Abstract: Techniques are provided for estimating left atrial pressure (LAP) or other cardiac pressure parameters based on various parameters derived from impedance signals. In particular, effective LAP is estimated based on one or more of: electrical conductance values, cardiogenic pulse amplitudes, circadian rhythm pulse amplitudes, or signal morphology fractionation values, each derived from the impedance signals detected by the implantable device. Predetermined conversion factors stored within the device are used to convert the various parameters derived from the electrical impedance signal into LAP values or other appropriate cardiac pressure values. 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.

Abstract: A system for pericardial lead implantation is disclosed herein. The system includes an implantation tool and a stimulation lead. The implantation tool includes a tubular body, a first lumen, a second lumen, a stylet or guidewire, a first port, and a second port. The first and second lumens longitudinally extend through tubular body. The first port is in communication with the first lumen, and the second port is in communication with the second lumen. The stylet or guidewire is longitudinally displaceable in the first lumen and across the first port. A tissue adhesive is selectively administrable through the second port via the second lumen. The stimulation lead includes a distal end and an engagement feature. Placing the engagement feature in the first port and causing the stylet or guidewire to displace in a first direction across the first port causes the lead to attach to the implantation tool.

Abstract: A multi-channel implantable syncope monitor that monitors ECG data, myopotential data, EEG data, photoplethysmography (PPG) data, and position sensor data is used to capture physiologic data about a patient who is experiencing a syncopal event. The timing of the events within the simultaneously captured physiologic data can then be used to more accurately determine potential sources of origin of the syncopal event.

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: Disclosed herein is an implantable medical lead. The lead may include a longitudinally extending body having a distal end, a proximal end, a helical core assembly extending between the distal and proximal ends, and an outer jacket about the helical core assembly. The helical core assembly may have at least one helical ridge. In some instances, the at least one helical ridge may be at least two helical ridges and the helical core may further include least two helical troughs. In some such cases, the at least two helical ridges may define the at least two helical troughs.

Abstract: Disclosed herein is an implantable medical lead for implantation within a right ventricle of a heart and powered by an implantable pulse generator. The lead includes a lead body having a proximal end configured to couple to the generator, a distal end, an electrode at the distal end, and a distal portion extending proximally from the distal end. When the distal portion is in a non-deflected state, the distal portion biases to assume a configuration including first, second and third generally straight segments and first and second bends. The first segment is proximal of the distal end, the second segment is proximal of the first segment, the third segment is proximal of the second segment, the first bend is between the first and second segments, and the second bend is between the second and third segments.

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: Methods and systems are provided for expediting set-up of a multi-electrode lead (MEL). In accordance with specific embodiments, such an MEL includes N groups of electrodes, with each of the N groups including at least M electrodes, where N?2 and M is ?2. Electrodes in a same group are within 5 mm of one another. Electrodes in separate groups are at least 10 mm from one another. Specific embodiments relate to methods for identifying cathode-anode electrode configurations that can be used to not exceed a maximum acceptable capture threshold, and that provide a sensed intrinsic R-wave amplitude of at least a minimum acceptable sensing threshold. Such thresholds can be default values, or can be defined by a user (e.g., clinician, physician, nurse, or the like).

Abstract: An implantable lead includes a lead body, a header body, a fixation mechanism, a rotatable shaft and a rotation limit element. The fixation mechanism is disposed in the header body and is extendable out of the header body for securing the header body to cardiac tissue of the patient. The shaft is provided in the header body and is coupled to the fixation mechanism for translating rotational movement of the shaft into linear displacement of the fixation mechanism. The rotation limit element is disposed in the header body. The rotation limit element engages the header body once the shaft is linearly displaced by a predetermined distance with respect to the header body to prevent further rotation of the shaft and limit additional displacement of the fixation mechanism with respect to the header body.

Abstract: Methods and systems are presented for displaying patient activity data from implantable cardiac device (ICD). The method includes: sensing an activity level, storing the sensed activity level as a first coordinate of an activity data point, generating an average activity level from a predetermined number of sensed activity levels, storing the average activity level as a second coordinate of the activity data point, accumulating a number of times the activity data point having the first and second coordinates occurs, and storing the accumulated number of times. These steps are repeated for a predetermined period of time, and a plurality of activity data points each having an associated accumulated number of times is stored. The method further includes graphically displaying each of the plurality of activity data points with the associated accumulated number of times.

Abstract: An exemplary method includes providing surface ECG information acquired using a multi-lead ECG system, providing geometric information acquired using a magnetic resonance imagine system, X-ray imaging system or an ultrasound system and determining one or more stimulation sites for stimulation of the left ventricle based at least in part on the ECG information and the geometric information. Various other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An attachment mechanism for creating an electrical connection between a lead and a nerve bundle is disclosed herein. The attachment mechanism includes an electrically insulative polymer material including an electrode region of the polymer material sufficiently impregnated with nanotubes to be electrically conductive.

Abstract: An implantable electrical medical lead for a pulse generator includes a distal electrode, a connector for electrical connection with the pulse generator, an electrical conductor within the lead extending between the connector and the distal electrode, and an insulating sheath of flexible resilient material normally covering the electrical conductor having self sealing properties to re-insulate the electrical conductor in the event a rupture of the sheath should occur which exposes the electrical conductor. The insulating sheath includes an outer insulative layer, an inner insulative layer, and an intermediate plasticized layer to seal any occurring rupture in the insulating sheath and re-insulate the electrical conductor which has been exposed.

Abstract: An exemplary method includes acquiring cardiac electrical activity information, detecting a T wave and, based on the detecting, calling for delivery of matter to the heart where the matter may include one or more of stem cells, progenitor cells, nutrients and drugs. Another exemplary method includes calling for delivery of electrical energy to cells destined for implantation in the body or cells already implanted in the body. Such delivery may be timed according to cardiac electrical activity and/or delivered at an energy level below a capture threshold of neighboring tissue. Various other exemplary technologies are also disclosed.

Abstract: A body-implantable lead suitable for use in conjunction with implantable cardiac devices and method for assembling a body-implantable lead suitable for use in conjunction with implantable cardiac devices. The body-implantable lead includes a lead body having at least one inner lumen and at least one elongated conductor cable residing within the inner lumen. An end portion of the conductor cable is joined by an aligned weld joint directly to an end portion of a lead component. Exemplary lead components include, but are not limited to, an electrode member, an elongated conductive connector pin of a proximal connector, a conductor extending from a proximal end of a distal tip of the lead, and a second elongated conductor cable residing within a second inner lumen of the lead body.

Abstract: An implantable medical lead for coupling to an implantable pulse generator may be configured for improved safety. The lead may include: a first electrode; a second electrode in electrical communication with the first electrode; and an active circuit element in electrical communication with the first electrode and the second electrode. The active circuit element may be configured to change an impedance of the lead. The active circuit element may be configured to change the impedance of the lead in response to a pacing signal or a signal having opposite polarity to a pacing signal. A method of using an implantable medical lead for improved safety may include changing an impedance of an implantable medical lead from a relatively high impedance to a relatively low impedance and/or changing an impedance of an implantable medical lead from a relatively low impedance to a relatively high impedance.

Abstract: A lead implantation tool is disclosed herein. The tool may be configured to operably couple to a lead connector end of an implantable cardiac electrotherapy lead including an active fixation helix tip and wherein the lead connector end includes a contact pin proximally extending from the lead connector end. The tool may include a feature configured to couple to the contact pin and a first mechanism configured to convert linear movement into rotational movement of the contact pin relative to the lead connector end. The tool may further include a second mechanism that causes a stylet extending through the tool and into the contact pin to at least one of distally and proximally displace within the contact pin.

Abstract: An implantable system terminates atrial fibrillation by applying optimized anti-tachycardia pacing (ATP). In one implementation, the system senses and paces at multiple sites on the left atrium. At each site, the system senses reentrant circuits causing the atrial fibrillation. In one implementation, the system applies ATP tuned to the frequency of the reentrant circuit at the electrode that senses the most regular reentrant circuit. In another implementation, the system applies ATP at multiple electrodes, delivering each pulse at each site when the excitable gap is near the site. In other variations, the ATP is optimized for different patterns of sequential, simultaneous, or syncopated delivery to terminate the atrial fibrillation. The system can also monitor multiple heart chambers for cardiac events that favor terminating atrial fibrillation via ATP. The system then times delivery of the ATP according to these cardiac events.

Abstract: A medical electrical lead for conducting electrical signals between an electrical stimulator and a heart site includes a lead body extending from a distal non-conductive disk member to a proximal connector for attachment to the stimulator, first and second spaced electrodes protruding from the disk member for puncturing engagement with the epicardial surface of the heart in the region of an AVN fat pad containing ganglia which extend to the AV node providing an electrical connection between the atrium and the ventricle, a first conductor extending from the first electrode to a first terminal of the connector, and a second conductor extending from the second electrode to a second terminal of the connector such that electrical current from the electrical stimulator is caused to flow through the ganglia between the first and second electrodes to stimulate the AV node to control ventricular rate in the presence of atrial fibrillation.

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.