Abstract: A method and system for tracking quality of life in a patient with angina includes obtaining activity data and cardiac data, determining a level of physical activity of the patient and identifying an ischemic episode based on the cardiac data obtained during the physical activity. The method also provides for recording an activity level at the time the ischemic episode occurs. Furthermore, the method also provides for presenting activity level trends related to activity levels at the onset of ischemia to a user.

Abstract: Techniques for reducing orthostatic hypotension are described. One technique detects an incident of orthostatic hypotension in a patient, and in response, increases cardiac stroke volume, at least in part, by stimulating the patient's phrenic nerve.

Abstract: An exemplary method includes delivering a maintenance therapy that aims to prevent occurrence of apnea, sensing information, based at least in part on the information, determining if apnea exists and, if apnea exists, delivering a termination therapy that aims to terminate the apnea. An exemplary implantable device includes an input for information pertaining to respiration and control logic to call for overdrive pacing at a first rate that aims to minimize occurrence of a respiratory condition, to analyze the information for occurrence of the respiratory condition and, upon occurrence of the respiratory condition, to call for overdrive pacing at a higher rate. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An implantable medical device includes a sealed casing enclosing electronic circuitry and a plurality of electrical terminals connected to the electronic circuitry and projecting out of a mounting surface. A header has an undersurface for mounting engagement on the mounting surface of the casing and first and second oppositely directed elongated receptacles, the first receptacle being positioned proximate the electrical terminals. The header also includes at least one conductive connector block having a bore aligned with each of the first and second receptacles for receiving a proximal end portion of a lead extending through the elongated receptacle and carrying at least one electrical terminal and a wire electrically connects each of the connector blocks with an associated electrical terminal, at least the wire from the connector block associated with the first receptacle being of minimal length because of its close proximity to the plurality of electrical terminals.

Abstract: An apparatus for and method of measuring pressure through a septum in a patient's heart is provided. A lead inserted into the right side of a heart is routed through the septum to gain access to the left side of the heart. The lead includes a mounting mechanism that secures the lead to one or both sides of the septal walls. The lead also includes one or more sensors for measuring cardiac pressure on the left side of the heart and, as necessary, the right side of the heart.

Abstract: Provided herein are implantable devices, and methods for use therewith, that perform at least one of a cardiac assessment and an autonomic assessment. An implantable device is used to sense a cardiac electrogram (EGM) signal, and cardiac intervals are measured within a portion of the sensed EGM signal. Anchor points are identified based on the measured cardiac intervals, and for each identified anchor point, a segment of at least three consecutive said cardiac intervals that is generally centered about the anchor point is defined. The segments defined for the anchor points are averaged to produce an average segment. At least one of a cardiac assessment and an autonomic assessment is performed based on the average segment. This can include assessing a patient's autonomic tone based on the average segment, assessing a patients risk of SCD based on the average segment and/or detecting a myocardial ischemic event based on the average segment.

Abstract: A system for automatically evaluating the sensing and detection of physiological processes by an implantable medical device, such as an implantable cardiac stimulation device. The system includes an automatic testing algorithm which iteratively adjusts at least one of the threshold and gain settings of the device and evaluates the accuracy of the detection for refining the programming of the device. The algorithm can include sampling the physiological process beginning at a relatively low rate to avoid excessive burden on the processing and battery capacity available and progressively increasing the rate to obtain higher resolution data. The algorithm can also evaluate the observed physiological process for periodicity and can determine repetition of an irregular pattern, such as bigeminy, and use the determined pattern for predictive purposes to refine the programming of the device. The algorithm employs observation of a change in observed pattern as indicia for loss of proper detection.

Abstract: An exemplary implantable microarray device includes an inlet for a body fluid, a plurality of individual reaction cell arrays where each reaction cell array includes a series of reaction cells configured to receive the body fluid, a sensor array to sense a reaction result for an individual reaction cell array where the reaction result corresponds to a reaction between the body fluid and at least one reagent in each of the reaction cells of the individual reaction cell array and a positioning mechanism to position an individual reaction cell array with respect to the sensor array. Various other exemplary technologies are also disclosed.

Abstract: This invention relates generally to systems and methods for optimizing the performance and minimizing complications related to implanted sensors, such as pressure sensors, for the purposes of detecting, diagnosing and treating cardiovascular disease in a medical patient. Systems and methods for anchoring implanted sensors to various body structures is also provided.

Abstract: An implantable cardiac stimulation device provides biventricular pacing and pacemaker mediated tachycardia (PMT) detection. The device includes a pulse generator that provides right ventricular and left ventricular pacing pulse pairs to a right ventricle and left ventricle of a heart in a biventricular pacing mode. A sensing circuit senses activations of an atrium of the heart and a pacemaker mediated tachycardia detector times a plurality of V-P intervals from first issued pacing pulses of each pacing pulse pair to sensed activations of the atrium. A limit circuit of the PMT detector sets V-P interval limits response to the plurality of timed V-P intervals and a compare circuit determines if a last timed V-P interval is within the V-P interval limits. The timed V-P intervals are preferably recorded in a histogram format.

Abstract: A method for adjusting AV/PV delay using a pacing device may include: setting an initial AV/PV delay for the pacing device; setting a threshold for a value related to cardiac function; determining a value based on cardiac function or monitoring a value related to cardiac function; and controlling the AV/PV delay to lengthen the AV/PV delay when the determined/monitored value exceeds the set threshold. The system may include an implantable pacing device; and a processor configured to: set an initial AV/PV delay for the pacing device; set a threshold for a value related to cardiac function; at least one of monitor a value related to cardiac function and determine a value based on cardiac function; and control the AV/PV delay to lengthen the AV/PV delay when the value related to cardiac function or the value based on cardiac function exceeds the set threshold.

Abstract: Briefly, values representative of ventricular end-diastolic volume (EDV) are detected using ventricular electrodes and then heart failure, if occurring within the patient, is evaluated based on ventricular EDV. In this manner, ventricular EDV is used as a proxy for ventricular end-diastolic pressure. By using ventricular EDV instead of ventricular end-diastolic pressure, heart failure is detected and evaluated without requiring sophisticated sensors or complex algorithms. Instead, ventricular EDV is easily and reliably measured using impedance signals sensed by implanted ventricular pacing/sensing electrodes. The severity of heart failure is also evaluated based on ventricular EDV values and heart failure progression is tracked based on changes, if any, in ventricular EDV values over time.

Abstract: Techniques are provided for use by an implantable medical device for determining optimal or preferred atrioventricular (AV) pacing delay values for use in pacing the heart. Briefly, the atria and ventricles are paced using an initial AV pacing delay set to a value less than an intrinsic AV conduction delay so that intrinsic ventricular depolarizations are avoided. An internal electrical cardiac signal is sensed and atrial evoked responses and subsequent ventricular evoked responses are identified therein. Time delays between the atrial and ventricular evoked responses are measured and then a preferred or optimal AV pacing delay value is determined based on: the initial AV pacing delay; the measured time delays between the atrial and ventricular evoked responses; and on a predetermined preferred time delay to be achieved between atrial and ventricular evoked responses. Similar procedures are employed in connection with atrial sensed events. A calibration procedure is also described.

Abstract: Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

Abstract: Implantable systems, and methods for use therewith, for monitoring arterial blood pressure on a chronic basis are provided herein. A first signal indicative of electrical activity of a patient's heart, and a second signal indicative of mechanical activity of the patient's heart, are obtained using implanted electrodes and an implanted sensor. By measuring the times between various features of the first signal relative to features of the second signal, values indicative of systolic pressure and diastolic pressure can be determined. In specific embodiments, such features are used to determine a peak pulse arrival time (PPAT), which is used to determine the value indicative of systolic pressure. Additionally, a peak-to-peak amplitude at the maximum peak of the second signal, and the value indicative of systolic pressure, can be used to determine the value indicative of diastolic pressure.

Abstract: Analysis of metabolic gases by an implantable medical device allows the assessment of the status of a congestive heart failure patient by providing for the assessment of cardiac output. The present invention is directed to an implanted medical device configured to measure concentrations of metabolic gases in the blood to determine cardiac output of a patient. The device is also configured to measure changes in the cardiac output of a patient. The present invention is also directed to a method of measuring cardiac output by an implanted medical device. Further, the detection of changes in cardiac output utilizing an implanted medical device as disclosed herein is useful in a method of detecting exacerbation of congestive heart failure. The implanted medical device can also be used to pace a heart to modify cardiac output in a patient.

Abstract: A monitoring and/or stimulation device to receive a signal from a lead sensor positioned in the heart of patient. The monitoring and/or stimulation device processes the blood pressure data received from the sensor to determine an augmentation pressure for each heart beat. The augmentation pressure may be tracked over time or compared to a template to determine the circadian state of the patient. The augmentation pressure may be tracked or analyzed over a longer time period to detect other heart conditions such as hypertension.

Abstract: In fabricating a header assembly of an implantable medical device, one end of a bore contact wire attached to a connector block is keyed with one guiding channel at an upper region of a feedthru adapter and through the adapter to its undersurface. An opposite end is bent into conformance with an orientation channel on the adaptor undersurface. A tip end of a feedthru wire connected to electronic circuitry of the medical device and projecting out of a casing mounting surface is bent for alignment with the orientation channel so end portions of the feedthru wire and bore contact wire are in end to end engagement, then welded together. A plastic header is molded to encapsulate the adapter, connector block, and bore contact wire and, when solidified, has an undersurface for engagement on the casing and an elongated receptacle aligned with a connector block bore to receive the lead.

Abstract: Methods and systems are provided for performing ventricular arrhythmia monitoring using at least two sensing channels that are each associated with different sensing vectors, for example by different pairs of extracardiac remote sensing electrodes. Myopotential associated with each of the sensing channels in monitored, and a ventricular arrhythmia monitoring mode is selected based thereon (e.g., based on determined myopotential levels). Ventricular arrhythmia monitoring is then performed using the selected monitoring mode.

Abstract: An electrolyte including ?-butyrolactone, a cosolvent and an alcohol is disclosed, which may be used in an electrolytic capacitor with very high operating voltage. Optional additional additives are added to the electrolyte to enhance its conductivity and reliability.