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: An implantable medical device (IMD) includes one or more semiconductor switches and one or more switch driver circuits. The semiconductor switches, in response to one or more switch-on and switch-off commands that each have a voltage magnitude, switch between a conductive state and a non-conductive state, respectively, to thereby selectively supply one or more therapy pulses using electrical energy from an electrical energy source. The switch driver circuits, in response to drive commands, selectively supply the switch-on and switch-off commands to the semiconductor switches. The switch driver circuits, using a portion of the supplied therapy pulses, increase the voltage magnitudes of the switch-on and switch-off commands to a magnitude that maintains the switch in the conductive state or the non-conductive state, respectively, while the therapy pulses are being supplied.

Abstract: A method and system nodal rhythm detection and treatment is provided. Detecting consecutive atrial events within a nodal activity window around ventricular events identifies nodal rhythm. Nodal rhythm is treated by calculating and applying a new atrial escape interval adjusted by the interval between the atrial and ventricular events.

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: A method of evaluating ventricular performance of a heart employing sensors to measure a ventricular dimension signal and deriving indices of ventricular performance therefrom. Premature Shortening (PS) and Isovolumic Lengthening (IL) comprise two indices of ventricular performance determined from analysis of the left ventricular dimension signal during the transition from ventricular filling to ventricular ejection. Measured values of PS and IL are compared to other measured values or reference values to determine if ventricular performance has improved (or worsened). In some embodiments, the dimension sensors may comprise piezoelectric sonomicrometer crystals that operate as ultrasound transmitters and receivers. The sensors may be mounted in relation to a ventricle of the heart either temporarily or permanently, and may be configured either separately from or integrally with cardiac pacing leads.

Abstract: The invention is directed to methods and apparatus for automatically changing from bi-ventricular pacing, in which an implantable medical device (IMD) applies pacing stimuli to both ventricles of a heart during a cardiac cycle, to single-ventricle pacing, in which the IMD paces one ventricle and inhibits pacing of the other. An IMD applying the techniques of the invention automatically changes from bi-ventricular pacing to single-ventricle pacing, or vice versa, as a function of the reliability of left ventricular pacing. Exemplary techniques for determining the reliability of left ventricular pacing include impedance measurement, capture testing, capture threshold testing, or any combination thereof.

Abstract: An implantable medical device (IMD) includes a connector header for making electrical and mechanical connections with a proximal connector assembly of an electrical medical lead and includes a retainer for retaining a penetrable grommet within a header grommet aperture. A connector block disposed within a header body of the connector header has a threaded bore aligned with a header grommet aperture and a connector block bore aligned with a header connector bore. The penetrable grommet is disposed within the header grommet aperture, and a setscrew is threaded into the threaded bore having a setscrew socket disposed to be engaged by a tool inserted through the penetrable grommet within the header grommet aperture to enable rotation of the setscrew within the threaded bore to tighten the setscrew against or to loosen the setscrew from a lead connector element received in the header connector bore.

Abstract: A heart model provides a simulative environment for lead implantation and affixation. In one embodiment, removable silicone plugs are provided at appropriate locations so that an inserted lead can be affixed to the plugs with a helical tip. A simulative venous structure is provided that has increased lubricity to facilitate the insertion and manipulation of the lead.

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: A system and method for use in an implanted cardiac pacing device, whereby an optimal AV delay is determined at or near lower rate (pacing) limit (LRL) by determining measuring the variance, or instability, of the QT interval for a set of intervals. In one embodiment, asynchronous “LRL pacing” with a first programmed AV delay determines a measure of QT variance. The difference between the maximum QT and the minimum QT is expressed as QT difference (QTD). For each programmed AV delay the QT variance is again measured and the optimal AV delay produces minimum QTD. In another embodiment, AV delay is modulated around base values for a time. The difference between QT for the modulated AV and for the base AV (dQT) is measured at each base value, and the optimal AV delay corresponds to the smallest dQT.

Abstract: The invention is directed to a programmer for communication with different medical devices that utilize different telemetry communication techniques. The programmer receives telemetry signals from a given medical device, and selects an appropriate communication mode, which can be pre-programmed into the programmer as one of a plurality of possible communication modes. The programmer can configure itself for communication with a given medical device based on the telemetry signal it receives. Specifically the programmer is implemented as a software based, power efficient receiver/transmitter based upon an inexpensive, simple motor-controller DSP.

Abstract: A system and method for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy delivery, or a clinician warning. Assessment of cardiac function may be made based on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.

Abstract: Techniques for stabilizing the rate of a ventricle, during conducted atrial fibrillation for example, adjust the escape interval of an implantable medical device to increase or decrease the pacing rate. In some embodiments, the escape interval is adjusted to achieve and maintain a percentage of pacing. In other embodiments, the stability of the ventricular rate is quantified as a function of measured R-R intervals, and the escape interval is adjusted to achieve and maintain a level of stability. In still other embodiments, a mean compensatory pause length is determined, and the escape interval is adjusted as a function of the mean compensatory pause length, to maintain the escape interval at or near the mean compensatory pause length.

Abstract: Improvements in connector headers of implantable medical devices (IMDs) for making electrical and mechanical connections with a connector element of a proximal connector assembly of an electrical medical lead and components thereof are disclosed. A connector block disposed within a header body of the connector header has a threaded bore aligned with a header grommet aperture and a connector block bore aligned with a header connector bore. A penetrable grommet is disposed within the header grommet aperture, and a setscrew is threaded into the threaded bore having a setscrew socket disposed to be engaged by the tool inserted through the penetrable grommet within the header grommet aperture to enable rotation of the setscrew within the threaded bore to tighten the setscrew against or to loosen the setscrew from a lead connector element received in the header connector bore.

Abstract: Neurostimulation is delivered to one or more predetermined locations on or within a patient in order to treat effects of sleep apnea by modulating autonomic nervous activity. Delivery of neurostimulation at predetermined locations can decrease sympathetic nervous activity and/or increase parasympathetic nervous activity, countering the increased intrinsic sympathetic activity associated with apnea-arousal cycles. In some embodiments, neurostimulation is delivered to the spinal cord of the patient via an implanted electrode. In other embodiments, neurostimulation is delivered transcutaneously to the spinal cord or other locations via electrodes located on the surface of the patient. In some embodiments, delivery of neurostimulation is initiated or modified in response to detection of apneas.

Abstract: An IMD includes a variable sense amplifier that can be adjusted to counteract the variability created in EGM's due to lead maturation. The effects of lead maturation are either predictively assumed or individually assessed on a given patient. The sense amplifier is then adjusted to assure positive identification of desired events and eliminate unwanted events.

Abstract: The invention is directed to techniques for monitoring organ rejection. An implanted device monitors the impedance of the transplanted organ. When the impedance measurements indicate that the organ is being rejected, the device provides early warning of rejection.

Abstract: A programmer operating in association with a diverse number of implantable medical devices (IMDs) is in a bi-directional operable data, voice and video communications with a remote web-based expert data center. The programmer is in telemetric wireless communications with the IMDs. The data center is equipped to manage the operational and functional aspects of the programmer remotely thus importing expertise to the patient environment. Specifically the communications scheme is scalable and adaptable to enable high-speed interactions between the programmer and the remote center across various communications media. The remote center is able to remotely assess, monitor, evaluate for failure or conduct other performance checks on the programmer to implement a remote solution to those problems.

Abstract: A medical device is directed to techniques for removing polarization artifacts from electrical activity signals in order to detect presence of an evoked response. More specifically, a medical device receives a signal that represents electrical activity within a heart of a patient following delivery of a stimulation pulse to the heart and reconfigures a filter state of a filter from an initial filter state to remove the polarization artifact from the electrical activity signal in order to determine whether a cardiac event, such as an evoked response has occurred. The medical device may, for example, when the filter of the medical device is a digital filter, recalculate the values of digital filter components using the present input value of the electrical activity signal as a direct current (DC) input value of the digital filter.

Abstract: The invention provides a system and method for easy and reliable connection of patient-originated medical data through a simple port of a computer to a dedicated web site. A device originating medical data, such as an implanted pacemaker, downloads data into a transmit/receive device, and the data is then transformed in an interface unit to be accepted by a simple port of a computer, e.g. a keyboard port or a mouse port. The patient logs on to a dedicated web site, and transfers the data along with typed input to the web site for analysis. Following analysis, a reply message is sent back to the patient, which may include a control instruction for modifying or reprogramming the operation of the device that is used to originate the medical data. For a pacemaker application, the data transformation is done at a simple interface unit that is portable and easily manipulated by the patient.