Abstract: An implantable myocardial stimulation lead comprises a lead body having a distal end and a proximal end, and an electrical connector carried by the proximal end of the lead body. An electrode header carried by the distal end of the lead body has an axis and includes a helical fixation element extending along the axis, the electrode header having a surface configured to receive a driver for rotating the electrode header to screw the helical fixation element into the tissue of the heart. The lead body carries along its length a strain relief member resisting excessive bending of the lead body.

Abstract: Systems for locating an optimal site within a brain of a patient for deep brain stimulation include a main cannula having an internal lumen, a guiding cannula having a bent distal end portion configured to pass through the lumen of the main cannula and guide a microelectrode into the brain, a depth adjustment mechanism configured to adjust an insertion depth of the guiding cannula, and a longitudinal angle adjustment device configured to adjust a longitudinal angle of the guiding cannula. The depth adjustment mechanism and longitudinal angle adjustment device adjust a position of the guiding cannula such that the microelectrode locates the optimal site for the deep brain stimulation.

Abstract: Described are implantable devices and methods for treating various disorders of the pelvic floor by means of electrical stimulation of tissue volumes at two or more locations adjacent sacral nerves or portions thereof, and/or pudendal nerves of portions thereof. Two or more electrical stimulation regimes are applied on a continuous, alternating, intermittent or other basis to the respective tissue volumes in an amount and manner effective to treat a number of disorders, including, but not limited to, urinary and/or fecal voiding dysfurictions such as constipation, incontinence disorders such as urge frequency and urinary retention disorders, sexual dysfunctions such as orgasmic and erectile dysfunction, pelvic pain, prostatitis, prostatalgia and prostatodynia.

Abstract: A method for delivering therapy in a medical device that includes a two-tiered approach of determining the presence of a lead-related condition, and determining, in response to a lead-related condition being present, the presence of oversensing. Deliver of therapy by the medical device is controlled in response to determining that both the lead-related condition and oversensing are present.

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: An implantable electrode array (30) that can adopt a first, preferably straight, configuration selected to allow the array to be inserted into an implantee's body, such as the cochlea, and at least a second, preferably spirally curved, configuration where the electrode array is adapted to apply tissue stimulation to the cochlea. The array (30) includes an elongate carrier (31) having a proximal end and a distal end and a plurality of electrodes (36) supported by the carrier (31) at respective longitudinally spaced locations thereon. The array (30) further comprises an outer layer (33) adhered to the elongate carrier (31) by an intermediate bioresorbable adhesive layer (32) positioned at least partially between the carrier (31) and the outer layer (33).

Abstract: A method and device, such as an implantable cardiac device, for motion and noise immunity in hemodynamic measurement is presented. The method includes obtaining a template waveform representing hemodynamic performance of a heart during a first hemodynamic state and obtaining an autocharacterization measure from an autocharacterization (e.g., autocorrelation) of the template waveform. The method further includes obtaining a test waveform during a second hemodynamic state, performing a cross-characterization (e.g., cross-correlation) of the template waveform and test waveform to identify a cross-characterization measure, and comparing the autocharacterization measure with the cross-characterization measure as a measurement of hemodynamic status of the second hemodynamic state. The device includes hardware and/or software for performing the described method.

Abstract: This document discusses, among other things, a lead assembly including a lead body, at least one conductor extending through the lead body, and a covering having varied material properties. In an example, the covering is made by forming pieces of material having varied material properties. In another example, the covering is made by varying parameters such as heat or tension during wrapping of a piece of material onto a lead assembly.

Abstract: A medical device, such as an implantable medical device (IMD), determines values for one or more metrics that indicate the quality of a patient's sleep, and controls delivery of a therapy based on the sleep quality metric values. For example, the medical device may compare a sleep quality metric value with one or more threshold values, and adjust the therapy based on the comparison. In some embodiments, the medical device adjusts the intensity of therapy based on the comparison, e.g., increases the therapy intensity when the comparison indicates that the patient's sleep quality is poor. In some embodiments, the medical device automatically selects one of a plurality of therapy parameter set available for use in delivering therapy based on a comparison sleep quality metric values associated with respective therapy parameter sets within the plurality of available therapy parameter sets.

Abstract: A device and method for delivering electrical stimulation to the heart in a manner which provides a protective effect against subsequent ischemia is disclosed. The protective effect is produced by configuring a cardiac pacing device to intermittently switch from a normal operating mode to a stress augmentation mode in which the spatial pattern of depolarization is varied to thereby subject a particular region or regions of the ventricular myocardium to increased mechanical stress.

Abstract: In an exercise machine, when a measurement starts, an electrocardiographic signal is detected by an electrocardiographic sensor 1 (ST33), a load drive is started (ST4), and heartbeat rate intervals of the electrocardiographic signal are sequentially obtained. A fluctuation of heartbeat rate intervals PI(n) % is obtained from a calculation formula in which the RR interval RR(n+1) of the current heartbeat is subtracted from the RR interval RR(n) of the previous heartbeat, which is then divided by RR(n) and multiplied by 100% (ST5). Entropy is calculated from 128 pieces of such PI (ST6). From the change of the entropy under the gradually increasing load (ST8), a minimum point of the entropy is obtained, which point is designated as an anaerobic threshold point (ST7). The load of the exercise machine is controlled employing this anaerobic threshold.

Abstract: A plethysmogram signal is sensed from a patient and provided to a programmer device for monitoring the condition of the patient and for optimizing pacing parameters of a cardiac device implanted in the patient. The programmer device analyzes the plethysmogram signal for cardiac performance associated with different pacing parameters. The cardiac performance is indicated by, for example, a pulse amplitude response, a degree of pulsus alternans, or irregularity in the pressure pulses detected in an atrial fibrillation patient. The pacing parameters resulting in the best cardiac performance are selected as the optimum pacing parameters. In one embodiment, the programmer device monitors a Valsalva maneuver performed by a patient. Optimum pacing parameters are derived by analysis of the plethysmogram signals obtained during performance of the Valsalva maneuver while the patient is paced using different pacing parameters.

Abstract: At least one system and at least one method permit a clinician to view or hear power consumption data during a Spinal Cord Stimulation (SCS) system fitting procedure. For example, a clinician's programming computer includes a display of power consumption for each effective stimulation configuration under evaluation during fitting. A clinician performing the fitting procedure uses a programming computer to select various stimulation configurations. The power consumption of the SCS configuration(s) presently and/or previously exercised is displayed for the clinician. By comparing the power consumption for each configuration, the clinician may select a configuration consuming less power while providing effective therapy. Suggestions for low power configurations may be provided by the programming computer.

Abstract: A telemetry component according to an embodiment of the invention, such as a programmer or a monitor for an implantable medical device (“IMD”), includes at least one radio frequency (“RF”) antenna that is configured to accommodate far-field telemetry between the telemetry component and the IMD. The RF antenna is shaped, sized, positioned, and otherwise configured to account for surface current cancellation caused by induced surface current on an electrically conductive surface of the telemetry component.

Abstract: Techniques for enabling both preventive overdrive pacing and antitachycardia pacing (ATP) within an implantable device are provided. The device gains the benefits of overdrive pacing for preventing the onset of a tachycardia and, if one nevertheless occurs, ATP is employed to terminate the tachycardia. In particular, a technique is provided for promptly detecting the onset of atrial tachycardia during preventive overdrive pacing based on loss of capture of atrial pacing pulses. A technique is also provided for using detection of loss of capture of atrial or ventricular pacing pulses to trigger automatic switching from overdrive pacing to ATP. A setup technique determines whether to enable the automatic switching from overdrive pacing to ATP within a particular patient. Also, techniques are provided for verifying loss of capture of atrial or ventricular backup pacing pulses and for detecting low amplitude ventricular fibrillation based on loss of capture of ventricular backup pacing pulses.

Abstract: Polarization signals, which represent voltages measured at a pacemaker electrode, are not constant and may drift. Polarization signal drift, which often precedes undesirable pace polarization artifacts, is more significant when the pacemaker is inhibited from providing an electrical stimulation to the patient's heart. The present invention provides an implantable system and methods for stabilization of a polarization signal. Electrical pulses may be applied to stabilize a polarization signal. In one implementation of the invention, polarization signal stabilization may be used as part of process to terminate tachycardia.

Abstract: An exemplary method includes sensing respiratory information related to tidal volume, based at least in part on the respiratory information, determining if the tidal volume is less than a limit and, if the tidal volume is less than the limit, calling for diaphragm activation at a stimulation power based on a nonincreasing monotonic relationship with respect to decreasing difference between the tidal volume and the limit. Various other technologies are also disclosed.

Abstract: One embodiment of the present invention provides an implantable cardioverter-defibrillator for subcutaneous positioning over a patient's ribcage, the implantable cardioverter-defibrillator including a housing, wherein the housing conforms to the patient's ribcage when subcutaneously positioned; an electrode disposed upon a portion of the housing; and an electrical circuit located within the housing, wherein the electrical circuit is electrically coupled to the electrode.

Abstract: Improved methods and devices perform respiratory control of a person due to conditions such as sleep apnea. According to one embodiment, a respiratory control method includes delivering stimulation signals according to one or more stimulation parameters to phrenic nerves of a person. The person's chest activity is monitored, e.g., by sensing signals in a chamber of the person's heart, to determine the person's respiratory cycle. The stimulation cycle and respiratory cycle are compared. In response, the one or more stimulation parameters are adjusted. In subsequent stimulation cycle(s), the method delivers the stimulation signals according to the adjusted stimulation parameters. This feedback mechanism may continue until respiratory control is captured.

Abstract: A system and method for obtaining ECG signals from an ambulatory patient are disclosed herein. The system is configured to be inexpensive, small, and robust for outpatient monitoring. The system is configured to be a low power consuming device. The system provides options for a variety of settings and real-time access to the ECG signals being recorded during the recording period.