Abstract: An implantable medical device lead having a flow measurement sensor mounted thereon is provided with a capsule mounted proximate to the sensor. The capsule is used to house electrical circuitry corresponding to the sensor in order to prevent impedance on conductors of the lead, which gradually decreases over chronic periods, from directly affecting signal transmission between the sensor and the electrical circuitry. The electrical circuitry includes a charge amplifier used for processing signals from the sensor. In some cases, the amplifier can be initially calibrated and periodically tuned so as to have consistent functioning with the sensor over chronic periods.

Abstract: IMDs and methods are provided for electroporation treatment of subcutaneous tumors. In some embodiments, IMDs of the present invention may store and introduce chemotherapy drugs into the body prior to electroporation therapy. High frequency stimulation of tissue in or around the tumor may also be provided to increase tissue temperature prior to electroporation therapy. Still further, delivery of the electroporation therapy may be synchronized with cardiac qRs complex to avoid impeding normal cardiac rhythm. Algorithms to suspend therapy in the event of edema may also be incorporated.

Abstract: In general, the invention provides for commencing an atrioventricular (AV) search in response to an indicator of an autonomic nervous system (ANS) activity. An implantable medical device (IMD) may be configured to apply this technique, and also to apply rate adaptive ventricular pacing. In response to ANS activity such as an abrupt increase in cardiac sympathetic nervous activity, the IMD performs an AV search to find the intrinsic AV interval of the patient. The invention includes selection of a maximum AV delay so that the AV search will not adversely affect hemodynamic function.

Abstract: A method for monitoring drug dose, intake and effectiveness includes a drug delivery device in data communications with at least one implantable medical device. The method is preferably implemented in a web-enabled environment in which a remote data center communicates with the implantable devices (IMDs) in a patient via a programmer or the pill dispenser. The method may include facilitating access by a physician, clinician, or other user of the remote data center to review and monitor the IMDs or the drug delivery regime remotely. The method further provides a dynamic drug management system, compatible with a web-enabled interactive data communication environment that accurately monitors dose and specific drug effectiveness in a patient to enhance patient care.

Abstract: A closed loop system for monitoring drug dose, intake and effectiveness includes a drug delivery device in data communications with at least one implantable medical device. The system is preferably implemented in a web-enabled environment in which a remote data center communicates with the implantable devices (IMDs) in a patient via a programmer or the pill dispenser. A physician, clinician, or other user may access the remote data center to review and monitor the IMDs or the drug delivery regime remotely. The system further provides a dynamic drug management system, compatible with a web-enabled interactive data communication environment that accurately monitors dose and specific drug effectiveness in a patient to enhance patient care.

Abstract: A mapped location of one or more electrodes within an electrical mapping volume is superimposed onto an ultrasound image corresponding to the electrical mapping volume.

Abstract: Mechanical activity of a heart is sensed by a cardiac lead that carries a triboelectric sensor. The triboelectric sensor produces a triboelectric signal in response to cardiac contractions. A lead fabricated according to the invention can be used for a variety of purposes, including without limitation, pacing capture verification, electromechanical conductivity status of the myocardium (including detecting relatively reduced myocardial activity indicative of ischemia, myocyte necrosis, arterial stenosis and the like). The sensor allows detection of mechanical activity without signal blanking traditionally utilized to stimulate and sense cardiac activity. Traditional circuitry can be employed to stimulate/sense while a triboelectric sensor unit(s) detect evoked and/or intrinsic mechanical cardiac activity.

Abstract: An implantable medical device (IMD) monitors at least one characteristic of P-waves within an electrogram signal. By monitoring changes in the characteristic over time, the IMD detects degradation of the atrial myocardium. In some embodiments, the IMD detects ischemia, an increased probability of the occurrence of angina, or a risk of future atrial fibrillation based on changes in the characteristic over time. The IMD can include a memory to store information relating to the detection and other diagnostic information for retrieval and evaluation by a clinician, and/or an alarm to alert the patient of the detection. In some embodiments, the IMD switches out of an atrial-tracking ventricular pacing mode, decreases the maximum tracking rate for an atrial-tracking ventricular pacing mode, increases the aggressiveness of rate-responsive atrial pacing, and/or initiates or modifies delivery of a therapy, such as a drug or neurostimulation, in response to the identification.

Abstract: An implantable medical device lead having a flow measurement sensor mounted thereon is provided with a capsule mounted proximate to the sensor. The capsule is used to house electrical circuitry corresponding to the sensor in order to prevent impedance on conductors of the lead, which gradually decreases over chronic periods, from directly affecting signal transmission between the sensor and the electrical circuitry. The electrical circuitry includes a charge amplifier used for processing signals from the sensor. In some cases, the amplifier can be initially calibrated and periodically tuned so as to have consistent functioning with the sensor over chronic periods.

Abstract: A system for monitoring drug dispensation and drug effects on physiological signals or implantable medical device (IMD) performance is provided. The system includes a drug dispenser adapted for telemetric communication with an IMD, an IMD capable of acquiring time-based physiological or device performance data, and a programmer/monitor for receiving and displaying IMD-acquired data and drug dispensation data. The system may further include a patient activator for transmitting signals indicative of symptoms experienced by a patient associated with a side-effect caused by a drug or a condition for which the drug has been prescribed to treat. In an associated method, a drug dispensation signal is generated upon activation of the drug dispenser. IMD-acquired data, drug dispensation data, and patient symptom data are retrieved by a programmer/monitor. IMD-acquired data is combined with or grouped according to drug dispensation data and displayed.

Abstract: An implantable medical device system for detecting cardiac conditions such the long-term ischemic heart disease, an occlusion of a coronary artery by a thrombus or an impending as a myocardial infarction. The implantable medical device (IMD) system includes a sensor that outputs a blood flow rate signal representing a rate of blood flow through a coronary sinus of a patient's heart. An implantable medical device (IMD) includes a microcomputer circuit configured to analyze the blood flow rate signal and detect a cardiac condition as a function of the blood flow rate signal. The system can also includes an implantable lead that senses electrical activity from the patient's heart. The microcomputer circuit monitors an ST segment of the electrical activity signal and detects a cardiac condition as a function of blood flow rate signal in conjunction with the electrical activity signal.

Abstract: In general, the invention is directed to techniques for capture testing of a capture threshold in cooperation with measurement of other cardiac parameters. Physiological or non-physiological parameters may indicate a possible change in the capture threshold, and a significant change in a cardiac parameter may trigger more frequent monitoring of the capture threshold. In addition, measurement of cardiac parameters in relation to measurement of the capture threshold may be useful in diagnosing problems and forecasting possible loss of capture.

Abstract: Mechanical activity of a heart is sensed by a cardiac lead that carries a triboelectric sensor. The triboelectric sensor produces a triboelectric signal in response to cardiac contractions. A lead fabricated according to the invention can be used for a variety of purposes, including without limitation, pacing capture verification, electromechanical conductivity status of the myocardium (including detecting relatively reduced myocardial activity indicative of ischemia, myocyte necrosis, arterial stenosis and the like). The sensor allows detection of mechanical activity without signal blanking traditionally utilized to stimulate and sense cardiac activity. Traditional circuitry can be employed to stimulate/sense while a triboelectric sensor unit(s) detect evoked and/or intrinsic mechanical cardiac activity.

Abstract: A method and corresponding system for updating or installing new software loaded into the memory of an implantable medical device(IMD) implanted within a body of a patient is described. The updated or new software may be installed in the memory of the IMD without the patient having to travel to a clinic or hospital, and may be effected by employing modem telecommunication and Internet techniques in conjunction with a remote computer system.

Abstract: Methods, devices and systems for automatically generating invoices when medical services are provided to a patient are described. Invoices are automatically generated by the system, for example, when monitoring of certain aspects of the performance of an implantable medical device(IMD) implanted within a body of a patient is initiated by the patient or remotely, or when the delivery of a therapy to the patient through the IMD is initiated locally or remotely. The IMD is capable of bi-directional communication with a communication module, a mobile telephone and/or a Personal Data Assistant (PDA) located outside the patient's body.

Abstract: A system for monitoring drug dispensation and drug effects on physiological signals or implantable medical device (IMD) performance is provided. The system includes a drug dispenser adapted for telemetric communication with an IMD, an IMD capable of acquiring time-based physiological or device performance data, and a programmer/monitor for receiving and displaying IMD-acquired data and drug dispensation data. The system may further include a patient activator for transmitting signals indicative of symptoms experienced by a patient associated with a side-effect caused by a drug or a condition for which the drug has been prescribed to treat. In an associated method, a drug dispensation signal is generated upon activation of the drug dispenser. IMD-acquired data, drug dispensation data, and patient symptom data are retrieved by a programmer/monitor. IMD-acquired data is combined with or grouped according to drug dispensation data and displayed.

Abstract: A system for monitoring drug dispensation and drug effects on physiological signals or implantable medical device (IMD) performance is provided. The system includes a drug dispenser adapted for telemetric communication with an IMD, an IMD capable of acquiring time-based physiological or device performance data, and a programmer/monitor for receiving and displaying IMD-acquired data and drug dispensation data. The system may further include a patient activator for transmitting signals indicative of symptoms experienced by a patient associated with a side-effect caused by a drug or a condition for which the drug has been prescribed to treat. In an associated method, a drug dispensation signal is generated upon activation of the drug dispenser. IMD-acquired data, drug dispensation data, and patient symptom data are retrieved by a programmer/monitor. IMD-acquired data is combined with or grouped according to drug dispensation data and displayed.

Abstract: A mapped location of one or more electrodes within an electrical mapping volume is superimposed onto an ultrasound image corresponding to the electrical mapping volume.

Abstract: According to the present invention a sensing means is provided for chronically measuring and/or sensing contractions of a right ventricle (RV) and/or a left ventricle (LV). The sensing means can include a tensiometric sensor, a single or a multiple axis accelerometer to measure peak endocardial acceleration due to atrial and ventricular depolarizations. For example, a tensiometric stylet, disposed within a portion of the coronary sinus, great vein, or branches of the great vein, simultaneously senses atrial contractions, RV contractions and LV contractions and provides an output signal related thereto. When an atrial contraction occurs, pacing stimulation is delivered to the LV upon expiration of a predetermined A-LV delay interval. The A-LV delay interval for the pacing therapy is adjusted so as to avoid delay between the respective contractions of RV and LV, respectively, and thereby promote ventricular synchrony.

Abstract: IMDs and methods are provided for electroporation treatment of subcutaneous tumors. In some embodiments, IMDs of the present invention may store and introduce chemotherapy drugs into the body prior to electroporation therapy. High frequency stimulation of tissue in or around the tumor may also be provided to increase tissue temperature prior to electroporation therapy. Still further, delivery of the electroporation therapy may be synchronized with cardiac qRs complex to avoid impeding normal cardiac rhythm. Algorithms to suspend therapy in the event of edema may also be incorporated.