Abstract: Control of defibrillation therapy delivered by implantable medical devices (IMDs) using hemodynamic sensor feedback is disclosed. The hemodynamic sensor feedback allows for increased control over application of atrial defibrillation therapy. Specifically, the therapy is delivered when a fibrillation episode results in a discrete loss of hemodynamic function. Defibrillation therapy is thus withheld for hemodynamically benign arrhythmias.

Abstract: An implantable medical device substrate is free form cut to the shape of the interior of the device. The free form shape allows more efficient use of not only the interior space of the device but also of the substrate itself. Integrated circuit components are formed to fit the shape of the substrate, freeing areas in the device for additional components, or allowing the device to be made smaller through a maximized use of the available space-volume.

Abstract: An RF antenna flexible circuit interconnect is disclosed with unique micro connectors. The RF antenna flexible circuit interconnect further includes a planer flexible body having an embedded RF transmission line with a first end and a second end. A first antenna micro connector is electrically coupled to the first end of the RF transmission line and a second antenna micro connector is electrically coupled to the second end of the RF transmission line. Each of the first and second antenna micro connectors include an antenna micro connector housing and an antenna central contact socket securely positioned within the antenna micro connector housing. The antenna central contact socket may also include inward bending fingers and may be designed to engage a pin that is inserted into the central contact socket.

Abstract: An implantable medical device (“IMD”) configured in accordance with an example embodiment of the invention generally includes a housing, a connector header block coupled to the housing, and an optional telemetry antenna coupled to the header block. The optional antenna assembly is suitably configured to support the intended IMD application (e.g., the desired telemetry range, the intended IMD implant location, or other practical considerations). The optional antenna assembly may be utilized by itself or in cooperation with a permanent telemetry antenna of the IMD. In one practical embodiment, the optional antenna assembly has a connection end that is compliant with known pacemaker electrode lead standards, which allows the IMD to leverage existing connection methodologies.

Abstract: The voice controlled system of the present invention permits hands-free interactive control of a medical data processing instrument that interfaces with an implanted medical device. In an example embodiment, the system includes a microphone and a speech recognition circuit coupled to the microphone and adapted to recognize an audio signal from the microphone. The audio signal corresponds to one of a subset of commands from a set of commands and each command corresponds to a task to be performed on the implanted medical device. The speech recognition circuit is further adapted to convert the audio signal into a selection code and match the selection code to one of the subset of commands. The system further includes a display device and a processor arrangement coupled to the speech recognition circuit and to the display device. The processor arrangement is configured to receive data indicative of an implanted medical device state and select the subset of commands as a function of the device state.

Abstract: A pressure module is provided which comprises a capsule having a cavity formed therein, and a pressure transducer disposed within the cavity of the capsule. A feedthrough pin, fixedly coupled to the capsule, extends into the capsule and is electronically coupled to the pressure transducer.

Abstract: The invention is directed to sensing techniques that can be executed by an implantable medical device (IMD). The sensing techniques exploit the fact that useful information can be sensed during the periods where the sympathetic and vagal tone balance changes in a patient's nervous system. This balance generally changes when a patient is falling asleep or waking up from sleep. In accordance with the invention, sensed information is recorded specifically during the times where a patient is either falling asleep or waking up. The IMD can be designed to sense or identify when a patient is falling asleep or waking up, and can record the useful sensed information specifically during those times.

Abstract: A device external to an implantable medical device (IMD) is provided with an accurate reference clock. The programmer receives time data from the IMD and compares that data to time data from the reference clock. Based on this comparison, the programmer determines how much a clock within the IMD is drifting per unit of time. A correction factor is generated so that data received from the IMD can then be correlated to the correct reference time.

Abstract: In general, the invention is directed to techniques for capture testing of a capture threshold in cooperation with measurement of other cardiac parameters. Physiological or non-physiological parameters may indicate a possible change in the capture threshold, and a significant change in a cardiac parameter may trigger more frequent monitoring of the capture threshold. In addition, measurement of cardiac parameters in relation to measurement of the capture threshold may be useful in diagnosing problems and forecasting possible loss of capture.

Abstract: A telemetry antenna for an implantable medical device includes one or more portions having a non-linear configuration. In some embodiments, the non-linear configuration provides an antenna having a greater antenna length than the linear lengthwise dimension of the antenna structure. In some embodiments, the non-linear configuration is a serpentine pattern.

Abstract: Oxygen saturation data is monitored during a predefined window to obtain a measurement of circulation delay. The measured circulation delay is used as a basis for determining therapies, including overdrive pacing. In some embodiments, circulation delay is used to identify patients that will benefit from overdrive pacing as a therapy for sleep disordered breathing.

Abstract: An integrated device for remote monitoring of implanted medical devices and surface ECG information includes components for collection of information from an implanted medical device, collection of surface ECG information, and remote communication of the collected information to a remote monitoring station. The remote monitoring station controls operation of the integrated device to automatically acquire the information without substantial patient intervention. In this manner, the device promotes accurate and timely collection of the information, and reduced depletion of battery resources within the implanted medical device.

Abstract: An implantable medical device uses a sampling scheme to obtain digital representation from analog signals. The analog signals represent intracardiac activity. Generally, a detector detects the amplitude of the analog signals and generates first and second difference signals. The first difference signal is generated after detection of significant changes in the analog signal amplitude. The second difference signal is generated upon confirmation of the absence of significant changes in the analog signal amplitude over a predetermined period of time. A frequency selection is implemented to select the sampling frequency based on the first and second difference signal.

Abstract: An implantable medical device operates to promote intrinsic ventricular depolarization according to a pacing protocol. The medical device monitors the AV interval and adjusts the Ventricular Pacing Protocol if the AV interval exceeds a threshold when the cardiac rate is elevated.

Abstract: A capture detection algorithm detects and distinguishes atrial capture. Atrial chamber reset (ACR) and AV conduction (AVC) algorithms are implemented to measure an atrial pacing threshold The data that is used to choose between ACR and AVC methods is used to determine the progression of the patient's disease state. Some of the significant aspects of the invention include enablement of accurate threshold measurements, including calculation of stability criteria, precise interval measurements and the use of reference interval to determine capture and loss of capture.

Abstract: The invention is directed to an implantable medical device that stimulates a nerve associated with respiration. The nerve may, for example be a phrenic nerve, and the stimulation may cause a diaphragm of the patient to contract. The implantable medical device receives a signal that indicates a need for increased cardiac output and stimulates the nerve in response to the signal. The implantable medical device may receive such a signal by, for example, detecting a ventricular tachyarrhythmia, sensing a pressure that indicates a need for increased cardiac output, or receiving a signal from a patient via a patient activator. Stimulation of the nerve may increase cardiac output of a beating or defibrillating heart.

Abstract: Apparatus and methods for analyzing implantable medical device (IMD) data and to distinguish specific morphologies for review. EGM waveforms of a cardiac cycle can be grouped according to waveform shape similarities, preferably accomplished using clustering algorithms. The EGM waveform can be divided into segments represented by a one dimensional vector for each segment, and nearest neighbor vector clustering used to group the waveforms according to morphological similarity. The waveforms can be further grouped at a second level into chronologically contiguous similar EGM waveforms. Interval data for a cardiac cycle may also be grouped according to interval similarity and chronology. The chronologically contiguous waveform and interval groupings may be further grouped. Large quantities of EGM data are automatically analyzed and annotated to focus the attention of a cardiologist on likely areas of concern, reducing the need to visually inspect endless streams of EGM waveforms.

Abstract: Methods and apparatus for an implantable medical device having a connector module that is welded to a housing. The apparatus comprises an implantable medical device that includes a housing and a connector module. The connector module includes an embedded fastener bracket with one or more weld tabs that are welded to the housing.

Abstract: A pacing mode is provided, in one embodiment, that permits missed or skipped ventricular beats. The mode monitors a full cardiac cycle (A-A interval) for the presence of intrinsic ventricular activity. If ventricular activity is present, a flag is set that is valid for the next cardiac cycle. At the beginning of the next cardiac cycle, the device determines if the flag is present. So long as the flag is present, the device will not deliver a ventricular pacing pulse in that cycle, even if there is no intrinsic ventricular activity. If there is no flag present at the start of a given cardiac cycle, a ventricular pacing pulse is delivered and this ventricular activity sets a flag for the subsequent cardiac cycle.

Abstract: Rate responsive pacing is limited in an atrial based pacing mode by the AV interval in order to avoid or minimize ventricular encroachment of atrial pacing. The AV or VA interval is used to permit rate responsiveness; modulate rate responsiveness or to determine a dynamic upper sensor rate.