Abstract: The subject invention relates to the detection, diagnosis and risk stratification of clinical events such as acute coronary syndrome, in patients with signs and symptoms of suspected cardiac origin. In one embodiment, a clinical event in a patient is diagnosed by obtaining the patient's ECG, and at least one in vitro diagnostic assay, preferably an assay for a marker of ischemia, and optionally in vitro diagnostic assays for necrotic markers or other cardiac indicators, and combining the foregoing results in an algorithm to provide a diagnosis or a risk stratification of the clinical condition.

Abstract: The invention relates to a heart rate monitor. The essential point of the invention is that a display element (201) of a display (20) of the heart rate monitor for displaying a settable minimum limit for a heart rate level is located at a first end (211) of a display element unit (210) controlled according to the heart rate level, on the same side of the display as the first end of the display element unit. Similarly, a display element (202) for displaying a settable maximum limit for a heart rate level is located at a second end (220) of the display element unit (210), on the same side of the display as the second end of the display element unit.

Abstract: In a programmer for an implantable medical device, a method for operating and controlling a implantable medical device, and in a computer software product, a graphical representation of a quantity influenced by the operation of the medical device is displayed, and parameters relating to the control of the device are associated with portions of the graphical representation. When an operator selects and alters the shape of the displayed graphical representation to illustrate a desired operational effect of the medical device on the quantity, a value associated with the altered shape is automatically modified and communicated to the implanted medical device. The operator thus is able to select parameters on the basis of the intended effect, rather than setting parameter values and then observing the effect.

Abstract: An implantable lead includes a distal portion carrying a tissue stimulating electrode, at least a portion of its outer surface being adapted to stimulate cardiac tissue, wherein the electrode is covered by a pliable, electrically conductive sheath. The sheath is made of an electrically conductive material that does not rely on porosity for electrical charge transfer. The sheath is constructed and arranged to minimize or eliminate tissue ingrowth while passing sufficient electrical energy to stimulate the tissue.

Abstract: The following disclosure describes several methods and apparatus for intracranial electrical stimulation to treat or otherwise effectuate a change in neural-functions of a patient. Several embodiments of methods in accordance with the invention are directed toward enhancing or otherwise inducing a lasting change in neural activity to effectuate a particular neural-function. Such lasting change in neural activity is defined as “neuroplasticity.” The methods in accordance with the invention can be used to treat brain damage (e.g., stroke, trauma, etc.), brain disease (e.g., Alzheimer's, Pick's, Parkinson's, etc.), and/or brain disorders (e.g., epilepsy, depression, etc.). The methods in accordance with the invention can also be used to enhance neural-function of normal, healthy brains (e.g., learning, memory, etc.), or to control sensory functions (e.g., pain).

Abstract: An implantable medical electrical lead particularly for stimulation of the sacral nerves comprises a lead body extending between a distal end and a proximal end, and the distal end having at least one electrode of an electrode array extending longitudinally from the distal end toward the proximal end. The lead body at its proximal end may be coupled to a pulse generator, additional intermediate wiring, or other stimulation device. A fixation mechanism is formed on or integrally with the lead body proximal to the electrode array that is adapted to be implanted in and engage subcutaneous tissue, particularly muscle tissue, to inhibit axial movement of the lead body and dislodgement of the stimulation electrodes. The fixation mechanism comprises a M tine elements arrayed in a tine element array along a segment of the lead proximal to the stimulation electrode array.

Abstract: An implantable cardiac stimulation device comprises a physiologic sensor and one or more pulse generators. The physiologic sensor is capable of sensing a physiologic parameter. The pulse generators can generate cardiac pacing pulses with a timing based on the physiologic parameter. The timed cardiac pacing pulses can prevent a sleep apnea condition. In one example, a cardiac stimulation device has a physiologic sensor and can be configured to pace a patient's heart according to a rest mode of operation. The cardiac stimulation device uses measurements from the physiologic sensor to prevent and treat sleep apnea using a revised rest mode of operation. The revised rest mode operates under a presumption that sleep apnea is primary to a reduced heart rate, rather than secondary, so that pacing at a rate higher than the natural cardiac rate during sleep will prevent sleep apnea.

Abstract: In a handheld piezoelectric acupuncture stimulator with a pen-like, substantially electrically insulating exterior casing (1), at one end of which an actuator button (5) is mounted, while the other end is provided with a contact pin (9), which is connected with a first electrode of a piezoelectric converter, which by means of a spring-loaded impact hammer actuated by the actuator button (5) may be mechanically operated for generation of a high voltage electric pain relieving pulse with a low energy content, the piezoelectric converter with associated electrodes and said impact hammer with associated spring system are mounted in a common electrically insulating interior casing (8) designed for form-fit mounting in the exterior casing (1), whereby the electric connection between the second electrode of the piezoelectric converter and a contact ring (7) on the exterior casing comprises a leaf spring contact (10), which projects through the interior casing (8) and extends between said interior casing and the exte

Abstract: A finishing wire with a ball nose tip is used to secure an implantable device such as a cardiac pacing lead during implantation procedures. The finishing wire includes a proximal shaft, and a ball-nosed distal end. The ball-nosed distal end of the finishing wire is sized to interface with an implantable device having a narrowed distal tip. The length of the finishing wire is greater than the length of the implantable device.

Abstract: A defibrillator circuit that delivers high voltage electrical defibrillation pulses and lower energy pacing pulses to a patient. The circuit includes a current regulator which is operative to control the current level applied to the patient. Control circuitry is provided which permits the current regulator to be disabled in the defibrillation mode of operation prior to application of defibrillation pulses. An H-bridge supplies pulses to the patient and the current regulation is provided serially with the H-bridge such that current is regulated regardless of the polarity of pulses applied to the patient.

Abstract: A method of pacing opposing chambers of a heart with a pacing system is provided. The pacing system comprises a first unipolar medical electrical lead having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator operably connected to the first and second unipolar medical electrical leads. The implantable pulse generator further comprises an hermetically sealed housing capable of serving as a can electrode, and means for switching electrode configurations between the first electrode and the can electrode, between the second electrode and the can electrode, between the first electrode and the second electrode and between the second electrode and the first electrode. A primary electrode configuration is determined.

Abstract: This is a neurostimulator that is configured to treat epilepsy and other neurological disorders using certain stimulation strategies, particularly changing various pulse parameters, during the imposition of a burst of those pulses. The invention includes the processes embodying those stimulation strategies.

Abstract: A communication system is provided which permits of communication between an deployed implantable medical device (IMD) and a large-scale powerful computer capable of manipulating complex nonlinear modeling of physiologic systems, and also capable of accounting for large amounts of historical data from a particular patient or a cohort group for improved modeling and predictive power, which may be expected to lead to improved patient outcomes. A deployed IMD may be polled by a routing instrument external to the host patient, and data may be received by wireless communication. This data may be transmitted to a central large-scale or other relatively powerful computer for processing according to an appropriate model. A treatment or instruction regimen, as well as appropriate firmware or software upgrades, may then be transmitted to the routing instrument for immediate or eventual loading into the IMD via wireless communication.

Abstract: A transvenous implantable medical device adapted for implantation in a body, and which is particularly adapted for use in a vessel such as the coronary sinus or cardiac great vein. The implantable medical device may take the form of a lead or catheter, and includes an extendable distal fixation member such as a helix. In one embodiment, the fixation member is a helix constructed of a shape memory metal or other super-elastic material. Upon deployment, the helix assumes a predetermined helix shape larger than the diameter of the lead body diameter. The helix functions to wedge or fix the lead within the vessel in a manner that does not impede the flow of blood through the vessel. The helix may be retracted for ease of repositioning and/or removal. In one embodiment of the invention, the fixation member may be advanced using a stiffening member such as a stylet. In another embodiment, the helix is coupled to a coiled conductor such that rotation of the conductor extends or retracts the helix.

Abstract: Dynamic overdrive pacing adjustment techniques are described for use in implantable cardiac stimulation devices. In a first technique, an overdrive pacing unit of a microcontroller of the implantable device operates to optimize various control parameters that affect overdrive pacing so as to achieve a desired degree of overdrive pacing for the particular patient in which the stimulation device is implanted. Parameters to be optimized include the number of overdrive beats paced once overdrive pacing is trigged, the overdrive pacing response function, the recovery rate, and various base rates. The control parameters are adjusted in a hierarchical order of priority until the desired degree of overdrive pacing is achieved. Adjustment of the number of overdrive beats, the recovery rate, and various base rates is iteratively performed by using incremental numerical adjustments.

Abstract: The present invention takes the form of a current limiting apparatus and method for limiting current flow, induced when the level of an external signal is greater than an external signal threshold signal level, in a conductive loop formed by a medical device implanted within a living organism having electrically excitable tissue. The system includes an implantable pulse generator (IPG) system having a housing, a signal generator disposed in the housing that generates an electrical signal, and at least one lead extending from the housing to convey electrical signal to the patient. To limit the induced current flow, the IPG includes current limiting componentry, an impedance increasing element, and/or alternating current blocking elements. These components provide an alternating current impedance path to the electrical ground from a lead coupled to the capacitive element. Also disclosed are techniques for reducing the effective surface area of the current inducing loop caused by the IPG system.

Abstract: A system and method provide for detecting atrial arrhythmias within an implantable medical device capable of sensing and pacing at least an atrium of a heart. Arrhythmia of the atrium is detected. In response to detecting atrial arrhythmia, delivery of pacing signals to the atrium is inhibited under certain conditions. While delivery of the pacing signals to the atrium is inhibited, the detected arrhythmia of the atrium is confirmed during a period of further evaluation. Delivery of pacing signals to the atrium is enabled upon ceasing of the atrial arrhythmia. Inhibiting delivery of the pacing signals during atrial arrhythmia evaluation advantageously provides for an increase in the rate at which the detected arrhythmia is confirmed.

Abstract: A body implantable system employs a lead system having at least one electrode and at least one thermal sensor at a distal end. The lead system is implanted within a patient's heart in a coronary vein of the left ventricle. The thermal sensor can be attached to a catheter that is disposed within an open lumen of the lead system. The thermal sensor senses a coronary vein temperature. The coronary vein temperature can be measured at a detector/energy delivery system and used as an activity indicator to adaptively control pacing rate. The measured coronary vein temperature can be also used with a left ventricular flow measurement to determine hemodynamic efficiency of the heart. A detected change in hemodynamic efficiency can be used by the detector/energy delivery system to modify the delivery of electrical pulses to the lead system.

Abstract: A method of obtaining an electrocardiograph (ECG) of a patient located in a turbulent electromagnetic environment. The method includes recovering an ECG signal from a patient. The signal, including added noise, is recovered near the cardiac region as the differential signal resulting from signals delivered by two electrodes forming part of a first measurement loop. The signal further consists of simultaneously recovering from the patient a second measurement signal incorporating at least the noise, as a differential signal resulting from the signals delivered by two electrodes forming part of a second measurement loop distinct from the first measurement loop. Then, the second measurement signal is added or subtracted from the first noisy ECG signal, in real time. The second measurement signal is as a function of the polarity of the noise in the second signal relative to the noise in the first noisy ECG signal.

Abstract: An implantable pulse generator and a method of operation, where the pulse generator is adapted to sense at least a first cardiac signal. Cardiac events are identified in the first cardiac signal, in response to which a blanking interval is started. The blanking interval includes a repeatable noise window blanking interval. When noise is detected during the repeatable noise window blanking interval, the noise window blanking interval is repeated. Depending upon the type of sensed cardiac event (paced or intrinsic) the blanking interval is adjusted to either to a first overall duration or a second overall duration. The second overall duration includes a first timed interval that has a programmable value. The repeatable noise window blanking interval starts after the first timed interval of the second overall duration. The duration of repeated repeatable noise window blanking intervals is summed and compared to a pacing escape interval.