Abstract: A drug delivery system and method in which an implantable medical device communicates with and controls an external drug delivery device with low energy potential signals. The implantable device generates potential signals modulated with digitally encoded command information by operating a current source to cause corresponding electrical potentials that can be sensed at the skin surface by the external drug delivery device. The drug delivery device then demodulates the sensed potentials and decodes the digital data to extract command information therefrom to deliver a drug accordingly.

Abstract: A data logging system and method in which an implantable medical device transmits logged data to an external data logging device with low energy potential signals. The implantable device generates potential signals modulated with digitally encoded data by operating a current source to cause corresponding electrical potentials that can be sensed at the skin surface by the external data logging device. The data logging device then demodulates the sensed potentials to derive the digital data and stores the data in a data logging storage medium.

Abstract: A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

Abstract: An antitachyarrhythmia system uses vagal nerve stimulation in combination with one or more additional techniques to lower the defibrillation threshold (DFT). Examples of such additional techniques include using electrical shock waveforms each including a plurality of pulses and using defibrillation electrode configurations each including an electrode placed in the coronary sinus or coronary vein.

Abstract: An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Abstract: A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

Abstract: An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Abstract: A lead for sensing and pacing a left ventricle of the heart includes a lead body having a proximal portion and a distal portion, a lumen extending through the lead body, a conductor extending through the lead body from the proximal end to the distal end and an electrode disposed on the distal portion of the lead body and electrically coupled to the conductor. A distal tip of the lead body is continuously deflectable upon advancement and withdrawal of a stylet through the lumen at the distal portion to access a selected branch of the coronary sinus. The distal tip of the lead body may be offset before or after continuously deflecting the distal tip.

Abstract: According to one embodiment, the present invention includes an elongate implantable medical lead having a distal portion that is relatively flexible, a proximal portion that is relatively stiff, and a transition portion which has a variable transition stiffness. The transition stiffness varies over the length of the transition portion that generally decreases in a distal direction. The relatively stiff proximal portion of the lead gives the lead steerability while the gradual change in stiffness in the transition portion reduces the likelihood that the lead will prolapse when it is guided into a branch vein. The distal stiffness is less than the proximal stiffness giving the lead a safe end that is unlikely to puncture vascular walls and is able to maneuver around various tortuosities when the lead is implanted into a patient.

Abstract: A medical electrical lead employs a load bearing sleeve arrangement. A medical electrical lead includes an outer sleeve, having proximal and distal ends, and is formed of a first material. At least one electrical conductor is situated within the outer sleeve and extends between the proximal and distal ends of the outer sleeve. At least one electrode is electrically coupled to the electrical conductor. A load bearing sleeve extends between the proximal and distal ends of the outer sleeve. The load bearing sleeve is formed of a second material different from the first material. The load bearing sleeve offers resistance to axial loading forces applied to the lead. The load bearing sleeve can be coextensive with the outer sleeve or extend along at least the majority of the length of the outer sleeve.

Abstract: One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

Abstract: A drug delivery system incorporated into a cardiac device for delivering a dose of a drug to a patient upon detection of a particular medical condition. The cardiac device may be, for example, an implantable cardioverter/defibrillator, cardiac pacemaker, or combination device that communicates via a radio frequency link with a drug delivery device. The drug delivery device is preferably an electrically modulated transdermal drug delivery device for delivering the drug transdermally in accordance with a signal received from the cardiac device.

Abstract: A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall.

Abstract: A medical electrical lead employs a load bearing sleeve arrangement. A medical electrical lead includes an outer sleeve, having proximal and distal ends, and is formed of a first material. At least one electrical conductor is situated within the outer sleeve and extends between the proximal and distal ends of the outer sleeve. At least one electrode is electrically coupled to the electrical conductor. A load bearing sleeve extends between the proximal and distal ends of the outer sleeve. The load bearing sleeve is formed of a second material different from the first material. The load bearing sleeve offers resistance to axial loading forces applied to the lead. The load bearing sleeve can be coextensive with the outer sleeve or extend along at least the majority of the length of the outer sleeve.

Abstract: A vascularly stabilized peripheral nerve cuff assembly is provided. One aspect of this disclosure relates to an electrode assembly used in the delivery of neural stimulation therapy. The electrode assembly includes a body adapted to at least partially encompass a blood vessel and a nerve proximate to the blood vessel. The electrode assembly also includes at least one electrode along at least a portion of the body. The at least one electrode is adapted to be electrically connected to a neural stimulator. According to an embodiment, the electrode assembly includes a spacer within the body, the spacer having a first and second end, the first end secured to an inside surface of the body and the second end adapted to pass between the vessel and the nerve and to be secured to the inside surface of the body. Other aspects and embodiments are provided herein.

Abstract: An implantable cardiac device with an exertion level sensor is programmed to determine a heart rate appropriate for a given measured exertion level in accordance with a physiological model and/or previously collected physiologic data. The device then compares the model's heart rate with a measured intrinsic heart rate. Based upon this data, the device is able to recognize changes in the patient's heart rate response and predict or recognize a chronotropically incompetent condition.

Abstract: A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall. A method for implanting the lead into the coronary vasculature is also provided, the method comprising the steps of inserting a stylet into the lead, inserting the lead into the coronary sinus, advancing the lead from the coronary sinus toward the toward the left atrium and into a coronary vein, removing the stylet, and sensing and pacing the heart.

Abstract: A system for selective activation of a nerve trunk using a transvascular reshaping lead is provided. One aspect of this disclosure relates to a system for spreading nerve bundles in a nerve trunk. The system includes a lead adapted to be chronically implanted in a blood vessel proximate a nerve trunk, and having an expandable portion adapted to be expanded to reshape the blood vessel to an elongated shape and to reshape the nerve trunk into an elongated shape to spread nerve bundles of the nerve trunk. The system also includes a plurality of electrodes and an implantable device coupled to the lead, where an electrical signal is delivered from the implanted medical device to one of the plurality of electrodes to transvascularly deliver neural stimulation from the electrode to at least one of the nerve bundles of the nerve trunk. Other aspects and embodiments are provided herein.

Abstract: Method and systems are directed to acquiring and organizing information associated with at least one syncope event. A syncope event may be a suspected syncope event, a verified syncope event or a syncope event that is suspected and verified. Automated processes are used to collect information associated with at least one syncope event and organize the information as a syncope log entry. At least one of acquiring the information and organizing the information is performed at least in part implantably.

Abstract: An apparatus, system, and method may operate to provide a connection signal using a first contact, measure a waveshape associated with a corresponding connection signal arising from the connection signal at a second contact connected to a first electrode using a lead, and provide a comparison result after determining whether the lead is a preselected lead type based on the waveshape.