Abstract: The present application describes an intravascular implantable pacing and/or defibrillation system. The described system includes a pulse generator that is implantable within a blood vessel and proportioned to blood flow through the blood vessel, and at least one lead attachable to the pulse generator. During implantation, the pulse generator is introduced into a patient's vasculature, advanced to a desired vessel and anchored in place within the vessel. The lead or leads are placed within the heart or surrounding vessels as needed to deliver electrical pulses to the appropriate location.

Abstract: An apparatus for applying a signal to a nerve for the treatment of a disorder includes a first electrode and a second electrode. Each of the electrodes is adapted to be secured to a nerve of a patient. A signal generator is electrically connected to each of the first and second electrodes. The signal generator is adapted to create a signal having a first waveform at the first electrode and a second waveform at the second electrode. The waveforms have parameters selected to block propagation of neural action potentials. The waveforms have a repeating pattern of cycles of pulses with a delay period between at least selected ones of said pulses. In one embodiment, the first and second waveforms are out of phase for a cycle of one of the waveforms to occur during a delay period of the other of the waveforms.

Abstract: Methods of implanting a two-part cardiac lead in a heart are disclosed. The two-part cardiac lead has inner and outer portions and a pin. The inner and outer lead portions are separately advanced to a location of interest within the vasculature of a patient. The pin is attached to a proximal end of the inner lead portion and can provide a connection between the inner and outer lead portions.

Abstract: An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate.

Abstract: Methods and devices for detecting and/or predicting onset of an undesirable physiological event or neural state, such as an epileptic seizure, facilitate rapid intervention with a treatment therapy such as neurostimulation or drug therapy. The methods and devices involve monitoring the patient's body temperature, preferably by an implanted temperature sensor, to detect a change in a body temperature parameter over a first time period, which may comprise an increase or decrease in the patient's body temperature, time rate of change of body temperature, moving average temperature, increase or decrease in body temperature exceeding a target temperature, elevated or reduced body temperature, or temperature stability parameter over a first time period. The sampling period may be changed manually or depending upon a sensed body parameter, including temperature. When a parameter change is detected that exceeds a threshold, neurostimulation therapy is delivered to a neural structure of the patient.

Abstract: In various method embodiments, a neural activity signal is sensed, a feature from the sensed neural activity signal is extracted, and a neural marker for the extracted feature is created. The neural marker includes information regarding the extracted feature. Various device embodiments comprise a port to receive a neural activity signal, and a feature extractor adapted to receive and process the neural activity signal to produce a neural marker that includes information for the neural activity signal. Various device embodiments comprise a display, a memory adapted to store a neural marker associated with a sensed neural activity signal, and a controller adapted to communicate with the memory and the display to provide a representation of the neural marker on the display.

Abstract: A catheter with a tissue property sensor provides for localization of myocardial infarction (MI) by utilizing one or more differences between properties of infarcted myocardial tissue and properties of normal myocardial tissue. The tissue property sensor is to be placed on endocardial wall or epicardial wall during catheterization to sense at least one tissue property allowing for detection of MI. Examples of the tissue property sensor include, but are not limited to, an optical sensor, an acoustic sensor, a contractility sensor, a temperature sensor, and a drug response sensor. In one embodiment, the tissue property sensor senses a tissue property in various locations on endocardial wall or epicardial wall and detects substantial changes in the tissue property that indicate a boundary between infarcted tissue and normal tissue.

Abstract: The implantable device is capable of performing thermal dilution analysis of the cardiac output of a patient using power delivered from an external source. By using power from an external source, the implantable device conserves its power resources for other purposes, such as for pacing or defibrillation therapy. In one example, an external programmer or bedside monitor provides power through a hand-held power delivery wand via electromagnetic induction, with the power routed from a subcutaneous coil to a heating element implanted in the right atrium, which heats blood as it passes through the right atrium. In another example, the heating element is formed of a material that generates heat in response to a beam of ultrasound provided by the wand. In either case, a downstream blood temperature profile is detected using a thermistor implanted in the pulmonary artery and cardiac output is then estimated by analyzing the temperature profile.

Abstract: Methods and an apparatus are described for treating at least one of a plurality of disorders of a patient characterized at least in part by vagal activity innervating at least one of a plurality of organs of the patient. Embodiments include a method for treating a patient having a gastro-intestinal disorder having a inflammatory basis, including positioning an electrode on a vagus nerve below a vagal innervation of a heart of the patient, and treating the patient's gastro-intestinal disorder by applying an electrical signal to the electrode, wherein the signal has a frequency of at least 500 Hz and is selected to down-regulate neural activity on the vagus nerve, allow partial restoration of nerve activity upon discontinuation of the electrical signal, and wherein the signal is configured to reduce pancreatic output and biliary output. An electrical signal is applied to the electrode to modulate vagal activity by an amount selected to treat the disorder. The signal may be blocking or a stimulation signal.

Abstract: An implantable medical device is configured so that all of the major components including a housing and attached leads are disposed within the vasculature of a patient. A tether extends from the housing of the device to an implant location where the tether is secured to tissue outside of the vasculature. In this manner, an intravascular medical device may be implanted at a location remote from final placement, delivered via the vasculature and anchored at the initial entry point.

Abstract: An exemplary method includes providing a first value indicative of electrode polarization, delivering a cardiac stimulus and determining a second value indicative of electrode polarization associated with the cardiac stimulus, comparing the second value to the first value to determine whether a change in cardiac condition has occurred and, based at least in part on the comparing, deciding whether to adjust a cardiac stimulation therapy.

Abstract: Methods and devices for electrically stimulating nerves and organs to induce and modulate the production of hormones according to desired hormone production patterns and hormone level patterns to treat gynecological conditions. Such methods and devices may be used to treat or alleviate the symptoms of menopause. In addition, such methods and devices may be used for birth control.

Abstract: In general, the invention is directed to techniques for determining appropriate first aid and applying first aid that is appropriate. A first aid system receives patient status information from an input device or a sensor, and presents first aid information as a function of the received patient status information. The first aid system may be incorporated with an external defibrillator. The first aid system may acquire patient status information through an interaction with an operator, in which the first aid system asks the operator to supply patient status information. In one embodiment of the invention, the operator may supply patient status information by touching a diagram representing at least a portion of a human body.

Abstract: Systems and methods for communicating with an implant within a patient's body using acoustic telemetry includes an external communications device attachable to the patient's skin. The device includes an acoustic transducer for transmitting acoustic signals into the patient's body and/or for receiving acoustic signals from the implant. The device includes a battery for providing electrical energy to operate the device, a processor for extracting data from acoustic signals received from the implant, and memory for storing the data. The device may include an interface for communicating with a recorder or computer, e.g., to transfer data from the implant and/or to receive instructions for controlling the implant. The device is secured to the patient's skin for controlling, monitoring, or otherwise communicating with the implant, while allowing the patient to remain mobile.

Abstract: A method for treating at least one of a plurality of disorders characterized at least in part by vagal activity includes positioning an electrode at a body organ innervated by the vagus. An electrical signal is applied to the electrode to modulate vagal activity. The electrical signal is applied at a frequency in excess of 3,000 Hz for the signal to create a neural conduction block to the vagus with the neural conduction block selected to at least partially block nerve impulses on the vagus.

Abstract: An implantable medical device with anti-infection agent. The implantable medical device may be configured for placement in the head of a patient and for monitoring or treatment of the brain. The implantable medical device may have a housing or it may have a housing and a member for providing a smooth interface between the device and the adjacent tissue. The anti-infection agent may be provided on or impregnated in the housing or the member. In some embodiments, the device includes a single module while in other embodiments a plurality of modules are coupled to provide a smaller profile. In some embodiments the implantable medical device may include both anti-infection and lubricious materials.

Abstract: An approach to providing disordered breathing therapy involves the use of a plurality of therapy devices to deliver a coordinated disordered breathing therapy regimen to the patient. The plurality of disordered breathing devices includes at least a therapy device that delivers an electrical stimulation therapy modulating a patient's baroreflex response. Other therapy devices may include a cardiac electrical stimulation device, an external respiratory therapy device, and/or other therapy devices used in the treatment of disordered breathing. A therapy controller coordinates the therapies delivered by the plurality of therapy devices.

Abstract: An implantable system applies tiered antitachycardia pacing (ATP) that may be combined with pre-pulsing therapy in order to reduce pain. In one implementation, an exemplary system applies a progression of increasingly potent pacing vectors, progressing in an initial tier from small electrodes inside the heart to later tiers that increasingly use a large electrode surface outside the heart. In the latter tiers, a pre-pulse may be added prior to each ATP pulse to reduce the sensation of pain.

Abstract: A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).

Abstract: Implantable systems, and methods for use therein, perform at least one of a cardiac assessment and an autonomic assessment. Premature atrial contractions (PACs) are induced to thereby cause corresponding premature contractions in the ventricles. Short-term fluctuations in cardiac intervals, that follow the premature contractions in the ventricles caused by the induced PACs, are monitored. At least one of a cardiac assessment and an autonomic assessment is performed based on the monitored fluctuations in cardiac intervals that follow the premature contractions in the ventricles caused by the induced PACs. This can include assessing a patient's risk of sudden cardiac death (SCD), assessing a patient's autonomic tone and/or detecting myocardial ischemic events based on the monitored fluctuations in cardiac intervals that follow the premature contractions in the ventricles caused by the induced PACs.