Abstract: Systems and methods provide for assessing the heart failure status of a patient and, more particularly, to generating a trend parameter based on a distribution of the patient's respiration rate. Systems and methods provide for detecting, using an implantable device or a patient-external device, patient respiration and computing a respiration rate based on the detected patient respiration. A distribution of the respiration rate is calculated, and a trend parameter based on the respiration rate distribution is generated. The trend parameter is indicative of a patient's heart failure status. An output signal indicative of the patient's heart failure status may be generated based on the trend parameter.

Abstract: An apparatus for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling.

Abstract: A neural stimulation system includes a safety control system that prevents delivery of neural stimulation pulses from causing potentially harmful effects. The neural stimulation pulses are delivered to one or more nerves to control the physiological functions regulated by the one or more nerves. Examples of such harmful effects include unintended effects in physiological functions associated with autonomic neural stimulation and nerve injuries caused by excessive delivery of the neural stimulation pulses.

Abstract: A system and method for handling data received from an implantable medical device (IMD) is provided. The method includes communicating a device parameter value of an IMD device parameter from the IMD to an external device and determining, at the external device, that the communicated device parameter value is at an improper value. Additionally, in response to the determining that the communicated device parameter value is at an improper value, automatically performing at least one of re-programming the IMD device parameter with a selected substitute device parameter value, ignoring, or purging non-programmable data.

Abstract: This document discusses capacitive elements including a first, second and third electrode arranged in a stack. The third electrode is positioned between the first and second electrode. An interconnect includes a unitary substrate shared with the first and second electrodes. The interconnect is adapted to deform to accommodate the stacked nature of the first and second electrodes. The unitary substrate includes a sintered material disposed thereon.

Abstract: A system and method provide for systolic interval analysis. In an example, an implantable device measures a cardiac impedance signal. A transformation of the cardiac impedance interval is generated. The device also measures a heart sound signal. A time interval between a point on the transformed signal of the cardiac impedance signal and a point on the heart sound signal is calculated.

Abstract: Methods and systems for media access control allow master and slave nodes of a network to communicate using the same carrier while avoiding collisions of transmissions. At least one slave node is an implantable device. Master nodes initiate all data exchange sequences, and slave nodes are responsive to the data exchange sequences. The exchange sequences begin by master nodes contending for use of the carrier through a countdown procedure. A set order of communications occurs between a master node who won the contention and a slave node being communicated with by the master node to transfer a data frame. Contention is then repeated to determine the next master node that is allowed to transfer a data frame. New master nodes entering the network employ a discovery process to poll for existing devices in the network.

Abstract: A system and method for recording sensing and pacing events in a cardiac rhythm management device. The method may be particularly useful in assessment of pacing parameters for ventricular resynchronization therapy.

Abstract: A cardiac rhythm management system provides for ambulatory monitoring of hemodynamic performance based on quantitative measurements of heart sound related parameters for diagnostic and therapeutic purposes. Monitoring of such heart sound related parameters allows the cardiac rhythm management system to determine a need for delivering a therapy and/or therapy parameter adjustments based on conditions of a heart. This monitoring also allows a physician to observe or assess the hemodynamic performance for diagnosing and making therapeutic decisions. Because the conditions of the heart may fluctuate and may deteriorate significantly between physician visits, the ambulatory monitoring, performed on a continuous or periodic basis, ensures a prompt response by the cardiac rhythm management system that may save a life, prevent hospitalization, or prevent further deterioration of the heart.

Abstract: The present invention provides medical devices that contain polyisobutylene urethane copolymers, polyisobutylene urea copolymers and polyisobutylene urethane/urea copolymers. More particularly, the present invention provides medical leads that contain such copolymer.

Abstract: An apparatus and method for enabling an implanted fractal antenna for radio frequency communications between an implantable medical device and an external device. The fractal antenna may be disposed within or outside of a header assembly of the device housing. Various examples include a three dimensional patterned cylinder usable as a tissue anchor or stent. In another embodiment the antenna may be cast, molded, stamped, punched, milled, laser cut, etched or other methods to form a fractal pattern in conductive media. In another embodiment the antenna may be formed of a printed circuit board (PCB) either with or without an included ground reference plane. In another embodiment the antenna may be formed in a fractal pattern and then wrapped around a part of the implantable device.

Abstract: An apnea classification system provides for apnea monitoring and differentiation based on several sleep apnea related parameters for diagnostic and therapeutic purposes. Monitoring of such sleep apnea related parameters allows the apnea classification system to differentiate among the different types of apnea and hypopnea and to identify an occurrence of periodic respiration. This information may then be used to determine the best method of therapy, or adjust current therapy parameters to more effectively treat a subject.

Abstract: Various system embodiments comprise an implantable lead, an implantable housing, a neural stimulation circuit in the housing, and a controller in the housing and connected to the neural stimulation circuit. The lead has a proximal end and a distal end. The distal end is adapted to deliver neural stimulation pulses to the ventral nerve root and the dorsal nerve root. The proximal end of the lead is adapted to connect to the housing. The neural stimulation circuit is adapted to generate neural stimulation pulses to stimulate the ventral nerve root or the dorsal nerve root using the implantable lead. The controller is adapted to control the neural stimulation circuit to deliver a neural stimulation treatment.

Abstract: Method and systems related to monitoring right ventricular function during pacing by a cardiac rhythm management device are described. One or more pacing parameters are selected to provide cardiac resynchronization therapy. For example, the one or more pacing parameters may be selected to provide an optimal or improved therapy. The heart is paced using the selected pacing parameters. While pacing with the selected parameters, pressure is sensed via a pressure sensor disposed the pulmonary artery. The sensed pressure is analyzed to determine right ventricular function achieved during the pacing using the selected pacing parameters. A signal, such as an alert signal or control signal, is generated based on the right ventricular function achieved during the pacing.

Abstract: A system and method for providing diagnosis and monitoring of congestive heart failure for use in automated patient care is described. At least one recorded physiological measure is compared to at least one other recorded physiological measure on a substantially regular basis to quantify a change in patient pathophysiological status for equivalent patient information. An absence, an onset, a progression, a regression, and a status quo of congestive heart failure is evaluated dependent upon the change in patient pathophysiological status.

Abstract: A lead assembly includes a ring component having mechanical coupling features, and at least one polymer component mechanically coupled with the mechanical coupling features of the ring component. Elongate tubing is disposed over the polymer component and is secured with the polymer component.

Abstract: Methods and systems involve adjusting an energy used for safety pacing based on the capture threshold. The safety pacing energy may be adjusted prior to a capture threshold test. During the capture threshold test, backup safety paces are delivered using the adjusted pacing energy. Following suspension of automatic capture verification, the device may enter a suspension mode. During the suspension mode, safety pacing pulses are delivered using a pacing energy adjusted based on capture threshold.

Abstract: An event-based approach to collecting and organizing information associated with events affecting respiration is presented. The detection or prediction of an event affecting the respiration of a patient initiates acquisition of information associated with the event. The respiratory logbook system acquires information associated with the event during the event and during intervals proximate in time to the event. The information is organized as a respiratory log entry. The user can access the information by operating a user interface. The information may be presented in textual or graphical form.

Abstract: Systems and methods for pacing the heart using resynchronization pacing delays that achieve improvement of cardiac function are described. An early activation pacing interval is calculated based on an optimal AV delay and an atrial to early ventricular activation interval between an atrial event and early activation of a ventricular depolarization. The early activation pacing interval for the ventricle is calculated by subtracting the measured AVEA from the calculated optimal AV delay. The early activation pacing interval is initiated responsive to sensing early activation of the ventricle and pacing is delivered relative to expiration of the early activation pacing interval.

Abstract: Various method embodiments of the present invention concern sensing patient-internal pressure measurements indicative of physiological exertion, identifying one or more steady state periods of physiological exertion based on the patient-internal pressure measurements, sensing extra-cardiac response data and cardiac response data corresponding to the one or more physiological exertion steady state periods, respectively comparing the extra-cardiac response data and the cardiac response data to extra-cardiac response information and cardiac response information associated with equivalent levels of physiological exertion intensity of the one or more steady state periods, and determining the likelihood that myocardial ischemia occurred during the one or more steady state periods based on the comparison of the extra-cardiac response data to the extra-cardiac response information and the cardiac response data to the cardiac response information.