Abstract: A method and apparatus for cardiac stimulation for addressing vasovagal syncope incorporates a detection algorithm in which a precipitous rate drop from a pre-existing average intrinsic heart rate value to a lower rate limit is sensed and if the patient is awake and the intrinsic rate remains below the lower rate limit for a predetermined number of beats, the patient's heart is paced at a rate that is a programmed differential above the prior average intrinsic rate for a second programmed time interval, at the conclusion of which the pacing rate is gradually decreased to the average heart rate existing prior to the sudden rate drop or to the lower rate limit.

Abstract: A valve disabler for use in high pressure pipe cleaning systems. The valve disabler of the present invention serves to disable a single cylinder in a multi-cylinder plunger pump so as to generate pulsatile pressure surges within a hose member. The pulsatile pressure surges cause the distal end of the hose member to move in a serpentine manner, thus allowing the hose member to negotiate down a tortuous path within the pipe without stalling or becoming otherwise impeded.

Abstract: Hemodynamic performance of the heart as a pump is optimized by using an accelerometer and signal processing circuitry to measure total acoustic noise (TAN) over predetermined time periods when a pacemaker is made to function in a variety of modes. By detecting the particular mode associated with minimum TAN, the optimum pacing mode is arrived at.

Abstract: A multiport header for a cardiac rhythm management device includes at least one standard port and a separate port for a left ventricular access lead. The left ventricular access lead can only be electrically and mechanically coupled to the proper port. Standard leads cannot be electrically or mechanically coupled to the port for the left ventricular access lead.

Abstract: A sling for supporting the urethra and neck of the bladder to prevent urinary incontinence is disclosed. The sling is designed to provide sufficient support to inhibit the unintended flow of urine, yet stretch in a controlled fashion so that the bladder can be voided at approximate times.

Abstract: A method and apparatus for attenuating polarization voltages or "afterpotentials" which develop at the heart tissue/electrode interface following the delivery of a pacing stimulus to the heart tissue such that the evoked response of the heart may be accurately detected to determine whether each pacing stimulus resulted in heart capture or contraction, thereby facilitating improved tracking of the capture threshold and minimizing power consumption while assuring therapeutic efficacy. The conventional large capacitance coupling capacitor used to suppress DC components of the pacing spike has another, much lower capacitance capacitor connected in series with it. The lower capacitance capacitor may be operable in either the autothreshold mode or in the normal pacing mode such that its value can be selectively inserted in series with the larger capacitance coupling capacitor to effectively lower the overall capacitance of the coupling capacitor following delivery of the pacing stimulus.

Abstract: The present invention discloses the use of peracid vapor as a sterilant. A process is disclosed for sterilizing a load by exposure to peracid vapor, the load being disposed in a sterilization chamber adapted to contain the peracid vapor, including the steps of exposing the load to the peracid vapor in the sterilization chamber at reduced pressure, i.e., below atmospheric pressure and introducing a quantity of another gas, the gas being of a type which does not interfere with the sterilization procedure, to increase the pressure in the chamber to a value above that at which the chamber was when the peracid vapor alone was present but below atmospheric pressure, whereby the penetration of any vapor penetrable portions of the load to be sterilized by the peracid vapor is enhanced.

Abstract: An improved high speed package printer for producing a plurality of high quality photographs of varying size, shape, and style based on one or a plurality of different film negatives. The improved package printer of the present invention accomplishes the goal of increased throughput and speed through the use of an automatic paper-loading feature, ultrasonic proximity sensors for dynamically measuring paper-slack loops, off-center printing for eliminating the need to advance the paper for punching after each exposure, a rotational prism for creating 10".times.13" photographs without physically rotating the film, a 13-UP lens deck including 12 wallet lenses and a single 5".times.7" retro-focus lens for creating 12 wallet-sized photographs and one 5".times.

Abstract: A method for reducing the affects of intrinsic detection latency in a cardiac rhythm management device, wherein said method is initiated immediately prior to delivering a stimulation pulse to the heart tissue. A coincidence of intrinsic and cardiac rhythm management initiated stimulus or the delivery of a stimulation pulse proximate the time of an intrinsic event due to intrinsic detection latency may results in delivery of unnecessary backup stimulus and/or imprecise determination of a pacing threshold. When stimulating the heart, the timing sequence for delivering a stimulation pulse typically depends upon the timing of a previous intrinsic or device initiated event. Further, the method of the present invention reduces the affects of intrinsic detection latency thereby facilitating improved detection of capture and determination of capture threshold for minimizing power consumption while assuring therapeutic efficacy.

Abstract: The present invention is a torque handle for use in inserting and positioning a pacing lead and guide wire, such as within a coronary vein. The torque handle is a handle with a lumen extending therethrough. A first clamping arrangement is located on the handle and receives the guide wire therethrough. A second clamping arrangement is also located on the handle. The second clamping arrangement sized to receive the body of the lead therethrough. In use, the physician determines whether torque is to be transmitted along the lead, the guide wire or both. Torque is transmitted by clamping or loosening the designated clamping arrangement around the lead, the guide wire or both, and then rotating the handle. As the handle is rotated, torque is transmitted along the length of the clamped lead or guide wire or both.

Abstract: The combination of a bottle used to contain pharmaceutical products such as capsules, pills, tablets, caplets, gelcaps or the like and a permanent indicia system having a plurality of indicators operated sequentially by an irreversible physical act producing a permanent dosage recording indicator, the exposure of a plurality of said indicators showing a cumulative dosage record.

Abstract: Loading mechanisms for front loading refuse trucks provided with fluid cylinder operated lift arms and associated fluid cylinder operated lift forks are provided with an improved operating system which allows the lift forks to attain one working position limit for tipping containers and an additional stowage position limit allowing the truck to travel with the arms fully raised.

Abstract: A cutting guide for assuring that mating bone segments will be properly aligned following excision of the joint therebetween comprises first and second alignment bar segments hingedly joined, end-to-end, whose angle of inclination therebetween can be readily set and fixed, is clamped to a toe to be treated by a pair of transversely extending arm members that can be clamped to the metatarsal and phalangeal bones. The coupling between the arm clamped to the metatarsal bone and its associated alignment bar segment allows limited rotation and fixing of the alignment bar. A cutting blade guide member having a blade receiving slot is adjustably mounted to and parallel with the clamping arm affixed to the phalangeal bone. The resulting cuts made through the head of the metatarsal bone and the base of the phalangeal bone on either side of the joint being removed will provide a predetermined inclination and direction to the toe following fusion thereof.

Abstract: An implantable cardiac rhythm management device includes a controller adapted to receive digitized electrocardiogram signals from leads placed on or in the heart. The device also incorporates an autosense algorithm which automatically adjusts the sensing threshold dependent upon an average or maximum amplitude of noise detected during a period following a sensed cardiac depolarization. The sensing threshold is automatically set on a beat-to-beat basis at a level such that the signal to noise ratio exceeds a preset value.

Abstract: A cardiac stimulating apparatus and method is described that non-intrusively determines an amount indicative of hemodynamic pulse pressure from an accelerometer signal. The amount indicative of pulse pressure is determined over several cardiac cycles and is used to optimize cardiac performance by evaluating the amount indicative of pulse pressure over varying timing intervals. The timing intervals are measured between at least one of intrinsic and paced stimulations of pre-selected chambers of the heart and a maximum pulse pressure indicates the optimum timing interval under manipulation. The cardiac stimulating apparatus and method may be used in any of several pacing modes including A-V pacing, V-V pacing, or A-A pacing.

Abstract: An apparatus and method for assessing the status of well-being of patients being treated for CHF using cardiac pacing as a therapy. By sampling the output from an activity sensor or the like, and by noting the frequency with which the averaged rectified sensor output exceeds a preset threshold following changes in the pacing mode, the efficacy of the new mode compared to the previous one can be evaluated.

Abstract: An improved high speed package printer for producing a plurality of high quality photographs of varying size, shape, and style based on one or a plurality of different film negatives. The improved package printer of the present invention accomplishes the goal of increased throughput and speed through the use of an automatic paper-loading feature, ultrasonic proximity sensors for dynamically measuring paper-slack loops, off-center printing for eliminating the need to advance the paper for punching after each exposure, a rotational prism for creating 10".times.13" photographs without physically rotating the film, a 13-UP lens deck including 12 wallet lenses and a single 5".times.7" retro-focus lens for creating 12 wallet-sized photographs and one 5".times.