Abstract: An implantable pulse generator communicates with external devices such as device programmers and network repeaters to exchange data. The communication utilizes a communication protocol such that data is transferred in packets and transport control information is included for each of the packets. Network routing information may also be provided for each of the packets to establish additional capabilities including network addressing, priority control, or recipient validation. Information exchange instructions are executed by the implantable pulse generator to take data from one or more application programs being executed by the implantable pulse generator, divide the data into packets, and add the transport control information, and network routing information if desired, for outgoing packets.

Abstract: A method or system for computing and/or setting optimal cardiac resynchronization pacing parameters is presented. Among the parameters which may be optimized in this manner are an atrio-ventricular delay interval, an inter-atrial interval and a biventricular offset interval.

Abstract: A device for analyzing a physiological signal, such as an electrocardiogram or electrogram, that was previously collected, filtered, sampled and digitized. The device memorizes the digitized signal and analyzes it by decomposing the signal into a plurality of N parameterized bump functions, where each bump function is a continuous function defined by three successive intervals, respectively, a first monotonic parameterized function, an affine function, and a second monotonic parameterized function, with one of the monotonic parameterized functions being increasing and the other decreasing. The parameterized functions are preferably half-Gaussian functions, and the affine function preferably has a null slope. Each N bump function is classified by recognizing at least one parameter characteristic of each wave, and allotting a standardized label, selected among a plurality of predetermined labels, according to one or to more of the characteristic parameters thus recognized.

Abstract: A heart sound analyzer component of an apparatus in one example extracts from composite heart sound information one or more discrete heart sounds of one or more corresponding distinct heart sound sources.

Abstract: This document discusses, among other things, an external device capable of independently distinguishing between pace pulses delivered by an implantable cardiac rhythm management device to different locations of a subject's heart. In one example, polarity of the pace pulses is detected along two different electrocardiograph (ECG) vectors defined by three external skin electrodes. In a further example, the detection of a ventricular depolarization is also used to assign location information to pace pulses. In another example, characterizing information (e.g., polarity, amplitude, pulsewidth, time difference between a pace pulse and a corresponding heart depolarization) is used to classify pace pulses into distinct classes to which location information can be assigned. An ECG display/recorder of the external device is capable of annotating pace pulses or markers using the location information.

Abstract: The present invention provides delivery systems for and methods of delivering ion channel protein genetic material to cardiac cells in areas adjacent to where an electrode is to be positioned in a patient's heart to improve or correct the signal to noise ratio of cardiac signals, such as the P-wave. More specifically, there is provided a system and method for delivering sodium ion channel proteins or nucleic acid molecules encoding sodium ion channel proteins to a site in the heart adjacent to an electrode to increase the expression of the same, thereby enhancing the cardiac signal amplitude and enabling improved sensing of cardiac signals by an implanted pacemaker.

Abstract: The invention concerns a cardiac pacemaker comprising a stimulation pulse generator (RVP; LVP) for biventricular stimulation of a heart, which is to be connected to at least one right-ventricular electrode for the stimulation of a right ventricle of the heart and to at least one left-ventricular electrode for the stimulation of a left ventricle of the heart and is connected to a control unit and is adapted to trigger right-ventricular and left-ventricular stimulation pulses with an interventricular delay time which is adjustable by means of the control unit. The invention is characterized in that the control unit is connected to an impedance detection unit which is to be connected to intercardiac electrodes and is adapted to form from an input signal formed by the impedance detection unit and dependent on the intracardiac impedance, an output signal indicating an optimum biventricular stimulation mode.

Abstract: A real-time detection technique and a real-time, adaptive, model-independent control technique for detecting and stabilizing pathological physiological rhythms, such as repolarization alternans, on the basis of the rate dependence of excitable tissue such as cardiac and neuronal tissue is presented. Unlike other control methods, which require a number of beats to locate the period-1 fixed point, the technique locates the period-1 fixed point almost instantaneously, rapidly eliminating any higher-period or aperiodic rhythms.

Abstract: A delivery system and method for delivering a right ventricular lead into a right ventricle includes a delivery device having an inflatable balloon at a distal end. The device is inserted into the venous system, the balloon is inflated and the device is floated along a blood flow path within the venous system through the heart and into the pulmonary artery. The lead is delivered into the right ventricle using the device. In one embodiment, the device is a catheter that facilitates placement of a guide wire into the right ventricle for delivery of the lead. The catheter is then removed and the lead is inserted into the right ventricle over the guide wire.

Abstract: Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.

Abstract: Techniques are described for analyzing auscultatory sounds to aid a medical professional in diagnosing physiological conditions of a patient. A data analysis system, for example, applies singular value decomposition to auscultatory sounds associated known physiological conditions to define a set of one or more disease regions within a multidimensional space. A diagnostic device, such as an electronic stethoscope or personal digital assistant, applies configuration data from the data analysis system to generate a set of one or more vectors within the multidimensional space representative of auscultatory sounds associated with a patient. The diagnostic device outputs a diagnostic message associated with a physiological condition of the patient based on the orientation of the vectors relative to the disease regions within the multidimensional space.

Abstract: A method and apparatus for detecting a lead-related condition that includes determining whether a first oversensing criteria is satisfied, determining whether a second oversensing criteria is satisfied, determining whether an impedance criteria has been satisfied, and generating an alert in response to more than one of the first oversensing criteria, the second over sensing criteria and the impedance criteria being satisfied.

Abstract: A control system for a continuous flow rotary blood pump is provided. A normal operating range of the blood pump is established. The normal operating range may comprise a normal pump flow range and a normal pressure head range. A target rotational speed of the pump is set in accordance with the normal operating range. A current operating condition of the blood pump is determined. The current operating condition may comprise a current pump flow, a current pressure head, and a current rotational speed of the pump. The current operating condition is compared with the normal operating range. An appropriate control algorithm is selected from a plurality of available control algorithms based on the comparison. The target rotational speed of the pump is adjusted using the selected control algorithm to maintain or recover the normal operating range.

Abstract: An apparatus and method for obtaining information, such as heart rate or the presence of atrial fibrillation, from electrodes applied to the feet of a subject. A scale having electrodes may be used for this purpose. The signal obtained from the electrodes is digitized and filtered to obtain an electrocardiographic signal exhibiting periodic, sequential, discrete, magnitudinal variations associated with the heartbeats of the subject. The electrocardiographic signal is then analyzed to identify discrete magnitudinal variations useful for obtaining the desired information. In determining the heart rate of the subject, an interval between variations having a desired magnitudinal characteristic may be employed. The absence of such variations is indicative of atrial fibrillation.

Abstract: Apparatus and methods for performing remote detection of physiological activity are described. One aspect of the invention involves obtaining information concerning respiration and heart function. In one embodiment, the invention includes a source containing an oscillator configured to illuminate the subject with electromagnetic signal beam and a receiver configured to observe changes in the amplitude of the electromagnetic signal reflected by the subject.

Abstract: Methods and systems for securing tissues, e.g., cardiovascular tissues, are disclosed. A method in accordance with one embodiment of the invention includes inserting a portion of a catheter into an opening between a first portion of cardiovascular tissue and a second portion of cardiovascular tissue. The method can further include drawing the first and second portions of the cardiovascular tissue into contact with each other by drawing a vacuum in a region adjacent to the first and second portions of cardiovascular tissue via the catheter while the catheter is positioned between the first and second portions. The tissue portions can be fused by heating the tissue from within the opening, e.g., via radio frequency energy. This technique, and associated catheter system, can be used to close a patent foramen ovale or other openings in cardiovascular tissue.

Abstract: Errors in pitch (frequency) allocation within a cochlear implant are corrected in order to provide a significant and profound improvement in the quality of sound perceived by the cochlear implant user. In one embodiment, the user is stimulated with a reference signal, e.g., the tone “A” (440 Hz) and then the user is stimulated with a probe signal, separated from the reference signal by an octave, e.g., high “A” (880 Hz). The user adjusts the location where the probe signal is applied, using current steering, until the pitch of the probe signal, as perceived by the user, matches the pitch of the reference signal, as perceived by the user. In this manner, the user maps frequencies to stimulation locations in order to tune his or her implant system to his or her unique cochlea.

Abstract: The present invention is directed toward a sensing architecture for use in cardiac rhythm management devices. The sensing architecture of the present invention provides a method and means for certifying detected events by the cardiac rhythm management device. Moreover, by exploiting the enhanced capability to accurately identifying only those sensed events that are desirable, and preventing the use of events marked as suspect, the sensing architecture of the present invention can better discriminate between rhythms appropriate for device therapy and those that are not.

Abstract: A medical electrical lead includes a first low voltage electrode adapted for intimate contact with tissue at an implant site, in order to provide pacing stimulation, and a second low voltage electrode positioned in proximity to the first electrode, isolated from the first electrode and adapted to function in conjunction with the first electrode to provide bipolar sensing of near-field signals. A porous layer is formed over the second electrode; the porous layer allows conduction therethrough while preventing contact between the second electrode and tissue in proximity to the implant site.

Abstract: An implantable medical device includes two or more pacing output channels coupled to a single unipolar electrode or bipolar electrode pair. The implantable medical device can control each pacing output channel to deliver pacing pulses via the single electrode or electrode pair at different times and with different amplitudes. In some embodiments, the implantable medical device is used to deliver extra-systolic stimulation therapy. In such embodiments, a first pacing output channel can be controlled to deliver pacing pulses via the electrode or electrode pair with an amplitude sufficient to depolarize a chamber of the heart. A second pacing output channel is controlled to deliver extra-systolic pulses, which can have a lower amplitude than the pacing pulses, via the electrode or electrode pair an extra-systolic interval after sensed or paced depolarizations of the chamber. In some embodiments, the implantable medical device delivers ESS therapy and cardiac resynchronization therapy (CRT).