Abstract: The present invention generally relates to systems and methods for stimulating tissue using focused energy. In certain embodiments, the invention provides a system for stimulating tissue that includes a first energy source, a second energy source, and a focusing element that focuses at least the first or second energy source so that the first and second energy sources target the same region of tissue such that the combined effect stimulates the tissue.

Abstract: An apparatus for generating focused currents in biological tissue is provided. The apparatus comprises an electric source capable of generating an electric field across a region of tissue and means for altering the permittivity of the tissue relative to the electric field, whereby a displacement current is generated. The means for altering the permittivity may be a chemical source, optical source, mechanical source, thermal source, or electromagnetic source.

Abstract: A method of implanting a spinal cord stimulator lead in the epidural space of a human or animal subject. The method includes discharging a first pressurized fluid through a first lumen in the stimulator lead directly onto a tissue obstruction to form a partial/pilot or full/final opening in the tissue obstruction. If a full opening was not formed sufficient for passage of the stimulator lead, the method further includes inserting a distal-end portion of the stimulator lead into the partial opening and then delivering a second pressurized fluid through a second lumen in the spinal cord stimulator lead and into a balloon for expanding a distensible balloon to clear the tissue obstruction sufficient for passage of the stimulator lead. The method further comprising advancing the stimulator lead past the cleared tissue obstruction and into place for use to deliver therapeutic energy to spinal tissue adjacent the contacts.

Abstract: A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Abstract: An implantable medical device has a housing having a first housing surface side, a second housing surface side opposing the first housing surface side, and an intermediate surface side extending between the first and second housing surface sides. The implantable medical device has an antenna device arranged at the first housing surface side, continuing at the intermediate surface side and further at the second housing surface side. Improved radiation characteristics are obtained in a desired direction.

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Abstract: Methods and systems are disclosed for determining whether a patient is a responder to cardiac resynchronization therapy. The beginning and ending of the intrinsic ventricular depolarization are determined through signals measured from one or more electrodes implanted in the patient's heart. An interval between the beginning and ending of the intrinsic ventricular depolarization is computed and is compared to a threshold. The threshold may be determined empirically. The pacing parameters of a heart stimulation device, such as a pacemaker, may then be configured, for example, by setting the paced atrio-ventricular delay based on whether the patient responds positively to cardiac resynchronization therapy.

Abstract: A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used as a safety check to stop an electrical therapy when it is believed to be potentially harmful to continue the therapy.

Abstract: According to a method and device for modulating intracellular calcium concentration in biological tissue, a stimulation probe is applied to the tissue, a non-excitatory stimulation pulse is generated, and the pulse is conveyed to the stimulation probe. In one embodiment concerning cardiac tissue, a stimulation probe is applied to a patient's heart, a signal is received from at least one sensor responsive to the patient's cardiac muscle activity, a non-excitatory stimulation pulse responsive to the signal is generated, and the pulse is conveyed to the stimulation probe.

Abstract: Methods for intravascularly-induced renal neuromodulation. In some embodiments, a method can include positioning a pair of bipolar electrodes within renal vasculature of a human patient and expanding a balloon within the renal vasculature. The method can further include delivering an electric field via the bipolar electrodes.

Abstract: A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used to evaluate a plurality of parameter values for selecting an approximately optimal parameter value.

Abstract: Methods and apparatus are therefore provided herein for stimulating a desired physiological effect. The methods and apparatus can be used to control micturition, defecation and/or ejaculation. The methods and apparatus also can be used to control pain in the lower pelvic region, for example and without limitation, interstitial cystitis. The methods and apparatus also can be used to increase sexual sensation.

Abstract: An electrocardiogram (ECG) monitoring system configured to determine an index that comprises a set of indicators, where each indicator is indicative of a level of signal quality in an ECG lead. Further, the ECG monitoring system assigns a first indicator from the set of indicators to a first ECG lead signal and communicates the first indicator to a user.

Abstract: A cardiac rhythm management (CRM) system includes a non-invasive hemodynamic sensing device and an implantable medical device to sense a hemodynamic signal and derive one or more cardiac performance parameters from the hemodynamic signal. The non-invasive hemodynamic sensing device includes at least a portion configured for external attachment to a body in which the implantable medical device is implanted. The one or more cardiac performance parameters are used for various diagnostic, monitoring, and therapy control purposes.

Abstract: Certain cardiac arrhythmias can be prevented by appropriate electrical stimulation of autonomic nerves innervating the heart. An implantable cardiac rhythm management device is configured to deliver such stimulation when an autonomic imbalance is predicted to be present via an endovascular electrode. Autonomic imbalance may be predicted to be present based upon circadian rhythms, detected heart rates, or detected heart rate variability.

Abstract: Methods and apparatus for implanting a neural stimulation lead in a patient's body are described. A lead assembly comprises a pointed-tip stylet, a stimulation lead, and an optional tube to deploy a fixation element attached to the lead. One embodiment of the implant methods starts with inserting the pointed-tip lead assembly directly into tissue. After the desired implant position is determined, the pointed-tip component is separated from the stimulation lead and removed from the tissue, leaving the stimulation lead implanted. After confirmation that the stimulation lead is in the right tissue location, the pointed-tip component is removed from the body, leaving the stimulation lead in place. The stimulation lead can be connected to a neurostimulator to delivery therapies to treat neural disorders, such as urinary control disorders, fecal control disorders, sexual dysfunction, and pelvic pain, etc.

Abstract: An implantable electrode array that includes multiple spaced apart electrodes to which current can be individually sourced and sunk. The array includes a carrier that supports the electrodes. One or more control modules that source current to or sink current from the electrodes are disposed in recesses within the carrier. A sheet of material more flexible than the carrier is disposed between, on one side, the carrier and the control modules and, on the other side, the electrodes. Conductors over which instructions and power are applied to the control modules and conductors that extend between the control modules are the electrodes are embedded in and extend through the sheet of flexible material.

Abstract: A cardiac therapy device having a cardiac assist pump, a defibrillation unit, and a control unit, which is connected to the cardiac assist pump and the defibrillation unit to control them. The cardiac assist pump is implemented in case of use to pump blood from a ventricle into an associated artery and thus relieve the respective ventricle. The defibrillation unit is implemented for automatic defibrillation of a ventricular fibrillation and the control unit is implemented to activate the cardiac assist pump and the defibrillation unit in a coordinated manner in case of a ventricular fibrillation such that the cardiac assist pump first increases its performance to initially cause a pressure relief of at least one assisted ventricle in case of use and the defibrillation unit only subsequently delivers a defibrillation shock, when a ventricular pressure relief is provided.

Abstract: Methods and apparatus are provided for treating contrast nephropathy, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

Abstract: A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluting implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.