Abstract: A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).

Abstract: Pacing parameters are provided to address cross talk and intrinsic ventricular events occurring within a predefined blanking period following an atrial event. The parameters are used in conjunction with protocol for minimizing or reducing ventricular pacing, wherein ignoring intrinsic ventricular events during the blanking period might otherwise affect the performance of the protocol.

Abstract: The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.

Abstract: Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.

Abstract: A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).

Abstract: A hood for mounting over an outlet in a wall of a catch basin is disclosed. The hood includes a hood wall that forms a prow in a horizontal plane. The prow extends along an axis of the hood thereby achieving optimal flow conditions in the catch basin. In some embodiments the hood wall is shaped to be at least partially sealably mounted to the interior wall of a catch basin have a circular cross section in a horizontal plane. This novel hood shape facilitates installation of the hood in the circular catch basin, while also reducing the flow of oil and other pollutants into the outlet pipe in the circular catch basin. In some embodiments a perforated screed is also disclosed that surrounds the hood to aid in the capture of floatable pollutants.

Abstract: Methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.

Abstract: An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a p-wave, ADI/R pacing resumes to monitor ventricular response.

Abstract: An implantable medical device and associated method provide atrial pacing and measure an atrial ventricular (AV) delay. An autonomic function index is computed using the AV delay. The autonomic function index may be compiled in a medical report. In some embodiments, the autonomic function index is used to adjust atrial pacing control parameters.

Abstract: A pacing protocol is provided that reduces or minimizes ventricular pacing in favor of intrinsic conduction. When operating in a mode that provides ventricular pacing, a series of conduction checks are performed to determine if intrinsic conduction has returned. These conduction checks occur according to a predetermined pattern that general includes longer intervals between subsequent attempts. A maximum interval is provided such that conduction checks are not repeated sequentially at the same time of day when at this maximum interval.

Abstract: Provided herewith are methods and apparatus for optimizing ventricle-to-ventricle (V-V) pacing delay intervals based upon ECG-based optimization calculated as a linear function of P-wave duration sensed PR (intrinsic) interval sensed (or paced) QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized V-V interval such as from an echocardiographic study, an operating V-V interval value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured more frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.

Abstract: A method for use in an implantable medical device, comprising: sensing a signal corresponding to ventricular wall acceleration; and determining a metric of atrial function using the ventricular wall acceleration signal. The method includes sensing the ventricular wall acceleration signal during at least during a sensing window corresponding to a ventricular filling phase.

Abstract: An apparatus for reducing pollution in wastewater that collects in a catch basin is disclosed. The apparatus includes a hood affixed to an interior wall of a catch basin over an outlet, and a skirted boom adjacent to at least a portion of said hood and fixed relative to the hood. The skirted boom includes an upper portion and a skirt extending down from the upper portion. The skirted boom is installed so that the upper portion of the skirted boom is adjacent to said hood at the static water level in the catch basin and the skirt extends downward, preferably below the bottom of the hood. A tether assembly for installing the apparatus and a method of using the same is further disclosed.

Abstract: A medical device for monitoring a patient condition includes a first combination of a light source and a light detector to emit light into a volume of tissue, detect light scattered by the volume of tissue, and provide a first output signal corresponding to an intensity of the detected light. A control module is coupled to the light source to control the light source to emit light at least four spaced-apart light wavelengths, and a monitoring module is coupled to the light detector to receive the output signal, compute a measure of tissue oxygenation in response to the light detector output signal, and detect tissue hypoxia using the measure of tissue oxygenation.

Abstract: A medical device for monitoring a patient condition includes a sensor capable of being advanced transvascularly to be positioned along a volume of tissue, the sensor including a first combination of a light source and a light detector to emit light into a volume of tissue and to detect light scattered by the volume of tissue and to generate a first output signal corresponding to an intensity of the detected light. A control module is coupled to the light source to control the light source to emit light at least four spaced-apart light wavelengths, and a monitoring module is coupled to the light detector to receive the output signal and compute a measure of tissue oxygenation using the light detector output signal.

Abstract: Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time at least two subsequent V2 sensing events decremented by the adjusted PEI.

Abstract: Techniques for adjusting pacing therapy based on ventriculo-atrial delay are described herein. These techniques may be used to control ventricular filling times during the delivery of pacing therapy. In some examples, a device or system delivers pre-excitation fusion pacing therapy to a ventricular chamber, determines a ventriculo-atrial delay interval for the ventricular chamber for at least one cardiac cycle, and adjusts the pacing therapy delivered by the implantable medical device to compensate for decreased ventricular filling time when the ventriculo-atrial delay interval is less than a threshold. In some examples, the device or system may adjust the pacing therapy by decreasing a pacing rate of the implantable medical device, increasing a pre-excitation interval for pacing of the ventricular chamber, and/or switching from a fusion pacing mode to a biventricular pacing mode.

Abstract: A hood for mounting over an outlet in a wall of a catch basin is disclosed. The hood includes a hood wall that forms a prow in a horizontal plane. The prow extends along an axis of the hood thereby achieving optimal flow conditions in the catch basin. In some embodiments the hood wall is shaped to be at least partially sealably mounted to the interior wall of a catch basin have a circular cross section in a horizontal plane. This novel hood shape facilitates installation of the hood in the circular catch basin, while also reducing the flow of oil and other pollutants into the outlet pipe in the circular catch basin. In some embodiments a perforated screed is also disclosed that surrounds the hood to aid in the capture of floatable pollutants.

Abstract: An apparatus for reducing pollution in wastewater that collects in a catch basin is disclosed. The apparatus includes a hood affixed to an interior wall of a catch basin over an outlet, and a skirted boom adjacent to at least a portion of said hood and fixed relative to the hood. The skirted boom includes an upper portion and a skirt extending down from the upper portion. The skirted boom is installed so that the upper portion of the skirted boom is adjacent to said hood at the static water level in the catch basin and the skirt extends downward, preferably below the bottom of the hood. A tether assembly for installing the apparatus and a method of using the same is further disclosed.

Abstract: A pacing protocol is provided that reduces or minimizes ventricular pacing in favor of intrinsic conduction. When operating in a mode that provides ventricular pacing, a series of conduction checks are performed to determine if intrinsic conduction has returned. These conduction checks occur according to a predetermined pattern that generally includes longer intervals between subsequent attempts. The AV interval provided for dual chamber based pacing is modulated and generally moves from a larger value to a nominal value as the interval between unsuccessful conduction checks increases.