Abstract: Methods and apparatus for treating fibrillation utilize biphasic waveforms. A cardiac stimulator includes a defibrillation circuit that uses a pulse width modulated capacitive discharge to generate various biphasic waveforms, one or more of which may be delivered to the heart to treat the fibrillation.

Abstract: Methods and apparatus for treating fibrillation utilize biphasic waveforms. A cardiac stimulator includes a defibrillation circuit that uses a pulse width modulated capacitive discharge to generate various biphasic waveforms, one or more of which may be delivered to the heart to treat the fibrillation.

Abstract: A multiprogrammer system, for monitoring and optimizing implant performance, includes at least two programmers and an implant. Each programmer may perform inquiry and programming operations on the implant. In an inquiry operation, the programmer retrieves some or all of the configuration parameters from the implant. In a programming operation, the programmer provides one or more modified parameters to the implant. As part of the programming operation, the programmer is configured to verify that it is aware of the implant's current parameters before sending modified parameters. The current programmer verifies that the implant's parameters have not been altered since the current programmer's last interaction with the implant. If the parameters have been altered, the current programmer aborts the programming operation and provides notification. The verification may be performed by the implant, i.e.

Abstract: Methods and apparatus for treating fibrillation utilize biphasic waveforms. A cardiac stimulator includes a defibrillation circuit that uses a pulse width modulated capacitive discharge to generate various biphasic waveforms, one or more of which may be delivered to the heart to treat the fibrillation.

Abstract: A technique for acquiring and accessing information from a medical implantable device is provided. Analog waveforms of interest are sensed and processed by signal acquisition circuitry. Analog parameters of interest are applied to selector switches which are controlled by a logic circuit. The logic circuit is also coupled an A/D converter for converting the analog signals to digital values. The digital values are stored in dedicated registers and are available for telemetry to an external device upon receipt of a request or prompt signal. When a digitized value is accessed and telemetered, the control logic circuit changes the conductive state of the selector switches to apply the corresponding analog signal to the A/D converter. The resulting digital value is applied to the corresponding register to refresh the accessed and telemetered value. The technique permits the external device to request and configure the implanted device to send only digitized values of interest.

Abstract: It has been determined that certain dual-chambered cardiac stimulators may operate in a region in which an atrial pacing event may obscure the detection of a ventricular tachyarrhythmia. Various exemplary techniques may be used to improve the ability of dual-chamber cardiac stimulators to detect such ventricular events. In accordance with one technique, it is determined whether a ventricular event should be classified as a ventricular tachyarrhythmia. If not, the VA interval is restarted as usual. However, if the ventricular event may be classified as a ventricular tachyarrhythmia, it is determined whether the ventricular event falls within the region in which an atrial pacing event may obscure its detection. If not, then the VA interval is restarted as usual. However, if the ventricular event falls within this region, the VA interval is restarted with the VT rate detection boundary.

Abstract: An ionically conductive polymeric composition is disclosed. The composition is especially useful for coating an implantable hot can defibrillator electrode. The polymeric composition, for example, polyethylene oxide containing NaCl or a similar ionic medium, can be used to coat and fill the pores of a high surface area electrode to provide a continuous ionic network from the can to the adjacent body tissue. The conductive polymeric composition is biocompatible, chemically and mechanically stable and does not dissolve or leach out over the useful lifetime of the defibrillator. A hot can defibrillator employing the polymeric coating avoids development of high polarization at the can/tissue interface and maintains a more uniform defibrillation threshold than conventional implantable defibrillators, thus increasing the feasibility of pectoral implantation, particularly in a “dry pocket” environment.

Abstract: A cardiac stimulator for measuring pacing impedance includes a tank capacitor for delivering charge to the heart via leads, a shunt resistor, and high-impedance buffers for measuring pacing current through the shunt resistor. During the stimulation pulse, the voltage across the shunt resistor, as sampled by a high-impedance buffer, variously indicates lead and cardiac tissue resistance or capacitance. A high-impedance buffer measures the voltage between the tank capacitor and ground immediately following the stimulation pulse to allow estimation of the lead/heart tissue capacitance. A lead/heart tissue capacitance estimate is determined by look-up table is in memory or successive approximation. When the lead/heart tissue capacitance and lead resistance have been determined, a plurality of parameters for analyzing and optimizing a cardiac stimulation system may be calculated, such as the instantaneous current, the average current, the charge, and the energy delivered to the cardiac tissue.

Abstract: Methods and apparatus for treating fibrillation utilize biphasic waveforms. A cardiac stimulator includes a defibrillation circuit that uses a pulse width modulated capacitive discharge to generate various biphasic waveforms, one or more of which may be delivered to the heart to treat the fibrillation.

Abstract: A multiprogrammer system for monitoring and optimizing implantable device performance. In one embodiment, the system includes at least two programming devices and an implantable device. Each of the programming devices may be used to perform inquiry and programming operations on the implantable device. In an inquiry operation, the programming device retrieves some or all of the configuration parameters from the implantable device. In a programming operation, the programming device provides one or more modified parameters to the implantable device. As part of the programming operation, the programming device is configured to verify that it is aware of the implantable device's current parameters before sending the modified parameters. In other words, the current programming device verifies that the implantable device's parameters have not been altered by another programming device since the current programming device's last interaction with the implantable device.

Abstract: A cardiac stimulator capable of measuring pacing impedance includes a tank capacitor for delivering charge to the heart via device leads, a shunt resistor, and high-impedance buffers for measuring pacing current through the shunt resistor. Soon after the leading edge of the stimulation pulse, the voltage across the shunt resistor, as sampled by a high-impedance buffer, indicates lead and cardiac tissue resistance. Just prior to opening the pacing switch to terminate the stimulation pulse, the voltage across the shunt resistor is sampled by a high-impedance buffer and held once again to allow the capacitance of the lead/heart tissue to be calculated. In alternative embodiments, a high-impedance buffer measures the voltage between the tank capacitor and ground immediately following the stimulation pulse to allow estimation of the lead/heart tissue capacitance.

Abstract: Methods and apparatus for treating fibrillation utilize biphasic waveforms. A cardiac stimulator includes a defibrillation circuit that uses a pulse width modulated capacitive discharge to generate various biphasic waveforms, one or more of which may be delivered to the heart to treat the fibrillation.

Abstract: A method of making a stimulator electrode with a conductive polymer coating is disclosed. A polymeric coating, such as polyethylene oxide containing NaCl or a similar ionic medium, coats and fills the pores of a high surface area electrode to provide a continuous ionic network from the can to the adjacent body tissue. In certain embodiments, the underlying high surface area, porous electrode is made by chemically etching a smooth electrode surface, such as that of a conventional titanium housing, followed by applying a thin coating of a noble metal such as platinum. In other embodiments, a noble metal or an oxide thereof, such as platinum black or iridium oxide, is applied to a titanium housing to form a porous, high surface area electrode. The conductive polymeric coating is then applied over the porous noble metal or metal oxide.

Abstract: A lead assembly adapted for endocardial fixation to a human heart is provided. The lead assembly includes a lead body that has a proximal end provided with a connector for electrical connection to a cardiac stimulator. The cardiac stimulator may be a pacemaker, a cardioverter/defibrillator, or a sensing instrument. The distal end of the lead body is connected to a tubular electrode housing. The lead body consists of one or more noncoiled conductor cables surrounded by a coextensive insulating sleeve. Each conductor cable consists of a conducting element covered by a coextensive insulating sleeve. The conducting element may be a single filament wire or a plurality of individual conductor wires. In contrast to conventional leads, the lead body of the present invention does not require coiled conductor wires. Lead body diameters of 1.04 mm or smaller are possible.

Abstract: A cardiorespiratory monitor that generates bioimpedance sensing signals that produce substantially no interference with bioimpedance signals generated by implanted devices. The monitor detects the bioimpedance signal generated by the implanted device, using a voltage detector or a telemetry circuit, for example. The monitor analyzes this detected signal to generate a bioimpedance sensing signal that will not interfere with the sensed signal. For instance, if the monitor produces a pulsed sensing signal, the pulses are delivered in an interval of the detected signal where no pulses are present. Similarly, if the monitor produces a high frequency AC sensing signal, the zero crossings of the AC sensing signal are positioned during the delivery of a pulse by the implanted device.

Abstract: A circuit substrate utilizes buried edge connectors. The buried edge connectors are mechanically disposed within the edge of the substrate and have substantial thickness. The configuration and method for making the same provides relatively large edge connectors mechanically constrained in the edge of a circuit substrate.

Abstract: A thin film capacitor for use in an implantable defibrillator. A first dielectric polymer filmlayer has a metallized film on one side thereof. A second dielectric polymer film layer has a metallized film on one side thereof. The first and second layers are overlain on each other and wound spirally with the metallized film of one layer adjacent the dielectric polymer of the other layer. The beginnings and ends of the first and second metallized films are offset from the respective beginnings and ends of the first and second polymer film layers. The dielectric layers can be tapered in increasing thickness toward the respective beginnings and ends of the layers. The dielectric layers can themselves comprise at least two layers of differing polymer materials, the preferred materials being polyvinylidene fluoride and polyester for improved energy density and self-healing properties.

Abstract: A multiprogrammer system for monitoring and optimizing implantable device performance. In one embodiment, the system includes at least two programming devices and an implantable device. Each of the programming devices may be used to perform inquiry and programming operations on the implantable device. In an inquiry operation, the programming device retrieves some or all of the configuration parameters from the implantable device. In a programming operation, the programming device provides one or more modified parameters to the implantable device. As part of the programming operation, the programming device is configured to verify that it is aware of the implantable device's current parameters before sending the modified parameters. In other words, the current programming device verifies that the implantable device's parameters have not been altered by another programming device since the current programming device's last interaction with the implantable device.

Abstract: A cardiac stimulator capable of measuring pacing impedance includes a tank capacitor for delivering charge to the heart via device leads, a shunt resistor, and high-impedance buffers for measuring pacing current through the shunt resistor. Soon after the leading edge of the stimulation pulse, the voltage across the shunt resistor, as sampled by a high-impedance buffer, indicates lead and cardiac tissue resistance. Just prior to opening the pacing switch to terminate the stimulation pulse, the voltage across the shunt resistor is sampled by a high-impedance buffer and held once again to allow the capacitance of the lead/heart tissue to be calculated. In alternative embodiments, a high-impedance buffer measures the voltage between the tank capacitor and ground immediately following the stimulation pulse to allow estimation of the lead/heart tissue capacitance.

Abstract: A method and apparatus for evaluating heart rate variability of the heart of a person in order to forecast a cardiac event. A cardiac stimulator receives heart beat signals from the heart and determines a measurement of heart rate variability based on statistical data derived from the heart beat signals and sensing data derived from a sensor. This measurement of heart rate variability is compared with previously stored heart rate variability zones defining normal and abnormal heart rate variability. These zones are modifiable after the occurrence of a cardiac event. Once a cardiac event is detected, a pathway is computed which extends from a generally normal heart rate variability condition to an abnormal heart rate variability condition. Subsequent measurements of heart rate variability are compared with this pathway. Selective therapy regimes are initiated depending on the measurement of heart rate variability.