Abstract: A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

Abstract: An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Abstract: An implantable cardiac rhythm management device is programmed and configured to detect a death event. When such an event is detected, the device ceases recording of physiological data, thus preserving in the device's memory the data collected at and shortly before the time of death. A death event may be detected by detecting of an absence of intrinsic electrical activity in the patient's heart and a lack of an evoked response to a predetermined number of pacing pulses.

Abstract: A method and apparatus for automatically adjusting the sensing threshold of cardiac rhythm management devices. The invention is particularly suited for implementation in devices such as implantable cardiac pacemakers and implantable cardioverter/defibrillators. A method and apparatus are provided in which a noise level and signal level for a sensing channel are determined for each cardiac cycle with the sensing threshold of the channel being adjusted in accordance therewith.

Abstract: A method and apparatus for automatically adjusting the sensing threshold of cardiac rhythm management devices. The invention is particularly suited for implementation in devices such as implantable cardiac pacemakers and implantable cardioverter/defibrillators. A method and apparatus are provided in which a noise level and signal level for a sensing channel are determined for each cardiac cycle with the sensing threshold of the channel being adjusted in accordance therewith.

Abstract: Exhaust gas clean-up catalysts that contain one or two or more noble metals chosen from the group platinum (Pt), rhodium (Rh), ruthenium (Ru), Iridium (Ir), osmium (Os) and other noble metals, and at least one of tungsten (W) metal or tungsten oxide and, optionally, at least one of niobium (Nb) metal, niobium oxide, molybdenum (Mo) metal, or molybdenum oxide, and which can also contain the metal oxide(s) ceria and/or zirconia if necessary, are especially useful for cleaning up hydrocarbons in exhaust gases.

Abstract: A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

Abstract: Exhaust gas clean-up catalysts that contain one or two or more noble metals chosen from the group platinum (Pt), palladium (Pd), rhodium (Rh), ruthenium (Ru), Iridium (), osmium (Os) and other noble metals and one, two or more metal oxides chosen from the group tungsten (W), niobium b) and molybdenum (Mo) oxides, and which can also contain the metal oxide(s) ceria and/or zirconia if necessary, are especially useful for cleaning up hydrocarbons in exhaust gases.

Abstract: A method and apparatus for automatically adjusting the sensing threshold of cardiac rhythm management devices. The invention is particularly suited for implementation in devices such as implantable cardiac pacemakers and implantable cardioverter/defibrillators. A method and apparatus are provided in which a noise level and signal level for a sensing channel are determined for each cardiac cycle with the sensing threshold of the channel being adjusted in accordance therewith.

Abstract: A method and apparatus for automatically adjusting the sensing threshold of cardiac rhythm management devices. The invention is particularly suited for implementation in devices such as implantable cardiac pacemakers and implantable cardioverter/defibrillators. A method and apparatus are provided in which a noise level and signal level for a sensing channel are determined for each cardiac cycle with the sensing threshold of the channel being adjusted in accordance therewith.

Abstract: A cardiac pacing system that enhances the ability of a cardiac pacer to automatically detect whether a pacing stimulus results in heart capture or contraction. The cardiac pacing system includes a pacing circuit that attenuates polarization voltages or “afterpotential” which develop at the heart tissue/electrode interface following the delivery of a stimulus to the heart tissue, which thereby allows the pacing electrodes to be utilized to sense an evoked response to the pacing stimulus. The cardiac pacing system utilizes the pacing electrodes to sense an evoked response, thereby eliminating the necessity for an indifferent electrode to sense an evoked response. The present invention allows accurate detection of an evoked response of the heart, to thereby determine whether each pacing stimulus results in capture.

Abstract: A cardiac electrical stimulation system that enhances the ability of the system to automatically detect whether an electrical stimulus results in heart capture or contraction. The cardiac electrical stimulation system may be utilized, for example, as a cardiac pacer or as a cardioverter defibrillator. The cardiac electrical stimulation system includes an electrical stimulation circuit that attenuates polarization voltages or “afterpotential” which develop at the heart tissue/electrode interface following the delivery of a stimulus to the heart tissue, which thereby allows the stimulation electrodes to be utilized to sense an evoked response to the electrical stimulus. The cardiac electrical stimulation system utilizes the stimulation electrodes to sense an evoked response, thereby eliminating the necessity for an indifferent electrode to sense an evoked response.

Abstract: An implantable cardiac rhythm management device adapted to receive and digitize electrocardiogram signals from leads placed on or in the heart and capable of automatically adjusting an evoked response detection threshold dependent upon a modulation of the amplitude of the evoked response. Respiration, activity level, and lead maturation, among others, all effect the modulation of the evoked response and the amplitude of a signal associated with evoked response. The present invention automatically adjusts the evoked response detection threshold to account for this modulation. Without limitation, the automatic adjustment of the evoked response detection threshold may be utilized during an automatic capture verification sequence. In the event of non-capture or fusion beats during an automatic adjustment, the evoked response detection threshold is not adjusted.

Abstract: A cardiac pacing/defibrillation system that enhances the ability of a cardiac pacer to automatically detect whether a pacing stimulus results in heart capture or contraction. The cardiac pacing/defibrillation system includes a pacing circuit that attenuates polarization voltages or “afterpotential” which develop at the heart tissue/electrode interface following the delivery of a stimulus to the heart tissue, which thereby allows the pacing electrodes to be utilized to sense an evoked response to the pacing stimulus. The cardiac pacing/defibrillation system may utilize the ventricular coil electrode and superior vena cava coil electrode to sense an evoked response, thereby eliminating the necessity for an additional ventricular lead for sensing an evoked response. The present invention allows accurate detection of an evoked response of the heart, to thereby determine whether each pacing stimulus results in capture.