Abstract: An electro-mechanical activation probe obtains information pertaining to both myocardial electrical activity and myocardial mechanical activity at each of a plurality of locations relative to the myocardium of a heart chamber. For each location, the temporal difference between a feature of the electrical activity, such as the QRS complex of an IEGM, and a feature of the mechanical activity, such as the onset of myocardial contraction, is compared to obtain a mechanical activation delay. A stimulation electrode is then positioned at one of the locations based on the comparison. The electrode may be positioned at the location having the greatest mechanical activation delay. Other mechanical activity, such as contractual force, may be used in conjunction with the mechanical activation delay to determine the optimal electrode location.

Abstract: An implantable stimulation device that maps the location of irritable foci causing an atrial arrhythmia is provided by certain embodiments disclosed herein. The device may, for example, collect intra-cardiac data from a plurality of electrodes spatially distributed throughout a chamber of the heart. This data may be compared with data related to the location of each electrode and the electrical properties of the heart to approximate a point of origin for the atrial arrhythmia. Further embodiments may provide methods and systems for using this information to provide more efficient treatment of the atrial arrhythmia. For example, an optimized ATP pulse train may be determined based on the location of one or more irritable foci. Such an ATP pulse train may be applied to more efficiently terminate the atrial arrhythmia.

Abstract: An economical, repeatable, and non-invasive method and apparatus for the calibration of implantable pressure sensors that can minimize patient discomfort and risk of infection. In one embodiment, a calibration system for calibrating a first pressure sensor coupled to a management device and implanted into a human patient is provided. The calibration system includes a mouthpiece, a pump, a second pressure sensor, and a computer. The pump provides a positive pressure into an airway of the human patient via the mouthpiece. The second pressure sensor measures the airway pressure of the human patient, and the computer is coupled to the pump and monitors pressures measured by the first and second pressure sensors. Here, the computer also calculates one or more calibration constants based on the pressures measured by the first and second pressure sensors and provides the calibration constants to the management device to calibrate the first pressure sensor.

Abstract: An implanted cardioverter defibrillator (ICD) delivers an electrical therapy signal to the heart of a patient. When ventricular fibrillation or another condition of the heart requiring high voltage therapy is sensed, the therapy signal is delivered to the heart. When a partial short-circuit or other low impedance condition occurs, an over-current protection circuit will stop delivery of a shocking pulse. The ICD will then reduce the voltage of the shocking pulse and try again to deliver electrical therapy. This process is repeated until a voltage level is found that is able to deliver the electrical therapy without causing an over-voltage condition. Alternate lead configurations may also be tried in an attempt to find a signal path that is not affected by the low impedance or short-circuit condition.

Abstract: Cardiac electrical activity includes intrinsic signals as well as paced or stimulated signals. Waveforms of cardiac electrical activity may be detected by a variety of systems, including surface ECG systems and various implantable cardiac devices including implantable cardiac stimulation devices. Intrinsic cardiac signals and various cardiac conditions influence these waveforms in ways that can be identified using various detection criteria, and from which cardiac markers may be generated. Musical notations are linked to these cardiac markers as appropriate, and are sounded as a function of time to generate musical sound which is indicative of the patient's cardiac function.

Abstract: Implantable systems that can monitor myocardial electrical stability, and methods for use therewith, are provided. Also provided are novel pacing sequences that are used in such monitoring. Such pacing sequences are designed to reveal alternans at low to moderate heart rates.

Abstract: An exemplary controller includes an input for receiving information related to a signal of supraventricular origin, control logic to determine a control signal and an output to deliver the control signal to thereby actively filter the signal of supraventricular origin in the His bundle. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Systems and methods are provided for obtaining measures of blood oxygen saturation using an implantable device implanted within a patient and a non-implanted device external to the patient, while limiting the amount of processing that need be performed by the implantable device. Other embodiments limit the amount of processing that is performed within the implantable device by monitoring changes and blood oxygen saturation without determining actual measures of blood oxygen saturation.

Abstract: Methods and devices are provided for reducing motion artifacts when measuring blood oxygen saturation. A portion of the light having the first wavelength, a portion of light having the second wavelength and a portion of the light having the third wavelength are received. A first signal is produced based on the received portion of light having the first wavelength. Similarly, a second signal is produced based on the received portion of light having the second wavelength, and a third signal is produced based on the received portion of light having the third wavelength. A difference between the second signal and the first signal is determined, wherein the difference signal is first plethysmography signal. Similarly, a difference is determined between the third signal and the first signal to produce a second plethysmography signal. Blood oxygen saturation is then estimated using the first and second plethysmography signals.

Abstract: An implantable medical device and methods of manufacture are provided for implantation in a body. The device includes a device housing having an interior cavity and electronic circuitry located in the interior cavity of the device housing. The electronic circuitry detects a physiologic condition of the body and delivers a therapy to the body. The device further includes a feed-through assembly having a feed-through housing that is joined to the device housing. The feed-through assembly includes conductors held in the feed-through housing and electronically connected to the electronic circuitry. A back-fill member is joined to the feed-through housing. The back-fill member has an opening there through communicating with the interior cavity of the device housing. A sealing element is hermetically secured in the opening through the back-fill member. The sealing element and back-fill member are formed of different first and second materials, respectively.

Abstract: An implantable cardiac stimulation device is equipped with a hardware elastic buffer. In an exemplary device, the hardware elastic buffer comprises SRAM and a SRAM controller. The device optionally includes averaging, concatenating, filling and/or other features.

Abstract: Provided herein are implantable systems, and methods for use therewith, for estimating a level of noise in a signal produced by an implantable sensor that is sensitive to motion induced noise. Sample data is obtained that is representative of a window of a signal produced by the implantable sensor that is sensitive to motion induced noise. Such sample data includes a plurality of samples each having a magnitude (e.g., amplitude). Each of at least some of the samples is assigned to one of a plurality of bins based on the magnitude of the sample, wherein each bin corresponds to a different range of magnitudes. The plurality of bins includes at least a low bin defining a lowest magnitude range and a high bin defining a highest magnitude range. A level of motion induced noise in the sensor signal is estimated based on a distribution of the samples to the bins.

Abstract: An implantable cardiac device minimizes apnea burden. In one implementation, the device administers a series of cardiac pacing trials using a different value for a pacing parameter in each trial and then measures an apnea burden corresponding to each trial in order to determine a value which reduces apnea burden when used for ongoing cardiac pacing. In one implementation the implantable cardiac device performs series of trials in cycles, during which a first series of trials determines a value for a first pacing parameter for reducing apnea burden while other pacing parameters are held constant. Subsequent series of trials subject the other pacing parameters, in turn, to their own series of pacing trials while holding the non-subjected pacing parameters constant. Through multiple cycles, the device optimizes each parameter in turn based on continually improving values for the other pacing parameters.

Abstract: A method and system are provided for tracking ST shift data. The system includes an implantable medical device having an input configured to receive cardiac signals. Each cardiac signal has an associated heart rate and includes a segment of interest. The implantable medical device further includes a processor configured to determine segment variations of the segment of interest in the cardiac signals. The processor determines a heart rate associated with each of the segment variations with each heart rate falling within a corresponding heart rate range. The implantable medical device also includes a memory configured to store a group of histograms for a corresponding group of heart rate ranges. The histograms store distributions for the segment variations within corresponding heart rate ranges.

Abstract: A control system for an implantable cardiac therapy device, the device defining a plurality of sensing vectors including at least one impedance sensing vector and operating under a set of a plurality of variable operating parameters that define conditions for delivery of therapy and wherein the control system evaluates signal quality from the at least one impedance sensing vector and, if the quality is sufficient to discern valvular events, the control system adjusts the set of operating parameters to dynamically improve cardiac performance, including synchrony with valvular events, and if the quality is insufficient to discern valvular events, but sufficient to discern peaks, the control system adjusts the set of operating parameters to dynamically improve cardiac performance independent of valvular events, and if the quality is insufficient to discern peaks, the control system adjusts the set of operating parameters to induce cardiac performance towards a defined performance goal.

Abstract: A method and apparatus are provided for controlling interrogation of an implantable device such as a pacemaker, an implantable cardioverter, or a defibrillator utilizing an external device in a home environment. The method controls how frequently a patient can retrieve status information from the implantable device based on a time period elapsed since a last interrogation and a power level of a battery.

Abstract: A myocardial infarction patch for placement over a myocardial infarction includes an electroactive polymer (EAP) structure. Varying electricity supplied to the EAP structure causes the patch to expand and contract over the myocardial infarction. The expansion and contraction of the patch can be coordinated with the expansion and contraction of the heart. The electricity is provided to the EAP via a pacemaker, defibrillator, ICD or similar pulse-generating device. Causing the patch to expand and contract against the myocardial infarction can improve the ejection fraction of the heart.

Abstract: Implantable systems, and method for use therewith, are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments, as will be described below, are for use with an implantable device that include one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering AATP and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.

Abstract: An implantable medical device includes a device body at least partially formed of a polymeric material including a base polymer and a block copolymer. The block copolymer includes at least one polyethylene oxide (PEO) block and at least one polyisobutylene (PIB) block. The PEO and PIB blocks may be coupled together by a urethane or urea linkage. The block copolymer may be a triblock copolymer, PEO-PIB-PEO, and the base polymer may be a polystyrene-polyisobutylene-polystyrene triblock copolymer.

Abstract: A metal or metal alloy foil substrate, preferably an unetched and uncoated metal or metal alloy foil substrate, such as but not limited to titanium, palladium, lead, nickel, tin, platinum, silver, gold, zirconium, molybdenum, tantalum, palladium-silver alloy, platinum-rhodium alloy, platinum-ruthenium alloy, and/or platinum-iridium alloy, is used as the cathode in an electrolytic capacitor, preferably an aluminum electrolytic capacitor having a multiple anode flat, stacked capacitor configuration. Despite a 120 Hz bridge capacitance measurement lower than with etched aluminum, the use of an unetched and uncoated metal or metal alloy foil cathode according to the present invention will inhibit gas production and not cause the capacitor to swell. Furthermore, an electrolytic capacitor built with a 30 micron unetched and uncoated foil cathode according to the present invention can deliver a stored to discharge energy ratio sufficient for use in pulse discharge applications, such as an in an ICD.