Abstract: A lead connection assembly of an implantable medical device (IMD) may include at least two different types of electrical connectors. In some examples, the lead connection assembly may include first and second electrical connectors that have at least one of a different electrical contact arrangement, a different lead connection receptacle geometry or a different size than the first electrical connector. The first electrical connector may be electrically connected to a first therapy module that generates cardiac rhythm therapy that is delivered to a heart of a patient, and the second electrical connector may be electrically connected to a second therapy module that generates electrical stimulation that is delivered to a tissue site within the patient. The second electrical connector may be configured to be incompatible with a lead that delivers the cardiac rhythm therapy to the patient.

Abstract: Improved assemblies, systems, and methods provide an electrical signal processor for acquisition and processing of electric signals from tissue. The electrical signal processor is sized and configured to be implanted in subcutaneous tissue. The electrical signal processor includes an electrically conductive case of a laser welded titanium material. Control circuitry is located within the case, the control circuitry including a rechargeable power source, a receive coil for receiving a first radio frequency wireless telemetry to recharge the power source, and an antenna for receiving a second radio frequency wireless telemetry for communication with the electrical signal processor.

Abstract: Electrocardiogram wave data in which a component of cardiac massage is removed from the electrocardiogram wave data is generated, so that the electrocardiogram wave at the time of cardiopulmonary resuscitation is identified. An electrocardiogram wave processing system of obtaining and processing the electrocardiogram wave data includes a wave identification unit that identifies an electrocardiogram wave from the obtained electrocardiogram wave data, a feature selection unit that selects a feature pattern including a feature when a cardiac massage has been performed with respect to the electrocardiogram wave data identified by the wave identification unit, a generation unit that generates a component of the cardiac massage using the feature pattern selected by the feature selection unit, and a removal unit that removes, from the obtained electrocardiogram wave data, the component of the cardiac massage generated by the generation unit.

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: 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: An implantable medical device includes a lead, a pulse generator, an autothreshold module and a control module. The lead includes electrodes positioned within a heart. At least one of the electrodes senses cardiac signals. The pulse generator delivers a stimulus pulse through at least one of the electrodes. The autothreshold module performs a threshold search when operating in an autothreshold mode and causes atrial stimulus pulses to be delivered in an atrium of the heart at an overdrive rate during the threshold search. The control module determines an AV conduction time and applies an overdrive AV adjustment to the AV conduction time to generate an AV delay. The autothreshold module uses the AV delay in connection with delivering ventricular stimulus pulses to a ventricle of the heart.

Abstract: An implantable medical device includes an acoustic transducer for intra-body communication with another medical device via an acoustic couple. The acoustic transducer includes one or more piezoelectric transducers. In one embodiment, an implantable medical device housing contains a cardiac rhythm management (CRM) device and an acoustic communication circuit. The acoustic transducer is electrically connected to the acoustic communication circuit to function as an acoustic coupler and physically fastened to a wall of the implantable housing, directly or via a supporting structure. In one embodiment, the implantable medical device receives an incoming acoustic signal from the other medical device, detects an error rate associated with the incoming acoustic signal, and adjusts a carrier frequency for an outgoing acoustic signal to be transmitted to the other medical device using the error rate.

Abstract: Specific embodiments provided herein relate to diagnosing, with improved specificity, occurrences of episodes relating to disorders that are known to affect T-wave morphology. One or more propensity metric is obtained, each of which is indicative of a patient's propensity for a specific disorder that is known to affect T-wave morphology. T-wave variability is monitored. Additionally, there is monitoring for a specific change in T-wave morphology that is known to be indicative of episodes relating to a disorder. When the specific change in T-wave morphology is detected, a diagnosis is determined for detecting the specific change in T-wave morphology, taking into account the propensity metric(s) and the T-wave variability.

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: Improved assemblies, systems, and methods provide an implantable pulse generator for prosthetic or therapeutic stimulation of muscles, nerves, or central nervous system tissue, or any combination thereof. The implantable pulse generator is sized and configured to be implanted subcutaneously in a tissue region. The implantable pulse generator includes an electrically conductive case of a laser welded titanium material. Control circuitry is located within the case. The control circuitry includes a rechargeable power source, a receive coil for receiving an RF magnetic field to recharge the power source, and a microcontroller for control of the implantable pulse generator. The improved assemblies, systems, and methods also provide a stimulation system for prosthetic or therapeutic stimulation of muscles, nerves, or central nervous system tissue, or any combination thereof.

Abstract: An implantable fixation structure includes a c-shape bone fixation clip adapted to fit over and attach to a bony bridge element in the middle ear of a patient. A c-shape electrode fixation clip is adapted to fit over and attach to an electrode array element in the middle ear of the patient. A connecting bar has a first end connected to the bone fixation clip and a second end connected to the electrode fixation clip. A coupling clip is connected to the connecting bar between the first end and the second end and adapted to fit over and attach to a cochlear implant element and hold the cochlear implant element in a desired position relative to the middle ear of the patient.

Abstract: Cardiac devices and methods discriminate non-captured intrinsic beats during evoked response detection and classification by comparing the features of a post-pace cardiac signal with expected features associated with a non-captured response with intrinsic activation. Detection of a non-captured response with intrinsic activation may be based on the peak amplitude and timing of the cardiac signal. The methods may be used to discriminate between a fusion or capture beat and a non-captured intrinsic beat. Discriminating between possible cardiac responses to the pacing pulse may be useful, for example, during automatic capture verification and/or a capture threshold test.

Abstract: Implantable systems, and methods for use therein, perform at least one of a cardiac assessment and an autonomic assessment. Short-term fluctuations in PR intervals, that follow the premature contractions in the ventricles, are monitored. At least one of a cardiac assessment and an autonomic assessment is performed based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles. This can include assessing a patient's risk of sudden cardiac death (SCD), assessing a patient's autonomic tone and/or detecting myocardial ischemic events based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles.

Abstract: An improved arbitration scheme for allowing concurrent stimulation and telemetry listening in a microstimulator is disclosed. A listening window for telemetry is permitted to proceed, and access to the microstimulator's coil granted, during at least a portion of the inter-pulse period that follows the issuance of a stimulation pulse. This is permissible because access to the coil is not needed during the entirety of the inter-pulse period. For example, the listening window can issue during that portion of the inter-pulse period when the decoupling capacitor is discharged, but cannot issue during that portion of the inter-pulse period when the compliance voltage is being generated for the next stimulation pulse. However, because compliance voltage generation occupies only a small portion of the inter-pulse period, the technique is not substantially limited.

Abstract: A method and apparatus for delivering cardiac resynchronization therapy (CRT) in which an evoked response electrogram is recorded during one or more cardiac cycles and used to aid in the selection of resynchronization pacing parameters and/or to monitor the effectiveness of resynchronization therapy. The morphology of an evoked response electrogram may be recorded and analyzed to determine if and when intrinsic activation of one ventricle is occurring in order to optimally adjust the programmed atrio-ventricular (AV) delay interval for ventricular resynchronization pacing of a patient with intact AV node conduction.

Abstract: An apparatus for applying a signal to a nerve for the treatment of a disorder includes a first electrode and a second electrode. Each of the electrodes is adapted to be secured to a nerve of a patient. A signal generator is electrically connected to each of the first and second electrodes. The signal generator is adapted to create a signal having a first waveform at the first electrode and a second waveform at the second electrode. The waveforms have parameters selected to block propagation of neural action potentials. The waveforms have a repeating pattern of cycles of pulses with a delay period between at least selected ones of said pulses. In one embodiment, the first and second waveforms are out of phase for a cycle of one of the waveforms to occur during a delay period of the other of the waveforms.

Abstract: A method and apparatus for adjusting a sensing parameter in a medical device that includes a sensing electrode sensing cardiac signals, a processor to determine an adjusting characteristic associated with the cardiac signals sensed over a predetermined sensing window, and a control unit to update the sensing parameter in response to the determined adjusting characteristic.

Abstract: An external defibrillator is customized for at least one person, i.e., an anticipated patient, through creation of a profile for the anticipated patient that allows the defibrillator and users of the defibrillator to provide customized treatment to the patient. The profile may include treatment parameters for the anticipated patient, such as defibrillation therapy parameters selected for the patient. The profile may also include a baseline recording of a physiological parameter of the patient, and medical history and personal information regarding the patient. In some embodiments, the external defibrillator stores a profile for each of one or more anticipated patients within a memory. In other embodiments, a profile for an anticipated patient is stored within a medium associated with that anticipated patient. The medium may, for example, be a removable medium for external defibrillators.

Abstract: An external defibrillator is customized for at least one person, i.e., an anticipated patient, through creation of a profile for the anticipated patient that allows the defibrillator and users of the defibrillator to provide customized treatment to the patient. The profile may include treatment parameters for the anticipated patient, such as defibrillation therapy parameters selected for the patient. The profile may also include a baseline recording of a physiological parameter of the patient, and medical history and personal information regarding the patient. In some embodiments, the external defibrillator stores a profile for each of one or more anticipated patients within a memory. In other embodiments, a profile for an anticipated patient is stored within a medium associated with that anticipated patient. The medium may, for example, be a removable medium for external defibrillators.

Abstract: An external defibrillator is customized for at least one person, i.e., an anticipated patient, through creation of a profile for the anticipated patient that allows the defibrillator and users of the defibrillator to provide customized treatment to the patient. The profile may include treatment parameters for the anticipated patient, such as defibrillation therapy parameters selected for the patient. The profile may also include a baseline recording of a physiological parameter of the patient, and medical history and personal information regarding the patient. In some embodiments, the external defibrillator stores a profile for each of one or more anticipated patients within a memory. In other embodiments, a profile for an anticipated patient is stored within a medium associated with that anticipated patient. The medium may, for example, be a removable medium for external defibrillators.