Abstract: A method of identifying potential driver sites for cardiac arrhythmias includes acquiring a plurality of electrograms from a plurality of locations on at least a portion of a patient's heart. Using the acquired electrograms, at least one electrical activity map is generated. Desirable electrical activity maps include complex fractionated electrogram standard deviation and mean maps, dominant frequency maps, peak-to-peak voltage maps, and activation sequence maps. Using one or more of these maps (e.g., by analyzing one or more electrogram morphological characteristics represented by these maps), at least one potential driver site can be detected.

Abstract: An implantable cardiac device has a heart stimulator for electrically stimulating the heart of a patient, detector that measures a physiologic parameter that is affected by the status of a cardiovascular disease associated with sympathetic activation, a signal processor that determines at least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the measured parameter, and analyzer that automatically analyzes the determined Mayer wave component in relation to a predetermined reference value to determine the status of the cardiovascular disease. The detector is a cardio-mechanical parameter detector that measures, as said physiologic parameter, a mechanical change in at least one of the four chambers of the heart. In a corresponding method for monitoring the status of a cardiovascular disease associated with sympathetic activation of a patient having an implantable electric heart stimulator a physiologic parameter affected by the cardiac disease is measured.

Abstract: A medical device lead includes an insulative lead body, outer and inner conductive coils, and a flexible core assembly. The outer conductive coil extends through the lead body and is coupled to a first electrode at a distal end of the outer conductive coil. The inner conductive coil extends coaxially with the outer conductive coil, is coupled to a second electrode at a distal end of the inner conductive coil, and includes a central lumen. The flexible core assembly is disposed in the central lumen and is comprised of a material that has a saturation magnetization of at least about 1.5 T and a relative permeability of greater than one. The flexible core assembly includes a positioning interface configured for manipulation of the flexible core assembly such that the flexible core assembly translates through the central lumen during insertion and extraction of the flexible core assembly.

Abstract: A system and method are provided for the detection of acute myocardial infarction (AMI) using a staged approach for accurate and rapid detection. Physiological signals in a patient's body are sensed and corresponding physiological parameters are derived in a staged approach in order to determine the probability that AMI is occurring in a patient in a first detection stage. If the computed probability from physiological signals indicates the possibility of AMI, then the patient is prompted, such as through a patient-wearable device, to answer specific AMI-related questions to assist in diagnosis of AMI in a second stage. AMI is detected when the computed probability in the second stage exceeds a predefined detection threshold. A patient or physician alert may then be generated, which may further include the transfer of data via a communication link or network, in response to an AMI detection signal.

Abstract: Various embodiments relating to MRI safe, multi-polar active fixation stimulation leads with co-radial construction are disclosed. Some embodiments, allow the use of the generally smaller diameter co-radially constructed body (coated wires) to construct an active fixation lead, with an extendable/retractable fixation mechanism. Some embodiments use a connector assembly with an inner terminal ring, a terminal pin partially rotatably positioned within the annular inner terminal ring, and one or more resilient C-clips disposed within circumferential recesses. The resilient C-clips mechanically and electrically couple the inner terminal ring and the terminal ring while substantially limiting relative longitudinal translation of the terminal pin.

Abstract: An implantable medical device controls an anti-tachyarrhythmia therapy by detecting a tachyarrhythmia episode from a cardiac signal and analyzing the detected tachyarrhythmia episode in a tachyarrhythmia detection and analysis process to determine whether the anti-tachyarrhythmia therapy needs to be delivered. The tachyarrhythmia detection and classification process includes detection of inhibitory events each indicating that the tachyarrhythmia episode is of a type not to be treated by the anti-tachyarrhythmia therapy or that the tachyarrhythmia episode is not sustaining. The detection of each of the inhibitory events causes the tachyarrhythmia detection and classification process to be restarted or extended, or the delivery of the anti-tachyarrhythmia therapy to be withheld.

Abstract: A system and method for monitoring an individual's physiological condition and detecting abnormalities therein, comprising concurrently receiving an electrocardiograph signal and a ballistocardiograph signal. The electrocardiograph and ballistocardiograph signals are conditioned to minimize background extraneous noise after which, each signal is concurrently processed and analyzed to detect repeating cyclical patterns and further characterized to identify individual components of the repeating cycles. At least one individual component in one signal is selected as a reference marker or a selected component in the other signal. The two signals are then synchronized, outputs produced therefrom and stored in a database.

Abstract: A system and method for monitoring an individual's physiological condition and detecting abnormalities therein, comprising concurrently receiving an electrocardiograph signal and a ballistocardiograph signal. The electrocardiograph and ballistocardiograph signals are conditioned to minimize background extraneous noise after which, each signal is concurrently processed and analyzed to detect repeating cyclical patterns and further characterized to identify individual components of the repeating cycles. At least one individual component in one signal is selected as a reference marker or a selected component in the other signal. The two signals are then synchronized, outputs produced therefrom and stored in a database.

Abstract: A microcontrolled electrocardiographic monitoring circuit with differential voltage encoding is provided. An input signal path includes an electrode, a low pass filter, and an amplifier, which are each connected in-line. The electrode senses an input signal via a conductive surface and the amplifier outputs a filtered amplified output signal. A microcontroller circuit includes an input codec, an analog-to-digital converter, and an encoder. The analog-to-digital converter is connected to the input signal path through an output of the amplifier and converts the filtered amplified output signal into a data stream of discrete digital values. The encoder determines a differential voltage between a current discrete digital value and a prior discrete digital value in the data stream. Persistent memory is connected to the microcontroller circuit via a peripheral serial interface bus, wherein the differential voltages for each of the discrete digital values in the data stream are stored into the persistent memory.

Abstract: An active implantable medical device for cardiac resynchronization with automatic optimization of atrioventricular and interventricular delays is disclosed. The device collects an endocardial acceleration signal EA and calculates the atrioventricular delay AVD and the interventricular delay VVD. The device isolate in the EA signal a component EA4 corresponding to the fourth EA peak and measure a temporal parameter related to a time interval between the detection of an atrial event (P/A) and the occurrence of the EA4 component. The device isolates an EA1 component corresponding to the first EA peak and measures a non-temporal parameter (APEA1) related to the peak amplitude or a signal energy of the EA1 component. The optimal AVD (AVDO) is determined by the temporal parameter related to the EA4 component, and is calculated for a plurality of different values of VVD to obtain a plurality of pairs of optimal values {AVDO, VVD}.

Abstract: The disclosure describes techniques for objectification of posture state-responsive therapy based on patient therapy adjustments. The techniques may include sensing posture states of a patient, delivering posture-state responsive electrical stimulation therapy to the patient based on the sensed posture states, receiving patient adjustments to the electrical stimulation therapy delivered to the patient, determining a number of the patient adjustments received over a time interval, and presenting a representation of the number of the patient adjustments received over the time interval to a user.

Abstract: A system and method for use in a medical device for discriminating cardiac events establishes population-based thresholds corresponding to cardiac signal morphology metrics for discriminating between a first cardiac event and a second cardiac event. A population-based threshold criterion for discriminating cardiac events is established. The population-based threshold criterion is applied to a cardiac signal segment and the segment is classified if the criterion is satisfied. A patient-specific threshold is established in response to the sensed cardiac signal segment not being classified after applying the population-based threshold criterion. The sensed signal segment is classified in response to the patient-specific threshold comparison.

Abstract: To control cardiac arrhythmias such as atrial fibrillation post-operatively, various non-ablative agents include polymers, fibroblasts, neurotoxins, and growth factors are introduced into one or more cardiac fat pads into the atrioventricular nodal fat pad in proximity to the autonomic ganglia therein. Any desired technique may be used for introducing the agent, including injection. The sinoatrial nodal fat pad target site and the atrioventricular nodal fat pad target site are identified using a stimulator, which may have electrodes coupled thereto or which may coupled to electrodes built into a delivery system.

Abstract: A method for monitoring an individual's physiological condition and detecting abnormalities therein, comprising concurrently receiving an electrocardiograph signal and a ballistocardiograph signal. The electrocardiograph and ballistocardiograph signals are conditioned to minimize background extraneous noise after which, each signal is concurrently processed and analyzed to detect repeating cyclical patterns and further characterized to identify individual components of the repeating cycles. At least one individual component in one signal is selected as a reference marker for a selected component in the other signal. The two signals are then synchronized, outputs produced therefrom and stored in a database.

Abstract: Generating a three-dimensional representation of cardiac electrical activity within a subject's heart includes collecting, from a catheter having a distal portion that includes sensors that sense electrical activity and which catheter distal portion is positioned within a cardiac chamber of a subject, data for electrical activity sensed by the catheter distal portion while positioned within the chamber of the heart. The method also includes executing an imaging algorithm on the collected electrical activity data to generate a three-dimensional representation of cardiac electrical activity within a volume of the subject including all or a portion of the subject's heart. The method further includes displaying the imaged three-dimensional cardiac electrical activity.

Abstract: Method and apparatus (120) for modifying gene expression in cardiac muscle cells (110), by the application of electric fields.

Abstract: An article comprising a drive cable suitable for high-speed operation in an anatomy having small-radii bends is disclosed. The drive cables disclosed herein include one or more physical adaptations that enable them to be “tuned” to avoid large amplitude vibrations during operation.

Abstract: A heart assist device connection system comprises an inflow connector in fluid-tight communication with an inflow section of a heart assist device. The connector is configured to be releasably connected to an inlet extension inserted into a patient's ventricle. The connector has one or more recesses configured to match a protrusion on the inlet extension. The system also comprises an outflow connector in fluid communication with an outflow section of the heart assist device. The outflow connector is configured to be releasably connected to a conduit attached-to the patient's vasculature.

Abstract: A programmer allows a clinician to identify desirable combinations of electrodes from within an electrode set implanted in a patient that enable delivery of desirable neurostimulation therapy by an implantable medical device. The clinician may create neurostimulation therapy programs that include identified desirable electrode combinations. In some embodiments, the clinician may use the programmer to select a program, such as a program identified during a neurostimulation programming session, and direct the programmer to replicate the selected program. The programmer may change one or more parameters of the selected program, such as pulse amplitude or duty cycle, when generating the copy of the selected program.

Abstract: A diagnostic device for determining the amount of change required in a coronary sinus to reduce valve regurgitation. The device includes a distal tube having a distal anchor at a distal end portion of the distal tube, a proximal tube having a proximal anchor at a distal end portion of the proximal tube, and an adjustor to move the distal tube relative to the proximal tube. The proximal tube and the distal tube together form a telescoping elongate body adapted to fit within the coronary sinus, and the device includes a scale to measure the movement of the distal anchor relative to the proximal anchor.