Abstract: For exchanging medical data in a healthcare system having multiple patient domains, with at least one of these domains being isolated from the other domains by virtue of a patient identifier for the other domains not having access to patient identifiers used by the isolated domain, patient-related data for a given patient are provided and are sent to this manager. The manager compares the data with stored data to identify an identifier of the given patient utilized by one of the other domains. This identifier is returned to the isolated domain, wherein it is employed for enabling an association of locally or externally generated medical data of the patient with an externally or locally utilized identifier of the patient with an externally or locally utilized identifier of the patient. The isolated domain may utilize model and serial numbers of implantable medical devices as the patient identifiers.

Abstract: An implantable medical device has an electronic circuit and a telemetry circuit both connected to a common ground, and at least one RF telemetry antenna that is formed by a number of parts of the implantable device that are capable of functioning as an antenna. When implanted, these parts are in contact with tissue. For voltage protection, the RF antenna circuit is connected to the parts of the RF telemetry antenna via at least one capacitor. The capacitor is dimensioned to withstand a voltage amplitude of a pulse that would be capable of modifying the state of, or destroying, any component in the RF telemetry circuit or the electronic circuit.

Abstract: In a method and an apparatus for creating hemodynamic sensor signal templates using an implantable medical device connectable to a patient heart activity of the patient is sensed in order to identify a paste or sensed sequence of events of a heart cycle. Hemodynamic sensor signals for consecutive heart cycles are sensed and the sensed hemodynamic sensor signals for consecutive heart cycles are stored. The sensed sensor signals are classified dependent on at least one predetermined heart event sequence condition. A template may be created using the classified sensor signals.

Abstract: An implantable medical apparatus for detecting diastolic heart failure, DHF, has a DHF determining device for determining at least one blood pressure parameter for detecting a DHF state of the heart of a patient. The DHF determining device includes a pressure measuring unit for measuring pulse pressure in a cardiac cycle for a predetermined workload situation of the patient as the blood pressure parameter, and a comparator compares the measured pulse pressure with a predetermined reference value. A pacemaker includes such an apparatus and a control unit that optimizes pacing therapy depending on the result of the comparison of the measured pulse pressures with the predetermined reference values.

Abstract: A motion sensor, and an implantable cardiac stimulator incorporating such a motion sensor, has a fluid-type housing containing a fluid that includes at least one type of anisotropic molecules, the anisotropic molecules exhibiting an anisotropic property having a state that changes dependent on motion. The housing of the motion sensor is located externally on an animate subject, or is implanted in the animate subject, and includes externally accessible electrodes that detect a change in the state of the anisotropic property and emit an output signal representative of an activity level of the subject.

Abstract: For attaching a cardiac stimulator lead at a desired position inside a heart, the stimulator lead having a flexible tube from which a helix is extendible at a distal end thereof by a screw rotating motion and having a proximal end interconnected with an operating member, a tool has a flexible portion wire with an engagement formation at a distal end thereof that mates with a complimentary engagement formation at a proximal end of the operating member. The tool has a handle containing an internal cavity, with a proximal portion of the torsion wire being rotationally rotated by the handle in the internal cavity, and a resilient yoke is formed in the internal cavity, with at least a part of the yoke engaging grooves and ridges in a circumferential boundary surface of the internal cavity.

Abstract: An implantable medical apparatus for detecting diastolic heart failure, DHF, has a DHF determining device for determining at least one blood pressure parameter for detecting a DHF state of the heart of a patient. The DHF determining device has a pressure measuring unit for measuring the absolute value of left atrial pressure during the diastasis phase just before atrial contraction, or the absolute value of the pressure in the pulmonary vein when the pulmonary valve is closed, for a predetermined workload situation and a rest situation of the patient. A comparator compares the difference between left atrial pressure or pulmonary vein pressure, in the workload and rest situations, with a predetermined pressure difference reference value. A pacemaker includes such an apparatus and a control unit that optimizes pacing therapy depending on the result of the comparisons with the reference values.

Abstract: An implantable heart stimulating device for indicating congestive heart failure (CHF) has a processor and a sensor combination that senses at least two heart events during one heart cycle at different locations of the heart. The processor is supplied with signals from the sensor combination relating to the sensed events, and determines therefrom at least one heart time interval between the sensed events in the same heart cycle. The processor determines a CHF indicator value representing a degree of CHF based on a variability measure calculated from at least two heart time intervals from at least two different heart cycles. The processor determines the CHF indicator value in relation to previous CHF indicator values.

Abstract: In an electrically conductive lead adapted for implantation in a human or animal body, and a method for making such a lead, a drug-dispensing member is disposed at a distal end portion of the lead, at which an electrode member is disposed that is adapted to emit and/or sense electrical signals associated with medical therapy. The drug-dispensing member has a configuration so that, after implantation, the amount of drug released into the body per time unit is automatically controlled to smoothly vary with time from al larger amount to a smaller amount in accordance with a predetermined relationship of the amount of drug released as a function of time.

Abstract: In an implantable heart-monitoring device and system, and a heart-monitoring method, a control circuit is connected to one or more sensors, a first of which is positionable in the coronary sinus region of a heart and senses at least one blood constituent, and at least one other of the sensors supplying a signal to the control circuit indicative of the activity of the heart. In response to signals from the first sensor and with information about the activity of the heart from the other sensor, the control circuit determines a first value of the blood constituent during a first portion of a heart cycle, and determines a second value of the blood constituent during a second portion of the heart cycle.

Abstract: In an implantable medical device and a manufacturing method therefore, the implantable medical device has at least an electronics module and a battery module, each contributing functionally as well as to the shape of the outer enclosure of the implantable medical device. Different modules, and different versions of different modules, can be combined in different combinations, according to a device specification, to form different medical devices.

Abstract: An apparatus for detecting cardiac events in electrograms has a feature extraction unit that derives features of the cardiac events for discriminating among different types of cardiac events. A clustering unit groups cardiac events with similar features into respective clusters defined by predetermined cluster features. The feature extraction unit determines a feature vector describing waveform characteristics of cardiac events in the electrogram by a wavelet transform. The clustering unit determines the distance between the feature vector and corresponding cluster feature vectors in order to assign the cardiac event in question to that cluster which results in a minimum distance, providing that the minimum distance is less than a predetermined threshold value. A heart stimulator provided with such a cardiac event detecting apparatus detects the occurrence of an arrhythmia and appropriately controls a pulse stimulator to treat the arrhythmia.

Abstract: A biventricular cardiac stimulation device has a pulse generator for delivering stimulation pulses at least to the ventricles of a patient's heart. An evoked response detector has independent first and second ventricular sensing channels for ventricular evoked response detection in the ventricles. The pulse generator is controlled to deliver stimulation pulses to the second ventricle with a VV time delay after delivery of a stimulation pulse to the first-stimulated ventricle, the VV time delay being shorter than an evoked response detection time window that follows delivery of the stimulation pulse to the first-stimulated ventricle. An evoked response detector closes the evoked response detection window, or discards detections therein, in response to the emission of a stimulation pulse to the second-stimulated ventricle during the evoked response detection time window of the first-stimulated ventricle.

Abstract: An implantable medical device has a conductive housing containing circuitry for operation of the device and radio frequency circuitry for transmitting and/or receiving radio frequency signals. An insulating header is arranged adjacent to the conductive housing. A conductive structure is provided on a surface of, and/or within, the insulating header. An antenna feed is operatively interconnected between the radio frequency circuitry and the conductive structure. The conductive structure is galvanically connected to the conductive housing, and the conductive structure and the conductive housing, in combination, operate as a transmitting and/or receiving antenna for the radio frequency signals.

Abstract: A heart monitoring device has a control circuit that derives an impedance value indicative of the impedance between different electrode surfaces. The control circuit determines and monitors a negative rate of change of the impedance value and determines whether the negative rate of change, or its absolute value, increases or decreases over a number of heart cycles. Alternatively or additionally, the control circuit may determine and monitor a relationship between a positive rate of change and a negative rate of change of the impedance value. The device can, in particular, be used to detect and treat a diastolic dysfunction of a heart.

Abstract: In a device and a method for determining a cardiac condition from a detected cardiac signal, an input signal is formed from the detected cardiac signal and supplied to an analysis unit. The analysis unit forms an analysis signal from the input signal, having a real part substantially corresponding to the input signal and an imaginary part that is a predetermined transformation of the input signal. A calculation unit operates on the analysis signal to calculated at least two heart-related parameters therefrom. The heart-related parameters are supplied to a processing unit that combines the heart-related parameters in a predetermined manner for identifying a cardiac condition.

Abstract: An implantable heart stimulator has an electrically conductive housing containing a pulse generator, with an electrode lead connected to the housing. The electrode lead has a proximal portion extending substantially from the housing to a location, after implantation, which is beyond the entry of the lead into the venous system and before the entry of the lead into the superior vena cava. A current source supplies an infection control current between the housing and an electrically conductive surface on the exterior of the proximal portion of the electrode lead, for counteracting bacterial growth. The housing may have a header to which the electrode lead is connected, in which case the header is provided with an electrically conductive surface as well, which can serve as an electrode for the infection control current.

Abstract: A battery unit has a battery encapsulation formed by first and second encapsulation parts joined by a weld along a weld zone, with a battery contained in the battery encapsulation between the first and second encapsulation parts. Either the battery has a recess exstending along the weld zone, or overlaping edges of the first and second encapsulation parts are bent away from the battery to form a recess. The recess provides a heating insulating space that protects the battery from damage during welding along the weld zone.

Abstract: An implantable heart stimulator has a pulse generator, implantable in a subcutaneous pocket, and an electrode lead connected thereto for delivering stimulation pulses to a patient's heart. The pulse generator has an electrically conductive housing, and the electrode lead has a proximal portion which after implantation, extends substantially from the housing to a location situated beyond entry into the venous system and before entry into the superior vena cava. The proximal portion has an exterior with an electrically conductive surface, which together with the housing, form an infection control current electrode. A counter electrode is disposed outside of the subcutaneous pocket, and a current source supplies an infection control current between the infection control current electrode and the counter electrode for counteracting bacterial growth at least on an exterior of the housing.

Abstract: An implantable bi-ventricular heart stimulating device and system, suitable for treating congestive heart failure, have a control circuit with first and second pacing circuits and first and second sensing circuits. The device operates with time cycles corresponding to normal heart cycles. The control circuit determines: (a) whether a signal typical of an evoked response to a pacing pulse delivered by the first pacing circuit is sensed within a first time interval and (b) whether a signal typical for an R-wave transferred from the second ventricle, or from some other part of the heart, to the first ventricle is detected within a first time window. The operation of the device depends on whether the conditions (a) and (b) are fulfilled.