Abstract: A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall. A method for implanting the lead into the coronary vasculature is also provided, the method comprising the steps of inserting a stylet into the lead, inserting the lead into the coronary sinus, advancing the lead from the coronary sinus toward the toward the left atrium and into a coronary vein, removing the stylet, and sensing and pacing the heart.

Abstract: A method for extracting features from cardiac acoustic signals includes the steps of obtaining a cardiac acoustic signal, and extracting physiologically significant features from the cardiac acoustic signal using a neural network. A method for evaluating cardiac acoustic signals includes the steps of obtaining a cardiac acoustic signal, analyzing the cardiac acoustic signal with a wavelet decomposition to extract time-frequency information, and identifying basic heart sounds using neural networks applied to the extracted time-frequency information. A method for determining cardiac event sequences from cardiac acoustic signals includes the steps of obtaining a cardiac acoustic signal, and processing a sequence of features extracted from the cardiac acoustic signal by a probabilistic finite-state automaton to determine a most probable sequence of cardiac events given the cardiac acoustic signal.

Abstract: A lead comprising both a main lead and a transverse lead. The main lead includes a main lead body with a longitudinal axis and at least one electrode. The Transverse lead includes a transverse lead body and at least one electrode, where the transverse lead body extends laterally from the main lead body and curves around the longitudinal axis of the main lead body to partially encircle at least a portion of the main lead. In one embodiment, the transverse lead is adapted to press the at least one electrode on the transverse lead against endocardial tissue. At least a portion of the main lead and at least a portion of the transverse lead are both adapted to be housed within and pass through an implant catheter. In an alternative embodiment, there is a lead system which comprises a first lead and a second lead, where the second lead includes a sleeve, where the first lead is adapted to move through the sleeve to attach the first lead to the second lead.

Abstract: A compress garment for application to a body generally includes a member sized and shaped for positioning onto a body when in position conforms to and supports a body shape. A least one, preferably a multiple number of access windows disposed in the garment member for enabling dermal application and removal of a medical electrode. The access windows are located on the garment member at positions enabling access to pre-selected dermal areas.

Abstract: An electrical method and apparatus for stimulating cardiac cells causing contraction to force hemodynamic output during fibrillation, hemodynamically compromising tachycardia, or asystole. Forcing fields are applied to the heart to give cardiac output on an emergency basis until the arrhythmia ceases or other intervention takes place. The device is used as a stand alone external or internal device, or as a backup to an ICD, atrial defibrillator, or an anti-tachycardia pacemaker. The method and apparatus maintain some cardiac output and not necessarily defibrillation.

Abstract: An electro-acupuncture device for controlling nausea. The device includes a base unit which is includes a wrist-watch like housing, circuitry for generating electro-acupuncture stimulus disposed within the housing, and a strap for securing the housing to the wrist. The base unit has a standardized construction. The device also includes a releasably attachable electrode assembly. The electrode assembly attaches to the base unit of the device. The electrode assembly includes a pair of electrodes and connectors for connecting the electrodes to the circuitry of the base unit. The output of the device is dependent upon the circuitry of the electrode assembly. Thus various electrode assemblies can be made. The circuitry of the base unit modifies the output of the device depending upon which electrode assembly is attached to the base unit.

Abstract: A method for detecting an arrhythmia hidden by rapid pacing in a rate adaptive pacemaker/defibrillator. Unmasking a potential arrhythmia is accomplished by lengthening the pace cycle length by a small amount for a number of cycles followed by a shortening of the pace cycle length for the same number of cycles giving an average pacing rate equivalent to the desired rate. This can occur at all times or only when conditions make arrhythmia masking possible. Changing the pace cycle by a small amount over a number of cycles will move the arrhythmia and paced rhythm out of synchronization. Forcing the pacer to continue sensing the arrhythmia is accomplished by insuring that the pacer's sense refractory is less than one half of the pacing cycle length. This is done by constraining the programming of that value to one half the minimum pacing cycle length or using an adaptive sense refractory period.

Abstract: A system and method of neuromodulation adjunct (add-on) therapy for coma and traumatic brain injury, comprises an implantable lead-receiver and an external stimulator. Neuromodulation is performed using a pulsed electrical stimulation. The external stimulator contains a power source, controlling circuitry, a primary coil, and predetermined programs. The primary coil of the external stimulator inductively transfers electrical signals to the lead-receiver, which is also in electrical contact with a vagus nerve. The external stimulator emits electrical pulses to stimulate the vagus nerve according to a predetermined program. The predetermined programs have different levels of control, which is password protected. The external stimulator may also be equipped with a telecommunications module to control the predetermined programs remotely.

Abstract: A method and apparatus for developing a database of mean body surface ECG flutter wave data maps for classification of atrial flutter are described. ECG signals from a plurality of torso sites and multisite endocardial recordings are obtained during CCW and CW typical atrial flutter and atypical atrial flutter. Flutter wave episodes are divided into two or three successive time intervals showing stable potential distributions from which data maps are computed. Body surface mapping of CCW and CW typical atrial flutter and atypical atrial flutter is compared with endocardial activation sequence mapping to confirm validity between the body surface ECG pattern and the underlying right or left atrial activation sequence. The body surface ECG map patterns of CCW and CW typical atrial flutter are characterized by a stereotypical spatial voltage distribution that can be directly related to the underlying activation sequence and are highly specific to the direction of flutter wave rotation.

Abstract: An elongated coronary vein lead having a variable stiffness lead body and most preferably adapted to be advanced into a selected coronary vein for delivering a pacing or defibrillation signal to a predetermined region of a patient's heart, such as the left ventricle is disclosed. A method of pacing and/or defibrillating a patient's heart using the lead is also described. The method of pacing or defibrillating the heart includes advancing the coronary vein lead through both the coronary sinus and into a selected coronary vein of a patient's heart, connecting the lead to an electrical pacing source and applying electrical stimulation to a particular chamber of the patient's heart via the implanted lead. The lead includes a variable stiffness lead body that enhances the ability of the lead to be retained in a coronary vein after the lead has been implanted therein.

Abstract: A fetal heart monitoring system and method for detecting and processing acoustic fetal heart signals transmitted by different signal transmission modes. One signal transmission mode, the direct-contact mode, occurs in a first frequency band when the fetus is in direct contact with the maternal abdominal wall. Another signal transmission mode, the fluid propagation mode, occurs in a second frequency band when the fetus is in a recessed position with no direct contact with the maternal abdominal wall. The second frequency band is relatively higher than the first frequency band. The fetal heart monitoring system and method detect and process acoustic fetal heart signals that are in the first frequency band and in the second frequency band.

Abstract: An elongated coronary vein lead having a variable stiffness lead body and most preferably adapted to be advanced into a selected coronary vein for delivering a pacing or defibrillation signal to a predetermined region of a patient's heart, such as the left ventricle is disclosed. A method of pacing and/or defibrillating a patient's heart using the lead is also described. The method of pacing or defibrillating the heart includes advancing the coronary vein lead through both the coronary sinus and into a selected coronary vein of a patient's heart, connecting the lead to an electrical pacing source and applying electrical stimulation to a particular chamber of the patient's heart via the implanted lead. The lead includes a variable stiffness lead body that enhances the ability of the lead to be retained in a coronary vein after the lead has been implanted therein.

Abstract: A system for detecting electrode-tissue contact comprises a multi-electrode catheter having a location sensor and a plurality of contact electrodes. The catheter preferably further comprises a reference electrode that is preferably protected from making contact with tissue. The system further comprises a signal generator to transmit test signals to each of the contact electrodes and to the reference electrode. Tissue contact is detected by comparing the signals across the tip electrode to a return electrode versus the signal across the reference electrode to a return electrode. Ablation energy may be delivered to the contact electrodes if contact of the electrode with tissue is detected.

Abstract: A system which includes a catheter and at least a first and second lead, where the catheter includes an elongate catheter body having at least two lumens through which the first and second leads pass. In one embodiment, the leads are reduced diameter leads having a complete, partial or no stylet lumen. The elongate catheter body further includes a first section and a second section, where there is a transition (e.g., a tapered portion) between the first section and the second section. A first lumen extends through the first section and the second section between a first inlet at the proximal end to a first outlet at the distal end. A second lumen extends through the first section between a second inlet at the proximal end to a second outlet at a point in the first section. In one embodiment, the second outlet is located approximately at the transition between the first section and the second section.

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator or cardioveter of the multisite type, including a circuit for measuring intercardiac impedance. Electrodes are placed in at least one ventricular site and one atrial site, and are connected to a circuit for the collection of cardiac signals, to detect a depolarization potential, as well as to a stimulation circuit, to apply stimulation pluses to at least some of the aforementioned sites. The measurement of a trans-pulmonary bio-impedance is obtained by injecting a current from an injection circuit (16) between the case (18) of the device and a first atrial (RA−) (or ventricular) site, and measuring a differential potential (20) between the case (18) and a point of measurement located in a second atrial (RA+) (or ventricular) site using a collection circuit.

Abstract: An implantable ventricular cardioverter/defibrillator applies a quantity of electrical energy to a heart for terminating a ventricular arrhythmia while preventing the induction of atrial fibrillation. The cardioverter/defibrillator includes a ventricular arrhythmia detector and an atrial pacer that delivers atrial pacing pulses to an atrium of the heart when the ventricular arrhythmia detector detects a ventricular arrhythmia. A generator applies a quantity of electrical energy to the heart in timed relation to a delivered atrial pacing pulse to terminate the ventricular arrhythmia to avoid inducing atrial fibrillation.

Abstract: A method and system for ventricular defibrillation by coordinating the delivery of defibrillation shocks with sensed ventricular fibrillation complexes in a way which improves the probability of success of the defibrillation shock. Ventricular electrical activity is monitored in two ventricular locations during ventricular fibrillation to detect coarse ventricular fibrillation complexes and contractions of the ventricular cardiac tissue. The defibrillation shock is delivered in coordination with the occurrence of coarse ventricular fibrillation complexes and the contractions of ventricular cardiac tissue, and specifically to occur on the up-slope portion thereof, for optimal probability of success.

Abstract: A capture-detection cardiac pacemaker wherein a stimulation success can be reliably detected immediately after stimulation pulse output. The cardiac pacemaker according to this invention generally includes at least one stimulation electrode arranged in the region of the heart designed to output stimulation pulses to the heart, and a control unit connected to a pulse generator for controlling the stimulation pulse output. The control unit is connected to a sensor arranged at the myocardium for checking stimulation success at the heart by detecting the myocardial impedance pattern immediately after a stimulation pulse output and still within the diastolic phase of the heart, and controlling the stimulation pulse output based thereon.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation is disclosed. In accordance with the method, atrial defibrillation shocks are delivered synchronously with an R wave if the current R-R interval meets one or more safety criteria so as to be considered shockable. A shockable R-R interval may be defined as one that exceeds the previous QT interval by a specified therapy margin. In one embodiment, the previous QT interval is estimated based upon the measured preceding R-R interval.

Abstract: A catheter for the introduction into blood vessels having a lumen and guide means arranged therein wherein the guide means include a pre-bent wire (26) displaceable in the longitudinal direction of the catheter (10) and the catheter (10) has at its distal end an exit lock means (38) such that the pre-bent wire (26) can issue from the catheter (10) through the exit lock means (38) at the distal end.