Abstract: A nerve cuff stimulation electrode for cervical VNS is provided and configured to be arranged so as to at least partially surround or enclose one of the vagus nerves. The cuff stimulation electrode has at least two contacts configured to deliver electric stimulation pulses to a vagus nerve. The cuff stimulation electrode further has or may be attached or connected to a tilt sensor, a kinematic sensor, and/or a pulsation sensor configured to generate a signal representative of arterial and venous pressures. The implantable tilt sensor is configured to output a posture signal indicating a patient's posture, thus allowing discrimination between supine and semi-recumbent or erect postures.

Abstract: A heart stimulator having an electric input that is connectable to a plurality of electrodes is disclosed and includes a stimulation control unit, one or more stimulation units, an impedance determination unit and an impedance evaluation unit. The stimulation units generate stimulation pulses and deliver a stimulation pulse when triggered by the stimulation control unit. The stimulation control unit is operatively connected to one or more stimulation units to control pacing parameters such as pacing site and/or the timing of stimulation pulses to be delivered by the one or more stimulation units. The impedance determination unit determines impedance values reflecting intracardiac impedance, and the impedance evaluation unit evaluates the impedance values and provides an evaluated impedance signal to the stimulation control unit.

Abstract: Exemplary versions of the invention include methods and apparatuses for assessing ventricular activation time by determining a point in time t1 of an initial positive deflection on a far-field electrogram and a point in time t2 of a first peak of the negative deflection on a near-field electrogram of a same heart cycle. They also determine a time difference between points in time t1 and t2 said time difference representing the ventricular activation time. A progression of ventricular conduction disorders such as the left bundle branch block (LBBB) and the right bundle branch block (RBBB) can be monitored. Trending analysis of the ventricular activation time provides a means for monitoring the progression of ventricular conduction diseases.

Abstract: A delivery tool for an implantable medical device to be introduced into a human or animal body, in particular, an implantable leadless pacemaker, the delivery tool having an outer sheath and an inner sheath, wherein the inner sheath is configured to be retractable into a lumen of the outer sheath, wherein a distal side of the inner sheath is configured to provide regions which are reversibly collapsible and non-collapsible in diameter, wherein a non-collapsible region is arranged at the distal end of the inner sheath. A system including a delivery tool and an implantable medical device is also provided.

Abstract: A method is disclosed for irradiation planning for the irradiation of a moving target volume located in a body with a particle beam irradiation facility by means of rescanning, which method has the steps of defining the target volume in a reference condition of the motion, dividing the target volume among a plurality of target points that can be individually approached with a particle beam, calculating a nominal dose to be deposited in each of the target points of the target volume, defining a number of rescanning passes in which each of the target points of the target volume are approached, calculating a mean motion to be expected of the target points of the target volume based on a motion model, taking into account the mean motion to be expected of the target points of the target volume in the irradiation planning in such a manner that the deviation of the expected dose deposition from the nominal dose for each target point is determined, and the nominal dose for each target point is corrected on the basis

Abstract: A cardiac device and method thereof for detecting atrial fibrillation within a mean heart signal of a body, wherein the cardiac device includes at least two sensing electrodes. The method includes providing an input heart signal, detecting sense events (VS) and noise events (VN), and generating further noise events (VN) each at a predetermined time interval after a noise event (VN) has been detected and when the noise event (VN) continues. The method includes incrementing a noise counter for each noise event (VN) and each further noise event (VN), and terminating the detection of atrial fibrillation when the noise counter reaches a predetermined limit.

Abstract: A heart monitoring and/or therapy device for detecting and quantifying fusion beats, wherein the device includes an IEGM signal sensing channel that puts out a recorded IEGM signal and an evaluation unit operatively connected to the IEGM signal sensing channel that detects fusion beats. The evaluation unit comprises or is connected to a template memory including at least a first template electrogram signal and a second template electrogram signal. The evaluation unit compares the recorded IEGM signal with both, the first and the second template electrogram signal and determines at least a first degree of similarity reflecting the similarities between the recorded electrogram signal and the first template electrogram signal, and a second degree of similarity reflecting the similarities between the recorded electrogram signal and the second template electrogram signal. The evaluation unit then calculates a fusion index (FI) from the at least two degrees of similarity.

Abstract: A method for determining the signal quality of samples in a physiological signal, in particular an electrocardiogram (ECG) signal, is provided. A supra-threshold sample sum, a noise threshold crossing sum, or both are calculated in a noise detection window including the sample to be evaluated, and low signal quality is indicated if either or both of the sums exceed respective values. ECG beat detections can then be labeled as unreliable based on the determination of low signal quality for one or more samples between the detections.

Abstract: An implantable medical device including a data communication interface connected to a pulse generator. The pulse generator generates and delivers forward current pulses and reverse current pulses, wherein a polarity of the reverse current pulses is opposite to the polarity of the forward current pulses. Generates pulses representing binary digits, wherein a first kind of digits (1 or 0) is represented by a current pulse, and a second kind of digit respective of the other type of binary digits (0 or 1) is represented by a pause between current pulses. The data communication interface together with the pulse generator deliver current pulses with strictly alternating polarity such that every other current pulse is a reverse current pulse of opposite polarity compared to an immediately preceding forward current pulse. Thus, every string of current pulse is both, charge balancing and information encoding.

Abstract: A spinal cord stimulation device having a stimulation unit for generation and delivery of stimulation pulses, a control unit for controlling the stimulation unit with respect to stimulation intensity and an autonomic nervous system (“ANS”) sensing unit that is configured to generate ANS indicating signals that represent an increased sympathetic tone or an increased parasympathetic tone, respectively. The control unit is configured to control the intensity of respective stimulation pulses depending on a respective ANS indicating signal as generated by said ANS sensing unit.

Abstract: An implantable cardiac electrostimulator includes an atrial sensing channel generating an atrial sense event signal upon detection of atrial activity, a ventricular sensing channel generating a ventricular sense event signal upon detection of ventricular activity, a VES detector detecting ventricular extrasystoles, atrial and ventricular stimulation pulse generators, and a stimulation control unit. The stimulation control unit determines scheduled delivery times of atrial stimulation pulses (T(A)) and/or ventricular stimulation pulses (T(V)), and triggers delivery if no atrial sense event signal arises before the end of an atrial escape interval (VAI) timing out at T(A), or if no ventricular sense event signal arises before the end of a ventricular escape interval (VEI) timing out at T(V). T(A) and T(V) depend upon detection of a ventricular extrasystole, and proper atrioventricular synchrony is maintained by setting a physiologically adequate A-V-delay between T(A) and T(V).

Abstract: Implantable electromedical device or loop recorders or ILRs that solve the problem of very low arrhythmia detection specificities in, i.e., high number of false positives, based on detection and analysis of external noise, specifically muscle noise surrounding the electromedical device. Embodiments generally employ active detection of lead or device movement that induces signal artifacts indicative of external noise. One or more embodiments may detect lead or device movement through use of a piezoelectric transducer, for example located proximally to the device or in the lead of the electromedical.

Abstract: An implantable cardiac device is provided. The implantable cardiac device includes a sensing unit adapted to measure an intrathoracic or intracardiac impedance, pressure, and/or accelerometry input stream, which includes a patient's respiratory waveforms. Furthermore, the implantable cardiac device includes a quantizer-unit adapted to sample the input stream with an initial sampling frequency Fs, providing input samples of the input stream. The implantable cardiac device further includes a filter bank 50 suited to perform a streaming Wavelet transformation on the input samples on a sample-by-sample basis, using the initial sampling frequency Fs provided by the quantizer-unit, wherein the streaming Wavelet transformation is adapted to perform a source separation, extracting, and separating the respiratory waveforms of the input stream.

Abstract: Detects external noise using a motion sensor signal for example to increase the specificity of arrhythmia detections based on active muscle noise detection. Whenever a motion signal is present that is below or above a certain frequency, for example 5 Hz, or within a certain frequency range, for example 1 to 10 Hz, and/or above a certain amplitude, for example greater than 1 mg, or close to a known motion pattern, then the detection of fast ventricular arrhythmia is suspended. For the detection of slow arrhythmia, for example asystole or syncope, an episode is confirmed when a short lasting motion sensor signal occurs. Uses a motion sensor based signal, for example as obtained from an accelerometer on an implantable electrode lead and/or implantable device.

Abstract: The present disclosure refers to a heart stimulator comprising a stimulation control unit, a stimulation unit, an impedance measurement unit and an impedance evaluation unit. The stimulation control unit is operatively connected to the stimulation unit to control timing of stimulation pulses by said stimulation unit. The impedance measurement unit is configured to determine an impedance signal reflecting intracardiac impedance. The impedance evaluation unit is operatively connected to the impedance measurement unit and to the stimulation control unit and is configured to evaluate the impedance signal so as to determine an isovolumic contraction time, an isovolumic relaxation time, an ejection time and a filling time from said impedance signal. The stimulation control unit is further configured to control timing of stimulation pulses depending on a performance index.

Abstract: An implantable heart monitoring device including a sensing unit, a signal quality analysis unit, and an evaluation unit. The sensing unit is connected to at least one electrode that picks up electric potentials. The sensing unit processes electrical signals corresponding to the electric potentials, and generates sense signals including events corresponding to myocardial contractions. The signal quality analysis unit determines whether a noise condition (NC) and/or a low signal indication is present for an event and generates an indication signal. The evaluation unit evaluates the sense signals and the indication signals, treats a detected event as non-valid if a NC and/or low signal indication signal is present for that event, and uses only intervals defined by two consecutive events which do not have a NC and/or a low signal indication to determine a rate of events of the sense signal.

Abstract: A heart monitoring and/or therapy device for detecting and quantifying fusion beats, wherein the device includes an IEGM signal sensing channel that puts out a recorded IEGM signal and an evaluation unit operatively connected to said IEGM signal sensing channel that detects fusion beats. The evaluation unit comprises or is connected to a template memory including at least a first template electrogram signal and a second template electrogram signal. The evaluation unit compares the recorded IEGM signal with both, the first and the second template electrogram signal and determines at least a first degree of similarity reflecting the similarities between the recorded electrogram signal and the first template electrogram signal, and a second degree of similarity reflecting the similarities between the recorded electrogram signal and the second template electrogram signal. The evaluation unit then calculates a fusion index (FI) from the at least two degrees of similarity.

Abstract: A heart monitoring system comprises a ventricular sensing stage sensing excitation or contraction of ventricular myocardium, an activity sensor unit determining a signal reflecting a patient's physical activity, a ventricular impedance or conductance measuring module, said modules comprising a current source unit adapted to provide a sub-threshold excitation current to the myocardium and comprising an impedance or conductance measurement unit for measuring the resulting voltage on said electrode at the myocardium, a signal generator module, a filter module, a memory, a control unit adapted to derive single measures |?Z| of magnitude of impedance or conductance change over a preset sample time interval, determine the variability TARVI in the impedance or conductance change, compare this variability and the activity sensor output signal with a threshold and recent history, determine if sleep disturbed breathing (SDB) is present, and log the SDB episode in the memory device.

Abstract: Exemplary methods and apparatuses are disclosed that provide for determination of an atrio-ventricular delay on a beat-to-beat basis by determining a P-wave duration from electric signals corresponding to electric potentials in a heart, and determining the atrio-ventricular delay on a beat-to-beat basis such that the atrio-ventricular delay for an individual heart cycle depends on the P-wave duration of a same or an immediately preceding heart cycle.

Abstract: A method of enhancing the signal-to-noise ratio (SNR) of measured electrocardiogram (ECG) signals is provided. The method includes the steps of providing at least three cardiac input signals derived from the measured ECG signals S1 and forming a first estimate U1 S2 from each of at least three pairs of input signals. Moreover, the method includes the steps of forming a second estimate U2 S3 from each of at least three input signals; comparing S4 the polarity and the amplitude of a first and second estimate U1, U2 to at least one threshold T; generating S5 a composite signal X, wherein the polarity and the amplitude of the composite signal X depend on the result of the comparison; and using S6 the generated composite signal X to produce an output signal with enhanced signal-to-noise ratio (SNR). Furthermore, a corresponding cardiac device is also provided.