Abstract: A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

Abstract: A reinforced suture sleeve designed to cover and protect a medical lead from physical damage resulting from an over tightened suture is described. The reinforced suture sleeve comprises a metallic tubular insert with at least one slot that cut through the surface of the insert in a spiraled pattern. A biocompatible and pliable polymeric body is molded over the insert. The spiraled cut slot in the metallic tubular insert provides flexibility without degrading structural integrity. An alternate embodiment comprises a polymeric body provided with an embedded fiber mesh made of polymeric fibers, metallic fibers or combinations thereof. The fiber mesh prevents an over tightened suture from cutting through the suture sleeve and damaging the medical lead.

Abstract: Fitting a multi-channel cochlear implant system to an implanted patient is described. A fit map database is accessed that contains parameter data from fit maps of previously measured cochlear implant patients. For subsets of signal channels in each fit map, an average deviation is established between estimated parameter values and measured parameter values across signal channels not in a given subset based on measured parameter values of signal channels in the given subset. For a given number of signal channels, a subset of the same number of signal channels is identified that has a minimum average deviation. Then fit parameters for signal channels in the identified subset are measured and fit parameters for the remaining signal channels not in the identified subset are estimated.

Abstract: The capability to suspend a patient alert relating to a monitored physiologic parameters addresses a need to selectively shut off a patient-alert signal or signals during the time a patient is being treated for an excursion in the parameter. Of course, in general a signal call attention to a patient's a potentially deleterious status or condition for which they should seek medical attention. Once a chronically-implanted monitoring device has detected or provided information about the parameter relative to a desired value, trend, or range and a clinician has been notified and intervened the alert signal is temporarily disabled for a predetermined period. That is, once the notification occurs and alert has served its purpose, the alert mechanism is selectively deactivated while the patient ostensibly begins to gradually correct the monitored physiologic parameter under a caregiver's direction and control. After which time, the alert will reactivate.

Abstract: Various neural stimulator embodiments comprise controller circuitry, neural stimulation output circuitry, sensor circuitry and a memory. The neural stimulation output circuitry is configured to deliver the neural stimulation. The controller circuitry is configured to control stimulation parameters of the neural stimulation delivered by the neural stimulation output circuitry. The sensor circuitry, including at least one sensor, is configured to sense a response to the neural stimulation. The controller is configured to communicate with the sensor circuitry. The memory has instructions stored therein, operable on by the controller circuitry.

Abstract: Methods, devices and systems are provided to efficiently identify, from among a plurality of possible neurostimulation parameter sets, one or more preferred neurostimulation parameter sets that treat a targeted pain of a patient. A plurality of different neurostimulation parameter sets are tested on the patient to thereby identify those tested neurostimulation parameter sets that treat the targeted pain. Each of the tested neurostimulation parameter sets defines an electrode configuration that differs from the other tested neurostimulation parameter sets.

Abstract: Methods and systems are disclosed for analyzing three dimensional orthogonal ECG measurements to assess patient risk of a subsequent cardiac event based on evaluation of cardiac vector values in view of risk factors defined by the invention.

Abstract: A cardiac function variation evaluation apparatus includes: a continuous flow type auxiliary artificial heart 20 connected to a ventricle (10A); a pressure sensor 30 for detecting ventricle (10A) internal pressure; and means (a personal computer 40) for evaluating contractile variation of the ventricle, to which the auxiliary artificial heart 20 is connected, based on internal area APMp of a closed-loop of a relationship between the ventricle internal pressure detected by the pressure sensor 30 and a consumption power of the auxiliary artificial heart 20. Thus, the contractile variation of the ventricle, to which an auxiliary artificial heart is connected, can be continuously evaluated not by use of an ultrasonic echo apparatus or a conductance catheter but by use of a non-invasive method.

Abstract: A method of locating a tip of a central venous catheter (“CVC”) having a distal and proximal pair of electrodes disposed within the superior vena cava, right atrium, and/or right ventricle. The method includes obtaining a distal and proximal electrical signal from the distal and proximal pair of electrodes and using those signals to generate a distal and proximal P wave, respectively. A deflection value is determined for each of the P waves. A ratio of the deflection values is then used to determine a location of the tip of the CVC. Optionally, the CVC may include a reference pair of electrodes disposed within the superior vena cava from which a reference deflection value may be obtained. A ratio of one of the other deflection values to the reference deflection value may be used to determine the location of the tip of the CVC.

Abstract: In general, the disclosure is related to characterization of implanted electrical stimulation electrode arrays using post-implant imaging. The electrode arrays may be carried by implanted leads. Characterization of implanted electrode arrays may include identification of the type or types of leads implanted within a patient and/or determination of positions of the implanted leads or electrodes carried by the leads relative to one another or relative to anatomical structures within the patient. In addition, the disclosure relates to techniques for specifying or modifying patient therapy parameters based on the characterization of the implanted electrode arrays.

Abstract: A delivery system for implanting a biostimulation device comprising a stylet extending along an axis from knob end to a threaded end configured to engage an internally threaded nut of the biostimulation device and a catheter tube configured to axially contain the stylet. The catheter tube comprises a feature that engages a corresponding feature on the biostimulation device whereby the stylet can be rotated relative to the catheter tube for disengagement of the stylet threaded end from the biostimulation device threaded end.

Abstract: An integrated catheter placement system for accurately placing a catheter within a patient's vasculature is disclosed. In one embodiment, the integrated system comprises a system console, a tip location sensor for temporary placement on the patient's chest, and an ultrasound probe. The tip location sensor senses a magnetic field of a stylet disposed in a lumen of the catheter when the catheter is disposed in the vasculature. The ultrasound probe ultrasonically images a portion of the vasculature prior to introduction of the catheter. ECG signal-based catheter tip guidance is included in the integrated system to enable guidance of the catheter tip to a desired position with respect to a node of the patient's heart. Various aspects for visualizing and manipulating display of the ECG signal data acquired via the present system, together with aspects of various ECG sensor configurations, are also disclosed.

Abstract: The invention relates to a multielectrode probe having a silicon substrate which supports multiple conductive electrodes for deep-brain electrical stimulation or recording of neural responses. The substrate has an upper end with multiple conductive portions for bonding to lead wires, and an elongated shank extends from the upper end. The shank supports multiple spaced-apart electrodes, typically ten in number, and conductive traces electrically connect the electrodes and conductive traces. Multiple probes are combined, and supported as an array by a cylindrical alignment cylinder.

Abstract: Apparatus and method for at least partially fitting a medical implant system to a patient is described. These apparatuses and methods comprise using a dynamic mutation rate. This genetic algorithm may comprise generating successive generations of child populations. In executing the genetic algorithm, children may undergo mutations based on a mutation rate. This mutation rate may be dynamic and be based on the characteristics of the children in the generation. Additionally, values may be frozen during execution of the genetic algorithm if the likelihood that the value has converged on a particular value exceeds a threshold.

Abstract: Systems and methods for monitoring the acoustic coupling of medical devices is disclosed. An illustrative system for monitoring the acoustic coupling of an acoustic transducer attached to a patient's body includes a signal generator adapted to supply an electrical signal to the transducer, a circuit configured to measure at least one electrical parameter of the transducer, and a processor adapted to evaluate the degree of acoustic coupling of the transducer to the body based on the measured electrical signal. The processor can measure the frequency response of the acoustic transducer to the electrical signal, a time domain response of the acoustic transducer to the electrical signal, or a combination of both.

Abstract: A modular external defibrillator system in embodiments of the teachings may include one or more of the following features: (a) a base containing a defibrillator module to deliver a defibrillation shock to a patient, (b) a patient parameter monitoring pod connectable to a patient via patient lead cables to collect patient data, the patient data including at least one patient vital sign, (c) a power supply sharing link between the base and the pod, the pod receiving power from the base via the power sharing link, the pod being operable to collect patient data without receiving power from the base, and (d) an external battery charger, the battery charger interrogating the batteries to determine battery information used for battery charging, the battery information including at least one of charging voltage, charging current, and charge time.

Abstract: Methods of locating a tip of a central venous catheter (“CVC”) relative to the superior vena cava, sino-atrial node, right atrium, and/or right ventricle using electrocardiogram data. The CVC includes at least one electrode. In particular embodiments, the CVC includes two or three pairs of electrodes. Further, depending upon the embodiment implemented, one or more electrodes may be attached to the patient's skin. The voltage across the electrodes is used to generate a P wave. A reference deflection value is determined for the P wave detected when the tip is within the proximal superior vena cava. Then, the tip is advanced and a new deflection value determined. A ratio of the new and reference deflection values is used to determine a tip location. The ratio may be used to instruct a user to advance or withdraw the tip.

Abstract: Various aspects of the present subject matter provide a filter module. In various embodiments, the filter module comprises an input, an output, a signal path from the input to the output, a filter and a switch. The filter has a transfer response to attenuate a frequency of a neural stimulation signal. The switch is adapted to place the filter in the signal path when the neural stimulation signal is applied and to remove the filter from the signal path when the neural stimulation signal is not applied. Other aspects are provided herein.

Abstract: The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include an external programmer comprising a user interface that receives user input defining therapy parameter values for delivery of therapy to a patient, and user input associating one or more of the therapy parameter values with a plurality of posture states based on user input, a processor that automatically defines therapy parameter values for delivery of therapy to a patient when the patient occupies the posture states based on the association, and an implantable medical device that delivers the therapy to the patient in response to detection of the posture states.

Abstract: An MRI compatible electrode circuit construct is provided. The construct includes at least two filter components constructed from an electrode wire. One filter component may be a resonant LC filter at or near an electrode/wire interface that resolves the issue of insufficient attenuation by effectively blocking the RF induced current on the wire from exiting the wire through the electrode. The second filter component may include one or more non-resonant filter(s) positioned along the length of the electrode wire that resolve(s) the issue of excessive heating of the resonant LC filter by significantly attenuating the current induced on the wire before it reaches the resonant LC filter. The non-resonant filter(s) may also attenuate the RF current reflected from the resonant LC filter thereby resolving the issue of the strong reflected power from the resonant filter and the associated dielectric heating.