Abstract: The present disclosure relates to medical devices and methods, for use in a vascular system. The apparatus includes a balloon catheter having an elongate body, balloon, and fluid control valve for ischemic post-conditioning therapy and/or reperfusion.

Abstract: A pacemaker initiates and times a monitoring interval in response to an event such as a therapy delivery to a patient. The monitoring interval is specified to include a duration of an anticipated acute response to the event, such as vagal surge. One or more physiological parameters indicative of the acute response are detected during the monitoring interval for analyzing therapeutic effect of the event. In various embodiments, one or more pacing parameters are adjusted for a response interval specified to include the duration of the anticipated acute response to allow for the analysis and maximization of the therapeutic effect. In various embodiments, the event includes a session of pacing therapy delivered according to an intermittent cardiac stress augmentation pacing protocol, and the therapeutic effect is analyzed to adjust that protocol.

Abstract: Pacing post-conditioning (PPC) therapy is applied to a patient to minimize ischemic injury associated with MI and/or reperfusion injury associated with a post-MI revascularization procedure. In various embodiments, a PPC therapy is delivered by executing a pacing protocol with pacing parameters determined and dynamically adjusted based on patient-specific factors to ensure efficacy and safety of the patient.

Abstract: Methods and devices for treating a blockage in the coronary arterial system are provided. Some blockages in the coronary arterial system restrict the blood flow to a portion of the heart, causing ischemia or infarction. Such blockages may be treated by displacing, removing and/or breaking up the blockage, which allows blood to reperfuse into the infarcted portion of the heart. Before, during, and/or after the reperfusion, cardioprotective pacing is provided to the heart. The devices have multiple electrodes in order to provide multiple locations at which the cardioprotective pacing may be delivered. The devices are adapted to deliver cardioprotective pacing to the heart via the electrode that results in a relatively high level of dyssynchrony of the heart.

Abstract: A cardiac pacing system introduces a transitional period when pacing mode changes, such as when pacing starts and stops, or when one or more pacing parameter values change substantially. For each pacing parameter that changes substantially when the pacing mode changes, its value is adjusted incrementally over the transitional period to protect the heart from potentially harmful conditions associated with an abrupt change in the value of that pacing parameter.

Abstract: An external cardiac stimulation patch integrates a transcutaneous cardiac stimulation device and body-surface electrodes with a skin patch. The skin patch is to be attached onto a patient to provide for electrical contacts between the body-surface electrodes and a patient. The transcutaneous cardiac stimulation device delivers pacing pulses to the heart of the patient through pacing electrodes selected from the body-surface electrodes.

Abstract: Embodiments of the invention are related to monitoring devices and methods with osmometric sensors, amongst other things. In an embodiment, the invention includes an implantable heart failure monitoring system including an implantable osmometric sensor configured to generate a signal corresponding to osmotic strength of a bodily fluid, the osmometric sensor comprising a rigid wall member defining an enclosed volume resisting deformation, the rigid wall member comprising a semi-permeable membrane; a signaling element comprising a first pressure sensor; and a second pressure sensor. Other aspects and embodiments are provided herein.

Abstract: Embodiments of the invention are related to monitoring devices and methods with osmometric sensors, amongst other things. In an embodiment, the invention includes an implantable heart failure monitoring system including an osmometric sensor, the osmometric sensor configured to generate a signal corresponding to the osmotic strength of a bodily fluid, and a controller in communication with the osmometric sensor, the controller configured to receive and process the signal corresponding to the osmotic strength of a bodily fluid. Other aspects and embodiments are provided herein.

Abstract: Cardioprotective pacing is applied to prevent and/or reduce cardiac injury associated with cardiac catheterization or surgery. Pacing pulses are generated from a pacemaker and delivered through one or more pacing electrodes incorporated onto one or more devices used in the cardiac catheterization or surgery. The pacemaker controls the delivery of the pacing pulses by executing a cardioprotective pacing protocol. In one embodiment, the one or more pacing electrodes are incorporated onto an intravascular ultrasound (IVUS) catheter. In another embodiment, the one or more pacing electrodes are incorporated onto one or more cardiac surgical instruments such as a heart stabilizer and a sternal retractor.

Abstract: A transcutaneous cardiac stimulation system delivers pacing pulses according to a cardioprotective pacing protocol. The pacing pulses are delivered through body-surface electrodes attached onto a patient. The cardioprotective pacing protocol specifies pacing parameters selected to augment cardiac stress on the patient's myocardium to a level effecting cardioprotection against ischemic and reperfusion injuries.

Abstract: Systems and methods for temporarily pacing a patient's heart are provided. One system includes a vascular treatment system having a vascular access system and a therapy system. The therapy system includes an indeflator and an elongate medical device and the elongate medical device has an inflatable member and an electrode. The indeflator is adapted to provide pressurized fluid to the inflatable member and electrical signals to the electrode, with its operation manually or automatically controlled. Devices for electrically and fluidly coupling the indeflator and the elongate medical device are also provided.

Abstract: A system delivers multiple enhanced therapies to limit myocardial damage post-revascularization. The system includes a catheter that incorporates features for delivering cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy. In one embodiment, a method for delivering cardiac protection therapies to a heart is provided. One or more catheters are provided having a balloon, at least one pacing electrode and at least one hemodynamic sensor. Cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy are concurrently delivered using the one or more catheters. The pacing and ischemia are adapted to protect the heart from ischemic and reperfusion injuries. The delivery of the CPPT and the intermittent ischemia are controlled using a closed-loop system monitoring a signal sensed by the at least one hemodynamic sensor.

Abstract: A pacing system includes a pacemaker and a pacing protocol module externally attached to the pacemaker. The pacing protocol module stores the pacing protocol. The pacemaker controls delivery of pacing pulses by automatically executing the pacing protocol. In one embodiment, the pacing protocol is a cardioprotective pacing protocol for preventing and/or reducing cardiac injury associated with myocardial infarction (MI) and revascularization procedure. The pacing pulses are generated from the pacemaker and delivered through one or more pacing electrodes incorporated onto one or more percutaneous transluminal vascular intervention (PTVI) devices during the revascularization procedure.

Abstract: A guide catheter system includes a guide catheter having a proximal end, a distal end, an outer wall and a first, second and third electrode wherein the first, second and third electrodes are spaced longitudinally apart from each other on the outer wall of the catheter, and an electrical impulse generator connected to the guide catheter wherein the electrical impulse generator includes a circuit for selecting an adjacent pair of electrodes to use as a bipolar electrode system to send an electrical impulse and a method of use thereof to treat vasospasm.

Abstract: A method and apparatus are described for delivering myocardial pacing and cryotherapy in conjunction with a coronary revascularization procedure using one catheter/stent system. In one embodiment, a balloon-stent delivery platform incorporates pacing electrode(s) on or near the distal tip for myocardial pacing.

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: Embodiments of the invention are related to monitoring devices and methods with osmometric sensors, amongst other things. In an embodiment, the invention includes an implantable heart failure monitoring system including an osmometric sensor, the osmometric sensor configured to generate a signal corresponding to the osmotic strength of a bodily fluid, and a controller in communication with the osmometric sensor, the controller configured to receive and process the signal corresponding to the osmotic strength of a bodily fluid. Other aspects and embodiments are provided herein.

Abstract: Embodiments of the invention are related to devices and methods for modulating renal function, amongst other things. In an embodiment, the invention includes an implantable occlusive device including a wall member defining an enclosed volume, the wall member can include a semi-permeable membrane. The device can also include a solution comprising a solvent and a solute disposed within the enclosed volume of the wall member. The semi-permeable membrane can be permeable to the solvent and impermeable to the solute. The enclosed volume can be configured to expand and contract in response to changes in the osmolality of a bodily fluid. The device can include a positioning member configured to maintain the position of the implantable occlusive device relative to a lengthwise axis of a lymphatic vessel.

Abstract: Disclosed herein, among other things, is a system for electrical stimulation of blood vessels. An embodiment of the system includes at least one electrode having electrical contact with a blood vessel. The embodiment also includes a stimulation circuit electrically connected to the electrode, the circuit adapted to provide stimulation to the vessel. The embodiment further includes a controller connected to the circuit, the controller adapted to select frequency and voltage parameters for the stimulation circuit to selectively affect vascular therapy, including constriction of the vessel and dilation of the vessel. According to various embodiments, the stimulation circuit and controller are contained within an implantable medical device (IMD). The system also includes a sensor connected to the controller, and the controller initiates and adjusts therapy based on a signal received from the sensor, in varying embodiments.