Abstract: This invention relates to a method for maintaining an electrotherapy device wherein the air temperature of the electrotherapy device environment is monitored and then adjusted based on the results of the monitoring step. The method may be accomplished by using an environmental carrying case. Additionally it is contemplated that air of the environment may be circulated to produce an ambient temperature. Monitoring the temperature may accomplished by using a thermostat or a temperature sensitive switch. In a preferred embodiment, a cooling means is activated when the temperature reaches a threshold temperature between 25° C. and 50° C., more preferably 43° C. The cooling means may be a fan. In a preferred embodiment, a heating means is activated when the temperature reaches a threshold temperature between −10° C. and 20° C., more preferably 0° C. The heating means may be heat strips.

Abstract: There is disclosed a system for monitoring a prenatal condition of a patient and reporting the monitored condition. The system includes a monitor which may be worn by the patient and which generates an electrical signal representing uterine electrical activity of the patient. A microprocessor is configured for analyzing a characteristic of the electrical signal to generate data indicative of the condition and a transmitter transmits the generated data to a receiver, separated from the monitor. The receiver receives the transmitted data and includes a display for displaying the received data.

Abstract: An implantable medical device provides atrial arrhythmia prevention pacing when an interatrial conduction disturbance is detected. The implantable medical device includes a signal processor that detects the interatrial conduction disturbance and a pulse generator circuit coupled to the detector that delivers the atrial arrhythmia prevention pacing pulses to the heart when the processor detects the interatrial conduction disturbance. The interatrial conduction disturbance may be a P-wave duration, a difference between odd and even P-waves, or a predetermined P-wave spectral energy distribution.

Abstract: An intra-aortic balloon pump (IABP) having improved automated electrocardiogram (ECG) based intra-aortic balloon deflation timing. Said IABP capable of automatically determining to either deflate the intra-aortic balloon upon the detection of the next cardiac cycle (non-predictive deflation) or at an earlier point derived from predicting the occurrence of the next cycle (predictive deflation). This automated determination is based upon a quantitative assessment of the performance of the intra-aortic balloon pump in predicting the prevailing cardiac rhythm. The accuracy of deflation based upon beat-to-beat interval prediction is scored relative to actual beat-to-beat interval. Once the cumulative prediction score of a predetermined number of historic beat-to-beat intervals reaches a predetermined threshold for non-predictive deflation, the non-predictive deflation mode is automatically activated. Scoring of beat predictions continues in this mode to signal when to switch back to predictive deflation.

Abstract: Anti-tachyarrhythmia therapy, such as a countershock, is provided to an atrium needing treatment, but delays its delivery for a programmable period of time following an indication of susceptibility to ventricular tachyarrhythmia (VT). This reduces the risk of reinducing VT during a period in which the heart is abnormally metabolically vulnerable to VT, including ventricular fibrillation (VF). The delay time may be independently programmed for different indications of VT, and may be synchronized to and delayed from the R-wave. The delay time may be adjusted, such as to exceed one second, or even to exceed several hours, in order to accommodate the metabolic abnormal susceptibility of the particular patient in the wide range of patients needing treatment of atrial tachyarrhythmias.

Abstract: An interface is associated with a structure which, in use, is deployed in an interior body region of a patient. The structure includes an operative element coupled to a controller, which establishes an operating condition for the operative element to perform a diagnostic or therapeutic procedure in the interior body region. The interface generates a first display comprising an image of the structure at least partially while the operative element performs the procedure. The interface also generates a second display comprising one or more data fields reflecting the operating condition of the controller. The interface enables selection of the first display or the second display for viewing on a display screen.

Abstract: An implantable lead which has an increased resistance to fracture and has the capability of continued function after fracture of a conductor. The lead is provided with a coiled conductor which may be monofilar or multifilar and which extends along the length of the lead, running from an electrical connector at the proximal end of the lead to an electrode at or near the distal end of the lead. In addition, the lead is provided with a stranded conductor which is electrically coupled to the coiled conductor at point along the lead body located proximal to the point of expected breakage of the coiled conductor and at a point along the lead body located distal to the point of expected breakage. The proximal and distal ends of the stranded conductor in some embodiments are also mechanically coupled to the coiled conductor.

Abstract: An implantable medical device determines activity levels over a set of time periods, preferably on the order of seconds, minutes and hours and a display is enabled for days or weeks at recorded activity levels over a range of dates. This enables physical review of patient functional status. Additional physiologic data can be recorded along with the activity data, and this too may be reported out from the implanted device to a medical communications system for alarm purposes, filtrating drugs or other monitoring tasks.

Abstract: A system and method for determining a reference baseline of individual patient status for use in an automated collection and analysis patient care system is described. A set of measures collected from a medical device having a sensor for monitoring at least one physiological measure of an individual patient is received. The collected device measures set includes individual measures which each relate to patient information recorded by the medical device during an initial time period. The collected device measures set are stored into a patient care record for the individual patient within a database organized to store one or more patient care records. The collected device measures set is processed into a set of reference measures. Each reference measure is representative of at least one of measured or derived patient information. The reference measures set is stored into the patient care record as data in a reference baseline indicating an initial patient status.

Abstract: A pulse generator housing for enclosing and containing pulse generator defibrillation circuitry. The housing is formed entirely of electrically conductive metal defining an electrically conductive outer surface which is connected to the pulse generator circuitry for delivering defibrillating energy to the heart. The pulse generator housing is implanted in the pectoral region proximate the heart with the conductive surface facing the heart. Regions of the conductive outer surface may be electrically isolated and dedicated for separately sensing and shocking. The outer surface may be coated with platinum. Additional coiled segment electrodes may extend from the housing and be electrically connected to the conductive outer surface so as to increase the effective conductive surface area.

Abstract: A patient-worn energy delivery apparatus for imparting electrical therapy to the body of a patient responsive to an occurrence of a treatable condition includes a voltage converter for converting electrical energy from an initial voltage to a final voltage, and a defibrillator electrically coupled between the converter and the patient and having an energy reservoir for receiving the electrical energy. The defibrillator produces preshaped electrical pulses such as defibrillation pulses and cardioversion pulses. The apparatus additionally includes an energy delivery controller electrically coupled to the patient and the converter and the defibrillator. The controller causes the converter to provide the electrical energy to the defibrillator at a specific charging rate in response to an energy level in the reservoir. The apparatus may include a plurality of electrodes interposed between the defibrillator and the patient and each electrode preferably has an impedance reducing means contained therein.

Abstract: A baseline wander filter (BWF) with linear phase response for an ECG signal measuring system includes two cascaded box car FIR filters to estimate the baseline wander. The cascaded box car filters form, in effect, a triangular FIR filter that generates a weighted sliding window average of the input samples to serve as the estimated baseline wander. The estimated baseline wander samples generated by the BWF are then subtracted from the corresponding input ECG samples. The boxcar filters can be designed to avoid multiplication by adding the samples and dividing the resulting sum by the number of coefficients. By choosing the number of coefficients as a power of two, binary division can be performed by shifting the bits of the resulting sum to the right. Accordingly, the present invention avoids the relatively large computational load of conventional FIR filter-based systems.

Abstract: A system and method for monitoring a patient status for an individual patient using a reference baseline in an automated collection and analysis patient care system is described. A set of collected measures recorded by a medical device adapted to be implanted in an individual patient is processed into a set of reference measures. The reference measures set is stored into a patient care record as data in a reference baseline indicating an initial patient status. The patient care record is stored within a database server. The collected device measures set includes individual measures which each relate to patient information recorded by the medical device adapted to be implanted throughout an initial time period. Each reference measure is representative of at least one of measured or derived patient information. 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.

Abstract: An apparatus for promoting energy flow in an organism includes a plurality of conductive elements and a dielectric material. The conductive elements are disposed on the dielectric material in a predetermined spatial relationship. The apparatus further includes an overlaying mechanism which supports the dielectric material with the conductive elements across predetermined regions of the organism. The predetermined regions include reflex points where the first conductive element of the conductive elements channelizes energy from a first reflex point in the vicinity of a first meridian in the organism. The first conductive element transmits the energy received from the first reflex point to a second conductive element of the conductive elements. The second conductive element transmits the received energy to a second reflex point in the vicinity of at least one of the first meridian and a second meridian in the organism, whereby healthy flow of energy throughout the organism energy is substantially increased.

Abstract: An over-the-wire balloon dilatation catheter has a stainless steel hypotube catheter shaft, an intermediate sleeve section bonded to the shaft and a distal balloon section connected to the sleeve section. The sleeve section is formed from relatively flexible polymer materials and includes an inner core tube which defines a guide wire lumen extending only through a distal portion of the catheter (including its sleeve and balloon sections) to facilitate fast balloon catheter exchanges. A distal end of the hypotube shaft is crimped laterally and the core tube is nested and bonded within the crimp to provide a proximal outlet for the guide wire lumen. The hypotube shaft provides an inflation lumen for the balloon, with the inflation lumen being continued as an annular inflation lumen through the sleeve section where an outer sleeve is bonded about the core tube and extends from the distal end of the hypotube shaft to the balloon section.

Abstract: Exertion levels of a patient are measured by monitoring signals from adaptive-rate sensors such as an accelerometer and or a minute ventilation sensor; sensor data is collected for conversion into metabolic equivalent measurements. The data obtained can be used to evaluate patient physical activity levels and can be used to assess the patient's condition and change pacing therapy or other treatments accordingly. An automatic adjustment of the adaptive-rate pacing therapy may be based on the activity levels detected by the metabolic equivalent measurements made by the pacemaker.

Abstract: An implantable cardiac device such as a pacemaker or an implantable cardioverter defibrillator (ICD) that stores a broad band electrogram signal in response to the detecting of a particular cardiac event. The system includes an external programmer which is capable of accessing the stored electrogram via a telemetry circuit so that the stored electrogram can be downloaded and reviewed on a display of the external programmer. The external programmer is also equipped with a digital filter emulator that is capable of emulating the filtering of the broad band electrogram signal that is being provided to the processor of the implanted cardiac device. The emulator therefore allows a treating physician to review an emulation of the waveform that the processor of the implanted cardiac device is seeing when the processor is initiating the delivery of therapeutic electrical stimulation to the heart.

Abstract: A marking and tracking apparatus for stereotactic surgery on a body. The apparatus includes a rigid scanning frame. The scanning frame includes a set of scanning markers for making corresponding images in a scanned image of the body, and multiple mounting points, such that when the scanning frame is attached to the body, each of the mounting points mates with a corresponding one of multiples anchors, such as threaded inserts, embedded in the body. The apparatus can also include a rigid tracking frame. The tracking frame includes a set of tracking markers for tracking a position of the frame using a remote sensing device, and multiple mounting points, such that when the tracking frame is attached to the body, each of the mounting points mates with a corresponding one of the anchors embedded in the body.

Abstract: A system for detecting ventricular tachycardia and supraventricular tachycardia using a multiple stage morphology based system. Cardiac signals are sensed from a patient's heart and analyzed for the occurrence of a tachycardia event. When a tachycardia event is detected, the method and system analyzes a plurality of features of the sensed cardiac signals in two or more discrimination stages. Each of the two or more discrimination stages classify the tachycardia event as either a ventricular tachycardia or a candidate supraventricular tachycardia event. When a discrimination stage detects the occurrence of a ventricular tachycardia, therapy is delivered to the heart to treat the ventricular tachycardia.

Abstract: A cardiac rhythm management system predicts when an arrhythmia will occur and in one embodiment invokes a therapy to prevent or reduce the consequences of the arrhythmia. A cardiac arrhythmia trigger/marker is detected from a patient, and based on the trigger/marker, the system estimates a probability of a cardiac arrhythmia occurring during a predetermined future time interval. The system provides a list of triggers/markers, for which detection values are recurrently obtained at various predetermined time intervals. Based on detection values and conditional probabilities associated with the triggers/markers, a probability estimate of a future arrhythmia is computed. An arrhythmia prevention therapy is selected and activated based on the probability estimate of the future arrhythmia.