Abstract: A medical device is operable to extend and/or retract elements suitable for a particular purpose. The elements are extended and/or retracted in response to a stress applied by way of stretching and/or retracting the device, among other methods. The elements may remain extended and/or retracted or may recoil back to an initial position upon the removal of the force. In various embodiments, the elements are used to treat or deliver treatment to a target site within a body.

Abstract: A medical device comprises a substrate (10) defining a major surface (9) defining a plane, including a plurality of first struts (14) along a first direction interconnected with a plurality of second struts (12) extending along a second direction not parallel with the first direction, wherein widths (11) of the second struts as measured along the major surface are larger than thicknesses of the second struts as measured perpendicular to the major surface such that when the substrate is stretched in the first direction, intermediate sections (15) of the second struts (12) rotate relative to the first struts (14) and the intermediate sections of the second struts bend out of the plane of the major surface. The medical device is operable to extend and/or retract elements suitable for a particular purpose. The elements are extended and/or retracted in response to a stress applied by way of stretching and/or retracting the device, among other methods.

Abstract: A medical device comprises a substrate (10) defining a major surface (9) defining a plane, including a plurality of first struts (14) along a first direction interconnected with a plurality of second struts (12) extending along a second direction not parallel with the first direction, wherein widths (11) of the second struts as measured along the major surface are larger than thicknesses of the second struts as measured perpendicular to the major surface such that when the substrate is stretched in the first direction, intermediate sections (15) of the second struts (12) rotate relative to the first struts (14) and the intermediate sections of the second struts bend out of the plane of the major surface. The medical device is operable to extend and/or retract elements suitable for a particular purpose. The elements are extended and/or retracted in response to a stress applied by way of stretching and/or retracting the device, among other methods.

Abstract: The invention is directed to delivery medical devices that enable consistent “on-demand” delivery of therapeutic agents to a vessel. The medical device of the current invention comprises retractable sheath comprising neckable elements. The medical device of the current invention comprises an expandable member, a hydrophilic coating comprising at least one therapeutic agent about the expandable member or structural layer and a retractable outer sheath with a selectively permeable microstructure. The design and methods disclosed herein ensures that therapeutic agent delivery occurs essentially only during retraction of the outer sheath, minimizing coating and/or therapeutic agent loss to the bloodstream and providing controlled delivery to the treatment site.

Abstract: The invention is directed to eluting medical devices that enable consistent “on-demand” delivery of therapeutic agents to a vessel. The medical device of the current invention comprises an expandable member, a hydrophilic coating comprising at least one therapeutic agent about the expandable member or structural layer and an outer sheath with a variably permeable microstructure. The design and methods disclosed herein ensures that therapeutic agent delivery occurs essentially only during expansion of the expandable member, minimizing coating and/or therapeutic agent loss to the bloodstream and providing controlled delivery to the treatment site.

Abstract: The invention is directed to delivery medical devices that enable consistent “on-demand” delivery of therapeutic agents to a vessel. The medical device of the current invention comprises retractable sheath comprising neckable elements. The medical device of the current invention comprises an expandable member, a hydrophilic coating comprising at least one therapeutic agent about the expandable member or structural layer and a retractable outer sheath with a selectively permeable microstructure. The design and methods disclosed herein ensures that therapeutic agent delivery occurs essentially only during retraction of the outer sheath, minimizing coating and/or therapeutic agent loss to the bloodstream and providing controlled delivery to the treatment site.

Abstract: The invention is directed to eluting medical devices that enable consistent “on-demand” delivery of therapeutic agents to a vessel. The medical device of the current invention comprises an expandable member, a hydrophilic coating comprising at least one therapeutic agent about the expandable member or structural layer and an outer sheath with a variably permeable microstructure. The design and methods disclosed herein ensures that therapeutic agent delivery occurs essentially only during expansion of the expandable member, minimizing coating and/or therapeutic agent loss to the bloodstream and providing controlled delivery to the treatment site.

Abstract: A layered electrode having a large tissue contact area of the portion of the electrode that is electrically active and providing low polarization losses, high pacing impedance and low chronic stimulation voltage. In a fundamental embodiment, the electrode tip has an outer layer of microporous material which is permeable to conductive body fluids which covers a layer of insulating material which is provided with at least one perforation through the thickness of the material. The at least one perforation provides a localized, high current density path. Both of these layers in turn cover the exterior surface of an electrically conductive, preferably metal, electrode body.

Abstract: A clinical programming system is disclosed for use with an implanted cardiac pacemaker to automatically determine the minimum pacing energy which is necessary to evoke an atrial depolarization. The system utilizes a series of pacing pulses of progressively decreasing energies to stimulate the atrium and detects following R-waves. The absence of an R-wave indicates the loss of atrial capture.

Abstract: A clinical programming system for use with an implanted cardiac pacemaker to automatically determine the minimum pacing energy which is necessary to evoke an atrial depolarization. The system utilizes a series of pacing pulses of progressively decreasing energies to stimulate the atrium, and detects an evoked response during the AV delay interval that follows each pulse. Initial P-wave intervals are subjected to morphological analysis to generate a P-wave template. Subsequent intervals are similarly analyzed and the results compared with the template. The absence of similarity with the template indicates the loss of atrial capture and that the minimum pacing energy has been reached.

Abstract: A leadless implantable cardiac arrhythmia alarm is disclosed which continuously assesses a patient's heart function to discriminate between normal and abnormal heart functioning and, upon detecting an abnormal condition, generates a patient-warning signal. The alarm is capable of sensing impedance measurements of heart, respiratory and patient motion and, from these measurements, generating an alarm signal when the measurements indicate the occurrence of a cardiac arrhythmia. Because it requires no external leads or feedthrough connectors, the hermetically-sealed patient alarm is minimally invasive and results in reduced trauma to a patient.

Abstract: A clinical programming system is disclosed for use with an implanted cardiac pacemaker to automatically determine the minimum pacing energy which is necessary to evoke a ventricular depolarization. The system utilizes a series of pacing pulses of progressively decreasing energies to stimulate the ventricle, and detects evoked responses through measurements of the integrals of the R-waves provided by a surface electrocardiogram. Upon loss of capture, the minimum pacing energy is a function of the energy of the last pacing pulse which evoked a ventricular depolarization.

Abstract: A time domain reflectometry (TDR) impedance sensor is provided for measuring body impedance along a lead or catheter implanted in a patient's cardiovascular system. The TDR sensor applies an electrical stimulus to the lead and measures reflections echoed from impedance variations along and distal to the lead, which are superimposed on the applied stimulus. The measured signals may be analyzed with respect to time-of-flight and distance along the lead to detect a plurality of physiologically meaningful signals.

Abstract: A patient-implantable cardiac stimulation apparatus adapted to measure body impedance, derive at least one physiological parameter from the impedance measurement, sample a time sequence of the physiological parameter and transmit the sequence to an external monitoring device for display and analysis. The apparatus may also sense intracardiac electrograms while it is measuring body impedance and deriving the physiological parameter, in which case it formats and transmits a combined intracardiac electrogram and physiological signal to the monitoring device.

Abstract: A method and apparatus for detecting cardiac arrhythmias are disclosed. The detecting method and apparatus sense cardiac electrical signals when the heart is functioning in a known cardiac state, such as a physiologically normal cardiac state, then define and store an array of amplitude windows wherein each sample in the array of amplitude windows corresponds to a sample of the known cardiac signal. Each amplitude window delineates a range of signal amplitudes bracketing the amplitude of the known cardiac electrical signal sample. The array of amplitude windows corresponds in time to periodically occurring known cardiac signal samples occurring within a predetermined time of interest.

Abstract: A method and apparatus for aligning periodic cardiac signal waveforms for the purpose of signal averaging over a number of cardiac cycles. The aligning method and apparatus sense cardiac electrical signals over a number of cardiac cycles, store a template characterizing these signals, reduce the data rate of the same sensed signals by temporal data compression, and store a compressed template sequence. Subsequently, the method and apparatus perform signal averaging by monitoring cardiac electrical signals, storing samples of these signals, temporally compressing these samples and scan correlating the compressed samples with the previously stored compressed template sequence to derive correlation coefficients.

Abstract: A method and apparatus for detecting cardiac arrhythmias in a patient's heart is disclosed. The monitoring method and apparatus sense cardiac electrical signals when the heart is functioning in a known cardiac state, then characterize this known cardiac state by storing a temporally compressed template of time sequence samples. The method and apparatus allow testing during multiple different cardiac states and provide for storage of templates associated with each state. Subsequently, when the heart is functioning in an unknown cardiac state, the method and apparatus monitor cardiac electrical signals by temporally compressing samples and scan correlating these samples with the previously stored template sequences to derive correlation coefficients. The method and apparatus then use these correlation coefficients to characterize cardiac function.

Abstract: A method and apparatus for storing a representation of a cardiac signal by compressing the data using scan correlation and temporal data compression techniques. The method and apparatus sense cardiac signals when the heart is functioning in a known cardiac state, then characterize this known state by storing a temporally compressed template of time sequence samples. The method and apparatus may perform testing for multiple different cardiac states and store templates associated with each state. Subsequently when the heart is functioning in an unknown cardiac state, the method and apparatus monitor cardiac signals by temporally compressing samples and scan correlating these samples with the previously stored templates to derive correlation coefficients. These correlation coefficients are a basis for identifying and classifying cardiac signal waveforms.

Abstract: A rate-responsive pacemaker employing a rate control parameter of respiratory minute volume, derived over a unipolar lead. The pacemaker performs the minute volume measurement by periodically applying a measuring current between the lead and a reference point on the pacemaker case. This measuring current has frequency components in a range from approximately 10 kilohertz to 1000 megahertz. Application of this measuring current allows the pacemaker to detect the voltage which arises from the applied current and, from the detected voltage, to measure the patient's spatial impedance. Spatial impedance and minute volume vary as a function of the patient's pleural pressure. The pacemaker derives minute volume and rate-responsive pacing rate from the spatial impedance measurement.

Abstract: A metabolic demand rate-responsive cardiac stimulation apparatus and method are disclosed which employ multiple physiological rate control parameters, such as respiratory minute volume, patient motion and cardiac stroke volume. The parameters are derived using a single standard pacing lead or transducer. The apparatus and method perform each physiological measurement by periodically applying a measuring current between two points within the apparatus. This measuring current has frequency components in a range of from approximately 10 kilohertz to 1000 megahertz. Application of this measuring current allows the apparatus to detect the voltage which arises from the applied current and, from the detected voltage, to measure the patient's spatial impedance. For a particular measurement, the apparatus controls which physiological parameter is sensed by regulating the frequency content of the measuring current.