Abstract: An implantable electronic tissue stimulating device for providing therapy to a patient is contained within an full metallic case resulting in reduced size, reduced assembly time, reduced parts cost and reduced labor cost, limits the exposure of the patient to possible allergic reactions to medical adhesives and polyurethanes. A hybrid electronic circuit and a battery for powering same are contained within a first portion of the full metal case and a header assembly including a metal header housing, a connector block holder, its lead connector blocks and a feed-through assembly also form a sealed unit. It is inserted into a second portion of the case with feed-through pins connecting the connector blocks to the hybrid. A weld is employed to join the two halves of the outer case together about its perimeter to form a stimulating device package of a smaller size and reduced manufacturing costs.

Abstract: A cast punch and mounting assembly for forming an opening in an orthopedic cast and securing a therapeutic treatment device within the opening adjacent a bone or musculoskeletal injury is provided. The assembly includes a cast punch housing which is fastened to the body surface beneath the cast. The cast punch housing includes a central bore and a guide rod extending outwardly from the central bore. The guide rod extends through the cast. A punch member and a drive member are operably connected to the guide rod and are moveable towards the central bore of the cast punch housing to core an opening in the cast above the central bore. The central bore includes engagement structure to releasably secure a therapeutic treatment device within the central bore of the cast punch housing.

Abstract: An electrode assembly including a tip electrode and a longitudinally extending axially aligned weld electrode egageably receiving a distal end of a coiled wire strand conductor at a proximal end. A connector member includes a fastener having an enlarged head and a threaded shank, the weld electrode includes an integral weld sleeve with an annular locking tab engageable with the enlarged head to prevent longitudinal movement while permitting rotational movement. The weld electrode has an internal bore for receiving an elongated stylet selectively engageable therewith for implanting and explanting the electrode assembly. The tip electrode includes an integral attachment sleeve having an outer peripheral surface extending in a direction away from the tip and having a longitudinally extending tapped bore for engagement with the threaded shank of the connector member. The weld sleeve and attachment sleeve are mutually stepped to prevent their relative rotation when in the locked position.

Abstract: A method and system for detecting nerve status and relative movement between a nerve and a proximity electrode. The method determines relative movement between a nerve and a proximity electrode by applying multiple signals to a calibration electrode where the energy level of each signal induces a predetermined nerve response. The method also applies multiple signals to the proximity electrode where the energy level of each signal also induces a predetermined nerve response. Based on the variation of the energy level of signals required to induce predetermined nerve responses, the method may detect relative movement between a nerve and a proximity electrode and nerve status.

Abstract: A body implantable medical device (IMD) includes a first shell and a second shell whose outer surfaces are biocompatible. The IMD further includes a battery enclosure defined by a cover and all or a portion of the first shell of the IMD housing. The cover of the battery enclosure is disposed between the inner surfaces of the first and second shells and has a greater rigidity than the first shell. An electrochemical cell, such as a flat liquid electrolyte battery, is provided in the battery enclosure. Electronic circuitry, supported on a flexible wiring substrate, is provided between the inner surface of the second shell and the cover of the battery enclosure. A hermetic seal is provided between the cover of the battery enclosure and all or a portion of the first shell. The hermetic seal is preferably a weld joint, such as a butt, spank or standing edge weld joint.

Abstract: A feedthrough connector for an implantable medical device includes a hermetically sealed housing containing an electrical circuit and a tubular barrel with an open end and a closed end defining a tubular channel that protrudes into the sealed housing while maintaining the seal of the housing. The inside of the tubular channel is open to the outside of the sealed housing through the open end and the tubular barrel also has a plurality of circumferentially spaced openings extending between an outer peripheral surface and the tubular channel. An electrical contact assembly electrically in common with the electrical circuit within the housing serves to make electrical contact with an electrical lead axially inserted into the open end of the tubular channel.

Abstract: Methods for failure recovery in a cardiac rhythm management system and apparatus capable of carrying out the methods. The methods include applying a first pacing therapy using one or more leads. The methods further include detecting a failure condition on one or more of the leads, wherein the failure condition prohibits or frustrates application of the first pacing therapy. The methods still further include applying a second pacing therapy using one or more of the leads subsequent to detecting the failure condition. The second pacing therapy is preferably chosen such that the detected failure does not interfere with the second pacing therapy. The second pacing therapy may be applied for only one cardiac cycle. The second pacing therapy may further be applied continuously until the failure condition is resolved, or it may be latched such that physician intervention is required to resume the first pacing therapy.

Abstract: Methods of adjusting output mapping in response to historical signal input data relative to a reference value, and apparatus to perform the methods. The methods are suited for use in adjusting rate-adaptive pacemakers in response to a patient's demonstrated activity relative to a predetermined activity level. The methods include using historical physiologic sensor input to derive a patient's activity. The methods further include tuning a rate-adaptive curve in response to a demonstrated exertion level and a demonstrated exertion time indicative of a breadth and frequency of a patient's activity above some reference value. Pacemakers adapted to perform the methods include a processor, at least one physiologic sensor, a variable-rate pulse generator and a memory for storing historical physiologic sensor data.

Abstract: A system for making anastomoses between hollow structures by mechanical means is provided with a device in the shape of an annular or tubular element comprising circumferentially provided means, such as pin-shaped elements, for joining the abutting walls of the hollow structures together. An applicator is intended for moving said annular or tubular element in position and activating the joining means thereof, so as to make the anastomosis. Possibly, intraluminal joining means can be inserted without using an annular or tubular element.

Abstract: An osmophore-pacifier. The osmophore-pacifier contains an odorant. When the osmophore-pacifier is sucked by an infant, it releases an odor which stimulates sucking behavior in the infant. The osmophore-pacifier includes a nipple, a shield portion, a matrix containing the odorant, and an air channel for releasing the odor. The odorant may be replaced with a different type of odorant in order to determine which odor stimulates continued sucking of the osmophore-pacifier, to promote sucking behavior, and to calm or soothe an infant in a state of agitation or pain.

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: An implantable lead and an improved method of manufacture is disclosed that is highly automated and simplified over prior art techniques. An implantable lead is disclosed having a flexible tubing member, a central coil member having a first portion having differing pitches, and a least one contact sleeve having a through radial hole for receipt of the wire member. A method for manufacture of the lead is disclosed by providing a coil member having a fixed pitch portion and a variable pitch portion, extending at least one filar member radially from the coil member, placing a lead body over the coil member, providing a contact sleeve over a portion of the lead body, the contact sleeve having a slot for receipt of the filar member, and welding the filar member to the contact sleeve.

Abstract: A flexible engaging delivery device (10) for delivery of a vaso-occlusion flexible engaging structure (24) to a vascular target site via a catheter (50) is disclosed comprising a catheter (50) having a lumen (52) and an introducer (48) disposed within the catheter (52). The introducer (48) comprises an outer sleeve (49), a shaft (12) and a wire (16) that is slidably movable within the shaft (12). A wire tip (22) is permanently connected to the wire (16), wherein the wire tip (22) is adapted to contact a matted portion (20) of the vaso-occlusion flexible engaging structure (24) and is used to deliver said flexible engaging structure from said flexible engaging device (10) to a vaso-occlusion target site.

Abstract: An anchor is provided for securing an elongated cylindrical member, such as a lead cable, to surrounding tissue. The anchor has a simple design that allows the anchor to be held in place on, e.g., a lead cable, without the need for sutures. In addition, the anchor may be manipulated to allow the anchor to move along the cylindrical member. Manipulation of the anchor is straight-forward, simple, and does not require tools, yet the anchor is reliably held in place, requiring intentional manipulation to be released. The anchor includes two coaxial sleeves holding the ends of a coaxial spring. As one sleeve is rotated in relation to the other, the spring is twisted, causing the inner diameter of the spring to increase or decrease. Once the inner diameter of the spring is increased to the point that is becomes larger than the outer diameter of the cylindrical member it surrounds, the anchor can slide on the cylindrical member.

Abstract: An implantable cardiac stimulation device has a system and method that monitors progression or regression in a patient's heart disease. A pulse generator delivers pacing pulses to the heart to cause evoked responses of the heart. A sensing circuit senses the evoked responses of the heart and generates evoked response signals. A processor is programmed to analyze the evoked response signals, to isolate a given characteristic of the evoked response signals and to quantify the isolated characteristics to provide corresponding quantized values. Relative changes in the quantized values over time are indicative of the progression or regression in the patient's heart disease. A memory stores the quantized values and a telemetry circuit transmits the stored quantized values to an external receiver for analysis.

Abstract: Apparatus for remodeling in the urinary tract of a human female comprising a remodeling device having a shaft with a profile and with proximal and distal extremities. A handle is secured to the proximal extremity of the shaft. A member is mounted on the distal extremity of the shaft. A plurality of needle electrodes are carried by the distal extremity of the shaft and are disposed circumferentially of the shaft. A pusher is carried by the handle for moving the needle electrodes from a retracted position in which they are within the profile of the shaft and an extended position in which they extend sidewise beyond the profile of the shaft. A pump is connected to the handle for supplying a cooling liquid to the distal extremity of the shaft so that it exits from the shaft in the vicinity of the needle electrodes. An RF generator is coupled to the handle and to the needle electrodes for supplying radio frequency energy to the needle electrodes.

Abstract: An implantation device is disclosed. The implantation device includes a curved main shaft having a first end and a second end, and a removable penetrating tip fitted onto the second end of the main shaft. The implantation device may be used to implant any object, particularly hair follicles, into the epithelium and/or subcutaneous tissue of a patient. A method of implanting an object into the epithelium and/or subcutaneous tissue of a patient is also disclosed.

Abstract: A vibrating pacifier which includes a housing, a nipple, and a massaging unit having a power supply for causing the nipple to vibrate. The power supply in the massaging unit supplies power to a vibrating unit that causes the nipple of the pacifier to vibrate, thus massaging a child's gums. The vibrating unit also provides a humming noise that is soothing to the child.

Abstract: A lead having an extendable and retractable fixation mechanism has a rotating terminal pin at the terminal end which rotates the fixation mechanism at the distal end. As the terminal pin is rotated, the fixation mechanism is extended or retracted from the distal end of the lead. A threaded collar allows for the fixation mechanism to smoothly extend and retract from the lead, and allows for a 1:1 turn ratio between the terminal pin and the fixation mechanism. A fluoroscopic ring disposed at the distal end of the lead provides information during the implantation process.

Abstract: A method for estimating the efficiency of a patient's body, and specifically for estimating the efficiency of a patient's body while undergoing different cardiac therapies. Acceleration and heart rates of the patient are measured while undergoing various therapies. The acceleration—heart rate ratio for each therapy is calculated. The ratios for each therapy are compared and the therapy that has the highest acceleration—heart rate ratio is determined to be the most efficient. The most efficient therapy allows the patient to have the most acceleration with the lowest corresponding heart rate.