Abstract: Devices, systems and methods for controlling (inhibiting or enabling) the delivery of electrotherapeutic signals to a heart using sensing of local and/or global ECG signals to detect ventricular arrhythmia or indication of possible ventricular arrhythmia in the heart. The devices, systems and methods process the sensed signals and are capable of delivering electroptherapeutic signals to the heart in the presence of a supra-ventricular arrhythmia such as atrial fibrillation and atrial flutter, while inhibiting the delivering electroptherapeutic signals in the presence of PVCs and/or extopic beats, and/or ventricular arrhythmia. The electrotherapeutic signals may include, among others, pacing signals and cardiac contractility modulating signals.

Abstract: Apparatus is provided, including a control unit (310), adapted to be implanted within a patient (324), and a corkscrew-shaped electrode mount (400), adapted to be implanted in a wall of a stomach of the patient. The corkscrew-shaped electrode mount includes first (404) and second (424) electrodes, at respective sites of the electrode mount, and a controller (420), wirelessly coupled to the control unit. Other embodiments are also described.

Abstract: A cardiac contractility modulating (CCM) device (30) includes an anti-arrhythmic therapy unit (38) for detecting a cardiac arrhythmia in a heart (2) of a patient based on processing electrical signals related to cardiac activity sensed at the heart, and for delivering anti-arrhythmic therapy to the heart. The device includes a cardiac contractility modulating (CCM) unit (40) capable of delivering cardiac contractility modulating (CCM) signals to the heart for modulating the contractility of a portion of the heart. The device may provide to the anti-arrhythmic therapy unit control signals associated with the delivery of the CCM signals to the heart. The control signals may be used to prevent interference of the CCM signals with the detecting of the cardiac arrhythmia. The device (30) includes a power source. The device may be an implantable device or a non-implantable device. The device may also include a pacing unit.

Abstract: A method is provided, including physically contacting a gastric implantation site of a stomach via a transluminal approach, physically contacting the site via a transabdominal approach, stabilizing the site, and implanting an electrode at the site based on the physical contact provided by the transluminal and transabdominal approach. Other embodiments are also described.

Abstract: Devices, systems and methods for controlling (inhibiting or enabling) the delivery of electrotherapeutic signals to a heart using sensing of local and/or global ECG signals to detect ventricular arrhythmia or indication of possible ventricular arrhythmia in the heart. The devices, systems and methods process the sensed signals and are capable of delivering electroptherapeutic signals to the heart in the presence of a supra-ventricular arrhythmia such as atrial fibrillation and atrial flutter, while inhibiting the delivering electroptherapeutic signals in the presence of PVCs and/or extopic beats, and/or ventricular arrhythmia. The electrotherapeutic signals may include, among others, pacing signals and cardiac contractility modulating signals.

Abstract: A method of assessing contractility of a cardiac muscle which has an activation parameter, the method comprising: (a) utilizing time correlated data pertaining to an activation parameter to produce a profile of said parameter; and (b) analyzing changes in said profile to generate an indication of contractility.

Abstract: A transcutaneous charging device for charging an implant comprising: a power input; a conversion circuit to convert power from said power input to transcutaneously charge said implant; a control; and an indication element; wherein said control is programmed to initiate an indication using said indication element when it is time to charge said implant.

Abstract: A cardiac stimulator for measuring pacing impedance includes a tank capacitor for delivering charge to the heart via leads, a shunt resistor, and high-impedance buffers for measuring pacing current through the shunt resistor. During the stimulation pulse, the voltage across the shunt resistor, as sampled by a high-impedance buffer, variously indicates lead and cardiac tissue resistance or capacitance. A high-impedance buffer measures the voltage between the tank capacitor and ground immediately following the stimulation pulse to allow estimation of the lead/heart tissue capacitance. A lead/heart tissue capacitance estimate is determined by look-up table is in memory or successive approximation. When the lead/heart tissue capacitance and lead resistance have been determined, a plurality of parameters for analyzing and optimizing a cardiac stimulation system may be calculated, such as the instantaneous current, the average current, the charge, and the energy delivered to the cardiac tissue.

Abstract: A cardiac contractility modulating (CCM) device (30) includes an anti-arrhythmic therapy unit (38) for detecting a cardiac arrhythmia in a heart (2) of a patient based on processing electrical signals related to cardiac activity sensed at the heart, and for delivering anti-arrhythmic therapy to the heart. The device includes a cardiac contractility modulating (CCM) unit (40) capable of delivering cardiac contractility modulating (CCM) signals to the heart for modulating the contractility of a portion of the heart. The device may provide to the anti-arrhythmic therapy unit control signals associated with the delivery of the CCM signals to the heart. The control signals may be used to prevent interference of the CCM signals with the detecting of the cardiac arrhythmia. The device (30) includes a power source. The device may be an implantable device or a non-implantable device. The device may also include a pacing unit.

Abstract: A multi-modal cardiotherapy device (100) includes an anti-arrhythmic unit (118) for delivering multiple types of anti-arrhythmic therapy to a heart, a cardiac contractility modulating unit (108) for delivering cardiac contractility modulating signals to the heart, and for applying anti-arrhythmic cardiac contractility modulating signal therapy to the heart, one or more sensing units (112) for sensing electrical signals related to electrical activity of the heart to provide an output signal, one or more detecting units (116) operatively connected to the sensing unit(s) (112) for detecting in the output signal cardiac events of the heart, a controller unit (106) operatively connected to the anti-arrhythmic unit (118), the cardiac contractility modulating unit (108) and the detecting unit(s) (116).

Abstract: A cardiac contractility modulating (CCM) device includes an anti-arrhythmic therapy unit for detecting a cardiac arrhythmia in a heart of a patient based on processing electrical signals related to cardiac activity sensed at the heart, and for delivering anti-arrhythmic therapy to the heart. The device includes a cardiac contractility modulating unit capable of delivering cardiac contractility modulating signals to the heart for modulating the contractility of a portion of the heart. The device may provide to the anti-arrhythmic therapy unit control signals associated with the delivery of the CCM signals to the heart. The control signals may be used to prevent interference of the CCM signals with the detecting of the cardiac arrhythmia. The device includes a power source. The device may be an implantable device or a non-implantable device. The device may also include a pacing unit.

Abstract: A technique for acquiring and accessing information from a medical implantable device is provided. Analog waveforms of interest are sensed and processed by signal acquisition circuitry. Analog parameters of interest are applied to selector switches which are controlled by a logic circuit. The logic circuit is also coupled an A/D converter for converting the analog signals to digital values. The digital values are stored in dedicated registers and are available for telemetry to an external device upon receipt of a request or prompt signal. When a digitized value is accessed and telemetered, the control logic circuit changes the conductive state of the selector switches to apply the corresponding analog signal to the A/D converter. The resulting digital value is applied to the corresponding register to refresh the accessed and telemetered value. The technique permits the external device to request and configure the implanted device to send only digitized values of interest.

Abstract: A cardiac stimulator for measuring pacing impedance includes a tank capacitor for delivering charge to the heart via leads, a shunt resistor, and high-impedance buffers for measuring pacing current through the shunt resistor. During the stimulation pulse, the voltage across the shunt resistor, as sampled by a high-impedance buffer, variously indicates lead and cardiac tissue resistance or capacitance. A high-impedance buffer measures the voltage between the tank capacitor and ground immediately following the stimulation pulse to allow estimation of the lead/heart tissue capacitance. A lead/heart tissue capacitance estimate is determined by look-up table is in memory or successive approximation. When the lead/heart tissue capacitance and lead resistance have been determined, a plurality of parameters for analyzing and optimizing a cardiac stimulation system may be calculated, such as the instantaneous current, the average current, the charge, and the energy delivered to the cardiac tissue.

Abstract: A cardiac stimulator capable of measuring pacing impedance includes a tank capacitor for delivering charge to the heart via device leads, a shunt resistor, and high-impedance buffers for measuring pacing current through the shunt resistor. Soon after the leading edge of the stimulation pulse, the voltage across the shunt resistor, as sampled by a high-impedance buffer, indicates lead and cardiac tissue resistance. Just prior to opening the pacing switch to terminate the stimulation pulse, the voltage across the shunt resistor is sampled by a high-impedance buffer and held once again to allow the capacitance of the lead/heart tissue to be calculated. In alternative embodiments, a high-impedance buffer measures the voltage between the tank capacitor and ground immediately following the stimulation pulse to allow estimation of the lead/heart tissue capacitance.

Abstract: A method and apparatus is provided for modifying contractility of the heart of a patient. The method includes receiving signals from a sensor coupled to the body of the patient indicative of physical exertion by the patient. The signals are analyzed to estimate a metabolic demand of the patient, and excitable tissue control (ETC) stimulation is applied so as to enhance contractility of the heart muscle responsive to the metabolic need.

Abstract: An intravascular lead having a distal and proximal ends, comprising at least one electrode electrically connected to a conductive insulated wire of a predetermined diameter, tapered at least at one predetermined location along said wire towards its distal end to provide a predetermined smaller diameter wire, thus presenting a main proximal relatively thick lead segment, and a relatively thinner distal lead segment, allowing catheterization of the cardiac sinus and in particular the delivery of said electrode into a selected coronary venule.

Abstract: A cardiorespiratory monitor that generates bioimpedance sensing signals that produce substantially no interference with bioimpedance signals generated by implanted devices. The monitor detects the bioimpedance signal generated by the implanted device, using a voltage detector or a telemetry circuit, for example. The monitor analyzes this detected signal to generate a bioimpedance sensing signal that will not interfere with the sensed signal. For instance, if the monitor produces a pulsed sensing signal, the pulses are delivered in an interval of the detected signal where no pulses are present. Similarly, if the monitor produces a high frequency AC sensing signal, the zero crossings of the AC sensing signal are positioned during the delivery of a pulse by the implanted device.

Abstract: A method for setting the parameters of an alert time window in an excitable tissue control device operative under a plurality of different cardiac conditions of a heart of a patient. The method includes providing said excitable tissue control device with a set of data including a plurality of sets of alert time window parameters. Each set of window parameters is uniquely associated with a different set of values of a plurality of cardiac condition defining parameters identifying one of the different cardiac conditions. Each set of window parameters includes at least a set of timing parameters usable for obtaining a beginning time point and an ending time point of the alert window. The sets of window parameters are obtained by processing data collected within a data collection session from a plurality of cardiac beats of the same patient under the different cardiac conditions.

Abstract: A cardiac stimulator capable of measuring pacing impedance includes a tank capacitor for delivering charge to the heart via device leads, a shunt resistor, and high-impedance buffers for measuring pacing current through the shunt resistor. Soon after the leading edge of the stimulation pulse, the voltage across the shunt resistor, as sampled by a high-impedance buffer, indicates lead and cardiac tissue resistance. Just prior to opening the pacing switch to terminate the stimulation pulse, the voltage across the shunt resistor is sampled by a high-impedance buffer and held once again to allow the capacitance of the lead/heart tissue to be calculated. In alternative embodiments, a high-impedance buffer measures the voltage between the tank capacitor and ground immediately following the stimulation pulse to allow estimation of the lead/heart tissue capacitance.

Abstract: A method and apparatus for modifying contractility of heart tissue. The method includes applying electrodes (34, 35, 38) to one or more sites in the heart (20) and making a determination at which of the sites, if any, to pace the heart. A parameter of an excitable tissue control (ETC) signal (50, 60) to be applied to the heart is set responsive to the determination, and the ETC signal is applied to at least one of the electrodes responsive to the parameter, so as to enhance contractility of the heart.