Abstract: This invention relates to an implantable lead, which comprises a conductor; an electrode assembly, arranged at a distal end of the lead, and comprising a housing defining an internal cavity; a helical guide spring arranged in a proximal portion of the cavity and having several spaced turns, and a fixation assembly, which is rotatable relative to the housing, and which includes a shaft extending into the cavity from a proximal end of the housing; and an extendable helical fixation element attached to the shaft at a distal end thereof and protruding beyond the distal end thereof. The fixation assembly has an interaction portion, which interacts with the helical guide spring for causing longitudinal movement of the fixation element when the shaft is rotated.

Abstract: An implantable medical device (100) is configured for generating a cardiogenic impedance signal representative of the cardiogenic impedance of at least a portion of a heart (10) of a subject (20) during at least a portion of cardiac cycle. A moment processor (132) calculates a moment parameter value based on the cardiogenic impedance signal. The moment parameter is representative of a weighted sum of impedance amplitudes within a time window centered at defined time instance within the cardiac cycle. The weights of the impedance amplitudes are further dependent on the length in time between the defined time instance and the point of time of the associated impedance amplitude. The moment parameter is of high diagnostic value and is employed by an arrhythmia classifier (132) in order to classify a detected arrhythmia of the heart (10), such as discriminate between hemodynamically stable or unstable arrhythmias and/or supraventricular or ventricular tachycardia.

Abstract: Systems and methods for optimizing the stimulation of a heart of a patient are disclosed herein. The method comprises delivering pacing therapy to the patient according to a pacing therapy setting schedule, using specific pacing intervals via specific electrode configurations. Further, sinus rate values are recorded over at least one cardiac cycle at each pacing therapy setting and it is determined whether a sinus rate value satisfies predetermined measurement conditions, wherein sinus rate values are used for trending the sinus rate over time if the measurement conditions are satisfied. The accepted sinus rate values, i.e. values that satisfy the measurement conditions, are trended over time, wherein each trended sinus rate value is created based on recordings from at least one cardiac cycle. A preferred pacing therapy setting is determined to be the pacing therapy setting that provides a lowest sinus rate.

Abstract: An implantable medical device is connectable to an epicardial left ventricular lead having at least one epicardial electrode and a myocardium penetrating catheter with at least one endocardial electrode and present in a lumen of the lead. The device comprises a pulse generator controller that controls a ventricular pulse generator to generate pulses to be applied to the epicardial and endocardial electrodes. The controller uses an endocardial-to-epicardial time interval or epicardial-to-endocardial time interval to coordinate endocardial and epicardial activation of the left ventricle to thereby achieve cardiac pacing that closely mimics the natural electrical activation pattern of a healthy heart.

Abstract: In implantable medical devices such a pacemaker or cardioverter/defibrillators (ICDs) and systems including such a device and an external programmer a measure of a hemodynamic parameter such as the cardiac output, the stroke volume, or the contractility of a patient is used to trend heart failure or in an AV/VV optimization scheme. The implantable medical device is adapted to measure the cardiac impedance and the cardiac impedance data is used to determine impedance morphology curves, which, in turn, are used to compute a measure of the hemodynamic parameter.

Abstract: An implantable medical device (100) is configured for generating a cardiogenic impedance signal representative of the cardiogenic impedance of at least a portion of a heart (10) of a subject (20) during multiple cardiac cycles. A transform processor (132) generates a spectrum signal by applying a time-to-frequency transform to the cardiogenic impedance signal. The spectrum signal is processed by a distribution processor (133) configured to calculate a distribution parameter indicative of a distribution in at least a portion of the spectrum signal. The calculated distribution parameter is of high diagnostic value and is employed by an arrhythmia classifier (134) in order to classify a detected arrhythmia of the heart (10), such as discriminate between hemodynamically stable or unstable arrhythmias and/or supraventricular or ventricular tachycardia.

Abstract: A method for producing a biocompatible material of the formula NaxKyNbO3, 0?x?0.8, 0.2?y?1, x+y=1 includes the steps of a) providing a Na-precursor and a K-precursor for NaxKyNbO3, b) mixing the precursors in solution wherein said precursors first react to form a sol and thereafter a gel, c) heat treating the gel to obtain an oxide of the material NaxKyNbO3, 0?x?0.8, 0.2?y?1, x+y=1. The material can be produced as a film, and the material or film can be provided on the exterior surface of a medical implant that will come into contact with body tissue and/or body fluids upon implantation thereof.

Abstract: An implantable medical lead has at least one electric conductor running along a lead body and electrically interconnecting at least one electrode at the distal portion of the lead with at least one lead terminal at the proximal portion of the lead. The lead also has at least one closed channel running along at least a portion of the lead body. The closed channel contains an extracorporeally detectable detection substance. A rupture to the lead will cause the detection substance to leak out of the channel and outside of the lead body. Lead damage can be confirmed by the absence of or a reduced amount of said detection substance inside the lead.

Abstract: Disclosed herein are systems and methods for automatically determining ST windows for ischemia detection. In one example, an R-wave is identified in a signal derived from an IEGM and the derivative signal data following the identified R-wave is analyzed so as to find portions of the derivative signal comprising samples having lower values than a predetermined threshold. Further, a portion of the derivative signal including samples having lower values than the threshold is determined to correspond to a ST window for that cardiac cycle if that portion fulfills predetermined requirements. A reference ST window based on a number of determined ST windows is determined. Using the reference ST window, ischemia can be detected by comparing IEGM data in the reference ST window with current IEGM data from a segment of the IEGM signal corresponding to the reference ST window.

Abstract: Implantable heart stimulator comprising a control unit including a memory, a sensing unit, a pulse stimulation unit adapted to generate stimulation pulses separated by a variable predetermined pacing interval (PI), and also a method in a heart stimulator. The heart stimulator is adapted to be connected to one or many heart electrode leads provided with stimulating and sensing electrodes in order to stimulate heart tissue by said stimulation pulses and sense electrical heart events. The heart stimulator comprises a control parameter measurement unit adapted to derive a control parameter value indicative of end-diastolic pressure (EDP).

Abstract: Implantable heart stimulator connectable to an electrode arrangement has a pulse generator adapted to deliver stimulation pulses to a heart of a subject; an impedance measurement unit adapted monitor at least one heart chamber of the heart of the subject to measure the impedance in the at least one monitored heart chamber for generating an impedance signal corresponding to the measured impedance. The impedance signal is applied to a processor where the signal is processed, according to specified criteria, and a fractionation index value is determined represented by the curve length of the impedance signal during a predetermined measurement period. The fractionation index value is a measure of different degrees of mechanical dyssynchrony of the heart.

Abstract: A pulse generating implantable medical device comprises a power source , a control unit, a plurality of switching units, a timing unit, a pulse generating unit adapted to generate one or more stimulation pulses to be applied to human or animal tissue via one or more stimulation electrodes, and a coupling capacitor in series with each stimulation electrode. A stimulation pulse is adapted to be applied during a stimulation pulse timing cycle that includes a stimulation phase and a recharge phase, and that the timing of a stimulation pulse timing cycle is controlled by the control unit via the timing unit and the switching units. The implantable medical device further comprises an energy storage unit and that, during the recharge phase, one or more of the switching units is adapted to establish electrical connection between the one or many stimulation electrodes and the energy storage unit in order to collect and store energy from applied stimulation pulses.

Abstract: An implantable medical system for detecting incipient edema has an implantable medical lead including an optical sensor having a light source and a light detector. The medical system further has an edema detection circuit that activates the light source to emit light, the light being directed into lung tissue of a patient and that obtains a light intensity value corresponding to an intensity of light received by the light detector, and that evaluates the light intensity value to detect a consistency with incipient edema.

Abstract: A connector for an implantable medical lead that is electrically and mechanically connectable to an implantable medical device, has a connector pin made of a first conducting material. A tubular insulator made of an insulating material concentrically surrounds at least a portion of the pin. A connector ring made of a second conducting material is concentrically positioned around at least a portion of the insulator. The insulator is connected to the connector ring by spark plasma sintering in the case of an active fixation lead, and is connected to the ring and the pin by spark plasma sintering in the case of a passive fixation lead.

Abstract: CRT settings for an implantable medical device are determined by applying pacing pulses to heart chambers of a scheme of different combinations of interchamber delays. A respective width parameter value representing an R or P wave width is determined for each such delay combination based on an ECG representing signal and the width parameter values are employed to estimate a parametric model defining the width parameter as a function of interchamber delays. Candidate interchamber delays that minimize the width parameter are determined from the parametric model and employed to determine optimal CRT settings. The technique provides an efficient way of finding optimal CRT settings when multiple pacing sites are available in a heart chamber.

Abstract: An implantable medical device measures an AV delay in connection with measurement of N physiological patient parameters. The parameters are used for identifying a sub-space of an N-dimensional parameter space. An expected AV delay is assigned to the identified sub-space based on the measured AV delay, where the parameter space with expected AV delays constitute decision support information to be used by the device for performing a selective heart pacing. This selective pacing is performed based on a priori probability determined using the support information and a measured set of N parameters. The a priori probability represents the probability of successful AV conduction at a current patient condition determined based on the measured parameters.

Abstract: In a method and implantable medical device for ventricular tachyarrhythmia detection and classification, upon detection of a ventricular tachyarrhythmia based on an electrocardiogram signal, cardiogenic impedance data representative of ventricular volume dynamics are collected and used for classifying the detected tachyarrhythmia as stable or unstable. In the latter case but typically not in the former case, defibrillation shocks or other forms of therapy are applied to combat the unstable ventricular tachyarrhythmia.

Abstract: A method for producing a biocompatible material of the formula NaxKyNbO3, 0?x?0.8, 0.2?y?1, x+y=1 includes the steps of a) providing a Na-precursor and a K-precursor for NaxKyNbO3, b) mixing the precursors in solution wherein said precursors first react to form a sol and thereafter a gel, c) heat treating the gel to obtain an oxide of the material NaxKyNbO3, 0?x?0.8, 0.2?y?1, x+y=1. The material can be produced as a film, and the material or film can be provided on the exterior surface of a medical implant that will come into contact with body tissue and/or body fluids upon implantation thereof.

Abstract: A connector for an implantable medical lead that is electrically and mechanically connectable to an implantable medical device, has a connector pin made of a first conducting material. A tubular insulator made of an insulating material concentrically surrounds at least a portion of the pin. A connector ring made of a second conducting material is concentrically positioned around at least a portion of the insulator. The insulator is connected to the connector ring by spark plasma sintering in the case of an active fixation lead, and is connected to the ring and the pin by spark plasma sintering in the case of a passive fixation lead.

Abstract: The invention relates to a medical implantable lead for monitoring and/or controlling an organ inside a human or animal body. The lead comprises a conducting arrangement having a first conducting coil of at least one electrically conducting wire for connecting a first electrode electrically to a connector to receive and/or transmit electric signals from and to the tissue, respectively. The lead is tapered in a distal portion and has a smaller cross sectional dimension at the distal portion than at the rest of the lead. The first conducting coil is terminated at a termination point on a distance from the distal end. The conducting arrangement has a first end conductor in the form of a non-coiled electric conductor or an eccentrically positioned small diameter coil which connects the first electrode electrically with the coil.