Abstract: Embodiments of the present invention relate to implantable systems, and method for use therein, that can detect myocardial ischemic events. In accordance with specific embodiments of the present invention, short-term fluctuations in cardiac intervals that follow premature ventricular contractions (PVCs) are monitored. This allows myocardial ischemic events to be detected based on these monitored fluctuations. The cardiac intervals for which fluctuations are being monitored can be, for example, RR intervals. Alternatively, or additionally, short-term fluctuations in other types of cardiac intervals may be monitored. Such other cardiac intervals include, for example, PR intervals, PP intervals, QT intervals and RT intervals.

Abstract: A nerve stimulation system includes a pulse generator and implantable lead. The pulse generator includes a sensing module and a pace circuit. The lead has an electrode array near the distal end and a connector at the proximal end for connection to the pulse generator. Conductors in the lead electrically connect the electrode array with the sensing module and pace circuit. The electrode array includes a first pair of small electrodes and a large electrode close to each other. The small electrodes and large electrode are physically separated from each other by insulative spaces extending generally transversely to a longitudinal axis of the lead. When the conductors are in electrical communication with the sensing module and pace circuit, the first pair of small electrodes are in electrical communication with both the sensing module and the pace circuit and the large electrode is in electrical communication with the pace circuit only.

Abstract: Electrode foils suitable for use in electrolytic capacitors, including those having multiple configurations, have improved strength, reduced brittleness, and increased capacitance compared to conventional anode foils for electrolytic capacitors. Exemplary methods of manufacturing an anode foil suitable for use in an electrolytic capacitor include forming a pattern of etch resist on a surface of a substrate; etching a first area of the surface substantially enclosed by the pattern and a second area in intervals between the pattern to form tunnels in first and second areas of the surface; and removing the resist material revealing a non-etched frame. The resist material may be deposited, for example, by ink-jet printing, stamping or screen printing. Additionally, an etch resist pattern may be used to form strength lines on the substrate surface.

Abstract: An implantable system includes terminals, a pulse generator, a sensing circuit, separate signal processing channels, and first, second and third multiplexers. The terminals are connected to electrodes via conductors of leads. Different subsets of the electrodes are used to define different electrical pulse delivery vectors, and different subsets of the electrodes are used to define different sensing vectors. The pulse generator produces electrical pulses, and the sensing circuit senses a signal indicative of an impedance associated with a selected sensing vector. The first multiplexer selectively connects outputs of the pulse generator to a selected one of the different electrical pulse delivery vectors at a time. The second multiplexer selectively connect inputs of the sensing circuit to a selected one of the different sensing vectors at a time. The third multiplexer selectively connects an output of the sensing circuit to one of the plurality of separate signal processing channels at a time.

Abstract: Electrode foils suitable for use in electrolytic capacitors, including those having multiple configurations, have improved strength, reduced brittleness, and increased capacitance compared to conventional anode foils for electrolytic capacitors. Exemplary methods of manufacturing an anode foil suitable for use in an electrolytic capacitor include forming a pattern of etch resist on a surface of a substrate; etching a first area of the surface substantially enclosed by the pattern and a second area in intervals between the pattern to form tunnels in first and second areas of the surface; and removing the resist material revealing a non-etched frame. The resist material may be deposited, for example, by ink-jet printing, stamping or screen printing. Additionally, an etch resist pattern may be used to form strength lines on the substrate surface.

Abstract: An electrode structure is incorporated into an implantable lead for deep brain stimulation. The electrode structure comprises multiple radial electrode elements. The radial electrode elements of the electrode structure are separated by holes (e.g., slots) and held together by end rings of the electrode structure. The electrode elements are separated from one another at a later stage of a manufacturing process through the use of centerless grinding that removes the end rings.

Abstract: A wireless implantable system is provided that is externally powered and comprises of a closed-loop feedback for treating both patients with obstructive and central sleep apnea. A method is provided for treating sleep apnea using an implantable device. The method comprises sensing an inspiration (IN) signal representative of inspiration experienced by a patient from a respiratory surrogate signal and sensing a respiratory effort (RE) signal representative of an amount of effort exerted by the patient during respiration.

Abstract: Techniques are provided for use by implantable medical devices such as pacemakers or by external systems in communication with such devices. An intracardiac electrogram (IEGM) is sensed within a patient in which the device is implanted using a cardiac signal sensing system. Cardiac events of interest such as arrhythmias, premature atrial contractions (PACs), premature ventricular contractions (PVCs) and pacemaker mediated tachycardias (PMTs) are detected within the patient using event detection systems and then portions of the IEGM representative of the events of interest are recorded in device memory. Subsequently, during an off-line or background analysis, the recorded IEGM data is retrieved and analyzed to identify false detections. In response to false detections, the cardiac signal sensing systems and/or the event detection systems of the implantable device are selectively adjusted or reprogrammed to reduce or eliminate any further false detections, including false-positives or false-negatives.

Abstract: A leadless cardiac pacemaker comprises a housing, a plurality of electrodes coupled to an outer surface of the housing, and a pulse delivery system hermetically contained within the housing and electrically coupled to the electrode plurality, the pulse delivery system configured for sourcing energy internal to the housing, generating and delivering electrical pulses to the electrode plurality. The pacemaker further comprises an activity sensor hermetically contained within the housing and adapted to sense activity and a processor hermetically contained within the housing and communicatively coupled to the pulse delivery system, the activity sensor, and the electrode plurality, the processor configured to control electrical pulse delivery at least partly based on the sensed activity.

Abstract: Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

Abstract: A method for patterning a metal substrate includes a series of surface treatments to control tunnel initiation at a micron or sub-micron level. In particular, the series of surface treatments include forming a hydration layer which acts as a mask while etching the surface of the metal substrate. The hydration layer mask enables control of the tunnel initiation on a micron or sub-micron level because the etching does not undercut the interface between the metal substrate and the hydration layer. As a result, the tunnels can be initiated in an orthogonal direction and closer together, thereby increasing the tunnel density.

Abstract: A high voltage resonant step-up convertor converts a lower voltage signal to a higher voltage signal. The converter may be used, for example, to supply power via electromagnetic coupling to an implantable medical device. In some embodiments, a power converter comprises a driver circuit and a resonant circuit. The resonant circuit generates a high voltage output signal at a selected frequency. The driver circuit is controlled by a low voltage signal and periodically generates a higher frequency signal (e.g., approximately twice the selected frequency) to drive the resonant circuit. In some embodiments, the driver circuit comprises another resonant circuit and a switching circuit. The switching circuit periodically pumps current to the other resonant circuit and isolates the two resonant circuits. The other resonant circuit periodically pumps current to the output resonant circuit.

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: A leadless cardiac pacemaker comprises a hermetic housing, a power source disposed in the housing, at least two electrodes supported by the housing, a semiconductor temperature sensor disposed in the housing, and a controller disposed in the housing and configured to deliver energy from the power source to the electrodes to stimulate the heart based upon temperature information from the temperature sensor. In some embodiments, the sensor can be configured to sense temperature information within a predetermined range of less than 20 degrees C. The temperature sensor can be disposed in the housing but not bonded to the housing.

Abstract: The present disclosure provides systems and methods utilizing a closed-loop neurostimulation apparatus. The apparatus includes at least one sensing electrode that monitors neurological activity of a subject and at least one stimulating electrode that applies stimulation pulses to the subject. An internal pulse generator is coupled to the at least one sensing electrode and the at least one stimulating electrode. The internal pulse generator causes the at least one stimulating electrode to apply stimulating pulses based at least in part on the monitored neurological activity.

Abstract: A method is provided for a bridge device to interface between an external device and an implantable medical device (“IMD”), the bridge device includes a system on a chip (“SoC”) having a memory, an input/output interface, a standard wireless computer network (“SWCN”) controller and a bridge controller integrated into a single integrated circuit (“IC”). The method includes configuring the bridge controller to convert data between a Medical Implant Communication Service (MICS) protocol and a SWCN protocol, coupling a MICS controller to the SoC, and configuring the MICS controller to manage operation of a first transceiver based on the MICS protocol. The method includes configuring the SWCN controller to manage operation of a second transceiver based on the SWCN protocol, communicating between the bridge device and an IMD utilizing the first transceiver, and communicating between the bridge device and an external device utilizing the second transceiver.

Abstract: Methods and systems are provided to deliver a neural stimulation therapy to treat apnea episodes. The methods and systems detect a respiratory pattern of a patient and identify a type associated with the respiratory pattern. A sleep stage is detected that the patient is experiencing and the method and system identify when the sleep stage warrants therapy. When the respiratory pattern corresponds to an apnea episode (AE) and the sleep stage warrants therapy, the methods and systems deliver an apnea episode terminating neuro-stimulation (AET-NS) therapy configured to terminate the AE. A type of AE therapy that is delivered may be based on the sleep stage that was detected. The methods and systems may determine whether the AET-NS therapy successfully terminated the AE, and, if not, adjust the AET-NS therapy and deliver a new AET-NS therapy.

Abstract: Techniques are provided for detecting pulmonary congestion based on an increase in right ventricular (RV) stroke volume over left ventricular (LV) stroke volume. In one example, the device generates an index based on accumulated differences between RV stroke volume and LV stroke volume while RV stroke volume exceeds LV stroke volume, such that the index is indicative of an ongoing imbalance between RV and LV stroke volume. The index is compared to a suitable threshold to detect a severe imbalance indicative of pulmonary edema. Additionally, techniques are described for estimating RV and LV stroke volumes based on pulmonary artery pressure, left atrial pressure, aortic pressure, LV strain or on various intracardiac or extracardiac impedance measurements.

Abstract: A method for use with an implantable system including a lead having multiple electrodes implantable proximate to a patient's left ventricular (LV) chamber includes simultaneously delivering pacing pulses over corresponding pacing vectors defined by electrodes proximate to the LV chamber. The method includes recording evoked responses responsive to the pacing pulses that are measured over separate corresponding sensing channels. The method also includes comparing the evoked responses to a template that represents local capture of a local LV tissue region along one or more of the corresponding pacing vectors. The comparison is used to determine whether the pacing pulses achieved local capture along the corresponding pacing vectors. At least one of the pacing pulses or pacing vectors are updated based on the comparison of the evoked responses to the template in order to determine a local capture threshold for the corresponding pacing vectors.

Abstract: Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination based on activation times. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in the left atrial (LA) chamber, the right atrial (RA) chamber, and at least one ventricular chamber of a patient's heart. For each of a plurality of cardiac cycles, there is a determination, based on the plurality of obtained IEGMs, of an LA activation time, an RA activation time, and a ventricular activation time. Arrhythmia discrimination is then performed based on the determined activation times.