Abstract: A hybrid implantable lead assembly includes a lead body, distal, proximal, and intermediate electrodes, coiled inductive elements, and an inductive circuit. The proximal and intermediate electrodes are disposed on the lead body between the distal electrode and a proximal end of the lead body. The proximal and intermediate electrodes are electrically connected with first and second pathways to sense electrical activity and/or deliver stimulus pulses. The first and second coiled inductive elements are electrically connected to the proximal and intermediate electrodes, respectively. The inductive circuit is electrically connected to the distal electrode. The first coiled inductive element and/or the second coiled inductive element has a first type of inductor structure and the inductive circuit has a different, second type of inductor structure that prevent magnetically induced electric current from flowing to the electrodes.

Abstract: An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.

Abstract: An implantable cardiac stimulation device and associated method perform a true or blanking period ventricular undersensing detection algorithm in response to ventricular loss of capture not associated with fusion or a change in capture threshold. The test identifies an originating cause of loss of capture, which may be ventricular undersensing of intrinsic R-waves or premature ventricular contractions occurring during a ventricular blanking period or atrial undersensing of P-waves resulting in blanking period ventricular undersensing. A corrective action is taken to reduce the likelihood of blanking period ventricular undersensing by automatically adjusting device operating parameters. The corrective action may include automatic adjustment of atrial sensitivity, shortening of the ventricular blanking period, or adjustment of the base stimulation rate.

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: Methods and systems are provided for configuring a Multi-Electrode Lead (MEL) that includes N groups of electrodes, with each of the N groups of electrodes including at least M electrodes, where N?2 and M?2. Sent via the MEL is a first communication sequence of bits that includes N groups of bits, with each of the N groups of bits corresponding to a different one of the N groups of electrodes and specifying which electrode(s), if any, within the group of electrodes is to be configured as an anode. Also sent via the MEL is a second communication sequence of bits that includes N further groups of bits, with each of the N further groups of bits corresponding to a different one of the N groups of electrodes and specifying which electrode(s), if any, within the group of electrodes is to be configured as a cathode.

Abstract: An exemplary method includes delivering a cardiac pacing therapy that includes an atrio-ventricular delay and an interventricular delay, providing a paced propagation delay associated with delivery of a stimulus to a ventricle, delivering a stimulus to the ventricle, sensing an event in the other ventricle caused by the stimulus, determining an interventricular conduction delay value based on the delivering and the sensing, determining a interventricular delay (?Sur) based on the interventricular conduction delay and the paced propagation delay and determining an atrio-ventricular delay based at least in part on the interventricular delay (?Sur). Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Methods and systems for determining an optimal defibrillation shock waveform for application to the heart of a patient may include measuring and/or collecting information for a cardiac waveform of a patient, produced as a result of either an electrical stimulus applied to a heart of the patient, which may be a pacing shock/stimulus and/or a defibrillation shock waveform, or as the result of intrinsic cardiac activation; determining a characteristic of the cardiac waveform; comparing the determined characteristic of the cardiac waveform to a plurality of values for the characteristic with optional reference to the defibrillator system impedance, wherein each value of the characteristic is associated with a predetermined value for a parameter of an optimal defibrillation shock waveform; and selecting the predetermined value for the parameter of the optimal defibrillation shock waveform based on the comparison.

Abstract: Systems and methods are provided for use by an implantable medical device capable of automatically adjusting the sensitivity with which electrical cardiac signals are sensed within a patient, i.e. a device equipped with Automatic Sensitivity Control (ASC.) In a first example, ASC parameters are automatically adjusted by the device itself based on parameters derived from both R-waves and T-waves and further based on a detected noise floor. In a second example, a profile representative of the shape of cardiac signals is generated by the device. ASC parameters are then adjusted based on the profile. In various embodiments, histograms are used to determine sizes and shapes of the R-waves and T-waves via statistical prevalence techniques. The histograms are also employed to derive the aforementioned profile.

Abstract: An exemplary method includes acquiring cardiac electrical activity information; detecting cardiac events within the information including T waves, QRS complexes and/or P waves; and calling for delivery of matter to the heart during a period of time based on the cardiac events. The delivery may occur between a detected T wave and its immediately subsequent QRS complex. The matter being delivered may include stem cells, progenitor cells, nutrients and/or drugs.

Abstract: A system enables high-frequency communication between an external communication device and one or more implantable medical devices. The system implements a communication protocol in which the external communication device interrogates any implantable medical devices within range to establish one-to-one communication links for purposes of exchanging data and/or programming the medical devices.

Abstract: An implantable cardioverter defibrillator (ICD) including a set of leads having electrodes disposed therein. The electrodes may include a weld electrode connected to an internal wire of the lead and the ICD and a tip electrode. The tip electrode may have a set of grooves or cut out regions in its outer surface to provide edge effects for currents applied through the tip electrode. The grooves or cut out regions may form gaps in the surface of the tip electrode exposing a medical compound that is housed within the tip electrode. The medical compound may elute through the gaps.

Abstract: An intravenous implantable optical sensor assesses the relative absorbance of multiple wavelengths of light in order to determine oxygen saturation. The calculation of oxygen saturation is enhanced by use of a function of hematocrit which is derived from the relative absorbance of light of an isobestic wavelength along two different length paths through the blood. The use of the hematocrit-dependent term and multiple wavelengths of light to calculate oxygen saturation provides results that are less susceptible to noise and variation in hematocrit and thus provides a more accurate measure of oxygen saturation over a wider range of conditions than previously possible. The optical sensor may form part of an implantable system which performs the calculation of oxygen saturation and uses the results for a diagnostic or therapeutic purpose.

Abstract: An exemplary method includes providing a mechanical activation time (MA time) for a myocardial location, the location defined at least in part by an electrode and the mechanical activation time determined at least in part by movement of the electrode; providing an electrical activation time (EA time) for the myocardial location; and determining an electromechanical delay (EMD) for the myocardial location based on the difference between the mechanical activation time (MA time) and the electrical activation time (EA time).

Abstract: An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay and an interventricular delay, monitoring patient activity, optimizing the atrio-ventricular delay and the interventricular delay for a plurality of patient activity states to generate a plurality of optimal atrio-ventricular delays and a plurality of optimal interventricular delays, storing the optimal atrio-ventricular delays and the optimal interventricular delays in association with corresponding patient activity states, detecting a change in patient activity, adjusting an atrial pacing rate in response to the detected change in patient activity based at least in part on a heart failure status and setting the atrio-ventricular delay and the interventricular delay, in response to the detected change in patient activity, using a stored optimal atrio-ventricular delay that corresponds to the patient activity and a stored optimal interventricular delay that corresponds to the patient activity.

Abstract: An implantable lead assembly includes an elongated body, a bobbin, and a conductor. The elongated body includes a distal end having an electrode and a proximal end having a header connector portion for coupling the elongated body with an implantable medical device. The bobbin is disposed in the elongated body. The conductor is disposed in the elongated body and is electrically coupled with the header connector portion and the electrode. The conductor is wound around the bobbin to form first and second inductive coils that are axially separated from each other by an inter-coil gap formed from the bobbin. The first and second inductive coils have different self resonant frequencies.

Abstract: An exemplary method includes analyzing data from multiple parameters detected by an implantable cardiac device and determining an extent of heart failure (HF) progression. The parameters may include electrical synchrony, mechanical synchrony, and/or electromechanical delay (EMD). A change in a width of the native and/or paced QRS complex may provide a measure of electrical synchrony. Characterization of a delay between local cardiac impedance (CI) and global CI may provide a mechanical dyssynchrony index. A delay between the timing of a peak of the QRS complex and LV contraction (e.g., detected by SVC-CAN impedance) may provide a measure for EMD. Each of the parameters may be analyzed independently or collectively to assess HF progression. Based on the analysis, one or more pacing delays (e.g. AV/PV and/or VV) of the implantable cardiac device may be modified. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: To provide radio-frequency (RF) bandstop filtering within an implantable lead, such as a pacemaker lead, one or more segments of the tip and ring conductors of the lead are formed as insulated coils to function as inductive band stop filters. By forming segments of the conductors into insulated coils, a separate set of discrete or distributed inductors is not required, yet RF filtering is achieved to, e.g., reduce lead heating during magnetic resonance imaging (MRI) procedures. To enhance the degree of bandstop filtering at the RF signal frequencies of MRIs, additional capacitive elements are added. In one example, the ring electrode of the lead is configured to provide capacitive shunting to the tip conductor. In another example, a capacitive transition is provided between the outer insulated coil and proximal portions of the ring conductor. In still other examples, conducting polymers are provided to enhance capacitive shunting. The insulated coils may be spaced at ¼ wavelength locations.

Abstract: An implantable medical lead is disclosed herein wherein the lead employs a helical distal tip anchor having improved fixation capabilities. The implantable medical lead may include a body and a helical anchor. The body may include a distal end and a proximal end. The helical anchor may be at least one of extending and extendable from the distal end. The helical anchor may include at least one loop including first and second straight sides that intersect at a first corner.

Abstract: An implant tool for use with an endocardial or other implantable lead having an extendable/retractable active fixation tip includes a housing, a shaft rotatably supported by the housing, and a shaft rotation mechanism for rotating the shaft through a predetermined angular travel. The shaft includes a lead attachment portion for selectively coupling a lead to the shaft such that the lead is rotatable with the shaft. The implant tool may include a control tab slidably supported by the housing, wherein longitudinal movement of the control tab actuates the shaft rotation mechanism. The shaft rotation mechanism may include a gear train, an electric motor, a double acting spring mechanism, or a retractable tape wound around the shaft. The gear train includes an input member coupled to the control tab and an output gear coupled to the shaft. The input member meshes with an input gear supported by the housing.

Abstract: An implantable cardiac defibrillation device diminishes fibrosis of a defibrillation electrode. The device includes an implantable lead having a defibrillation electrode adapted for implant in one of the superior vena cava and right ventricle of a heart, a pulse generator adapted to be coupled to the defibrillation electrode that provides defibrillation energy to the defibrillation electrode, and a power supply that maintains a negative voltage on the defibrillation electrode in the absence of defibrillating energy being provided to the defibrillation electrode.