the IMD. In some examples, a IMD may include a first therapy module configured to generate a first electrical stimulation therapy and a second therapy module configured to generate a second electrical stimulation therapy for delivery to the patient. The IMD may include a first lead connection assembly including a first electrical connector electrically coupled to the first therapy module and a second lead connection assembly including a second electrical connector electrically coupled to the second therapy module. In some examples, the first and second lead connection assemblies are distributed around the outer perimeter of the IMD housing.

Abstract: The present invention is configured to provide an offset weld and crimp in a coupling component that can be located entirely within a lumen of a lead body. This end is accomplished by providing an asymmetric coupling component is provided with a crimp recess, for example a groove or a bore extending along one side of the component and a thickened portion offset laterally from the groove or bore and having a welding surface displaced laterally from the groove or bore. While the embodiments illustrated herein are those employing a crimping groove, for purposes of understanding the invention it should be understood that a bore may be substituted. In preferred embodiments, the crimp recess is used to receive a stranded or cabled conductor within the lead body and the offset portion is used to attach to one or more filars of an electrode coil by welding thereto.

Abstract: An embodiment of a method uses an implantable device to deliver a heart failure therapy to a patient. The device is used to sense unintended motion of the patient caused by the neural stimulation and identify a sensed motion level for the sensed unintended motion, and to sense physiological activity of the patient, different than the sensed motion, and identify a sensed physiological activity level. Delivering the heart failure therapy includes delivering neural stimulation through an electrode to a neural target in an autonomic nervous system of the patient using the implantable device. The sensed motion level, the sensed physiological activity level, and the programmed mapping are used to determine the neural stimulation intensity level of the neural stimulation to be delivered for the motion level.

Abstract: Devices with both electrical and mechanical signal transducers can be used for improving sound perception by individuals with severe to profound hearing loss or tinnitus.

Abstract: A medical electrical lead includes a lead body, an inner assembly extending throught the lead body, an outer insulative layer covering the inner assembly, and an electrode mounted outside the exterior surface of the outer insulative layer. The inner assembly includes an elongate inner structure forming a lumen, an elongate conductor extending along an outer surface of the inner structure, and a conductive fitting coupled to the elongate conductor.

Abstract: Approaches for adjusting the pacing energy delivered by a pacemaker are provided. Adjusting the pacing energy involves performing a plurality of capture threshold tests, each capture threshold test measuring a capture threshold of the heart. One or more measured captured thresholds are selected, including at least one capture threshold that is higher relative to other measured capture thresholds acquired by the plurality of capture threshold tests. The pacing energy is adjusted based on the one or more selected capture thresholds.

Abstract: A cochlear implant electrode assembly device comprising an elongate electrode carrier member, a stiffening element, and a stiffening sheath that at least partially envelops the elongate member. The member is made of a resiliently flexible first material and has a plurality of electrodes mounted thereon. The member has a first configuration that allows it to be inserted into an implantee's cochlea. The member also has a second configuration wherein the member is curved to match an inside surface of the cochlea, and at least one intermediate configuration between the first and second configurations. Both the stiffening element and sheath are made of a material that is relatively stiffer than the member. The stiffening element and the stiffening sheath in combination bias the elongate member into the first configuration. If either the stiffening element or the stiffening sheath is removed or deactivated, the elongate member adopts an intermediate configuration.

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: Methods and devices for reducing phrenic nerve stimulation of cardiac pacing systems involve delivering a pacing pulse to a ventricle of a heart. A transthoracic impedance signal is sensed, and a deviation in the signal resulting from the pacing pulse may be used to determine phrenic nerve stimulation. Methods may further involve detecting the phrenic nerve stimulation from the pacing pulse by delivering two or more pacing pulse to the ventricle of the heart, and determining a temporal relationship. A pacing vector may be selected from the two or more vectors that effects cardiac capture and reduces the phrenic nerve stimulation. A pacing voltage and/or pulse width may be selected that provides cardiac capture and reduces the phrenic nerve stimulation. In other embodiments, a pacing pulse width and a pacing voltage may be selected from a patient's strength-duration curve that effects cardiac capture and reduces the phrenic nerve stimulation.

Abstract: A connector header includes a housing formed from a plastic material having a modulus of rigidity of 100 ksi or greater. The housing defines an opening for insertion of a lead. The connector header further includes a lead receptacle having an electrically conductive element. The electrically conductive element is operably couplable to a feedthrough of the implantable medical device. The lead receptacle is in communication with the opening and is disposed within the housing such that an electrical contact of the lead is electrically couplable to the conductive element of the receptacle when the lead is inserted into the receptacle.

Abstract: A method for improving renal function includes placing an electrode on a dorsal spinal cord within a central nervous system and applying an electrical current to the electrode. The electrode is positioned, and the electrical current is configured, to stimulate an afferent neuron without stimulating an efferent neuron, thereby causing an increase in renal excretion of sodium and water while having an insubstantial affect on a sympathetic nervous system.

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 beats, 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.