Abstract: A process for creating porous anode foil for use in an electrolytic capacitor of an implantable cardioverter defibrillator is provided. The process includes electrochemical drilling a plurality of etched metal foils in sequence one after the other in a bath containing electrochemical drilling (ECD) solution initially having a pH of less than 5. Alternatively, an etched foil sheet may be passed through the bath in a substantially continuous manner such that a portion of said etched foil sheet is in contact with the ECD solution is electrochemically drilled to generate pores.

Abstract: Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

Abstract: A leadless pacemaker for pacing a heart of a human includes a hermetic housing and at least two electrodes on or near the hermetic housing. The at least two electrodes are configured to deliver energy to stimulate the heart and to transfer information to or from at least one external device.

Abstract: A filtering scheme for an implantable medical device mitigates potentially adverse effects that may be caused by MRI-induced signals. In some aspects filtering is provided to attenuate MRI-induced signals on an implanted cardiac lead that is coupled to an implanted device. In some aspects the filter may be configured to complement a capacitor circuit (e.g., a feedthrough capacitor) that reduces the amount of EMI that enters the implanted device via the cardiac lead. In some implementations the filter consists of a LC tank circuit and a series LC circuit, where the LC tank circuit is in series with the cardiac lead and a cardiac stimulation circuit and the series LC circuit is in a shunt configuration across the cardiac stimulation circuit.

Abstract: Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters.

Abstract: A method of analyzing myocardial instability includes obtaining a physiological parameter representative of myocardial behavior over a set of cardiac cycles and determining reversal points in the physiological parameter over the set of cardiac cycles. The method also includes identifying myocardial instability based on the reversal points in the physiological parameter. A reversal point may correspond to a value of the physiological parameter, during a current cardiac cycle, that exceeds or is less than the values of the physiological parameter during prior and subsequent cardiac cycles. Optionally, the method includes calculating differences between values of the physiological parameter for consecutive cardiac cycles and detecting the reversal points when a current difference exceeds or is less than differences for prior and subsequent cardiac cycles.

Abstract: Embodiments of the present invention relate to implantable systems, and methods for use therein, that can detect T-wave alternans and analyze the detected alternans to provide information regarding cardiac instabilities and predict impending arrhythmias.

Abstract: Anode foil, preferably aluminum anode foil, is etched using a process of treating the foil in an electrolyte bath composition comprising a sulfate and a halide, such as sodium chloride. The anode foil is etched in the electrolyte bath composition by passing a charge through the bath. The etched anode foil is suitable for use in an electrolytic capacitor.

Abstract: Exemplary methods are described for providing responsive vascular control with or without cardiac pacing. An implantable device with responsive vascular and cardiac controllers interprets physiological conditions and responds with an appropriate degree of vascular therapy applied as electrical pulses to a sympathetic nerve. In one implementation, an implantable device is programmed to deliver the vascular therapy in response to low blood pressure or orthostatic hypotension. The device may stimulate the greater splanchnic nerve, to effect therapeutic vasoconstriction. The vascular therapy is dynamically adjusted as the condition improves. In one implementation to benefit impaired physical mobility, vascular therapy comprises vasoconstriction and is timed to coincide with a recurring segment of the cardiac cycle. The vasoconstriction assists circulation and venous return in the lower limbs of inactive and bedridden individuals.

Abstract: An exemplary method includes introducing current between a first pair of electrodes configured for placement internally in a patient, triggering a potential measurement between a second pair of electrodes configured for placement internally in a patient wherein communication of a signal through the patient allows for proper triggering, measuring potential between the second pair of electrodes and, based at least in part on the measuring and the introducing, determining a cardiac condition. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: In specific embodiments, one or more cardiogenic impedance signal template is stored, where each template has a corresponding morphology. Additionally, one or more cardiogenic impedance signal is obtained using electrodes implanted within a patient, where each signal has a corresponding morphology. The morphology of one or more obtained cardiogenic impedance signal is compared to the morphology of one or more stored template, to determine one or more metric indicative of similarity between the compared morphologies. The one or more metric indicative of similarity is used to analyze the patient's cardiac condition, to discriminate among arrhythmias and/or to adjust a cardiac pacing parameter.

Abstract: A set of cardiogenic impedance signals are detected along different sensing vectors passing through the heart of the patient, particularly vectors passing through the ventricular myocardium. A measure of mechanical dyssynchrony is detected based on differences, if any, among the cardiogenic impedance signals detected along the different vectors. In particular, differences in peak magnitude delay times, peak velocity delay times, peak magnitudes, and waveform integrals of the cardiogenic impedance signals are quantified and compared to detect abnormally contracting segments, if any, within the heart of the patient. Warnings are generated upon detection of any significant increase in mechanical dyssynchrony. Diagnostic information is recorded for clinical review. Pacing therapies such as cardiac resynchronization therapy (CRT) can be activated or controlled in response to mechanical dyssynchrony to improve the hemodynamic output of the heart.

Abstract: An apparatus and method for detecting phrenic nerve stimulation (PNS) including computing a power spectral density (PSD) of spatial data of a sensor; determining two spectral magnitudes from the PSD; computing a ratio of the two spectral magnitudes; and comparing the ratio to a threshold to detect PNS. In one example, detecting PNS includes computing a PSD of spatial data of an externally placed sensor; determining a diaphragmatic spectral magnitude and a respiratory motion spectral magnitude from the PSD; and computing a ratio of the diaphragmatic spectral magnitude to the respiratory motion spectral magnitude to detect PNS. In one example, detecting PNS includes computing an oscillation amplitude of spatial data of a sensor; computing a baseline wander amplitude of the spatial data of the sensor; computing a ratio of the oscillation amplitude to the baseline wander amplitude; and comparing the ratio to a threshold to detect PNS.

Abstract: Techniques are provided for use with an implantable medical device for detecting breaches in lead insulation or other lead failures. In one example, bipolar impedance is measured along single-lead vectors (i.e. intra-lead vectors) of a right atrial (RA) lead and a right ventricular (RV) leads. Impedance is also measured along various cross-lead vectors (i.e. inter-lead vectors) between electrodes of the two leads. A derived impedance value is then determined from a combination of the measured impedance values, wherein the derived impedance is sensitive to a shunt impedance arising from a breach within the RV lead. A lead breach is then detected relatively early based on the derived impedance by detecting a significant deviation in derived impedance over time. Unipolar impedance measurements are used to confirm the breach.

Abstract: A delivery system for implanting a biostimulation device comprising a stylet extending along an axis from knob end to a threaded end configured to engage an internally threaded nut of the biostimulation device and a catheter tube configured to axially contain the stylet. The catheter tube comprises a feature that engages a corresponding feature on the biostimulation device whereby the stylet can be rotated relative to the catheter tube for disengagement of the stylet threaded end from the biostimulation device threaded end.

Abstract: Described herein are methods, devices, and systems for treating human anemia. The methods, devices, and systems generally include monitoring a patients hemoglobin level and at least one of autonomic balance and inflammatory state to determine the etiology of the anemic state, modulating at least one of a sympathetic or parasympathetic nerve based on the cause of the anemia, monitoring for changes in the patients cardiac activity and state of inflammation, and hemoglobin level. An external neurostimulation system is describes, and well as a chronic implantable system. A method for treating a patient for anemia in conjunction with a renal denervation ablation catheter is also disclosed.

Abstract: A method for trending heart failure measures cardiogenic impedance (CI) and obtains signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The method identifies correction factors based on the signals and applies the correction factors to the contractility estimates. A system for trending heart failure includes a contractility module to determine contractility estimates from CI measurements taken along at least a first vector through a heart, and a collection module to receive signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The system further includes a factor module to identify correction factors based on the signals and a correction module to apply the correction factors to the contractility estimates.

Abstract: A multi-layer capacitor includes a first capacitor layer and a second capacitor layer adjacent and substantially parallel to the first capacitor layer. The second capacitor layer has a surface area that is less than the surface area of the first capacitor layer.

Abstract: An implantable medical lead includes a longitudinally extending body, an electrical conductor, an electrical component and a weld. The longitudinally extending body includes a distal end, a proximal end, and paddle region near the distal end. The electrical conductor extends through the body between the proximal end and the paddle region. The electrical component is on the paddle region and includes a sacrificial feature defined in a wall of the electrical component. The sacrificial feature includes a region that continues from the wall of the electrical component and a side that is isolated from the wall of the electrical component via a void defined in the wall of the electrical component. The weld is formed at least in part from at least a portion of the sacrificial feature. The weld operably couples the electrical component to the electrical conductor.

Abstract: Systems, devices and methods described herein can be used to monitor and treat cardiovascular disease, and more specifically, can be used to determine heart rate (HR), determine respiration rate (RR) and classify cardiac rhythms based on atrial intracardiac electrogram (IEGM) and atrial pressure (AP) signals. The atrial IEGM and AP signals are subject to spectrum transforms to obtain an atrial IEGM frequency spectrum and an AP frequency spectrum. Based on peaks in the atrial IEGM and AP frequency spectrums measures of HR and RR are determined, and arrhythmias are detected and/or arrhythmia discrimination is performed.