Abstract: An integrated circuit die includes an active area having source dopants and contacts. An active area metal layer overlies the active area. A sense area is disposed on the die. A sense area metal layer overlies the sense area. A plurality of polysilicon gate stripes, polysilicon openings, and body stripes are disposed on the die, and extend in a continuous and uninterrupted manner from the active area into the sense area. A first region from which source dopants and contacts have been excluded surrounds a periphery of the sense area. An etched region is disposed over the first region, thereby separating and electrically isolating the sense area metal layer from the active area metal layer.

Abstract: A system and method for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker in which maximum exertion levels attained by the patient are measured at periodic intervals and stored. The stored maximum exertion levels may then be used to update a long-term maximal exertion level, and the slope of the rate-response curve is adjusted to map the updated long-term maximal exertion level to a maximum allowable pacing rate. In accordance with the invention, the rate response curve is defined such that an exertion level corresponding to the patient's maximum exercise capacity would be mapped to a physiologically favorable maximum rate that is independent from a specified maximum sensor indicated rate.

Abstract: A system and method for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker. In accordance with the method, maximum exertion levels attained by the patient are measured at periodic intervals and stored. The stored maximum exertion levels may then be used to update a long-term maximal exertion level, and the slope of the rate-response curve is adjusted to map the updated long-term maximal exertion level to a maximum allowable pacing rate. The stored maximum exertion levels may also be used to update a sensor target rate which is used to adjust the slope of the rate response curve.

Abstract: A system and method for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker. In accordance with the method, maximum exertion levels attained by the patient are measured at periodic intervals and stored. The stored maximum exertion levels may then be used to update a long-term maximal exertion level, and the slope of the rate-response curve is adjusted to map the updated long-term maximal exertion level to a maximum allowable pacing rate. The stored maximum exertion levels may also be used to update a sensor target rate which is used to adjust the slope of the rate response curve.

Abstract: An integrated circuit includes a die having a device layer. An insulating layer is disposed over the device layer. A die street defines the outermost bounds of the die. A voltage divider network including a plurality of resistive elements derives a plurality of predetermined bias voltages. A field plate termination includes a plurality of field plates disposed on the oxide layer and are laterally spaced apart relative to each other and relative to the die street. Each of the plurality of field plates is electrically connected to a corresponding bias voltage. The bias voltage applied to a given field plate is determined by and increases with the proximity of that field plate relative to the die street.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation is disclosed. In accordance with the method, atrial defibrillation shocks are delivered synchronously with an R wave if the current R-R interval meets one or more safety criteria so as to be considered shockable. A shockable R-R interval may be defined as one that exceeds the previous QT interval by a specified therapy margin. In one embodiment, the previous QT interval is estimated based upon the measured preceding R-R interval.

Abstract: An apparatus and method is presented for improving cardiac function after successful termination of a tachyarrhythmia such as ventricular fibrillation. A series of electrical stimulation pulses are delivered prior to a defibrillation shock if one or more specific criteria are met.

Abstract: An integrated circuit die includes an active area having source dopants and contacts. An active area metal layer overlies the active area. A sense area is disposed on the die. A sense area metal layer overlies the sense area. A plurality of polysilicon gate stripes, polysilicon openings, and body stripes are disposed on the die, and extend in a continuous and uninterrupted manner from the active area into the sense area. A first region from which source dopants and contacts have been excluded surrounds a periphery of the sense area. An etched region is disposed over the first region, thereby separating and electrically isolating the sense area metal layer from the active area metal layer.

Abstract: A method and system for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker in which maximum exertion levels attained by the patient are measured at periodic intervals and stored in order to compute or update a maximum exercise capacity. The slope of the rate-response curve is then adjusted to map an exertion level corresponding to the updated maximum exercise capacity to a maximum allowable pacing rate. In accordance with the invention, a maximum exercise capacity is determined by cross-checking periodic maximum exertion level sensor values with a motion-level sensor value.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation is disclosed. In accordance with the method, atrial defibrillation shocks are delivered synchronously with an R wave if the current R-R interval meets one or more safety criteria so as to be considered shockable. A shockable R-R interval may be defined as one that exceeds the previous QT interval by a specified therapy margin. In one embodiment, the previous QT interval is estimated based upon the measured preceding R-R interval.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: A method and system for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker in which maximum exertion levels attained by the patient are measured at periodic intervals and stored in order to compute or update a maximum exercise capacity. The slope of the rate-response curve is then adjusted to map an exertion level corresponding to the updated maximum exercise capacity to a maximum allowable pacing rate. In accordance with the invention, a maximum exercise capacity is determined by cross-checking periodic maximum exertion level sensor values with a motion-level sensor value.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation is disclosed. In accordance with the method, atrial defibrillation shocks are delivered synchronously with an R wave if the current R-R interval meets one or more safety criteria so as to be considered shockable. A shockable R-R interval may be defined as one that exceeds the previous QT interval by a specified therapy margin. In one embodiment, the previous QT interval is estimated based upon the measured preceding R-R interval.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: Methods of adjusting output mapping in response to historical signal input data relative to a reference value, and apparatus to perform the methods. The methods are suited for use in adjusting rate-adaptive pacemakers in response to a patient's demonstrated activity relative to a predetermined activity level. The methods include using historical physiologic sensor input to derive a patient's activity. The methods further include tuning a rate-adaptive curve in response to a demonstrated exertion level and a demonstrated exertion time indicative of a breadth and frequency of a patient's activity above some reference value. Pacemakers adapted to perform the methods include a processor, at least one physiologic sensor, a variable-rate pulse generator and a memory for storing historical physiologic sensor data.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: A medical device system and method of plotting symbols representing complexes of selected arrhythmic events on an interactive display screen, for organizing, displaying and interacting with a patient's recorded arrhythmia episodes. Stored arrhythmic episode are selected from a plurality of arrhythmic episodes, where the stored arrhythmic episode having a plurality of complexes. A similarity value and a dissimilarity value is calculated for each complex of the plurality of complexes of the selected arrhythmic episode with respect to normal sinus rhythm complexes. Symbols representing the arrhythmic complexes are then plotted as a function of the calculated similarity values and the dissimilarity values on an interactive display screen. Additional information relating to the arrhythmic event is elicited through interacting with the symbols displayed on the interactive display screen.

Abstract: A medical device system and method of plotting symbols representing complexes of selected arrhythmic events on an interactive display screen, for organizing, displaying and interacting with a patient's recorded arrhythmia episodes. Stored arrhythmic episode are selected from a plurality of arrhythmic episodes, where the stored arrhythmic episode having a plurality of complexes. A similarity value and a dissimilarity value is calculated for each complex of the plurality of complexes of the selected arrhythmic episode with respect to normal sinus rhythm complexes. Symbols representing the arrhythmic complexes are then plotted as a function of the calculated similarity values and the dissimilarity values on an interactive display screen. Additional information relating to the arrhythmic event is elicited through interacting with the symbols displayed on the interactive display screen.

Abstract: A medical device system and method of plotting symbols representing complexes of selected arrhythmic events on an interactive display screen, for organizing, displaying and interacting with a patient's recorded arrhythmia episodes. Stored arrhythmic episode are selected from a plurality of arrhythmic episodes, where the stored arrhythmic episode having a plurality of complexes. A similarity value and a dissimilarity value is calculated for each complex of the plurality of complexes of the selected arrhythmic episode with respect to normal sinus rhythm complexes. Symbols representing the arrhythmic complexes are then plotted as a function of the calculated similarity values and the dissimilarity values on an interactive display screen. Additional information relating to the arrhythmic event is elicited through interacting with the symbols displayed on the interactive display screen.