Abstract: A method of operating an implantable medical device (IMD) includes demodulating a data signal incoming to the IMD, serially storing demodulated data received in the data signal in a first serial buffer register, transferring the received demodulated data to a parallel buffer register from the first serial buffer register, wherein the parallel buffer register operates according to a clock signal having a lower frequency than a clock signal used to operate a serial buffer register, switching the serial storing of demodulated data to a second serial buffer register during the transferring of the received demodulated data to the parallel buffer register, and alternating the serial storing of the received data between the first and second serial buffer registers.

Abstract: A system and method for detecting and treating symptoms of early decompensation utilizing a cardiac rhythm management. The system applies an electrical stimulus to the patient's heart at a first set of pacing parameters including a lower rate limit (LRL) setting, and acquires a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient. An average coronary venous end diastolic pressure (CV-EDP) value is calculated from the CVP signal. The system monitors the average CV-EDP value over a predetermined interval, and dynamically adjusts the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.

Abstract: A system and method for pacing rate control in a cardiac rhythm management (CRM) system. The method includes acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient and generating a CVP waveform from the pressure signal. A pacing stimulus is applied to the patient's heart, and the pacing rate is increased in response to increases in patient's metabolic demand. The CVP index is monitored during the pacing rate increase, and the CRM system detects a reduction in the patient's hemodymanic performance based on the CVP index and establishes a maximum rate setting based on the pacing rate corresponding to the reduction in the patient's hemodynamic performance.

Abstract: The current technology is relevant to a system having a programming device in communication with an implantable medical device, an implantable sensor, and electronic medical records. A user interface is in communication with the programming device, and the user interface is configured to receive an override parameter and override rationale.

Abstract: This document discusses, among other things, a system comprising a sensor signal processor configured to receive a plurality of electrical sensor signals produced by a plurality of sensors and at least one sensor signal produced by an implantable sensor, a memory that includes information indicating a co-morbidity of a subject, a sensor signal selection circuit that selects a sensor signal to monitor from among the plurality of sensor signals, according to an indicated co-morbidity, a threshold adjustment circuit that adjusts a detection threshold of the selected sensor signal according to the indicated co-morbidity, and a decision circuit that applies the adjusted detection threshold to the selected sensor signal to determine whether an event associated with worsening heart failure (HF) occurred in the subject and outputs an indication of whether the event associated with worsening HF occurred to a user or process.

Abstract: A ferrule for an implantable medical device (IMD) can employ stamped metal portion including an electrically-conductive ferrule portion. The stamped ferrule portion can be affixed to a wall of a housing of the IMD. The resulting ferrule can provide cost savings or higher production throughput over a ferrule employing machined ferrule portion.

Abstract: An integrated circuit for an implantable medical device can include a substrate, a first capacitor, and an electrostatic discharge (ESD) protection circuit. The first capacitor can include an electrically conductive lower polysilicon terminal and an electrically conductive upper polysilicon terminal that can be separated from the lower polysilicon terminal by a first capacitor dielectric material. The ESD protection circuit can include an ESD shunt transistor and a second capacitor. The ESD shunt transistor can be configured to be normally off, but can be configured to turn on and conduct between first and second power supply rails in response to an ESD event exceeding a specified ESD event threshold value. The second capacitor can includes a first substrate terminal and an electrically conductive second polysilicon terminal that can be separated from the first substrate terminal by a second capacitor dielectric material.

Abstract: An implantable apparatus can comprise an electrical test energy delivery circuit configured to provide an electrical test signal to a cervical location in a patient body. A detector circuit can use the electrical test signal to detect cervical impedance and generate a cervical impedance signal representing fluctuations in the detected cervical impedance. The implantable apparatus can comprise a therapy delivery circuit, such as configured to provide electrical neural modulation therapy using a neural modulation timing parameter, and a processor circuit that can be coupled to the electrical test energy delivery circuit, the detector circuit, and the therapy delivery circuit.

Abstract: A conductor assembly for an implantable medical device includes a first conductive coil and a second conductive coil co-radial with and electrically isolated from the first conductive coil. The first and second conductive coils each including a plurality of turns. Two or more adjacently wound consecutive turns of the first conductive coil alternate with two or more adjacently wound consecutive turns of the second conductive coil.

Abstract: The invention relates to cardiac rhythm management systems, and more particularly, to rate adaptive cardiac pacing systems and methods. In an embodiment, the invention includes a cardiac rhythm management device. The device can include a pulse generator for generating electrical pulses to be delivered to a heart at a pacing rate, a processor in communication with the pulse generator, and one or more sensors for sensing pulmonary function and cardiac function. The processor can be configured to increase the pacing rate if the pulmonary function is increasing with time and the cardiac function is not decreasing with time, maintain the pacing rate if the pulmonary function is increasing with time and the cardiac function is decreasing with time, and decrease the pacing rate if the respiratory function is decreasing with time.

Abstract: A catheter assembly employs an outer catheter with a pre-formed distal end and an open lumen. An inner catheter having an open lumen and a pre-formed distal end is movably disposed within the outer catheter. Relative rotation and extension of the inner and outer catheters provides the distal end of the catheter assembly with an adjustable range of two- and three-dimensional shapes. The inner catheter can include sections of varying stiffness, such that extension of the inner catheter within the outer catheter modifies the shape of the outer catheter's pre-formed distal end. One or both of the outer and inner catheters includes an occlusion balloon attached to the distal end thereof. The adjustable shaping of the catheter assembly's distal tip provides an improved system for locating and cannulating cardiac venous structures, particularly the coronary sinus via the right atrium.

Abstract: Systems and methods for adapting the performance of a wireless communication link with an implantable medical device (IMD) are disclosed. An illustrative method includes initiating a wireless link with the IMD, measuring an initial performance of the wireless link, determining whether the initial performance of the wireless link is adequate, adjusting an operating parameter related to the wireless link in the event the initial performance of the wireless link is inadequate, measuring a performance of the wireless link in response to the adjusted operating parameter, and setting the operating parameter to a prior setting if the measured performance of the wireless link does not improve in response to the adjusted operating parameter.

Abstract: An apparatus comprises one or more physiological sensing circuits that generate a sensed physiological signal and at least one of the physiological sensing circuits is implantable, a measurement circuit configured to recurrently measure one or more physiological parameters that indicate a status of heart failure of the subject, a comparison circuit configured to compare the one or more physiological parameter measurements to one or more physiological parameter target values, a therapy circuit configured to control delivery of one or more drugs to treat heart failure, and a control circuit in electrical communication with the comparison circuit and the therapy circuit and configured to recurrently adjust delivery of drug therapy according to the comparison of the measured physiological parameters to the physiological parameter targets.

Abstract: Systems and methods for temporarily pacing a patient's heart are provided. One system includes a hemostasis valve with an adjustable electrical connection, the adjustable electrical connection having one or more adjustable contacts. The adjustable contacts have a first, radially expanded configuration and a second, radially constricted configuration. In the radially constricted configuration, the adjustable contacts are configured to pierce through a layer of an elongate medical device that is disposed in the hemostasis valve. The elongate medical device has a distal electrode and a conductor extending along a portion of the elongate medical device. The adjustable contacts pierce through a make contact with the conductor, providing an electrical pathway to the distal electrode. Also provided are vascular access systems including a hemostasis valve and a guide catheter, guide wire torquers with adjustable contacts and methods of temporarily pacing a patient's heart.

Abstract: Methods for modulating nerve function are disclosed. An example method for modulating nerve function may include providing a transgene including a neuron-specific promoter and a gene encoding a light-sensitive protein, delivering the transgene to a body tissue including one or more target neurons, implanting a light source adjacent to the cell bodies of the one or more target neurons, and emitting light from the light source. Light may be exposed to the cell bodies of the one or more target neurons and may cause a conformational change in the light-sensitive protein.

Abstract: Systems, devices and methods for defining, identifying and using health-related significant events are disclosed. One aspect is a programmable device having machine executable instructions for performing a method to assist with managing a patient's health. In various embodiments, at least one previously-defined event is detected based on a number of acquired health-related parameters. The at least one detected event is recorded with an associated time when the at least one detected significant event occurred. An action is triggered based on the at least one detected event. The at least one detected event is displayed with at least one trended health-related parameter in a single display area. Other aspects and embodiments are provided herein.

Abstract: The technology disclosed herein generally relates to a method for providing an index disorder in automated patient care. A set of device measures is stored in a database. Quantitative health care data indicators in the database are provided, where the indicators were regularly recorded by a medical device for a patient under automated patient care. Collected device measures are retrieved with a processor. An index disorder is identified through derived measure determination and statistical calculation with a processor.

Abstract: An implantable electrical lead includes a lead body and a multi-layer coil conductor extending within the lead body. The multi-layer coil conductor includes a first coil layer and a second coil layer disposed about the first coil layer. The first and second coil layers are configured such that the multi-layer coil conductor has an axial stiffness substantially equal to an axial stiffness of the lead body adjacent to the multi-layer coil conductor.

Abstract: This document discusses, among other things, an inductive component that can include a core having two portions: (1) a first portion composed of a first material having a first magnetic saturation level; and (2) a second portion composed of a second material selected to provide inductance for the inductive component when an external magnetic field is greater than the first magnetic saturation level. In an example, the first portion can be composed of a material having a relatively low magnetic saturation level (e.g., a ferrite), and the second portion can be composed of a material having a relatively high magnetic saturation level (e.g., a high permeability iron alloy).

Abstract: A communicator facilitates communications with a remote server via a wireless network supporting a plurality of disparate data transport mechanisms having differing characteristics. A processor coupled to memory is disposed in a communicator housing, which is configured for portability. The memory stores wireless radio firmware and data transfer instructions that are executable by the processor for transferring data to the remote server in accordance with a priority level. The priority level is based in part on criticality of the data and the communicator status. A radio disposed in the housing effects communications via the wireless network in accordance with the firmware. A power source in the housing supplies power for communicator components. The processor executes program instructions for selecting a data transport mechanism among the plurality transport mechanisms based on the priority level, and transmits the data via the wireless network via the radio using the selected transport mechanism.