Abstract: The disclosure provides methods and apparatus of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants thereof. According to the disclosure monitoring and therapy delivery for a wide variety of acute and chronic cardiac dysfunctions are described and depicted. Various forms of paired or coupled pacing therapy delivery provided alone or in combination with neurostimulation therapy delivered by both implantable and external apparatus, including defibrillation therapy are also provided herein.

Abstract: A lead assembly is implanted utilizing a lead introducer inserted within an opening of the lead housing. The lead introducer includes an insertion portion and a handle connected to the insertion portion. The lead assembly can be extracted with a lead extractor inserted within an opening of the lead housing. The lead extractor includes an insertion portion having an expandable element, a flexible biocompatible covering around the expandable element, and a handle connected to the insertion portion.

Abstract: A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient's heart or reside in the intrathoracic blood vessels and for providing anti-bradycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-bradycardia pacing energy for delivery to the patient's heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.

Abstract: A valve opening detector for use in an implantable medical device detects opening of at least one valve in the left side of heart, and has an impedance measuring unit for measuring electrical impedance between measuring poles and for generating an impedance signal corresponding thereto, at least one of the poles being arranged in the coronary sinus and/or in the great cardiac vein of the heart. The valve opening detector also includes an impedance signal processor which processes the impedance signal to detect the opening of one or both valves in the left side of the heart.

Abstract: An atrial defibrillator includes a portable, non-implantable housing, a pair of defibrillator pads, a shock generator, and an analyzer. The pads are applied to the outside of a patient's body, and the shock generator delivers a shock to the patient via the pads. The analyzer receives a cardiac signal from the patient, determines from the signal whether the patient is experiencing atrial fibrillation, and enables the shock generator if the patient is experiencing atrial fibrillation. Unlike conventional external atrial defibrillators, such an atrial defibrillator can be used by a layperson in the comfort of a patient's own home. Furthermore, such a defibrillator does not cause the surgery-related problems associated with implantable atrial defibrillators. Moreover, because the patient can choose when to receive a shock, such a defibrillator is less likely to surprise and embarrass the patient than automatic implantable defibrillators are.

Abstract: An implantable cardiac stimulator including and accelerometer utilizes heart sound measurements to optimize the AV delay. One or more of the amplitude of the heart sound, the pre-ejection interval or the ejection interval is derived from the measurements and examined at various values of AV delay. The optimal AV delay is selected that corresponds to the highest cardiac function such as contractility, cardiac output and stroke volume. The stimulation device determines when the patient is at rest and the accelerometer provides a signal that corresponds to the audible component of a vibration produced as a result of ventricular contraction, blood movement toward the atrium, and the opening and closing of valves. The AV delay is adjusted within a range of values and the cardiac parameters are determined multiple times for each AV delay value. The average value of the cardiac parameter is examined to determine the optimal AV delay value.

Abstract: A system including an implantable defibrillation electrode includes a first layer of porous Polytetrafluoroethylene (PTFE) adjacent to at least one surface of the defibrillation electrode, the first layer of porous PTFE having a fibril length adapted to bleed gas away from the at least one surface of the defibrillation electrode, and a second layer of porous PTFE formed over the first layer, the second layer of porous PTFE having a fibril length adapted to prevent substantially all tissue in-growth.

Abstract: A method includes placing a first electrode into electrical contact with a first portion of the heart, placing a second electrode into electrical contact with a second portion of the heart, and transmitting an electrical pulse between the first electrode and the second electrode in response to a determination that a cardiac event is detected.

Abstract: A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and for providing cardioversion/defibrillation energy to the heart, the power supply comprising a capacitor subsystem for storing the cardioversion/defibrillation energy for delivery to the patient's heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing electrical energy to the capacitor subsystem.

Abstract: A subcutaneous implantable cardioverter-defibrillator which has an electrically active canister which houses a source of electrical energy, a capacitor, and operational circuitry that senses the presence of potentially fatal heart rhythms delivers cardioversion defibrillation energy between at least one subcutaneous lead and the electrically active canister. There are no transvenous, intracardiac, or epicardial electrodes. The electrically active canister and at least one lead is implanted utilizing a curved introducer to implant the electrically active canister subcutaneously at various locations around the thorax.

Abstract: An implantable medical device in which an electrogram is recorded and analyzed in order to detect changes indicative of cardiac ischemia. Cardiac ischemia may be detected by recording an electrogram from a sensing channel of the device and comparing the recorded electrogram with a reference electrogram. If cardiac ischemia is detected, a cardiac drug such as a thrombolytic agent is delivered.

Abstract: A dual-chamber cardiac pacemaker comprising an atrial detection unit which is adapted to detect electrical signals in the atrium of a heart as atrial sense events, a ventricular detection unit which is adapted to detect electrical signals of a ventricle of the heart as ventricular sense events, a stimulation unit which is adapted at least to trigger the delivery of electrical pulses to the ventricle as ventricular stimulation events, and a control unit which is connected to the atrial and the ventricular detection units and the stimulation unit and adapted to control triggering of the delivery of pulses in dependence on the atrial detection unit and the ventricular detection unit in such a way that pulse delivery to the ventricle is triggered after the expiry of an AV time after detection of an atrial sense or stimulation event if prior to expiry of the AV time no ventricular sense event is detected by the ventricular detection unit, wherein the control unit is further adapted to divide ventricular sense even

Abstract: An implantable cardiac stimulation device has a system and method that monitors progression or regression in a patient's heart disease. A pulse generator delivers pacing pulses to the heart to cause evoked responses of the heart. A sensing circuit senses the evoked responses of the heart and generates evoked response signals. A processor is programmed to analyze the evoked response signals, to isolate a given characteristic of the evoked response signals and to quantify the isolated characteristics to provide corresponding quantized values. Relative changes in the quantized values over time are indicative of the progression or regression in the patient's heart disease. A memory stores the quantized values and a telemetry circuit transmits the stored quantized values to an external receiver for analysis.

Abstract: A system for automating the process of generating reports, such as warranty and registration reports, for programmable medical devices. The system uses a variety of data collecting and checking techniques to make the generator and transmission of such reports more efficient.

Abstract: A device for attaching at least three electrodes to a subject for stimulating abdominal muscles of the subject, comprising an attachment mechanism for extending around the torso of the subject and a main locating element provided on the attachment mechanism for locating a central electrode of the at least three electrodes adjacent the umbilicus of the subject. Two secondary locating elements are also provided on the attachment mechanism disposed on respective opposite sides of the main locating element for locating two corresponding side electrodes of the at least three electrodes spaced apart from the central electrode. Application of at least one pulsed signal to the subject through the respective central and side electrodes stimulates the abdominal muscles of the subject.

Abstract: One embodiment of the present invention provides an implantable cardioverter defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator including a housing; an electrical circuit located within the housing; a first electrode coupled to the electrical circuit and located on the housing; and a second electrode coupled to the electrical circuit.

Abstract: Techniques for preventing inadvertent detection of AT termination may involve predicting potential undersensing of atrial events, and delaying detection of AT termination when undersensing of atrial events is predicted. For example, an implantable medical device may measure ventricular-atrial (VA) intervals of a heart rhythm using tracked atrial and ventricular events. The device calculates a slope of the series of the VA intervals, and estimates a prospective VA interval using the calculated slope and the most recently measured VA interval. The device determines whether the estimated VA interval is within a threshold range. When the estimated VA interval is outside of the threshold range, the device predicts possible undersensing of atrial events and delays detection of the AT episode termination. The delay detection of AT episode termination improves the accuracy of information collected by event counters.

Abstract: An implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and twelfth rib within a patient includes a duck-bill shaped housing. The housing includes a proximal end and distal end, where the width of the proximal end is less than the width of the distal end, and an electrode located on the housing.

Abstract: A rate-adaptive cardiac pacemaker has a detection unit 1, an event-determining unit 2, a stimulation control unit 3 and a stimulation unit 11, wherein the event-determining unit 2 is connected to the detection unit 1 and the stimulation control unit 3, and the stimulation unit 11 is connected to the stimulation control unit 3. The detection unit 1 detects ECG signals of a heart 100, and the event-determining unit 2, on the basis of the ECG signals detected by the detection unit 1 and signals emitted by the stimulation control unit 3, determines whether a detected event represents a spontaneous or a stimulated event (Ap, As; AES, Vp, Vs, VES).

Abstract: ECG-related adaptor/sensor structure and methodology which enables various selectable operational communication to occur both unidirectionally and bidirectionally between the adaptor/sensor structure, and remote structure which is intended to receive ECG-related physiologic data from the adaptor/sensor structure.