Abstract: An implantable medical device is configured so that all of the major components including a housing and attached leads are disposed within the vasculature of a patient. A tether extends from the housing of the device to an implant location where the tether is secured to tissue outside of the vasculature. In this manner, an intravascular medical device may be implanted at a location remote from final placement, delivered via the vasculature and anchored at the initial entry point.

Abstract: Several tools and simplified implant methods utilizing minimal surgical intrusion into a subject are disclosed for the proper inserting, advancement and positioning of a subcutaneous implantable medical device (IMD). A kit disclosed herein includes a poker for penetrating the skin and generating a small incision, a tissue spreader for increasing the incision width and an introducer and cannula for the proper insertion of the ILR subcutaneously. Diverse IMDs can be implanted using the kit, tools and methods included in the disclosure, including implantable pulse generators (IPGs), implantable loop recorders (ILRs) for collecting and transmitting cardiac activity signals and implantable cardioverter-defibrillators (ICDs) for delivering high voltage cardiac therapy via electrodes spaced from the myocardium.

Abstract: An extra-systolic stimulation (ESS) therapy addresses cardiac dysfunction including heart failure. ESS therapy employs atrial and/or ventricular extra-systoles via pacing-level stimulation to a heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). The present invention relates to therapy delivery guidance and options for improved ESS therapy delivery. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.

Abstract: This invention securely holds a fishing rod and reel in a variety of situations and automatically sets the fishing hook when a fish strikes the baited hook or lure. Adapters hold the vertical stand either on a pond bank, a boat or dock rail, or dock flooring. The vertical stand pivotally supports a rod and reel holder, which is configured to hold the fishing tackle securely and without damage. The fishing line is looped under the trigger lever, which is raised and rotated by the pull on the fishing line when a fish strikes the bait. The catch arm is released as the trigger lever is lifted. The rod and reel holder is spring loaded and pivots around the support point when the catch arm is released, thus snapping to a more upright position, which action sets the hook.

Abstract: A capacitor-discharge implantable cardioverter defibrillator (ICD) has a relatively smaller mass of less than about 120 grams. The smaller mass of the ICD is achieved by selecting and arranging the internal components of the ICD to deliver a maximum defibrillation countershock optimized in terms of a minimum physiologically effective current (I.sub.pe), rather than a minimum defibrillation threshold energy (DFT). As a result of the optimization in terms of a minimum effective current I.sub.pe, there is a significant decrease in the maximum electrical charge energy (E.sub.c) that must be stored by the capacitor of the ICD to less than about 30 Joules, even though a higher safety margin is provided for by the device. Due to this decrease in the maximum E.sub.

Abstract: A capacitor-discharge implantable cardioverter defibrillator (ICD) has a relatively smaller energy storage capacity of less than about 1.0 Amp-hours. The smaller energy storage capacity of the ICD is achieved by selecting and arranging the internal components of the ICD to deliver a maximum defibrillation countershock optimized in terms of a minimum physiologically effective current (I.sub.pe) rather than a minimum defibrillation threshold energy (DFT). As a result of the optimization in terms of a minimum effective current I.sub.pe, there is a significant decrease in the maximum electrical charge energy (E.sub.c) that must be stored by the capacitor of the ICD to less than about 30 Joules, even though a higher safety margin is provided for by the device. Due to this decrease in the maximum E.sub.

Abstract: A capacitor-discharge implantable cardioverter defibrillator (ICD) has a relatively longer device life of greater that 5 years. The longer life of the ICD is achieved by selecting and arranging the internal components of the ICD to deliver a maximum defibrillation countershock optimized in terms of a minimum physiologically effective current (I.sub.pe), rather than a minimum defibrillation threshold energy (DFT). As a result of the optimization in terms of a minimum effective current I.sub.pe, there is a significant decrease in the maximum electrical charge energy (E.sub.c) that must be stored by the capacitor of the ICD to less than about 30 Joules, even though a higher safety margin is provided for by the device. Due to this decrease in the maximum E.sub.

Abstract: A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the left pectoral region and the coronary sinus/great vein, with the left pectoral and coronary sinus/great vein electrodes connected in common. Optionally a ventricular electrode may also be employed in conjunction with one or more of the other listed electrodes to accomplish ventricular cardioversion or defibrillation.

Abstract: A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the right ventricle and the coronary sinus/great vein, with the right ventricular and coronary sinus/great vein electrodes connected in common. Optionally a subcutaneous electrode, preferably located in the left pectoral area may also be employed, coupled in common to the right atrial/SVC electrode.

Abstract: A low profile defibrillation catheter which is much thinner than existing devices. The thin structure is provided by using the current conductor as the electrode. The thin design is motivated by an electrical field analysis which reveals that the length of the catheter is the important determinant of defibrillation ability, and that the large radius and surface area of prior art devices was not beneficial.

Abstract: A defibrillator pulse generator for pectoral implant utilizing the metal case as an electrode and operative to supply unique patterns of monophasic, biphasic, or pairs of electrical pulses to the connected electrodes.

Abstract: A capacitor-discharge implantable cardioverter defibrillator (ICD) has a relatively smaller displacement volume of less than about 90 cc. The smaller volume of the ICD is achieved by selecting and arranging the internal components of the ICD to deliver a maximum defibrillation countershock optimized in terms of a minimum physiologically effective current (I.sub.pe), rather than a minimum defibrillation threshold energy (DFT). As a result of the optimization in terms of a minimum effective current I.sub.pe, there is a significant decrease in the maximum electrical charge energy (E.sub.c) that must be stored by the capacitor of the ICD to less than about 30 Joules, even though a higher safety margin is provided for by the device. Due to this decrease in the maximum E.sub.

Abstract: A defibrillator pulse generator for pectoral implant utilizing the metal case as an electrode and operative to supply unique patterns of monophasic, biphasic, or pairs of electrical pulses to the connected electrodes.

Abstract: A separation device to insulate implantable elements in the right ventricle of the heart. The separation devices include peripheral structures that are constructed and arranged to mount to one of the implantable elements. Further disclosed are collapsible, compressible and resilient separation structures and those molded of biodegradable and soluble compositions.

Abstract: A defibrillator pulse generator device for implantation in the pectoral position of a patient. The pulse generator device has a compact, light weight housing structure. A power source, a capacitive member and a sensing and control structure are enclosed in the housing structure. A connecting structure mounted on the housing provides connection to the electrode leads of the defibrillator system.

Abstract: Pressure and motion transducer, and cooperating circuitry for an implantable medical device is disclosed. The system includes a clock for the pulse excitation of a dynamic motion transducer and further includes circuitry for recovering the modulated signal from the transducer.

Abstract: An activity sensor mounted within the pacer detects the general activity level of the patient and alters the escape interval of the pacer between a preset minimum and maximum in response to the detected activity level of the patient.

Abstract: A hermetically sealed pressure transducer suitable for implantation in a human body. A pressure sensitive circuit is fabricated using contemporary silicon technology. The pressure sensitive circuit is sealed in an oil-filled chamber formed within a titanium cylinder having a glass substrate bottom and a thin titanium top. According to one embodiment, the pressure sensitive circuit contains a sealed inner chamber at a known pressure, thereby measuring pressure relative to a known value. A second embodiment vents the pressure sensitive circuit to produce a relative pressure measurement. A grill protects the assembly and aids insertion into the desired area. A lead connects the transducer to an implantable sensing circuit.

Abstract: An improved connector for interconnecting a furcated lead and signal generator to form a body implantable stimulator. The connector is secured to the signal generator to form a signal generator assembly. Jacks are provided in the connector to receive the lead furculae while facilitating conformance of furculae to the configuration of the signal generator assembly on wrapping of the furculae around the signal generator assembly. In a preferred embodiment, the jacks accept the furculae at different distances from the signal generator to allow a thinner signal generator assembly and at different depths to compensate for the difference in distance of the jacks from the signal generator.