Abstract: A process for determining whether the location of a stimulation electrode meets a selected heart performance criteria includes providing stimulation to the heart through the electrode and obtaining an impedance measurement during stimulation delivery using an impedance sensing vector formed by electrodes that do not include the stimulation electrode. The impedance measurements are processed, either alone or in combination with an electrogram, also obtained during stimulation, to obtain a measure of hemodynamic performance.

Abstract: An implantable medical device includes a first, short-range telemetry circuit; a second, long-range telemetry circuit; a first power system that powers the first telemetry circuit; and a second power system that powers the second telemetry circuit. The second power system includes an internal charging system and a rechargeable battery coupled to the internal charging system. The internal charging system may be configured for electromagnetic-inductive or RF-transmission coupling with an external charging system. A controller monitors the energy level of the rechargeable battery and provides an signal indicative of the level.

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: Embodiments of the invention present methods and systems for determining an optimal defibrillation shock waveform for application to the heart of a patient to stop a rhythm abnormality such as ventricular fibrillation or ventricular tachycardia.

Abstract: Disclosed herein are electronic devices, such as, for example, televisions, stereo systems, diagnostic equipment, cell phones, desktop or laptop PCs, medical pulse generators, or etc., including an integrated circuit including a printed circuit board including multiple layers and a wire bond pad. The multiple layers are sandwiched together in a planar unitary structure including a top surface, a bottom surface and a structure edge extending between the top surface and the bottom surface. The multiple layers include a first organic substrate layer joined to a second organic substrate layer. Each organic substrate layer includes a layer edge and a peripheral surface adjacent the layer edge. Each layer edge forms part of the structure edge. The wire bond pad includes an outer face, an inner face generally opposite the outer face, and a first rib. The inner face extends along the structure edge.

Abstract: A method for implanting an active fixation medical lead is disclosed herein. The lead may include a lead body distal end, a tissue fixation helical anchor and a structure. The tissue fixation helical anchor may be coupled to the lead body distal end and include a distal tip. The structure may be coupled to the lead body distal end and include a structure distal end including a first radiopaque marker. The structure may be biased to project the structure distal end near the distal tip. When the tissue fixation helical anchor is progressively embedded in the cardiac tissue, the cardiac tissue progressively displaces the structure distal end proximally.

Abstract: Techniques are provided for use by implantable medical devices for determining a preferred or optimal pair of electrodes for delivering biventricular pacing therapy. In one example, the implantable device is equipped with a right ventricular (RV) lead and a multi-pole left ventricular (LV) lead. Briefly, for each of a selected set of RV/LV electrode pairs, electrocardiac parameters are detected within a patient in which the device is implanted, including parameters representative of an intrinsic biventricular electrical separation between LV and RV and parameters representative of a mechanical contraction delay in the LV. An optimal RV/LV electrode pair is then determined for delivering biventricular pacing based on an analysis of the intrinsic biventricular electrical separation and the mechanical contraction delay. Pacing latency, pacing delay from LV to RV, and the maximum slope of an LV evoked response may be used as proxies or surrogates for mechanical contraction delay.

Abstract: Embodiments include a cardiac rhythm management system having a lead that includes an omni-directional pressure sensor that is configured to resist tissue in-growth and provide reliable and consistent pressure readings from within a patient's vasculature. Embodiments of the cardiac rhythm management lead may also include a variety of pacing and shocking electrodes.

Abstract: A method and system are provided to determine a defibrillation threshold (DFT). The method and system determine local conduction (LC) information for at least one LV region of the heart, and designate a ULV pacing electrode, where the ULV pacing electrode is located proximate to a region of the heart for which the LC information satisfies a predetermined LC characteristic. The method and system pace the heart from the ULV pacing electrode such that the region of the heart, for which the LC information satisfies the predetermined LC characteristic, becomes re-polarized early in a repolarization phase following pacing of the heart. The method and system deliver a ULV shock, obtain upper limit of vulnerability (ULV) information based on a heart response to the ULV shock; and obtain a DFT based on the ULV information.

Abstract: An enhanced intraluminal flow measurement system and method is conducive for a low-power ultrasonic system that can use continuous-wave (CW) Doppler sensing and wireless RF telemetry. Applications include measurement of blood flow in situ in living organisms. Implementations include an extraluminal component located outside of a body, such as a human or animal body, containing a lumen. The extraluminal component can be wirelessly coupled via an RF magnetic field or other RF field to an implantable intraluminal component. The intraluminal component (i.e. implant) is implanted inside of the lumen of the body such as a heart or elsewhere in a vasculature (such as in a dialysis shunt). The intraluminal component can telemeter, via RF electromagnetic signals, flow data directly out of the body housing the intraluminal component to be received by the extraluminal component.

Abstract: An enhanced intraluminal flow measurement system and method is conducive for a low-power ultrasonic system that can use continuous-wave (CW) Doppler sensing and wireless RF telemetry. Applications include measurement of blood flow in situ in living organisms. Implementations include an extraluminal component located outside of a body, such as a human or animal body, containing a lumen. The extraluminal component can be wirelessly coupled via an RF magnetic field or other RF field to an implantable intraluminal component. The intraluminal component (i.e. implant) is implanted inside of the lumen of the body such as a heart or elsewhere in a vasculature (such as in a dialysis shunt). The intraluminal component can telemeter, via RF electromagnetic signals, flow data directly out of the body housing the intraluminal component to be received by the extraluminal component.

Abstract: Implantable systems, and methods for use therein, perform at least one of a cardiac assessment and an autonomic assessment. Short-term fluctuations in PR intervals, that follow the premature contractions in the ventricles, are monitored. At least one of a cardiac assessment and an autonomic assessment is performed based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles. This can include assessing a patient's risk of sudden cardiac death (SCD), assessing a patient's autonomic tone and/or detecting myocardial ischemic events based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles.

Abstract: An enhanced pressure sensing system and method use an external diaphragm to address issues involved with accurate and prolonged measurement of fluid pressure, such as of blood flowing in a vascular structure. Some external diaphragms include a metallized layer or other highly impermeable layer to furnish a high degree of seal at least near to hermetic grade. As temperature of the intermediary fluid changes, the external diaphragm is able to move in a direction that minimizes differential pressure across the external diaphragm over an operational temperature range thereby reducing pressure change of the intermediary fluid due to change in temperature of the intermediary fluid. Relatively smooth hydrodynamic surfaces can be used as well as a bi-layer construction.

Abstract: Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's pre-ejection interval (PEI). A signal indicative of cardiac electrical activity and a signal indicative of changes in arterial blood volume are obtained. One or more predetermined features of the signal indicative of cardiac electrical activity and the signal indicative of changes in arterial blood volume are detected. The patient's PEI is determined by determining an interval between the predetermined feature of the signal indicative of cardiac electrical activity and the predetermined feature of the signal indicative of changes in arterial blood volume.

Abstract: Implanted systems and methods for monitoring a patient's arterial stiffness are provided. An implanted sensor is used to produce a signal indicative of changes in arterial blood volume for a plurality of beats of the patient's heart. A pulse duration metric is determined for each of a plurality of pulses of the signal, wherein each pulse of the signal corresponds to a beat of the patient's heart. Arterial stiffness is monitored based on the determined pulse duration metric for the plurality of pulses of the signal. This can include monitoring arterial stiffness based on a dispersion of the pulse duration metric and/or an average of the pulse duration metric.

Abstract: A method and system is provided for measuring current of injury (COI) during lead fixation. The method and system sense cardiac signals from a lead within a chamber of the heart while the lead is in a pre-fixation position and capture a baseline waveform from the cardiac signals while the lead is in the pre-fixation position. The baseline waveform is representative of an interface between the lead and a tissue region proximate a tip of the lead before the lead is actively attached to the tissue region of the heart. The method and system further sense cardiac signals from the lead within the chamber of the heart when the lead is in a post-fixation position and capture a post-fixation waveform from the cardiac signals when the lead is in the post-fixation position. The post-fixation waveform is representative of an interface between the lead and the tissue region proximate the tip of the lead after the lead is actively attached to the tissue region of the heart.

Abstract: Disclosed herein is a system for monitoring a motion of a cardiac tissue. The system includes a motion sensor configured to operably couple to the cardiac tissue. The motion sensor includes an electroactive polymer and is further configured to result in a deflection in the electroactive polymer when the cardiac tissue undergoes the motion. The deflection in the electroactive polymer generates an electrical event.

Abstract: A method of in vivo sensor recalibration includes implanting a sensor at an implantation site in a living body; taking a sensor reading with the implanted sensor; taking a first electrical reading across biological material adjacent the implanted sensor; taking a second electrical reading across biological material adjacent the implanted sensor subsequent in time to the taking of the first electrical reading; comparing the first electrical reading with the second electrical reading; and recalibrating the sensor based on the comparison of the first electrical reading to the second electrical reading.

Abstract: In various embodiments of the present invention, lower amplitude high frequency burst stimulation of cardiac fat pad(s) innervating the AV node and/or ventricle tissue performed in conjunction with ventricular pacing during refractory period is used to reduce the ventricular rate in order to terminate arrhythmias such as supraventricular tachycardia. In an embodiment of the present invention, one or more pace pulse delivered during a ventricular refractory period can be used to further extend the duration of the refractory period followed by a short burst of cardiac fat pad stimulation to temporarily slow AV conduction. In an embodiment of the present invention, this therapy slows the ventricular rate by altering conduction speed in both the AV node and the ventricles.

Abstract: Various techniques are provided for use with an implantable medical device for estimating cardiac pressure within a patient based on admittance (or related electrical values such as impedance or conductance) that takes into account the presence of acute MR within the patient. Briefly, the device detects an indication of acute MR, if occurring within the patient. The device also applies electrical fields to tissues of the patient and measures electrical parameters influenced by the electrical field, such as admittance, impedance or conductance. The device then estimates cardiac pressure within the patient based on the measured electrical parameter and the indication of acute MR. In one example, different linear correlation functions are used to convert admittance values to left atrial pressure (LAP) values depending upon the presence or absence of acute MR within the patient.