Abstract: A system and device are provided which include a gene regulatory system controlling expression of one or more expression cassettes present in or released by the device, by emitting one or more stimulations. An expression cassette includes a regulatable transcription control element that is responsive to the emitted stimulations linked to an open reading frame of interest. The system optionally includes a sensor to sense a parameter indicative of a need, a telemetry module to receive an external command, or a programmable device, for regulating gene expression of the open reading frame.

Abstract: Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.

Abstract: A stimulation system delivers stimulation to protect an ischemic region of a body from tissue damage caused by ischemia. The stimulation is delivered to one or more stimulation sites remote from the ischemic region to elicit a physiological effect that protects the ischemic region from the tissue damage caused by ischemia. In one embodiment, the stimulation system delivers cardioprotective stimulation to one or more stimulation sites remote from the heart to protect the heart from injuries associated with cardiac ischemic events. In another embodiment, the stimulation system delivers remote conditioning stimulation to one or more stimulation sites in or on the heart to protect a non-cardiac region from injuries associated with non-cardiac ischemic events.

Abstract: Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.

Abstract: A system for controlling the location of a therapeutic agent administered to a mammal is provided. The system employs a device that is capable of generating a magnetic field and a therapeutic agent labeled with a magnetically responsive moiety. Methods which employ the device and the therapeutic agent are also provided.

Abstract: An implantable medical device includes a light emitting circuit incorporated into an intravascular stent. The light emitting circuit emits a light to an ischemic region. The light has characteristics suitable for reliving the angina symptoms associated with ischemia.

Abstract: A stimulation system delivers stimulation to protect an ischemic region of a body from tissue damage caused by ischemia. The stimulation is delivered to one or more stimulation sites remote from the ischemic region to elicit a physiological effect that protects the ischemic region from the tissue damage caused by ischemia. In one embodiment, the stimulation system delivers cardioprotective stimulation to one or more stimulation sites remote from the heart to protect the heart from injuries associated with cardiac ischemic events. In another embodiment, the stimulation system delivers remote conditioning stimulation to one or more stimulation sites in or on the heart to protect a non-cardiac region from injuries associated with non-cardiac ischemic events.

Abstract: A stimulation system delivers stimulation to protect an ischemic region of a body from tissue damage caused by ischemia. The stimulation is delivered to one or more stimulation sites remote from the ischemic region to elicit a physiological effect that protects the ischemic region from the tissue damage caused by ischemia. In one embodiment, the stimulation system delivers cardioprotective stimulation to one or more stimulation sites remote from the heart to protect the heart from injuries associated with cardiac ischemic events. In another embodiment, the stimulation system delivers remote conditioning stimulation to one or more stimulation sites in or on the heart to protect a non-cardiac region from injuries associated with non-cardiac ischemic events.

Abstract: An implantable medical device includes a light emitting circuit incorporated into an intravascular stent. The light emitting circuit emits a light to an ischemic region. The light has characteristics suitable for reliving the angina symptoms associated with ischemia.

Abstract: An implantable device for delivering phototherapy is described that enables the phototherapy to be delivered to internal locations in either a clinical or ambulatory setting for treatment of post-MI patients. Telemetry circuitry enables the device to deliver the phototherapy upon command or be programmed to delivery the phototherapy according to a specified schedule. The device may also incorporate one or more sensing modalities that can be used to trigger delivery of phototherapy upon occurrence of a sensed event or condition. In one particular embodiment, the phototherapy device is incorporated into a cardiac rhythm management device that also delivers pacing and/or defibrillation therapy.

Abstract: A system for controlling the location of a therapeutic agent administered to a mammal is provided. The system employs a device that is capable of generating a magnetic field and a therapeutic agent labeled with a magnetically responsive moiety. Methods which employ the device and the therapeutic agent are also provided.

Abstract: A method and apparatus for assessing the risk of atrial fibrillation in a patient by calculating the relative frequency of short and long intervals between successive heart beats during sinus rhythm is presented. An imbalance of short over long sinus intervals has been found to indicate a higher risk of atrial fibrillation. An implantable cardiac device may be configured to automatically deliver interventional therapy to restore sinus interval balance when such an imbalance is detected.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as atrial fibrillation is presented. The ventricular rhythm of certain patients during an episode of atrial fibrillation may be such that shockable R—R intervals are infrequent or do not occur at all. Continuous electrical stimulation of the atria after detection of an atrial tachyarrhythmia may be utilized to modify the ventricular rhythm in such patients to increase the frequency of shockable R—R intervals.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as atrial fibrillation is presented. The ventricular rhythm of certain patients during an episode of atrial fibrillation may be such that shockable R-R intervals are infrequent or do not occur at all. Continuous electrical stimulation of the atria after detection of an atrial tachyarrhythmia may be utilized to modify the ventricular rhythm in such patients to increase the frequency of shockable R-R intervals.

Abstract: A method and apparatus for assessing the risk of atrial fibrillation in a patient by calculating the relative frequency of short and long intervals between successive heart beats during sinus rhythm is presented. An imbalance of short over long sinus intervals has been found to indicate a higher risk of atrial fibrillation. An implantable cardiac device may be configured to automatically deliver interventional therapy to restore sinus interval balance when such an imbalance is detected.

Abstract: A method and apparatus for preventing atrial fibrillation arising from a premature atrial contraction. Upon detection of a premature atrial contraction, a pace is delivered to a ventricle at a specified AV interval selected as either a late-pace or early-pace value. The resulting ventricular depolarization then occurs during a time when the atria are not vulnerable to the triggering of fibrillation.

Abstract: A controlled-power defibrillator and method of defibrillation for automatically compensating for changes in patient resistance during delivery of a defibrillation pulse. A switching power converter is connected between a storage capacitor and a pair of electrodes adapted for connection to a patient's body, either internally or externally. A closed-loop power control circuit is operatively connected to the power converter for control of the power delivered to the patient, the power control circuit generating a target voltage signal for the storage capacitor, the target voltage signal having a defined relationship with the waveform of the power desired to be delivered to the patient. The power control circuit monitors the actual voltage on the storage capacitor and adjusts the delivery of power to the patient as a function of the difference between desired and actual storage capacitor voltage.

Abstract: An atrial defibrillation system monitors activity of a heart, detects atrial fibrillation, and cardioverts detected atrial fibrillation. The system includes an implantable atrial defibrillator including a plurality of operating stages for monitoring heart activity, detecting atrial fibrillation, and cardioverting atrial fibrillation, a message generator for generating messages indicative of operating stage operation status, and a transmitter to transmit the messages indicative of operating stage operating status. A nonimplantable communication device is dimensioned to be hand-held and includes a receiver for receiving the transmitted messages indicative of operating stage operation status, an addressable memory for storing a plurality of voice signals, a decoder responsive to received messages indicative of operating stage operation status for addressing selected ones of the stored voice signals, and a converter for converting the selected voice signals to audible sound.

Abstract: An implantable atrial cardiovertor applies cardioverting electrical energy to atria of a heart with reduced discomfort to a patient. The cardiovertor includes a storage capacitor having a capacitance and a discharge control for controlling discharge of the storage capacitor to apply the cardioverting electrical energy to the atria of the heart. The discharge control causes the applied cardioverting electrical energy to have a biphasic waveform having a first phase and a second phase of opposite polarity and equal time duration. The time durations of the first and second phases are each greater than four milliseconds, and the capacitance of the storage capacitor is greater than or equal to 120 .mu.F.

Abstract: A defibrillation system for providing post-cardiac surgery atrial cardioversion includes a lead system having defibrillation electrodes for electrical contact with the heart beneath the skin of a patient and a non-implantable external defibrillator for providing defibrillation electrical energy. An interface unit is coupled between the external defibrillator and the lead system and includes an attenuator circuit for attenuating the defibrillation electrical energy provided by the external defibrillator.