Abstract: Methods and systems of the present invention provide for measurement of various cardiac parameters. Methods generally involve causing a change in volume and/or pressure in a heart chamber, measuring the change, and calculating at least one cardiac parameter based on the change. Systems typically include at least one actuator, at least one sensor, and a catheter or other device for positioning at least partially in a heart chamber. In some embodiments, the system may also include a controller, such as a computer or other processor, an external actuator, an external sensor, and/or an ECG device. Methods and systems of the invention may be used to more accurately diagnose cardiac conditions in order to make more informed treatment decisions.

Abstract: A cardiac rhythm and function management device configured to automatically adjust stimulation parameters used in delivering cardiac resynchronization therapy. Mechanical contraction intervals are measured using appropriately placed accelerometers and compared with optimum values. The stimulation parameters can then be adjusted accordingly in a manner that moves the mechanical contraction intervals toward their optimum values.

Abstract: An implantable cardiac system has a master pacing unit and a remote satellite pacing unit. The master pacing unit is electrically coupled to a right side of a patient's heart via a lead assembly. The satellite pacing unit is a leadless device mounted on the left side of the patient's heart and is wirelessly controlled by the master pacing unit. The satellite pacing unit is affixed to the heart by one or more mounting members. The base of the satellite unit case has a gel-like material which facilitates adhesion of the pacing unit to the heart tissue. The gel-like material promotes tissue growth to hold the pacing unit in place on the heart. The gel-like material may be composed of polyvinlpyrrolidone and may contain a steroid, such as dimethyl sulfoxide (DMSO), or dexamethazone sodium phosphate.

Abstract: A system and method for treatment of paroxysmal atrial fibrillation by destruction of conductive pathways between the pulmonary veins and the left atrium. A stent is delivered by catheter to the left atrium and to the ostium of a pulmonary vein to be treated. The stent is positioned in the pulmonary vein and is deployed to engage and support the pulmonary vein. The stent prevents stenosis of the pulmonary vein as a result of ablation of tissue. The ablation is produced by a coating of a biologically active material on the stent which destroys tissue or slows electrophyisiologic conduction through the tissue. Alternatively, ablation is performed using RF energy, cryoablation, laser energy, or other ablation techniques.

Abstract: A cochlear implant wherein the return path of the electrode array is located to increase current flow through the modiolus. The return electrode is placed at various locations outside the cochlea, and into the modiolus itself. In addition, the electrode array includes an inflatable membrane that is inflated to anchor the array in position in the cochlea with the electrode contacts pressed into contact with the modiolar wall and allowing the membrane to seal with the surrounding tissue of the cochlea, increasing the longitudinal resistance along the cochlear implant electrode, decreasing shunting of the injected current via scala tympani. In experiments that were conducted the current along the modiolus was determined to be, on average, 2.4 times larger with the return electrode in the modiolus than in an extracochlear location.

Abstract: Method and apparatus for displaying alternans data of an electrocardiogram signal having a plurality of odd beats and a plurality of even beats. The method can include calculating an odd median complex for at least one of the plurality of odd beats, the odd median complex having a plurality of odd data points; calculating an even median complex for at least one of the plurality of even beats, the even median complex having a plurality of even data points; comparing the plurality of odd data points with the plurality of even data points to generate a plurality of difference data points; assigning each one of the plurality of difference data points a color corresponding to an amplitude; displaying the plurality of difference data points as a difference curve; and displaying a plurality of difference curves in a temporal alignment.

Abstract: A minimal intrusive cardiac support apparatus is disclosed which requires only one incision into a main blood vessel or heart chamber. The apparatus includes a pair of generally coaxial and slideably arranged cannulae (one inner and one outer) communicatively coupled to a blood pump for providing right-heart and/or left-heart cardiac support during cardiac surgery. Optional balloons may be mounted on the outside of the inner and outer conduits which can be selectively inflated to seal off the sides surrounding vessel or to deliver cooling fluid or medication to the surrounding tissue. Using the apparatus, a method of pumping blood through the body is also disclosed.

Abstract: An ICD processing system for acquiring breathing pattern signals from intracardiac electrograms obtained from implantable cardiac devices. The system may include both an implantable ICD device and an external processing system. Both the ICD module and the external processing system processing data to generate a representation for the respiration rate for a patient using intracardiac electrogram data obtained by the ICD device. The ICD module and the external processing module communicate with each other to pass collected patient data from the ICD module to the external processing system. The ICD module and the external processing module process the electrogram data to obtain an processed data representation of the respiration data which is used to estimate the respiration rate.

Abstract: An exemplary method includes detecting movement of an in vivo oscillator using one or more in vivo sensors, receiving information from at least one of the one or more sensors, and deciding whether to switch an implanted cardiac therapy device from a lower tier of anti-arrhythmia therapy to a higher tier of anti-arrhythmia therapy based at least in part on the information. An exemplary implantable device includes a micro-electromechanical system (MEMS) capable of measuring acceleration and logic capable of determining postural sway based at least in part on acceleration measured by the MEMS. Various other exemplary methods, devices and systems are also disclosed.

Abstract: To implant a lead system for an implantable cardiac stimulation device, a guide wire is slidably introduced into a longitudinally extending internal passage of an elongated stylet. In turn, the combined stylet and guide wire are slidably introduced into the longitudinally extending lumen of an elongated tubular lead body of flexible resilient insulative material having a thrusting region near its distal end. With the distal end of the stylet in engagement with the thrusting region of the lead, the stylet together with the lead and guide wire are advanced until the lead should encounter a tortuous turn in the vasculature of the body. At this point, the guide wire is advanced through the stylet and into the vasculature until the distal end of the guide wire arrives at a chosen location. The stylet then re-continues its advance together with the lead until the lead reaches the desired implant location.

Abstract: A device for modulating a volume of neural tissue comprising: a cannula having a proximal end, a distal end, and a lumen extending to at least the distal end, an actuator mechanism at least partially disposed in the lumen of the cannula; a plurality of leads having at least one electrode disposed thereon, the plurality of leads being coupled to the actuator mechanism to reciprocate between a retracted position wherein the plurality of leads are radially constrained within the lumen and an extended position; and a guide provided at the distal end of the cannula to deflect the plurality of leads radially outwardly into the neural tissue when the actuator mechanism is moved to the extended position.

Abstract: An implantable medical device (IMD) provides for adaptive timing of the delivery of cardioversion shocks. In particular, the invention IMD provides for an adaptive cardioversion synchronization delay with respect to a cardiac event, such as a sensed P-wave or R-wave. When cardioversion with a first synchronization delay fails to terminate a tachycardia, for example, cardioversion may be attempted again with a second synchronization delay. The IMD may keep track of whether each synchronization delay is effective in terminating the tachycardia, and may employ a historically effective synchronization delay when applying cardioversion therapy to treat a subsequent tachycardia episode.

Abstract: An arrangement 10 for predicting tachyarrhythmia of a heart has a detection means 12 and an evaluation unit 18. The detection means 12 picks up electrical signals from the heart. The evaluation unit 18, which is connected to the detection means, determines a rate value that depends upon the respective heart rate. The evaluation unit also evaluate a plurality of correspondingly determined rates values, to determine a heart rate variability value that depends on the variability of the detected rate values, wherein the evaluation unit 18 responds to a rise in the heart rate variability value.

Abstract: The present invention provides structures and methods for delivering a complex slow-rise defibrillation waveform wherein in lieu of the simple truncation of prior art defibrillation waveforms, when a predetermined amplitude is reached for an ascending waveform (e.g., a ramp waveform), the waveform transitions to an exponential decay portion for a period of time and at the expiration of the period of time, a truncation occurs. In the event that a first complex bi-phasic ramp wave form is implemented, a second opposite polarity waveform may be delivered. Said second waveform is preferably of similar shape to the first waveform, but of a less magnitude amplitude, although the second waveform may comprise a traditional waveform. The implementation and feasibility of the waveforms according to the present invention in an ICD or an AED is relatively simple while providing significant advantages not previously known or used in the prior art.

Abstract: Methods and apparatus for determining T-wave alternan signatures (i.e., morphology and polarity) derived from a physiologic signal representative of a subject's heart activity; assessing changes in the myocardium Action Potential (“AP”) through analysis of the alternan signature derived from a physiologic signal representative of a subject's heart activity; and/or assessing spatial disassociation of alternan characteristics that are likely associated with the initiation of re-entrant arrhythmias.

Abstract: An alterphasic inverting stimulation strategy for use with a multichannel cochlear implant system consumes less power than similar strategies, yet provides better sound quality. The alterphasic inverting strategy is a strategy wherein stimulation pulses are strictly sequential, and wherein the timing and polarity of the channels is chosen such that positive and negative pulses are alternating in time in accordance with a defined pattern that staggers application of the pulses spatially across all the channels and inverts the polarity of pulses that are near each other either spatially or in time.

Abstract: An electrostimulator having electrode connections which are to be connected, at least at times, to a stimulation unit and to a detection unit of the electrostimulator. The stimulation unit is adapted to generate electrostimulation pulses for the stimulation of body tissue and to deliver the electrostimulation pulses to at least one of the electrode connections. The detection unit is adapted to detect successful stimulation of body tissue on the basis of an electrical signal occurring at least one of the electrode connections. The electrostimulator is adapted to record an electrical signal representative of an intracardial electrocardiogram by way of the at least one electrode connection. Arranged between the electrode line connection and the detection unit is a high pass filter with a lower limit frequency of greater than 100 Hz, and the detection unit is adapted to evaluate the high pass-filtered electrical signal.

Abstract: In general, channel occupancy techniques for multi-channel medical device communication are provided. More specifically, techniques are described for maintaining a communication session between an external device and an implantable medical device (IMD) to reduce the potential for conflict with other programmers. A device, such as an external device, includes a transmit module to transmit telemetry signals to an implantable medical device over a communication channel, and a control unit that communicates data to the IMD via the transmit module. The control unit communicates idle messages over the communication channel during gaps within the data communication to the IMD.

Abstract: A method and system for enabling secure communications between an implantable medical device (IMD) and an external device (ED) over a telemetry channel. A telemetry interlock may be implemented which limits any communications between the ED and the IMD over the telemetry channel, where the telemetry interlock is released when the ED transmits an enable command to the IMD via a short-range communications channel requiring physical proximity to the IMD. As either an alternative or addition to the telemetry interlock, a data communications session between the IMD and ED over the telemetry channel may be allowed to occur only after the IMD and ED have been cryptographically authenticated to one other.

Abstract: The present invention provides a novel device for portable percutaneous electrical nerve stimulation and electro-acupuncture. In the preferred embodiment, the device consists of a needle/electrode holder that has a linear electrode/needle guide channel and a power supply channel that intersects with the needle/electrode guide channel and serves for insertion of a pin electrode from an electrical generator (PENS unit). The pin electrode will provide an electrical contact with the needle and at the same time function as means for securing the needle in a desire position in the guide channel. The needle remains straight and the extended portion thereof is kept out of contact with the patient's skin.