Abstract: Template formation methods for use in implantable cardiac rhythm management devices. In an illustrative method, a signal is captured signal an implanted cardiac rhythm management device, and parameters for analysis of the captured signal are then defined. Then, in the example, additional signals can be captured and used to either verify or discard the captured signal defined parameters. The template formation methods provide for creating a robust template to compare with sensed cardiac complexes. Devices and systems configured to perform template formation and verification methods are also shown.

Abstract: Control of defibrillation therapy delivered by implantable medical devices (IMDs) using hemodynamic sensor feedback is disclosed. The hemodynamic sensor feedback allows for increased control over application of atrial defibrillation therapy. Specifically, the therapy is delivered when a fibrillation episode results in a discrete loss of hemodynamic function. Defibrillation therapy is thus withheld for hemodynamically benign arrhythmias.

Abstract: Circuitry for and method of power efficient operation of, and energy recovery from, tissue-stimulating electrodes having high charge capacities. Post-stimulation energy is recovered from the electrodes through a variety of techniques into circuit elements such as other electrodes, an intermediate distribution system, a power supply or any other elements, through the use of sequential switching. Energy is also recoverable from the intermediate distribution system, which preferably is comprised of one or more storage capacitors operating a different voltages. Efficient power transfer among circuit elements is effected by transferring energy while limiting element-element voltage differences and/or voltage differences between the elements and the capacitances of the electrodes.

Abstract: A system and method for monitoring and controlling the therapy of a cardiac rhythm abnormality victim at a remote site by proving immediate access to a medical professional at a central station. The method comprises the steps of: (1) providing a plurality of electrodes for receiving cardiac signals generated by the victim and for the application of electrical pulses to the victim at a remote site; (2) transmitting the signals from the remote site to a central station; (3) receiving the signals at the central station and displaying them for the medical professional; (4) selecting whether to delivery defibrillation or pacing therapy to the victim based on the medical professional's analysis of the signals (5) transmitting the selection results to the remote site; and (6) receiving the selection results at the remote site and applying the selected therapy to the victim.

Abstract: A medically implantable electrical connector includes a housing having a bore with an internal groove therein along with a pin sized for insertion into the housing bore. A film removing spring is disposed in the housing groove dynamic loading of the spring in the groove by the pin causing scraping of film from the groove and pin surfaces to provide lowered electrical resistance therebetween.

Abstract: A method and device are disclosed for neural stimulation with improved power consumption and/or effectiveness. The stimulus generator is arranged, for example via a look up table, to recognize proposed stimuli which will be masked by earlier or simultaneous stimuli. Such masked stimuli are either deleted, or replaced by another stimulus.

Abstract: An electrode arrangement for electrical stimulation of biological material has at least one stimulation electrode via which the biological material can be fed a stimulus signal. Furthermore, a counter electrode is present which forms a counter pole to the stimulation electrode, one sensor electrode is provided with the aid of which it is possible to determine a polarization voltage across the stimulation electrode.

Abstract: Methods and systems are provided for determining an increased likelihood of the occurrence of a cardiac arrhythmia, myocardial ischemia, congestive heart failure and other diseased conditions of the heart associated with elevated sympathetic neural discharges in a patient. The methods and systems comprise monitoring the sympathetic neural discharges of a patient from the stellate ganglia, the thoracic ganglia, or both, and detecting increases in the sympathetic neural discharges. The methods and systems may further comprise delivering therapy to the patient in response to a detected increase in the sympathetic neural discharge, such as delivering one or more pharmacological agents; stimulating myocardial hyperinnervation in the sinus node and right ventricle of the heart of the patient; and applying cardiac pacing, cardioversion or defibrillation shocks.

Abstract: A method and device for delivering ventricular resynchronization pacing therapy in conjunction with electrical stimulation of nerves which alter the activity of the autonomic nervous system is disclosed. Such therapies may be delivered by an implantable device and are useful in preventing the deleterious ventricular remodeling which occurs as a result of a heart attack or heart failure. The device may perform an assessment of cardiac function in order to individually modulate the delivery of the two types of therapy.

Abstract: An implantable medical device includes a dual-use sensor such as a single accelerometer that senses an acceleration signal. A sensor processing circuit processes the acceleration signal to produce an activity level signal and a heart sound signal. The implantable medical device provides for rate responsive pacing in which at least one pacing parameter, such as the pacing interval, is dynamically adjusted based on the physical activity level. The implantable medical device also uses the heart sounds for pacing control purposes or transmits a heart sound signal to an external system for pacing control and/or diagnostic purposes.

Abstract: Improved assemblies, systems, and methods provide an implantable pulse generator for prosthetic or therapeutic stimulation of muscles, nerves, or central nervous system tissue, or any combination. The implantable pulse generator is sized and configured to be implanted subcutaneous a tissue region. The implantable pulse generator includes an electrically conductive case of a laser welded titanium material. Control circuitry is located within the case, the control circuitry including a rechargeable power source, a receive coil for receiving an RF magnetic field to recharge the power source, and a microcontroller for control of the implantable pulse generator. Improved assemblies, systems, and methods also provide a stimulation system for prosthetic or therapeutic stimulation of muscles, nerves, or central nervous system tissue, or any combination.

Abstract: A cardiac monitoring and/or stimulation method and systems provide monitoring, defibrillation and/or pacing therapies, including systems detecting and/or treating cardiac arrhythmia. A system includes a housing coupled to a plurality of electrodes configured for subcutaneous non-intrathoracic sensing. A signal processor receives a plurality of composite signals associated with a plurality of sources, separates a signal from the plurality of composite signals using blind source separation, and identifies a cardiac signal. The signal processor may iteratively separate signals from the plurality of composite signals until the cardiac signal is identified. A method of signal separation includes detecting a plurality of composite signals at a plurality of locations, separating a signal using blind source separation, and identifying a cardiac signal. The separation may include a principal component analysis and/or an independent component analysis.

Abstract: An assembly is provided for an implantable medical lead. The assembly includes a first lead body comprising one or more electrical leads, and a hermetic encasement. The encasement comprises a housing having first and second openings and interior walls, an interior space defined by the interior walls, an electronic network housed within the interior space, and a circuit board extending through the first and second openings. The circuit board comprises a plurality of layers into which the electronic network is at least partially integrated, a first set of one or more terminals electrically coupling the electronic network to the first lead body, and a second set of one or more terminals electrically coupled to the electronic network for external electrical engagement.

Abstract: A method and an arrangement for predicting perioperative myocardial ischemia. Heart rate measurements are carried out for example at night- and day-time before the operation to obtain heart rate data. The heart rate data obtained is carried to a device configured to carry out heart rate variability analysis (HRV). Dynamic heart rate variability analysis is carried out by utilizing fractal analysis of the heart rate data and fractal correlation properties obtained from the measured heart rate data are examined to find considerable lowering of the fractal correlation properties during for example night-time when compared to day-time.

Abstract: A medical monitor is disclosed for implantation in a human body for monitoring biological activity and states as detected by implanted sensors. The medical monitor includes at least one hard disk drive an enclosure surrounding the at least one hard disk drive, and a transmitter and receiver for producing and transmitting signals. The medical monitor is in communication with the sensors, by which information on biological activity and states is stored on the at least one hard disk drive, wherein transmissions are encrypted as encrypted information for security of the user.

Abstract: Exemplary methods for increasing efficiency and/or increasing success of terminating ventricular tachyarrhythmia. An exemplary method includes stimulation of a parasympathetic nerve before, during and/or after delivery of antitachycardia pacing pulses, a cardioversion stimulus and/or a defibrillation stimulus. Various exemplary methods include delivering one or more stimulation pulses during postinspiration. Other methods and/or devices are also disclosed.

Abstract: An implantable medical device which has a sensor that provides a waveform to an energy accumulator, such as a capacitor. The waveform is representative of electrical activity from a nerve. The implantable medical device further includes a threshold detector which provides a discrete output signal when the energy in the signal energy accumulator exceeds a threshold. The signal energy accumulator can be periodically discharged and then recharged during the time period that electrical activity is being sensed from the nerve thereby generating a number of discrete output signals each time the recharged energy accumulator exceeds the threshold. The frequency and number of pulsed outputs is indicative of the sensed electrical activity.

Abstract: In an implantable heart stimulating device, system and method, electrical stimulation pulses are delivered to first and second ventricles of a heart with a variable time interval therebetween, and signals are sensed at two different positions in the heart, from which an impedance value is derived. A minimum value and a maximum value of the impedance value are determined during a heart cycle, and a relationship between the minimum and maximum values also is determined. The time interval is varied and the relationship is monitored over a number of heart cycles. The time interval is set so that the relationship satisfies a predetermined requirement.

Abstract: An implantable lead for use with an implantable medical device includes a lead body with first and second electrical conductors extending between its proximal and distal ends. An electrical connector at the proximal end of the lead body includes terminals electrically connected to the first and second conductors. First and second coaxial active fixation helices are coupled to the lead body's distal end, one being an anode, the other an electrically isolated cathode. Each helix has an outer peripheral surface with alternating insulated and un-insulated portions along its length with about a half of the surface area being insulated. The un-insulated portions of the helices may be formed as a plurality of islands in the insulated portions, or as rings spaced by insulative rings, or as longitudinally extending strips spaced by longitudinally extending insulative strips.

Abstract: A wireless electrode patch and system for measuring the physiological condition of a subject, more particularly to an electrode patch for ECG monitoring, and a method of sensing, analyzing and/or transmitting or relaying a physiological signal. The wireless electrode patch and system is lightweight, compact and reusable. The wireless electrode patch provides a low, power system for extended battery life and use. The wireless electrode patch and system allows for good reliable measurement of physiological signals from the subject. The wireless electrode is simple enough to apply as a single patch but versatile enough to be reconfigured as more than one patch.