Abstract: Implantable medical devices (IMD) configured for implantation within a recess formed in a cranium of a patient, as well as associated methods, are described. In some embodiments, the IMD includes a top external surface and another adjacent external surface, e.g., a side surface, which are oriented with respect to each other to define an acute angle. A connection module for an electrical lead or catheter may be included on the top external surface. Embodiments of the invention may facilitate implantation of an IMD within a recess formed in the cranium of a patient at a location remote to an incision made in the scalp of the patient.

Abstract: Methods and systems are provided for the circulation of blood using a purge-free miniature pump. In one embodiment, a pump is provided that may comprise a housing including a rotor and a stator within a drive unit. In this embodiment, the pump may establish a primary blood flow through the space between the drive unit and the housing and a secondary blood flow between the rotor and stator. In another embodiment, a pump establishes a primary blood flow outside the housing and a secondary blood flow between the rotor and stator. In yet another embodiment, a method is provided for introducing the pump into the body and circulating blood using the pump.

Abstract: In a method for positioning linear array of electrodes (LAE) mounted on distal end section of elongated flexible member in patient's respiratory airways (PRA) at level of diaphragm, a length of the member pre-determined to position LEA at the level of the diaphragm is inserted through PRA. Signals representative of an electrical activity of the diaphragm (EAdi) are detected through LAE, presence/absence of ECG signal components is detected in EAdi signals, and position of LAE in PRA is detected in response to presence/absence of ECG signal components in EAdi signals. Lower esophageal sphincter activity may be detected in EAdi signals, and position of LAE in PRA determined in response to the detected lower esophageal sphincter. End-expiratory occlusion of PRA may be performed to verify that the electrical activity of the diaphragm coincides with a negative deflection of PRA pressure again in view of determining adequate positioning of LAE.

Abstract: A single-chamber implantable device for detecting a patient's atrial activity using a monobody lead is disclosed. The monobody lead (10) includes a ventricular coil (16), a supraventricular coil (18), a distal electrode (14) forming three electrodes for detecting depolarization signals. A generator (12) of the implantable device collects a first unipolar signal (20) between the ventricular coil and the generator housing and a second unipolar signal (22) between the supraventricular coil and the generator housing. An independent component analysis is performed to the detected depolarization signals to determine an estimated atrial activity signal from the first and second unipolar signals.

Abstract: This disclosure describes a chopper mixer telemetry circuit for use in a wireless receiver. The receiver may be located in an implantable medical device (IMD) or external programmer. The chopper mixer telemetry circuit may include a mixer amplifier that operates as a synchronous demodulator to provide selective extraction of wireless signals received from a transmitter while suppressing out-of-band noise that can undermine the reliability of the telemetry link between an IMD or programmer and another device. The mixer amplifier may utilize parallel signal paths to convert the received telemetry signal into an in-phase (I) signal component and a quadrature (Q) signal component and recombine the I and Q signal components to reconstruct the total signal independently of the phase mismatch between the transmitter and receiver. Each signal path may include a chopper-stabilized mixer amplifier that amplifies telemetry signals within a desired band while suppressing out-of-band noise.

Abstract: An adapter for an endovascular device and a catheter steering device are provided. The adapter for an endovascular device includes a body, a conductive metal ring and a conductive wire. The body includes a first open end, a second open end, a central lumen having a substantially cylindrical surface extending from the first open end to the second open end, and a channel extending from the central lumen to an external opening. The conductive metal ring is attached to the surface of the central lumen, and the conductive wire is coupled to the conductive metal ring and extends through the channel and the external opening. The steering device for a catheter that has a plurality of lumens with spaced distal openings includes a stylet for disposition within one of the plurality of lumens, and a steering member for disposition within a different one of the plurality of lumens.

Abstract: A flexible catheter includes two electrical contacts in a distal region of the catheter and a distal aperture of a hose line. The electrical contacts are connected to a high frequency pulse generator for applying pulsed radio frequency energy for nerve stimulation. A temperature sensor is located in the distal region of the catheter. The flexible catheter is inserted into a region in the spinal canal and the pulsed radio frequency generator is operated, thereby applying pulsed radio frequency energy to a localized region to be treated. The temperature at the distal region of the catheter can also be monitored, and the pulsed radio frequency energy is applied in dependance on the monitored temperature. Further, a position of the catheter is probed by applying a test stimulation signal via the electrical contacts.

Abstract: Methods, devices, and systems induce neuromodulation by focusing a source of stimulation through a skull/brain interface in the form of an aperture formed in the skull, a naturally occurring fenestration in the skull, or a transcranial channel. Methods, devices, and systems identify where to locate skull/brain interfaces, accessories that can be used with the interfaces, and features for controlling stimulation delivered through the interfaces. Multiple indications for the skull/brain interfaces include diagnosis and treatment of neurological disorders and conditions such as epilepsy, movement disorders, depression, Alzheimer's disease, autism, coma, and pain.

Abstract: A current limiter for a defibrillation pulse is powered by the defibrillation pulse and switches the current delivery path open and closed when an excessive current condition exists. The excessive current condition is sensed by a sense resistor of the current limiter. The controlled current is delivered by an inductor which delivers a current which varies in a range about a predetermined current level during excessive current conditions. The current limiter dissipates little energy of the defibrillation pulse so that most of the energy produced by the defibrillator is delivered to the patient.

Abstract: A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator.

Abstract: A particular implantable device may include one or more antennas configured to receive a first far field radiative signal and a second far field radiative signal. The one or more antennas may be configured to receive the first far field radiative signal in a first frequency band and to receive the second far field radiative signal in a second frequency band. The implantable device may include a voltage rectifier configured to rectify the received first far field radiative signal and the received second far field radiative signal to provide a rectified voltage signal. The implantable device may further include a charge storage element operative to receive the rectified voltage signal and to store charge responsive to the rectified voltage signal. The implantable device may also include a therapy delivery unit powered by the charge storage element. The therapy delivery unit may be operative to deliver a therapy to a patient.

Abstract: An implantable medical device includes a housing; at least one module enclosed within the housing and configured to at least one of generate an electrical stimulation therapy for delivery to a patient or monitor a physiological parameter of the patient; one or more feedthroughs extending through the housing; a header assembly including one or more electrical connectors electrically coupled to the module via the feedthroughs; and a preformed gasket compressed between the housing and the header assembly forming a seal to electrically isolate the feedthroughs from an external environment.

Abstract: An implant tool and cannula facilitate the implantation of a medical device into a patient. The implant tool includes a housing that is held by a user and a needle attached to the housing. The cannula may be positioned over the needle and delivered to a target tissue within the patient. The cannula includes an electrode at a distal portion to deliver test stimulation to confirm the location of the target site or placement of the implant tool relative to the target site before removing the needle of the implant tool. In this manner, the cannula may be repositioned within the patient until the position of the implant tool and cannula relative to the target site is verified with the test stimulation.

Abstract: Delivery of peripheral nerve field stimulation (PNFS) in combination with one or more other therapies is described. The other therapy delivered in combination with PNFS may be, for example, a different type of neurostimulation, such as spinal cord stimulation (SCS), or a drug. PNFS and the other therapy may be delivered simultaneously, in an alternating fashion, according to a schedule, and/or selectively, e.g., in response to a request received from a patient or clinician. A combination therapy that includes PNFS may be able to more completely address complex or multifocal pain than would be possible through delivery of either PNFS or other therapies alone. Further, the combination of PNFS with one or more other therapies may reduce the likelihood that neural accommodation will impair the perceived effectiveness PNFS or the other therapies.

Abstract: An implantable medical device (IMD) includes a lead having one or more sensing electrodes and one or more therapy delivery electrodes, and a sensor configured to detect the presence of static and time-varying scan fields in a magnetic resonance imaging (MRI) environment. A controller, in electrical communication with the lead and the sensor, is configured to process signals related to tachycardia events sensed via the one or more sensing electrodes and to deliver pacing and shock therapy signals via the one or more therapy delivery electrodes. The controller compares the sensed static and time-varying scan fields to static and time-varying scan field thresholds. The controller controls delivery of anti-tachycardia pacing and shock therapy signals as a function of the detected tachycardia events, the comparison of the sensed static scan field to the static scan field threshold, and the comparison of the time-varying scan fields to the time-varying scan field thresholds.

Abstract: A method and apparatus is provided for determining whether a current atrial-ventricular (AV) delay during cardiac pacing is appropriate for proper mechanical coupling of the atrium and ventricle. If proper mechanical coupling is determined to not exist, an additional atrial contraction is induced within the same ventricular cycle to maintain atrial-ventricular mechanical coupling.

Abstract: A reliable endocardial map is obtained by constructing a matrix relationship between a small number of endocardial points and a large number of external receiving points using a multi-electrode chest panel. Inversion of the matrix yields information allowing the endocardial map to be constructed. Subsequent maps are obtained noninvasively using the multi-electrode chest panel, applying new electrical signals to the matrix relationship, and again inverting the matrix to generate new endocardial electrical maps.

Abstract: Providing stimulation signals for an implanted auditory prosthesis including receiving first and second sound signals at first and second sound input devices, each of the first and second signals having a signal-to-noise ratio; determining a signal parameter related to said signal-to-noise ratio of each of the first and second signals; selecting one of the first and second signals which has the greater signal-to-noise ratio; and generating stimulation signals for the implanted auditory prosthesis based on said selected sound signal.

Abstract: A header for an active implantable medical device includes a header block body and at least one active connector cavity configured to be attachable to an active lead. A first conductive leadwire has a first and second end, where the first end of the first conductive leadwire is electrically connected to the at least one active connector cavity and the second end of the first conductive leadwire is connectable to a hermetic terminal of the active implantable medical device. At least one abandoned connector cavity is located within the header block body configured to attachable to an abandoned lead. A second conductive leadwire has a first and second end, where the first end of the second conductive leadwire is electrically connected to the at least one abandoned connector cavity and the second end of the second conductive leadwire is connectable to the active implantable medical device housing.

Abstract: A system for stimulation/defibrillation of the left ventricle endocardially or from a vein in the coronary system including: a lead body (10) having a lumen, a distal end (12) with an anchor (14) connectable to a wall of a heart chamber or of a vein of the coronary system, and a proximal side with a connector (22) having a first terminal (26). The lumen of the lead houses a microcable (28) with an active free part (30) that emerges from the distal end. An insert (38) formed on the lead body includes a first electrical connection to the first terminal (26) of the connector, and a coupler selectively movable between (i) a released position wherein the microcable is free to slide in lumen of the lead body, and (ii) a closed position, wherein the microcable is both mechanically immobilized in the lead body and electrically connected to first electrical connection.