Abstract: Methods of modulating brain neural plasticity, improving memory and learning, improving recovery from traumatic brain injury, preventing epilepsy, treating memory disorders and chronic memory impairment, and treating persistent impairment of consciousness in humans and animals by vagus nerve stimulation are provided. These methods comprise selecting an appropriate human or animal subject and applying to the subject's vagus nerve an electrical stimulation signal having parameter values effective in modulating the electrical activity of the vagus nerve in a manner so as to modulate the activity of preselected portions of the brain.

Abstract: An implantable cardiac stimulation device is provided which alters the stimulation regime during determination of a capture threshold level. In order to avoid the potential for fusion beats which would interfere with a capture threshold level determination, a two-fold approach is used. First, the atrial refractoriness of the atrium of the patient's heart is extended by supplying a secondary atrial stimulation pulse during a prescribed time period following delivery of a primary atrial stimulation pulse. Second, the atrium is overdriven by providing an atrial stimulation pulse at a rate in excess of the intrinsic heart rate. Accordingly, the potential for fusion beats is significantly decreased and the reliability of the determined capture threshold level is increased. In a preferred embodiment, two closely placed stimulation pulses, i.e.

Abstract: An endoscopic infusion needle device includes a catheter within which an injection tube having a distal injection needle is slideably disposed. A proximal actuating handle is coupled to the proximal ends of the catheter and the injection tube, and a distal stopping structure is provided on distal portions of the catheter and the injection tube. In one embodiment, the stopping structures include a rigid elongate skeletal structure occupying a portion of the annular space between the tube and the catheter, and an annular band on the tube which resides within the skeletal structure. The skeletal structure fits tightly within the cannula, allows irrigation fluid to pass through the annular space between the tube and the catheter to exit the distal end of the catheter, prevents the annular band from escaping through the proximal end or the distal end of the skeletal structure, and maintains the tube in substantial axial alignment with the catheter.

Abstract: A system and method for providing patient status feedback via an automated patient care system with speech-based wellness monitoring are described. Device measures are collected through an implantable medical device on a substantially continuous basis from an implant recipient. The device measures are received as physiological measures for storage into a patient care record. The physiological measures include at least one of collected or derived physiological measures. Patient wellness indicators are obtained through voice feedback provided by the implant recipient substantially contemporaneous to the collection of at least one set of the device measures. The voice feedback is processed against a stored speech vocabulary into normalized quality of life measures for storage into the patient care record.

Abstract: In one aspect of the invention, there is provided a method and apparatus for early detection of subacute, potentially catastrophic infectious illness in a premature newborn infant. The method comprises: (a) continuously monitoring heart rate variability in the premature newborn infant; and (b) identifying at least one characteristic abnormality in the heart rate variability that is associated with the illness. This method can be use to diagnose illnesses such as, but not limited to, sepsis, necrotizing enterocolitis, pneumonia and meningitis. In another aspect, there is provided a method and apparatus for early detection of subacute, potentially catastrophic infectious illness in a patient.

Abstract: A system for magnetically assisted surgery includes a magnetic support structure, a patient support structure and a magnet having at least four poles attached to the magnetic support structure so that the magnet provides a near-field magnetic field in an operating region of a patient supported by the patient support structure. The magnet is moveable so that the direction of the magnetic field lines in the operating region is adjustable. The magnet may include a pair of essentially semicircular half-segments permanently magnetized and joined in an extremely stable disk configuration. The magnetic field and gradient field provided by the magnet is such that movement of the disk in one plane combined with rotation of the disk is sufficient to orient the magnetic field during surgical use, thereby reducing interference to medical imaging devices needed during surgery.

Abstract: A method and apparatus for alleviating or preventing hemodynamic collapse by delivering ventricular synchronized atrial pacing under certain conditions precedent to or during delivery of an anti-tachyarrhythmia therapy by an implantable cardioverter/defibrillator (ICD) are disclosed. The atrial pacing mode is preferably the AVT pacing mode, wherein the atria (A) are paced, the ventricles (V) are sensed, and the atrial pacing is triggered (T) by the ventricular sense signals. Alternatively, the ADD pacing mode can be employed if the underlying sinus atrial depolarizations can be sensed occasionally as non-refractory, atrial sense signals and employed to inhibit the delivery of an atrial pace pulse. The VS−AP delay between a ventricular sense (VS) and the delivered atrial pace (AP) pulse synchronization of the atrial pacing pulses can be selected to be a function of the prevailing V-V interval of the VT episode.

Abstract: Method and apparatus for providing on-demand stimulation of the gastrointestinal tract. The apparatus features an implantable pulse generator which may be coupled to the gastric system through one or more medical electrical leads. In the preferred embodiment the leads couple to the circular layer of the stomach. The pulse generator preferably features sensor for sensing abnormalities in gastric electrical activity. The pulse generator further features recognizing the type of gastric abnormality sensed. That is detecting whether gastric arrhythmia, bradygastria, dysrhythmia, tachygastria or retrograde propagation or uncoupling are present. If any of these gastric rhythm abnormalities are detected, then the pulse generator features emitting stimulation pulse trains to the gastric system to treat the detected gastric rhythm abnormalities. The stimulation pulse trains may take many forms and may be emitted for various periods of time.

Abstract: A system and method for identifying and displaying safety alert advisories. The system automatically performs a comparison of identification data with a safety alert advisory. The system stores identification data in a plurality of dedicated fields. Each of dedicated fields contains information related to the patient. Upon the telemetric retrieval of the data by an external programmer, the external programmer automatically cross-correlates the data in the dedicated fields with the safety alert advisories. Upon identification of a match between the data and one of the safety alert advisories, the identified safety alert advisory is displayed to a medical practitioner. In addition, the system provides a dedicated memory to store an advisory flag. The advisory flag is marked when the programmer identifies a safety alert condition that is relevant to one of the dedicated fields.

Abstract: An implantable cardiac stimulation device having an improved multi-level electronic module is disclosed. The multi-level module comprises at least two stacked internal substrates for mounting electronic components within a confined region formed between the two stacked substrates. Placement of the two stacked substrates creates an opening establishing fluid communication between the confined region and an exterior of the electronic module. A polymer dielectric coating, such as parylene, is vapor deposited over the entire electronic module which penetrates the confined region via the opening. The parylene provides enhanced protection against dielectric breakdown between the electronic components and their interconnections thereby enabling smaller separation distances between the electronic components. The parylene also provides support for the electronic components and their interconnections while acting as a moisture barrier and a particle getter.

Abstract: A method for detecting an arrhythmia hidden by rapid pacing in a rate adaptive pacemaker/defibrillator. Unmasking a potential arrhythmia is accomplished by lengthening the pace cycle length by a small amount for a number of cycles followed by a shortening of the pace cycle length for the same number of cycles giving an average pacing rate equivalent to the desired rate. This can occur at all times or only when conditions make arrhythmia masking possible. Changing the pace cycle by a small amount over a number of cycles will move the arrhythmia and paced rhythm out of synchronization. Forcing the pacer to continue sensing the arrhythmia is accomplished by insuring that the pacer's sense refractory is less than one half of the pacing cycle length. This is done by constraining the programming of that value to one half the minimum pacing cycle length or using an adaptive sense refractory period.

Abstract: A method and system for managing cardiac rescue events is disclosed. Unlike prior systems, this method and system uses a rescue scene computer to obtain patient and incident data at the rescue scene and then marry that data with ECG rescue data and automated external defibrillator (AED) rescue data. All of this data is then simultaneously transmitted to a base computer at an emergency medical center for review. Accordingly, a reviewer at the base computer can immediately review the ECG and AED performance in context with patient and incident data. The method and system includes a Windows-based single screen graphical user interface for entering and reviewing the data and particularly includes a window for viewing ECG data simultaneously with entry and review of all other data available in the single screen user interface.

Abstract: An electrotherapy apparatus includes a connecting mechanism coupled between an energy source and a pair of electrodes for contacting a patient. A controller coupled to the energy source configures the energy source to provide a selected one of a plurality of energy levels. The controller actuates the connecting mechanism to couple the energy source to the electrodes. A sensor coupled to the controller measures a parameter or parameters related to the energy delivered to the patient through the electrodes. The controller performs an operation using the output received from the sensor. Based upon the operation, the controller actuates the connecting mechanism to decouple the energy source from the electrodes. In an embodiment of the electrotherapy apparatus, the energy source includes a high voltage power supply for charging a capacitor to a selected one of a plurality of initial voltages.

Abstract: A system for delivery of a medium having ultrasound contrast enhancement agents therein to a patient includes a pressurizing device for pressurizing the medium, a fluid path connecting the pressurizing device to the patient and a concentration sensor in communication with the fluid path. The concentration of the contrast enhancement agents is measured by the concentration sensor during injection of the medium into the patient to assist in controlling the delivery system and/or an imaging procedure.

Abstract: It is important in cardiac pacing devices and systems to achieve efficient power utilization and conservation to extend the life of the battery cells, thereby extending the intervals between invasive medical procedures to replace components in the cardiac pacing system. A pacing supply design has cardiac pacing device comprises a battery, a discrete time switched capacitor pacing power supply comprising a charge transfer capacitor bank comprising at least two capacitors, and a pace output supply capacitor which can discharge current to the tissue of a patient. This invention involves the automatic control of a pacing supply design having a multiplicity of battery voltage multiplication factors and operating frequency settings. The pacing supply, voltage multiplier settings and operating frequency are automatically adjusted to compensate for changing pace output settings, load, cardiac cycle rate, and/or battery condition.

Abstract: A device for occluding a vessel employs one of a number of different expansion members joined to one or more elongate members. The expansion member may include a braid, one or more coils, ribs, a ribbon-like structure, a slotted tube, or a filter-like mesh. If the expansion member is enclosed by a suitable membrane, the device seals with the vessel wall to partially or completely occlude the vessel. A perforated membrane may be used to permit the perfusion of blood. The expansion member may be self-expanding, or it may be expanded by engaging it with one of the elongate members. Alternatively, the expansion member may be expanded by heating it.

Abstract: A method and system for verifying the integrity of normal sinus rhythm (NSR) templates and updating the NSR template after selected time intervals. At selected time intervals after establishing a NSR template, cardiac complexes are sensed and values for one or more cardiac parameters are measured. The values of the cardiac parameters are compared to predetermined value ranges for NSR cardiac complexes. When the values of the cardiac parameters fall within the predetermined value ranges, values for the differences between the values of the cardiac parameters for the cardiac complexes and the values for the cardiac parameters of the NSR cardiac complexes are calculated. When the values of the differences are greater than one or more threshold values, the NSR template is updated as a function of the sensed cardiac complexes.

Abstract: A system and method for automated collection and analysis of patient information retrieved from a medical device adapted to be implanted in a patient for remote patient care is described. A set of collected measures is periodically received from the medical device adapted to be implanted over a communications link which is interfaced to a network server. The collected measures set includes individual measures which each relate to patient information recorded by the medical device adapted to be implanted for an individual patient. The collected measures set is stored into a patient care record for the individual patient within a database server organized to store one or more patient care records. Each patient care record includes a plurality of the collected measures sets. One or more of the collected measures sets in the patient care record for the individual patient is analyzed relative to one or more other collected measures sets stored in the database server to determine a patient status indicator.

Abstract: The invention provides exemplary devices and methods for increasing cardiopulmonary circulation when performing cardiopulmonary resuscitation. In one exemplary method, a patient's chest is actively compressed during a compression phase. At least some of the respiratory muscles are stimulated to contract during a decompression phase to cause an increase in the magnitude and duration of negative intrathoracic pressure during the decompression phase. In this way, the amount of venous blood flow into the heart and lungs is enhanced.

Abstract: A pacemaker having a hysteresis feature which permits intrinsic heart activity, controlled by the sinus node to resume optimally after pacing. The pacemaker has a programmable lower rate and upper rate, a programmable lower hysteresis rate (LRH) corresponding to a lower rate hysteresis interval (LRHI), and a programmable rate (IR) intermediate an upper pacing rate (UR) and a lower pacing rate (LR). A microprocessor measures the average rate of change MAVG in the intervals between consecutive ventricular depolarizations, and compares the last intrinsic escape interval RRN to the lower rate hysteresis interval (LRHI). If the last intrinsic escape interval RRN is longer than the lower rate hysteresis interval (LRHI), and if the value of MAVG is greater than a first preselected value SL1 but less than a second preselected value SL2, the pacemaker stimulates at the lower rate hysteresis (LRH) and thereafter gradually increases the pacing rate up to the intermediate rate (IR).