Abstract: A neural prosthesis includes a centralized device that can provide power, data, and clock signals to one or more individual neural prosthesis subsystems. Each subsystem may include a number of individually addressable, programmable modules that can be dynamically allocated or shared among neural prosthetic networks to achieve complex, coordinated functions or to operate in autonomous groups.

Abstract: A method for applying a cardiac support device to a heart of a mammal includes surgically accessing a heart, providing a cardiac support device including a jacket, and positioning the jacket around at least a portion of the heart by applying a pulling force to the jacket. The step of positioning the jacket can include using a tool from a position superior to the heart to pull the jacket onto the heart. One device for placing a cardiac support jacket onto the heart includes first and second tubular walls. The second tubular wall is oriented within the first tubular wall and against an internal surface of the first tubular wall. The second tubular wall includes a plurality of grooves and has an open interior volume to hold the cardiac support jacket. Another device for placing a cardiac support jacket onto the heart includes a tubular wall having a plurality of lumens extending between opposite ends of the tubular wall.

Abstract: This document describes systems, devices, and methods for detecting or validating cardiac beats, such as in the presence of myopotential or other noise. In one example, an amplitude peak, which is a candidate for a detected cardiac beat, is used in a weighted average, along with a preceding and subsequent sample. The weighted average is compared to a noise threshold. Based on the result of comparison, the amplitude peak is either deemed an actual cardiac beat, or otherwise is deemed noise. The described systems, devices, and methods improve the accuracy of detecting an actual cardiac beat in the presence of noise, during normal sinus rhythm or during an arrhythmia such as ventricular fibrillation. This, in turn, improves the accuracy with which therapy is delivered or withheld by an implantable cardiac rhythm management device. In one example, such as where the system includes a cardiac signal detector with automatic gain control (AGC) circuitry, the weighted average is normalized.

Abstract: A cardiac pacemaker has an algorithm for dynamic overdrive of a patient's atria in order to suppress atrial tachyarrhythmias. The device further has circuitry for adapting the AV-delay during dynamic overdrive of the atria to a value adapted to the patient's needs.

Abstract: A method and apparatus delivering therapy in an implantable medical device that includes sensing a first cardiac signal and detecting cardiac events via a first electrode configuration, determining the presence of an episode requiring therapy in response to the detected cardiac events, sensing a second cardiac signal via a second electrode configuration, comparing, in response to an episode being present, portions of the second cardiac signal corresponding to the detected cardiac events with a predetermined template, and determining whether to deliver therapy in response to the comparing.

Abstract: An active implantable medical device for cardiac rhythm management, such as a pacemaker, defibrillator, and/or cardioverter, having an improved DDD/AAI operating mode that automatically switches between operating in an AAI and a DDD pacing mode for cardiac rhythm management. This device includes atrial and ventricular detection and stimulation circuits. It can function in a DDD pacing mode or an AAI pacing mode with ventricular detection.

Abstract: An epicardial lead installation tool having an elongated tool body extending between a tool body proximal and distal ends and encloses a tool body lumen. At least one suction pad supported by a suction pad strut extends distally to a distal end surface of the tool body distal end. A lead implantation tool extending between implantation tool proximal and distal ends is inserted through the tool body lumen to dispose the implantation tool distal end proximate to the tool body distal end. The lead implantation tool distal end is adapted to engage the distal electrode head of an epicardial lead to enable the extension of the assembly of the of the lead installation tool, the lead implantation tool and the epicardial lead through a skin incision and to apply the suction pad against the epicardium. Suction is applied through the suction pad to affix it to the epicardium while the implantation tool proximal end is manipulated to affix the distal fixation mechanism to the myocardium at the implantation site.

Abstract: Methods, systems and computer program products for selecting a shock profile for a defibrillator based on patient discomfort to a plurality of different defibrillating shocks include delivering a first defibrillating shock having an associated first shock profile to a patient, and measuring the associated physical displacement of a selected region in the patient. A second defibrillating shock having an associated second shock profile is delivered to the patient, and the associated physical displacement of the selected region in measured. One of the first or second shock profiles is selected based on which shock profile has the lesser amount of measured physical displacement.

Abstract: A method of programming a bionic ear cochlear implant provides access to the full functionality of the implant, while still providing a simple-to-administer, more reliable, and faster fitting experience for the patient and clinician. The method includes (a) conducting a pre-evaluation stage focused on sorting and identifying bad electrode contacts, reducing fitting time and improving patient performance; (b) conducting a programming stage wherein T and M levels are adjusted based on information derived during the pre-evaluation stage; and (c) conducting a post-evaluation stage wherein wired speech understanding tests are automatically run in order to provide an objective programming choice. The pre-evaluation stage automatically runs a set of objective tests, and then, based on the result of such tests, generates a template for the clinician to use during the programming stage. The objective tests, inter alia, identify and remove bad electrode contacts from the template.

Abstract: A method and system for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker in which maximum exertion levels attained by the patient are measured at periodic intervals and stored in order to compute or update a maximum exercise capacity. The slope of the rate-response curve is then adjusted to map an exertion level corresponding to the updated maximum exercise capacity to a maximum allowable pacing rate. In accordance with the invention, a maximum exercise capacity is determined by cross-checking periodic maximum exertion level sensor values with a motion-level sensor value.

Abstract: A non-sheath based medical device delivery system is provided including an elongated tubular guide body having a distal end fixedly attached to a resilient collet with a longitudinal opening to receive a medical lead or other device. The collet may be opened by actuating a retraction member to cause the closing member to slide proximally along the collet shaft, allowing the collet to maintain a normally open position. With the collet closed, the device may be advanced to a desired internal body location by advancing the guide body. The majority of the device body will be exposed, running alongside the guide body, allowing any sensors or electrodes located on the device body to be fully operational during the implantation procedure. The delivery system may be removed by opening the collet, to slidably disengage from the device body.

Abstract: An electrode 4 for detecting a biological signal and a loop antenna 3 are integrally mounted on a support 2 placed on the surface of a living body and a transmitter 5 is placed on the support 2. A biological signal detected on the electrode 4 is input through a connector 11 to electric circuitry 10 of the transmitter 5 and an electric signal processed by the electric circuitry 10 is output through connectors 12 and 13 to both ends of the loop antenna 3 from which the biological signal is emitted to a receiver. At this time, the opening face of the loop antenna 3 is in a direction almost perpendicular to the surface of a living body for improving sensitivity.

Abstract: An automated method for treating tinnitus by habituation through use of neurological feedback, comprising the steps of connecting a subject through a set of attached headphones to an electronic sound player that is connected to a PC workstation presenting sound examples by software to the subject who can refine them by manipulating a series of controllers on the player, making an electronic recording of the sound in a digital music format, storing the recording in the computer, transferring a copy of the electronic sound file to the subject's electronic music player, generating an EEC signature of the subject's brain activity in response to the presented sound, sound using the customized sound to stimulate the auditory system while the brain activity is recorded, wherein the computer continuously monitors for the feedback signatures and drives the sound stimuli appropriately.

Abstract: An implantable medical device that includes a microprocessor that characterizes cardiac activity of a patient to enable the implantable medical device to deliver therapy in response to an identified arrhythmia event. A monitor/controller monitors the characterized cardiac activity and the delivered therapy, and controls activation of triggered overdrive pacing subsequent to the delivered therapy.

Abstract: An improved processing approach is disclosed in order to allow for different rates of stimulation to be used for different electrodes in a multi-electrode cochlear implant. When the incoming signal is processed by filter array (35), each channel is processed to determine amplitude (37) and to estimate the period of the signal in that channel (39). The amplitude and period information is used to determine which electrode is stimulated, and the timing of that stimulation.

Abstract: An implantable medical device system includes an implanted device communicating with an external device via telemetry. The implanted device and the external device each have a telemetry module connected to an antenna system to support a radio-frequency (RF) telemetry link. The antenna system of the external device has a manually or automatically controllable directionality. The controllable directionality is achieved, for example, by using two or more directional antennas, one non-directional antenna and one or more directional antennas, or an electronically steerable phased-array directional antenna.

Abstract: A method for electrically stimulating an area in a spinal disc is presented. The method comprises implanting a lead with one or more electrodes in a placement site in or adjacent to one or more discs at any spinal level from cervical through lumbar, connecting the lead to a signal generator, and generating electrical stimulation pulses using the generator to stimulate targeted portions of the disc. Additionally, a system for relieving pain associated with a spinal disc is presented that comprises a lead with one or more electrodes, an introducer for introducing the lead to a placement site in or adjacent to the disc, a removable stylet for guiding the lead to the placement site in the disc, and a generator connected to the lead for generating electrical pulses to the lead for stimulating the disc.

Abstract: A heart stimulator has a pulse generator which emits stimulation pulses of different amplitudes, which are delivered to a patient's heart via a lead connected to the pulse generator. The pulse generator is controlled by a control unit, in a procedure for determining a stimulation threshold value, to emit stimulation pulses of successively unidirectionally changing amplitudes. Each stimulation pulse is followed by a test pulse having a predetermined high, constant amplitude delivered in a period corresponding to the refractory period after the preceding stimulation pulse. Each test pulse has an amplitude sufficient to capture a non-refractory heart. A measurement unit is connected to the electrode lead, and measures a signal picked up by the lead after each test pulse. The measured signals are supplied to a comparator, which compares the signals following the test pulses with each other.

Abstract: Calibration of adaptive-rate pacing by a cardiac rhythm management system using an intrinsic chronotropic response. The cardiac rhythm management system may include an adaptive-rate pacing device. The adaptive-rate pacing device may include an adaptive-rate sensor module for measuring an activity level of the individual. A monitor module may be coupled to the adaptive-rate sensor module, the monitor module monitoring an intrinsic chronotropic response. A calculator module may be coupled to the monitor module, the calculator module calculating a calibrated parameter for the adaptive-rate pacing device based on the intrinsic chronotropic response. An adjuster module may be coupled to the calculator module, wherein the adjuster module adjusts the adaptive-rate pacing device based on the calibrated parameter. The parameters of the adaptive-rate pacing device adjusted by the adjuster module may include a sensor rate target, a maximum sensor rate, and a response factor.

Abstract: This invention relates to an apparatus and method for making such apparatus for providing controlled and directional stimulation patterns for tissue stimulation. The apparatus may be useful in stimulation nervous tissue in the brain, about the spinal cord, on nerve roots, about peripheral nerves, and in muscles, among others. The apparatus includes a implantable pulse generator connected to a lead. The lead has electrodes placed about a perimeter. In addition, the lead may include electrodes placed longitudinally along the axis of the lead. By applying charge differences between circumferentially distributed electrodes, a smaller stimulation field may be established. In addition, by stimulating between electrodes distributed longitudinally on the same side, a directional flow field may be established. Such leads are especially useful in deep brain stimulation as the region in which a stimulation field is strong enough to produce tissue stimulation is directional and minimized.