Abstract: Methods and devices for diagnosis and treatment of cardiac conditions through the pericardial space are disclosed which are particularly suited for performing minimally invasive procedures from the surface of the heart including electrophysiology mapping and ablation, drug delivery, restenosis prevention, stent placement, etc. Some embodiments of a device disclosed herein can also be used advantageously to perform a medical procedure in a selected lumen of a patient's body.

Abstract: The system and method includes a manipulator for manipulating a surgical instrument relative to a patient's body and, a position sensor for sensing the position of the surgical instrument relative to the patient's body. The manipulator can be manually or computer actuated and can have brakes to limit movement. In a preferred embodiment, orthogonal only motion between members of the manipulator is provided. The position sensor includes beacons connected to the patient and manipulator or surgical instrument and, a three dimensional beacon sensor adapted to sense the location and position of the beacons. Redundant joint sensors on the manipulator may also be provided. The system and method uses a computer to actively interact with the surgeon and can use various different input and output devices and modes.

Abstract: A device for preventing clotting during atrial fibrillation includes optional electrical cardiac output forcing (ECOF) or ICD/AED back up. The device includes a power supply for operating the device and for providing the necessary output forcing signals. The power supply is located in a housing which may be implantable into a human patient. In one embodiment, the housing acts as an electrode. At least one additional electrode is connected to the housing and may be inserted into the human heart. A ventricular lead is mounted to the electrode along with an atrial lead. The housing also contains an electrical cardiac stimulator. When a certain cardiac event, such as atrial fibrillation, is detected, anti-clotting pulses are applied to the heart via the atrial lead. If and when ventricular fibrillation is detected, further pulses of a different voltage level are applied to the heart via the ventricular lead. In one embodiment, the anti-clotting pulses are synchronized to the R-wave sensed by the ventricular lead.

Abstract: The present invention relates to methods employing fiberoptic evanescent wave Fourier transform infrared (FEW-FTIR) spectroscopy using fiberoptic sensors operated in the attenuated total reflection (ATR) regime in the middle infrared (MIR) region of the spectrum (850 to 4000 cm−1). The apparatus and method claimed is applied to diagnostics and characterization of noninvasive and rapid (seconds) direct measurements of spectra (in real time) of normal and pathological tissues in vivo, ex vivo and in vitro. The aim of our invention is testing and monitoring of normal skin and various skin tumor tissues at the early stages of their development Furthermore the apparatus and method is suitable for fluid diagnostics, as well as endoscopic and biopsy applications. Specifically the remote diagnostics of normal skin and malignant tissue on the skin surface (directly on patient) can distinguish between normal and malignant skin.

Abstract: A catheter arrangement has an active catheter, positionable in a vessel or organ of an animal, having at least one transducer disposed proximal the catheter tip; and a fixed catheter, also positionable within the animal in the vicinity of the active catheter, carrying a number of reference transducers. A signal processing unit is arranged to selectively operate the transducers to send and receive signals between the active and fixed catheters. The signal processing unit operates to calculate from the received signals at least two independent locations of the active catheter relative to the fixed catheter and to combine the independently calculated locations to provide a weighted average determination of the location in which the relative contributions of the calculated locations to the determined location decrease as their associated error values increase.

Abstract: An implantable defibrillator apparatus having a plurality of defibrillation electrodes which can be applied to the heart muscle in order to apply electric defibrillation shocks thereto, and defibrillation-control means for selectively applying respective electric defibrillation shocks to the electrodes preferably sequentially in time and in synchronism with the QRS.

Abstract: Provided are 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 pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions.

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 collected measures is retrieved from a medical device adapted to be implanted in a patient. The collected device measures set includes individual measures which each relate to patient information recorded by the medical device adapted to be implanted during an initial time period. The collected device measures set is received from the medical device adapted to be implanted over a communications link which is interfaced to a network server. The collected device 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. 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.

Abstract: An elongate medical probe, having proximal and distal ends, whose position is tracked within the body of a subject includes a magnetic-field responsive optical element adjacent to the distal end, which modulates light passing therethrough responsive to an externally-applied magnetic field. The probe also includes a fiberoptic coupled to receive modulated light from the optical element and convey it to the proximal end of the probe for analysis of the modulation.

Abstract: An apparatus and method for photodynamic therapy or photodynamic diagnosis using an illuminator comprising a plurality of light sources generally conforming to a contoured surface and irradiating the contoured surface with substantially uniform intensity visible light. The light sources may comprise generally U-shaped fluorescent tubes that are driven by electronic ballasts. Adjustment of the ballast voltage controls the output power of the tubes. The tubes are supported by a sheet-metal or plastic housing and are covered by a polycarbonate shield which directs cooling airflow within the unit and prevents glass-patient contact in the event of tube breakage. An aluminum reflector located behind the tubes increases both the output irradiance and the uniformity of the output distribution. The spacing of the U-shaped tubes is varied to increase the output at the edges of the illuminator to make the output more uniform. Also, different portions of the tubes are cooled at different amounts, to improve uniformity.

Abstract: A method of analyzing experimentally derived electrocardiograph (ECG) data, and system for practicing said method, which allow tracking of subject cardiac status change and which allow accurate catagorization of subjects into various abnormal and normal classifications is disclosed. The presently preferred embodiment applies an algorithm which compares representative parameter, (eg. root-mean-square (RMS) mean), values derived from analysis of a selected portion of a single cycle of an ECG PQRST waveform obtained from investigation of a subject, to similarly derived representative parameter, (eg. RMS mean and RMS standard deviation), values for a composite ECG waveform present in a compiled data bank derived from (ECG) investigation of numerous subjects who were documented as normals, typically in each of a plurality of frequency range bands.

Abstract: An apparatus for the correction of alterations of the arch of the foot comprises a source of electric current with multiple step waveforms of variable duration and amplitude pulses, said source is connected to electrodes to be placed on the body of the patient to be treated, Detectors of the resistance existing at the ends of said electrodes during the use of the apparatus measuring means and transducers of the data supplied by the detectors and means for processing the resistance parameters obtained produce self-regulation of the generated waveforms. The electrodes are placed on different points of the patient's leg and foot according to the existing alteration. The apparatus allows a method based on electrostimulations with stepped pulse wave forms for treating and healing non-malforming alterations of the foot.

Abstract: A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions.

Abstract: A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions.

Abstract: An in-vitro testing system to assist in optimal programming of an ICD is provided which avoids the inconvenience and health risk associated with repetitive inductions of an arrhythmia. The system includes a high speed computer having analog-to-digital and digital-to-analog subsystems. The system includes software which provides real-time capture and storage of a patient's electrogram. Subsequently, the electrogram may be played and replayed into ICD software simulators at a variety of settings to determine candidate programming parameters. The system further includes an attenuator through which signals are fed on their way to an ICD. This arrangement provides a method by which validation of the simulation system may be achieved. The system also provides for the capture of output event markers simultaneously with the signal into a digital file for assessment of device performance.

Abstract: A holder for a wiring implement, such as a ball-point cartridge, eating implements, such as a fork, a knife or like implement. The holder is arranged for holding the implement (12) and comprises means (5, 6, 8, 9) for vibrating the housing (1) with a frequency in the order of 50 to 100 Hz and an amplitude of the force causing the vibration in the order of 0.3 to 2.5 Newton. Preferably, the frequency and amplitude are adjustable. The vibrating holder enables greatly improved motor control of the implement in question for many patients.

Abstract: In one aspect, 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 method and apparatus for removing tissue from a volume surrounding a region of interest with a body part of a patient is disclosed. The tissue removal volume and location is determined by stereotactic radiography. The size of the tissue removal volume surrounding the region of interest is derived by placing boundaries around the region of interest in each stereotactic radiographic image. A tissue removal tool is moved within the derived tissue removal volume. The tissue in the region of interest which has been previously diagnosed as cancerous can be marked with a radioactive isotope, for example, and the removal of such tissue from the removal volume which surrounds the region of interest can be monitored to determine whether the tissue in the region of interest has been completely removed.

Abstract: There is provided a system and method for determining, in a DDD or DDD(R) pacing system, when a delivered atrial pace pulse has failed to capture the patient's atrium. Each cycle, following a delivered ventricular pace pulse, or every N cycles a measure of change in QT interval is obtained and compared to stored criteria. When an atrial pulse has achieved capture, the difference in QT from the last beat will be small, normally less than 2 ms. However, if there has not been atrial capture, the delivered ventricular pace pulse is in fact asynchronous with respect to the atrium, and under these circumstances the change in QT is greater than 2 ms, e.g., in the range of 2-10 ms. Accordingly, when the pacemaker sees a change in QT within the 2-10 ms range, this indicates failure of capture, and responsive action is taken by either directly incrementing the energy level of the atrial pace pulses, or performing an atrial threshold search and then resetting the atrial pace energy level.