Abstract: An implantable pacemaker detects delivery of an anti-tachyarrhythmia shock by another device. The implantable pacemaker delivers cardiac stimulation therapy within a patient. The implantable pacemaker senses, via the electrode pair, an electrical signal. The implantable pacemaker detects the anti-tachyarrhythmia shock based on the sensed electrical signal by detecting DC voltage polarization across the electrode pair within the patient. The implantable pacemaker alters the cardiac stimulation therapy based on the detected anti-tachyarrhythmia shock.

Abstract: An implantable pacemaker detects delivery of an anti-tachyarrhythmia shock by another device. The implantable pacemaker delivers cardiac stimulation therapy within a patient. The implantable pacemaker senses, via the electrode pair, an electrical signal. The implantable pacemaker detects the anti-tachyarrhythmia shock based on the sensed electrical signal by detecting DC voltage polarization across the electrode pair within the patient. The implantable pacemaker alters the cardiac stimulation therapy based on the detected anti-tachyarrhythmia shock.

Abstract: An implantable pacemaker detects delivery of an anti-tachyarrhythmia shock by another device. The implantable pacemaker delivers cardiac stimulation therapy within a patient. The implantable pacemaker senses, via the electrode pair, an electrical signal. The implantable pacemaker detects the anti-tachyarrhythmia shock based on the sensed electrical signal by detecting DC voltage polarization across the electrode pair within the patient. The implantable pacemaker alters the cardiac stimulation therapy based on the detected anti-tachyarrhythmia shock.

Abstract: This disclosure relates to fault tolerant instantiations of a cardiac therapy delivery device such as an implantable cardiac stimulator (e.g., an implantable pulse generator, IPG, and/or an implantable cardioverter-defibrillator, ICD) coupled to an implantable physiologic sensor (IPS). According to the disclosure delivery of cardiac pacing and/or cardioversion-defibrillator therapy delivery can cause errors in output signals from an IPS. Resolution of such errors involves selectively energizing (or disconnecting the output signal from) the IPS during pacing and/or defibrillation therapy delivery. Programmable signal “blanking” in lieu of or in addition to the foregoing also improves the integrity of the output signal (i.e., continuously energize the IPS and ignore parts of the output signal). An ICD having a transient weakness in an insulated conductor used for the IPS signal can likewise have the IPS de-energized and/or blank the IPS output signal during high voltage therapy delivery.

Abstract: A system and method for measuring and communicating parameters of a brain, tissue, or other organs is disclosed. The system includes a sensor to sense the parameter of interest, an external device where the parameter may be displayed, processed or cause action to be taken, and a communication system to communicate the sensed parameter from the sensor to the external device. In another embodiment, the system includes a processing system for processing the sensed parameters and controlling an associated medical device.

Abstract: A device and method for measuring and communicating parameters of a brain, tissue or other organs is disclosed. The invention includes a sensor to sense the parameter of interest. The sensor is preferably located at the distal end of a probe. In the preferred embodiment, the sensor is part of a passive system that allows pressure or temperature measurements to be made and communicated to an attending practitioner when the passive system receives power from an external source. In an alternate embodiment, the sensor is part of a system having a long-term energy source and storage system that allows pressure or temperature measurements to be taken periodically or upon demand, stored and then communicated to an attending practitioner as desired. The invention also includes, in one embodiment, a method for measuring and communicating parameters of a brain, tissue or other organs.

Abstract: An implantable dual transducer apparatus for use with an implantable medical device and control method are disclosed. The dual transducer assembly includes two physiologic sensors coupled to the medical device via a pair of lead conductors. Switching circuitry is controlled by the medical device to selectively activate and deactivate the two physiologic sensors by application of a supply voltage of an appropriate polarity. Each sensor of the dual transducer assembly is connected to the pair of lead conductors through a respective power switch. In response to the polarity of the supply voltage applied to the lead conductors, the power switches activate or deactivate their respective sensor in an alternating manner. Selective activation of one of the sensor while concurrently deactivating the other sensor of the dual transducer assembly provides for reduced power consumption and reliable communication of sensor data and other information transmitted over the pair of lead conductors.

Abstract: A capacitive pressure and temperature sensing system for providing signals representative of the magnitude of body fluid absolute pressure at a selected site and ambient operating conditions, including body temperature, at the site. An implantable lead having a sensor module formed in its distal end is coupled to a monitor that powers a sensor circuit in the sensor module and demodulates and stores absolute pressure and temperature data derived from signals generated by the sensor circuit. The sensor module is formed with a pickoff capacitor that changes capacitance with pressure changes and a reference capacitor that is relatively insensitive to pressure changes. The sensor circuit provides charge current that changes with temperature variation at the implant site, alternately charges and discharges the two capacitors, and provides timing pulses having distinguishable parameters at the end of each charge cycle that are transmitted to the demodulator.

Abstract: A pacemaker capable of automatically adjusting the sensitivity of its sense amplifier to electrical cardiac signals is disclosed. In one embodiment, a pacemaker having a pressure sensor disposed on the distal end of its pacing/sensing lead counts the number of pressure events and electrical events which occur during an autosensitivity timing period. If the number of electrical events exceeds the number of pressure events by more than a predetermined margin, the sense amplifier's sensitivity threshold is decreased. If the number of electrical events does not exceed the number of pressure events by more than the predetermined margin, the sense amplifier's sensitivity threshold is increased. In another embodiment, the pacemaker maintains a running average of the peak voltages of sensed electrical events over a predetermined history period.

Abstract: A method of and apparatus for telemetering analog and digital data transcutaneously between an implantable medical device and an external receiver, such as between an external programmer and an implantable cardiac pacer. A damped carrier at 175 kilohertz is pulse position modulated by digital data. The data, along with synchronization and identification codes, are positioned into predefined ranges within predefined frames as measured by individual time periods. The data is uniquely identified by the position of one or more bursts of the carrier within the predefined range. An automatically initiated hand shake protocol maintains the link over slight variations in programmer head position with an indicator notifying the operator when repositioning is required. Analog data may be transferred in digital form or alternatively transferred using phase modulation of the carrier bursts. A cyclic redundancy code is used for link error detection.

Abstract: A method and apparatus for determination of battery end-of-service in a medical device in which the medical device comprises a cathode limited electrochemical cell having an active metal anode and a manganese dioxide cathode and means for digital telemetry of cell voltage. The sloped, well defined voltage curve of such a cell during cell discharge combined with precise information available through digital telemetry allows for improved determination of battery end-of-service for the medical device.

Abstract: An implantable physiologic device, e.g., a multi-programmable, microprocessor based cardiac pacemaker, is provided with data storage and transmission capabilities for transmitting out certain current operating parameters and sensed events and for storing counted events for transmission of counts, histograms and real-time clock data out on command. The device preferably comprises a rate responsive cardiac pacemaker for providing an optimized pacing rate of stimulation pulses as a function of at least one selected rate control parameter. Each rate control parameter has a value which varies as a function of changes in a patient's physiologic demand and includes a sensor system for sensing the rate control parameter value and for providing a sensor output representative thereof.

Abstract: An automatic capture restoration and threshold-seeking method and apparatus for use with a cardiac pacemaker derives control signals for restoring cardiac capture from a cardiac pressure sensor. The pressure sensor also provides input control signals for a threshold-seeking apparatus. Both pulse width and amplitude thresholds can be changed contemporaneously during both capture restoration and threshold seeking.

Abstract: A monitoring system for an oxygen sensing, dual-wavelength, reflectance oximetry based, rate responsive cardiac pacemaker, is capable of automatically and continually adjusting an oxygen sensor signal comparator threshold such that the effects of noise, sensitivity and drift on oximeter output signals sent to the pacemaker are minimized. A comparator and related circuitry are configured to sample and compare supply excitations for multiple oxygen sensor light sources. The comparator threshold is adjusted as a function of supply excitation for each light source independently of one another, thereby providing an oxygen sensing pacemaker with optimal noise immunity since one of the more vulnerable portions of the pacing system is the transfer of the light source signals which are susceptible to noise.

Abstract: A method of and apparatus for telemetering both analog and digital data transcutaneously between an implantable medical device and an external receiver, such as between an external programmer and an implantable cardiac pacer. A damped carrier at 175 kilohertz is pulse position modulated by digital data. The data, along with synchronization and identification codes, are positioned into predefined ranges within predefined frames as measured by individual time periods. The data is uniquely identified by the position of a burst of the carrier within the predefined range. An automatically initiated hand shake protocol maintains the link over slight variations in programmer head position with an indicator notifying the operator when repositioning is required. Analog data may be transferred in digital form or alternatively transferred using phase modulation of the carrier bursts. A cyclic redundancy code is used for link error detection.

Abstract: A rate responsive cardiac pacemaker for providing an optimized pacing rate of stimulation pulses as a function of at least one selected rate control parameter. Each rate control parameter has a value which varies as a function of changes in a patient's physiologic demand and includes a sensor system for sensing the rate control parameter value and for providing a sensor output representative thereof.

Abstract: A pacemaker system includes a dual sensor implantable pacemaker and an external programmer for automatically and simultaneously optimizing and initializing a plurality of pacing parameters. The pacemaker includes means for automatically initializing a sensitivity threshold, pacing pulse width, pacing pulse amplitude, activity threshold, and pressure rate response gain setting.

Abstract: A rate responsive pacemaker and a pacing method for optimizing the pacing decay curve after a period of increased activity. The pacing method includes the steps of selecting a set of predetermined achievement criteria such as an achievement rate and an achievement time interval. The achievement rate is selected between an upper pacing rate and a first pacing switch rate threshold. The pacing method then determines whether the achievement criterion has been met. If the achievement criterion has been met, then the decay time constant of the decay curve changes from a first value to a second value, as the pacing rate drops below the first pacing switch rate threshold. A second pacing switch rate threshold lower than the first pacing switch rate threshold is then selected, and, if the achievement criteria have been met, then the decay time constant of the decay curve is modified from the second value to a third value, as the pacing rate drops below the second pacing switch rate threshold.

Abstract: A method and apparatus are disclosed for telemetering both analog and digital data from an implantable medical device to an external receiver, such as between an implanted cardiac pacer and its external programming equipment. Analog data is first converted to digital format by an analog-to-digital converter, such that the transmission is digital data. A damped carrier at 175 kilohertz is pulse position modulated by the data. The modulation scheme defines a frame of slightly less than 2 milliseconds. The frame is divided into 64 individual time periods using a crystal clock. The data, along with synchronization and identification codes, are positioned into predefined ranges within each frame as measured by the individual time periods. The data is uniquely identified by the position of a burst of the carrier within the predetermined range.

Abstract: An implantable cardiac pacemaker and/or cardioverter/defibrillator employing an R-wave detector which atuomatically adjusts its sensing threshold in response to R-wave amplitude. The R-wave detector produces an output which is used to indicate the occurrence of ventricular contractions, and is used to reset the timing of the pacemaker and to indicate the occurrence of ventricular contractions for purposes of activating the associated cardioverter/defibrillator. Adjustment of the threshold is disable for a predetermined period following the delivery of each pacing pulse such that in the presence of continuous pacing for a predetermined period of time, the sensing threshold is returned to a desired, lower threshold level, allowing for detection of lower level R-waves, which may be indicative of tachyarrhythmia or fibrillation.