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: Exemplary systems and methods for automatically managing implantable medical device (IMD) related alerts are described. One method receives implantable medical device-related alerts. The method automatically manages the implantable medical device alerts by parsing the alerts through a set of predefined parameters.

Abstract: Exemplary medical devices and systems for providing remote support relating to implantable medical devices (IMDS) are described. One method generates a graphical user-interface (GUI) relating to an IMD on a local medical device configured to interrogate the IMD. The method also recreates the GUI on a remote medical device effective that a cursor of the GUI can be manipulated from both the local medical device and the remote medical device while selection of IMD parameter values is available only at the local medical device.

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: 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: Techniques are provided for evaluating mechanical dyssynchrony within the heart of patient in which a pacemaker, implantable cardioverter-defibrillator (ICD) or other medical device is implanted. In one example, 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.

Abstract: An implantable cardiac therapy device and methods of using a device including an implantable stimulation pulse generator, one or more implantable leads defining sensing and stimulation circuits adapted to sense and deliver therapy in at least one right side heart chamber, and an implantable controller in communication with the stimulation pulse generator and the one or more patient leads so as to receive sensed signals indicative of a patient's physiologic activity and deliver indicated therapy. The controller is adapted to monitor at least one indicator of cardiac dysynchrony and to compare the at least one indicator to a determined dysynchrony threshold. The threshold is determined for indications that the patient be further evaluated for cardiac resynchronization therapy. The controller is further adapted to set an alert when the at least one indicator exceeds the threshold to indicate to a clinician that evaluation for bi-ventricular pacing might be indicated.

Abstract: Techniques are provided for controlling magnetic resonance imaging (MRI) systems for imaging patients having implantable medical devices. In one example, a scaling factor is determined based on maximum local specific absorption rate (SAR) values for patients with implants and for patients without implants. The MRI determines the radio-frequency (RF) power and flip angle sequences to be used for a given patient, without regard to the presence of an implanted device. However, for patients with implanted devices, the MRI reduces its RF power or adjusts its flip angle sequences based on the scaling factor so as to ensure that the local SAR within the patient does not exceed acceptable levels. In other examples, rather than reducing the RF power of the MRI or adjusting the flip angles, blankets or pads formed of RF power attenuating materials, such as dielectrics, are positioned around the patient near the implantable device, to reduce the RF power incident tissues adjacent the device.

Abstract: An intrinsic inter-atrial conduction delay is determined by a pacemaker or implantable cardioverter-defibrillator based, at least in part, on far-field atrial events sensed using ventricular pacing/sensing leads. An atrioventricular pacing delay is then set based on the inter-atrial conduction delay. By detecting atrial events using ventricular leads, rather than using atrial leads, a more useful measurement of the intrinsic inter-atrial conduction delay can be obtained. In this regard, since atrial electrodes detect atrial activity locally around the electrodes, a near-field atrial event sensed using an atrial electrode might not properly represent the actual timing of the atrial event across both the right and left atria. Far-field atrial events sensed using ventricular leads thus allow for a more useful measurement of inter-atrial conduction delays for use in setting atrioventricular pacing delays.

Abstract: An intrinsic inter-atrial conduction delay is determined by a pacemaker or implantable cardioverter-defibrillator based, at least in part, on far-field atrial events sensed using ventricular pacing/sensing leads. An atrioventricular pacing delay is then set based on the inter-atrial conduction delay. By detecting atrial events using ventricular leads, rather than using atrial leads, a more useful measurement of the intrinsic inter-atrial conduction delay can be obtained. In this regard, since atrial electrodes detect atrial activity locally around the electrodes, a near-field atrial event sensed using an atrial electrode might not properly represent the actual timing of the atrial event across both the right and left atria. Far-field atrial events sensed using ventricular leads thus allow for a more useful measurement of inter-atrial conduction delays for use in setting atrioventricular pacing delays.

Abstract: An implantable device may employ anodal-based cardiac stimulation to improve hemodynamics. Anodal pacing may be provided on a conditional basis (e.g., upon detection of a defined condition). An implantable device may provide anodal pacing or cathodal pacing according to a defined ratio. An implantable device may use automatic capture detection to determine a pacing energy level that provides effective anodal pacing while attempting to minimize the power consumption associated with the anodal pacing.

Abstract: An exemplary method includes delivering stimulation energy via a right ventricular site; sensing an evoked response caused by the delivered stimulation energy at the right ventricular site; calculating a paced propagation delay for the right ventricular site (PPDRV); delivering stimulation energy via a left ventricular site; sensing an evoked response caused by the delivered stimulation energy at the left ventricular site; calculating a paced propagation delay for the left ventricular site (PPDLV); and determining an interventricular delay time (VV) for delivery of a bi-ventricular pacing therapy based in part on the paced propagation delay for the right ventricular site (PPDRV) and the paced propagation delay for the left ventricular site (PPDLV). Other exemplary methods, devices, systems, etc., are also disclosed.

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: 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.

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 system and method enables precise detection of the time of occurrence of a cardiac event of a heart. The method includes the steps of sensing electrical activity of the heart to generate an electrogram signal including the cardiac event, storing the electrogram signal, correlating the electrogram signal with an electrogram template, and identifying the time of occurrence of the cardiac event based upon the correlation.

Abstract: An implantable medical lead is disclosed herein. The lead may include a body and an electrical pathway. The body may include a distal portion with an electrode and a proximal portion with a lead connector end. The electrical pathway may extend between the electrode and lead connector end and may include a coiled inductor including first and second electrically conductive filar cores. The first and second filar cores may be physically joined into a unified single piece proximal terminal on a proximal end of the coiled inductor. The first and second cores may be physically joined into a unified single piece distal terminal on a distal end of the coiled inductor. The first and second filar cores may be helically wound into a coiled portion between the proximal and distal terminals, the filar cores being electrically isolated from each other in the coiled portion.

Abstract: An implantable medical device includes leads, a segment monitoring module, an impedance detection module and an ischemia module. The leads include electrodes that are configured to be positioned within a heart and that are capable of sensing cardiac signals having a segment of interest. The segment monitoring module determines segment variations of the segment of interest in the cardiac signals. The impedance detection module measures impedance vectors between predetermined combinations of the electrodes. The ischemia detection module monitors ischemia based on changes in the segment variations of the segment of interest and based on changes in the impedance vectors.