Abstract: An implantable lead which has an increased resistance to fracture and has the capability of continued function after fracture of a conductor. The lead is provided with a coiled conductor which may be monofilar or multifilar and which extends along the length of the lead, running from an electrical connector at the proximal end of the lead to an electrode at or near the distal end of the lead. In addition, the lead is provided with a stranded conductor which is electrically coupled to the coiled conductor at point along the lead body located proximal to the point of expected breakage of the coiled conductor and at a point along the lead body located distal to the point of expected breakage. The proximal and distal ends of the stranded conductor in some embodiments are also mechanically coupled to the coiled conductor.

Abstract: A headspace insulator for a battery cell operatively coupled to circuitry within an implantable medical device in including one or more of the following: (a) a body of electrically and thermally insulating material disposed between a battery electrode assembly and a battery cover, (b) a receiving area within the body that receives and isolates a battery feedthrough pin, (c) an indentation within the receiving area retaining the feedthrough pin within the receiving area, (d) a raised portion coupled to a battery cover providing an air gap between the cover and the headspace insulator near case-to-cover weld areas, (e) a feedthrough aperture adapted to receive a feedthrough assembly, (f) a pin aperture that receives the feedthrough pin, (g) a fillport aperture for electrolyte fluid flow through the headspace insulator, and (h) a slot that locates a battery weld bracket and isolates it from the feedthrough pin.

Abstract: A medical electrical lead includes an elastomeric multi-lumen tube, which includes a lumen having a substantially elliptical cross-section through which a conductor having a substantially circular cross-section may extend. The substantially elliptical cross-section of the lumen includes a minor axis having a first length and being deformable such that the first length of the minor axis extends to a second length.

Abstract: A catheter body includes a proximal portion, an intermediate portion extending from the proximal portion and defining a longitudinal axis, and a distal portion extending from the intermediate portion and terminated by a distal end of the catheter body; the distal portion forms a coil about a central loop axis, which is substantially parallel to the longitudinal axis. A first lumen extends through the proximal and intermediate portions of the catheter body and is terminated at an opening proximal to an ablation section, which is formed along the coil.

Abstract: A method for coating a medical device with a drug is provided. Energy, preferably thermal energy, is applied to a crystalline deposit of a drug on the surface of a medical device to increase the molecular mobility and form a conformable drug coating with a low density of micro-cracks and other mechanical defects that can degrade the coating toughness and effective adhesion to the device surface. In a preferred embodiment, solution evaporation methods are used to deposit a crystalline coating of an anti-inflammatory steroid on a medical electrode. Heat applied at a controlled temperature, for a predetermined amount of time, induces a solid-state phase change of the drug coating providing a smooth, uniform, well-attached, conformable coating to form a layer that will elute from the electrode over time when implanted in a patient's body.

Abstract: An implantable lead includes a defibrillation electrode and a sensor coupled thereto. The electrode and sensor are positioned along a body of the lead such that, when a fixation element couples the lead to an endocardial surface of a right ventricle, the sensor is located in a high flow region and a portion of the defibrillation electrode is located in proximity to a right ventricular apex.

Abstract: An implantable medical device and associated method for automatically generating morphology templates during fast cardiac rhythms, confirming a provisional template as a confirmed template, and using the confirmed template to classify subsequent detected arrhythmias. A provisional SVT template may be created during a fast ventricular rate and activated as a confirmed SVT template upon verification that the fast rate was due to an SVT. The confirmed SVT template may be used to discriminate SVT from VT/VF.

Abstract: An alternate sampling integrator circuit is disclosed that can concurrently sample and integrate signals received at an input. The circuit may include multiple sampling capacitors, an operational amplifier, and multiple switches. The switches switch the capacitors between a sampling mode and an integration mode.

Abstract: A programmer including a user interface, and techniques for programming a rate responsive implantable medical device using such a programmer and user interface are presented. The programmer may retrieve currently programmed rate response parameters and optimization target values of an implantable medical device. The programmer may display the currently programmed rate response parameters and optimization target values via a user interface. The programmer may also generate a current rate response curve and a current target rate histogram, and display the current rate response curve and current target rate histogram via the user interface. The programmer may receive changes to the displayed currently programmed rate response parameters and/or target values made by a user via the user interface, generate a pending rate response curve and/or a pending target rate histogram based on these changes, and display the pending rate response curve and/or pending target rate histogram via the user interface.

Abstract: A patient monitor is configured to interrogate an implantable medical device (IMD) and receive data from the IMD in response to the interrogation. The data received from the IMD includes electrogram (EGM) data, which the patient monitor frequency modulates for transmission, in real-time, onto a conventional telephone line. The frequency modulated EGM data that is transmitted from the patient monitor may in turn be displayed, in real-time, at a remote monitoring station in response to commands provided by a remote (DTMF) signal from a receiving station.

Abstract: A method and apparatus to provide therapy to a patient for protecting cardiac tissue from insult is disclosed. The method comprises delivering closed loop electrical stimulation to one or more predetermined portions of a portion of excitable tissue of the spinal cord of a patient; and monitoring one or more physiologic indices of the body. That is, a closed-loop feedback controller is used to apply electrical stimulation to preselected regions of the spinal cord of a patient's body based upon one or more aspects of the physiologic indices.

Abstract: A laser ribbon bond pad array connector is disclosed for electrically connecting a RF module to an IMD circuit board in an implantable medical device. The array connector includes a connector body with a plurality of electrically isolated bonding fingers embedded in the connector body. Each bonding finger includes a solder pad that is on a first surface of the connector body and a laser ribbon bond pad that is on a second surface of the connector body. The first and second surfaces are spaced apart in angular relations thereof.

Abstract: A surface area of an IMD electrode is increased by forming a conductive layer over an external portion of a sidewall of an IMD connector header and electrically coupling the conductive layer of the connector header to a conductive mounting surface of a hermetically sealed IMD housing; wherein the conductive mounting surface is an extension of an external conductive surface of the IMD, which external conductive surface forms the IMD electrode that is increased in surface area by the conductive layer formed over the connector header.

Abstract: The present invention generally relates to an improved implantable medical device (IMD) and more particularly to an ultrasonically weld perforated lid for an IMD to form a hermetic seal between the IMD and the perforated lid. Appropriately configured perforated lids retain one or more components within a cavity or port formed in a part of an IMD. Such lids preferably secure a pierceable resilient grommet, septum or other resilient member in a cavity or port. When an adjustment instrument, a pull tool or a syringe is temporarily inserted therethrough and later extracted, the resilient member heals (i.e., seals and/or reseals). Preferably, the resilient member abuts a mechanical stop and is compressed slightly during assembly and ultrasonic welding of the lid. The resilient member preferably has a lateral dimension like the cavity or port so that when the lid compresses the resilient member it expands slightly and contacts the interior cavity surfaces thus improving the seal.

Abstract: An implantable medical device includes two or more pacing output channels coupled to a single unipolar electrode or bipolar electrode pair. The implantable medical device can control each pacing output channel to deliver pacing pulses via the single electrode or electrode pair at different times and with different amplitudes. In some embodiments, the implantable medical device is used to deliver extra-systolic stimulation therapy. In such embodiments, a first pacing output channel can be controlled to deliver pacing pulses via the electrode or electrode pair with an amplitude sufficient to depolarize a chamber of the heart. A second pacing output channel is controlled to deliver extra-systolic pulses, which can have a lower amplitude than the pacing pulses, via the electrode or electrode pair an extra-systolic interval after sensed or paced depolarizations of the chamber. In some embodiments, the implantable medical device delivers ESS therapy and cardiac resynchronization therapy (CRT).

Abstract: Techniques and apparatus for estimating the temporal refractory period of a heart, for adjusting a parameter for delivery of extra-systolic stimulation (ESS) therapy and for detecting an arrhythmia during delivery of ESS therapy In some aspects, probe pulses are periodically delivered to estimate the location of the end boundary of the refractory period, and accordingly estimate its length. In some embodiments, the parameter is adjusted based on estimated length of the refractory period. For example, an extra-systolic interval (ESI) for delivery of ESS is adjusted to be a fixed interval longer than estimated lengths of the refractory period. In other aspects, the parameter is adjusted based on a measured delay (or latency) between delivery of an ESS pulse and detection of an evoked response resulting from the pulse. Also, delays between delivery of an ESS pulse and detection of a subsequent depolarization are monitored to detect an arrhythmia.

Abstract: The bi-ventricular implantable pulse generator described and depicted herein enables hemodynamic efficiencies for patients suffering from intraventricular conduction delays or conduction blockage. The pulse generator effectively overcomes such conduction delay or block (e.g., left bundle branch block, “LBBB,” or right bundle branch block, “RBBB”) by delivering a novel form of cardiac resynchronization therapy (CRT). Specifically, a single ventricular pre-excitation pacing stimulus is triggered from an atrial event (e.g., intrinsic or evoked depolarization). The triggering event may emanate from the right atrium (RA) or the left atrium (LA). A single ventricular pre-excitation pacing stimulus is delivered prior to the intrinsic depolarization of the other ventricle and thus promotes intraventricular electromechanical synchrony during CRT delivery.

Abstract: The invention is directed to techniques for electrode placement around a heart. A harness having one or more attachment sites may be secured around the heart, and electrodes may be secured at the attachment sites as desired by the physician for the patient. The electrodes may be, for example, pacing and sensing electrodes, defibrillation electrodes, or any combination thereof. The harness holds the electrodes in place and also impedes the progress of ventricular dilation. The electrodes attached to the harness may be used for any of several purposes, such as cardiac resynchronization, selective defibrillation, measurement of impedance, pacing and cardioversion.

Abstract: In an implantable medical device a real-time left atrial pressure (“LAP”) signal obtained from a patient's heart is used as a feedback control mechanism to adjust one or more device parameters. In one example the device identifies specific characteristics and attributes of the LAP signal that correlate to hemodynamic performance, and adjusts the device parameters to optimize the LAP characteristics and attributes. In a dual-chamber pacing system, the controlled operating parameter may include the atrioventricular pacing delay, and LAP attribute suitable for controlling the atrioventricular pacing delay time intervals of v-wave, a-wave, and/or c-wave characteristics of the LAP signal.

Abstract: A method and corresponding system for updating or installing new software loaded into the memory of an implantable medical device(IMD) implanted within a body of a patient is described. The updated or new software may be installed in the memory of the IMD without the patient having to travel to a clinic or hospital, and may be effected by employing modem telecommunication and Internet techniques in conjunction with a remote computer system.