Abstract: In some examples, a method for controlling delivery of cardiac therapy and cardiac sensing by a medical device system including electrodes for delivering the cardiac therapy may include storing, in a memory of the medical device system, a respective value for each of a plurality of cardiac therapy and/or sensing parameters and, in association with each of a plurality of heart position states, a respective modification of at least one of the cardiac therapy and/or sensing parameters. Such a method also may include determining a current one of the plurality of heart position states of the patient, modifying the at least one cardiac therapy and/or sensing parameter value according to the modification associated with the current heart position state, and controlling the delivery of the cardiac therapy and/or cardiac sensing according to the modified at least one cardiac therapy and/or sensing parameter value.

Abstract: In some examples, a method for controlling delivery of cardiac therapy and cardiac sensing by a medical device system including electrodes for delivering the cardiac therapy may include storing, in a memory of the medical device system, a respective value for each of a plurality of cardiac therapy and/or sensing parameters and, in association with each of a plurality of heart position states, a respective modification of at least one of the cardiac therapy and/or sensing parameters. Such a method also may include determining a current one of the plurality of heart position states of the patient, modifying the at least one cardiac therapy and/or sensing parameter value according to the modification associated with the current heart position state, and controlling the delivery of the cardiac therapy and/or cardiac sensing according to the modified at least one cardiac therapy and/or sensing parameter value.

Abstract: Techniques are disclosed for automatically calibrating a reference orientation of an implantable medical device (IMD) within a patient. In one example, sensors of an IMD sense a plurality of orientation vectors of the IMD with respect to a gravitational field. Processing circuitry of the IMD processes the plurality of orientation vectors to identify an upright vector that corresponds to an upright posture of the patient. The processing circuitry classifies the plurality of orientation vectors with respect to the upright vector to define a sagittal plane of the patient and a transverse plane of the patient. The processing circuitry determines, based on the upright vector, the sagittal plane, and the transverse plane, a reference orientation of the IMD within the patient. As the orientation of the IMD within the patient changes over time, the processing circuitry may recalibrate its reference orientation and accurately detect a posture of the patient.

Abstract: In some examples, medical device systems that deliver anti-tachyarrhythmia shock(s) (e.g., defibrillation shock(s)) to a heart of a patient in coordination with the respiration of the patient. In one example, a medical device system including therapy generation circuitry configured to generate a defibrillation shock. The medical device system also includes processing circuitry configured to identify a time at which a respiratory volume of a lung of a patient is at approximately end tidal volume or less; and control the therapy generation circuitry to deliver the defibrillation shock to a heart of the patient at the time that the respiratory volume of the lung of a patient is at the approximately end tidal volume or less.

Abstract: This disclosure describes implantable medical leads and medical device systems utilizing the leads. In some examples, an implantable medical lead comprises a first defibrillation electrode and a second defibrillation electrode, the first and second defibrillation electrodes configured to deliver anti-tachyarrhythmia shocks, and a pace electrode disposed between the first defibrillation electrode and the second defibrillation electrode, the pace electrode configured to deliver a pacing pulse that generates an electric field proximate to the pace electrode. The implantable medical lead further comprises a shield disposed between the first defibrillation electrode and the second defibrillation electrode and over a portion of an outer surface of the pace electrode, wherein the shield is configured to impede the electric field in a direction from the pace electrode away from a heart.

Abstract: Techniques are disclosed for automatically calibrating a reference orientation of an implantable medical device (IMD) within a patient. In one example, sensors of an IMD sense a plurality of orientation vectors of the IMD with respect to a gravitational field. Processing circuitry of the IMD processes the plurality of orientation vectors to identify an upright vector that corresponds to an upright posture of the patient. The processing circuitry classifies the plurality of orientation vectors with respect to the upright vector to define a sagittal plane of the patient and a transverse plane of the patient. The processing circuitry determines, based on the upright vector, the sagittal plane, and the transverse plane, a reference orientation of the IMD within the patient. As the orientation of the IMD within the patient changes over time, the processing circuitry may recalibrate its reference orientation and accurately detect a posture of the patient.

Abstract: In some examples, a method for controlling delivery of cardiac therapy and cardiac sensing by a medical device system including electrodes for delivering the cardiac therapy may include storing, in a memory of the medical device system, a respective value for each of a plurality of cardiac therapy and/or sensing parameters and, in association with each of a plurality of heart position states, a respective modification of at least one of the cardiac therapy and/or sensing parameters. Such a method also may include determining a current one of the plurality of heart position states of the patient, modifying the at least one cardiac therapy and/or sensing parameter value according to the modification associated with the current heart position state, and controlling the delivery of the cardiac therapy and/or cardiac sensing according to the modified at least one cardiac therapy and/or sensing parameter value.

Abstract: In some examples, medical device systems that deliver anti-tachyarrhythmia shock(s) (e.g., defibrillation shock(s)) to a heart of a patient in coordination with the respiration of the patient. In one example, a medical device system including therapy generation circuitry configured to generate a defibrillation shock. The medical device system also includes processing circuitry configured to identify a time at which a respiratory volume of a lung of a patient is at approximately end tidal volume or less; and control the therapy generation circuitry to deliver the defibrillation shock to a heart of the patient at the time that the respiratory volume of the lung of a patient is at the approximately end tidal volume or less.

Abstract: Electrically erasable flash memory and method. The memory has a data storage element and a voltage sensing circuit. The data storage element is configured to store data bits, each of the data bits having a data state. The voltage sensing circuit is selectively coupled to individual ones of data bits and is configured to bias the data bits with at least one of a bias current and a bias resistance and to read the data state of the individual ones of the plurality of data bits.

Abstract: According to the invention methods and structures for determining whether impingement of x-ray radiation upon potentially vulnerable discrete components, circuits and/or circuit pathways of an implantable medical device (IMD) causes modifications or damage thereto. The invention includes structures for deflecting impingement of x-ray radiation from said potentially vulnerable components, circuits and/or circuit pathways. The x-ray radiation can be generated by various imaging modalities or unknown sources. Myriad IMDs can utilize the teaching of the present invention, including for example, a pacemaker, a drug delivery pump, a nerve stimulation device, a muscle stimulation device, an implantable cardioverter-defibrillator, a subcutaneous defibrillator, a deep brain stimulator or the like.

Abstract: Memory array for storing a plurality of data bits. The memory array has flash memory cells, ROM memory cells addressing circuitry. The addressing circuitry is operatively coupled to both the plurality of flash memory cells and the plurality of ROM memory cells, the addressing circuitry being configured to address both the plurality of flash memory cells and the plurality of ROM memory cells.

Abstract: The invention relates to medical devices such as pacemakers, pulse generators, cardioverter-defibrillators and the like and more particularly relates to modular and reconfigurable medical system platforms and methods of designing, testing, controlling and implementing diverse therapies, diagnostics, physiologic sensors and related instrumentation using said medical system platforms. Methods, systems and devices provide a new design platform for implantable and external medical devices such as pacemakers, defibrillators, neurostimulators, heart monitors, etc. A real-time, highly flexible system of software and hardware modules enables both prototypes and products to respond to patient and customer needs with greater design and manufacturing efficiency. Certain embodiments integrate a general-purpose processor with interface circuitry to provide a standard platform for implementing new and conventional therapies with software models rather than custom circuitry.

Abstract: An implantable medical device (IMD) includes a detector for detecting the presence of x-ray radiation, where the presence of x-ray radiation is detected in response to the strength of the x-ray radiation exceeding a first threshold. In one embodiment, the IMD includes a processor for adjusting a cardiac stimulation rate IMD in response to determining that the strength of the detected x-ray radiation exceeds a second threshold. The second pre-selected x-ray radiation threshold is greater than the first pre-selected x-ray radiation threshold. In another embodiment, the implantable device includes a detector for detecting the presence of any amount x-ray radiation and a processor for adjusting a stimulation rate provided by the IMD in response to detected x-ray radiation to reduce the chance of over-sampling artifacts or inappropriate therapy delivery.

Abstract: Electrically erasable flash memory and method. The memory has a data storage element and a voltage sensing circuit. The data storage element is configured to store data bits, each of the data bits having a data state. The voltage sensing circuit is selectively coupled to individual ones of data bits and is configured to bias the data bits with at least one of a bias current and a bias resistance and to read the data state of the individual ones of the plurality of data bits.

Abstract: Memory array for storing a plurality of data bits. The memory array has flash memory cells, ROM memory cells addressing circuitry. The addressing circuitry is operatively coupled to both the plurality of flash memory cells and the plurality of ROM memory cells, the addressing circuitry being configured to address both the plurality of flash memory cells and the plurality of ROM memory cells.

Abstract: A radiation-based timer for use in an implantable medical device (IMD) includes a radiation source and a radiation detection circuit. The radiation source emits radiation particles during a process referred to as radioactive decay. The radiation detection circuit detects the radiation particles emitted during the decay process and tracks the number of radiation particles detected. When the number of radiation particles detected reaches a threshold value, a timer signal is generated. In this manner, the radiation-based timer generates a timer signal as a function of the radioactive decay of the radiation source. The timer signal may be used by one or more components of the IMD for any of a number of functions, including as a wakeup trigger for a communications and/or a sensor event.

Abstract: A radiation-based timer for use in an implantable medical device (IMD) includes a radiation source and a radiation detection circuit. The radiation source emits radiation particles during a process referred to as radioactive decay. The radiation detection circuit detects the radiation particles emitted during the decay process and tracks the number of radiation particles detected. When the number of radiation particles detected reaches a threshold value, a timer signal is generated. In this manner, the radiation-based timer generates a timer signal as a function of the radioactive decay of the radiation source. The timer signal may be used by one or more components of the IMD for any of a number of functions, including as a wakeup trigger for a communications and/or a sensor event.

Abstract: An implantable medical device (IMD) includes a detector for detecting the presence of x-ray radiation, where the presence of x-ray radiation is detected in response to the strength of the x-ray radiation exceeding a first threshold. In one embodiment, the IMD includes a processor for adjusting a cardiac stimulation rate IMD in response to determining that the strength of the detected x-ray radiation exceeds a second threshold. The second pre-selected x-ray radiation threshold is greater than the first pre-selected x-ray radiation threshold. In another embodiment, the implantable device includes a detector for detecting the presence of any amount x-ray radiation and a processor for adjusting a stimulation rate provided by the IMD in response to detected x-ray radiation to reduce the chance of over-sampling artifacts or inappropriate therapy delivery.

Abstract: An implantable medical device (IMD) includes a detector for detecting the presence of x-ray radiation, where the presence of x-ray radiation is detected in response to the strength of the x-ray radiation exceeding a first threshold. In one embodiment, the IMD includes a processor for adjusting a cardiac stimulation rate IMD in response to determining that the strength of the detected x-ray radiation exceeds a second threshold. The second pre-selected x-ray radiation threshold is greater than the first pre-selected x-ray radiation threshold. In another embodiment, the implantable device includes a detector for detecting the presence of any amount x-ray radiation and a processor for adjusting a stimulation rate provided by the IMD in response to detected x-ray radiation to reduce the chance of over-sampling artifacts or inappropriate therapy delivery.

Abstract: An electrical lead end cap includes a body defining a bore therein capable of receiving and retaining an end of an electrical lead and a connector capable of electrically coupling conductors leading to at least two electrodes. A method includes routing an electrical current induced in an electrical lead conductor disposed within body tissue to a plurality of electrodes, electrically coupled with the body tissue, via a circuit within an end cap attached to the electrical lead.