Abstract: Abnormal battery depletion can be detected in an implantable medical device. Battery capacity consumed can be measured using a coulometer and using a capacity-by-voltage device, and the measurements can be blended to determine battery status. A drop in battery voltage below a specified threshold can be detected to identify a high-current depletion fault, and an alarm can be provided to indicate the fault has been detected. The specified threshold can be determined as a function of battery capacity consumed. Other aspects and embodiments are provided herein.

Abstract: An implanted cardiac device detects an atrial arrhythmia and provides periodically updated atrial arrhythmia status as long as the arrhythmia is ongoing. A patient may request an indication of ongoing atrial arrhythmia status from external to the patient using a patient activator. The patient activator may include a magnet for closing a reed switch in the implanted device to provide the request or may provide the request over a telemetry link to the implanted device. The implanted device may provide the requested atrial arrhythmia status and other information in the form of an audible tone produced by the implanted device or as a message telemetered from the implanted device to the patient activator. The patient activator may include a tone detector and display for providing a visual indication of the atrial arrhythmia status indication. The magnet activator may also be employed to request or withhold atrial shock therapy.

Abstract: An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

Abstract: An implantable medical device (IMD), such as a defibrillator, performs a capacitor reform or other temporary high current mode, such as to maintain efficacy of a battery or a high voltage defibrillation energy storage capacitor in spite of non-use. Before performing the capacitor reform or other high current mode, a voltage delay test can be performed. A voltage delay can be declared when an initial battery voltage measurement is less than a later battery voltage measurement during a loaded condition such as the charging of the capacitor. If a voltage delay is present, the capacitor reform or other temporary high current mode is enabled, otherwise, the capacitor reform or other temporary high current mode is inhibited. This saves energy, increasing the life of the IMD before explant.

Abstract: Abnormal battery depletion can be detected in an implantable medical device. Battery capacity consumed can be measured using a coulometer and using a capacity-by-voltage device, and the measurements can be blended to determine battery status. A drop in battery voltage below a specified threshold can be detected to identify a high-current depletion fault, and an alarm can be provided to indicate the fault has been detected. The specified threshold can be determined as a function of battery capacity consumed. Other aspects and embodiments are provided herein.

Abstract: An implantable medical device (IMD), such as a defibrillator, performs a capacitor reform or other temporary high current mode, such as to maintain efficacy of a battery or a high voltage defibrillation energy storage capacitor in spite of non-use. Before performing the capacitor reform or other high current mode, a voltage delay test can be performed. A voltage delay can be declared when an initial battery voltage measurement is less than a later battery voltage measurement during a loaded condition such as the charging of the capacitor. If a voltage delay is present, the capacitor reform or other temporary high current mode is enabled, otherwise, the capacitor reform or other temporary high current mode is inhibited. This saves energy, increasing the life of the IMD before explant.

Abstract: An apparatus and method of automatically measuring the lead impedance of a high energy shock lead before delivery of high energy therapy used to treat heart arrhythmia. In one example, an impedance measurement circuit measures the impedance between electrodes in a plurality of pairs of electrodes. The measured lead electrode impedance is compared to a predetermined value to detect if the lead is shorted to another lead. If a high-energy shock electrode is shorted to another lead, a shorted lead indicator is set to a fault state. Based on the state of the shorted lead indicator, a processor prevents or allows the delivery of high energy therapy. By checking for a lead short before delivery of the therapy, all of the energy of the therapy is delivered to the patient rather than being bypassed by a shorted lead connection.

Abstract: An apparatus and method for appropriate selection of high energy shocking electrodes based on impedance measurements. In one example, an impedance measurement circuit measures the impedance between different sets of electrodes upon implant. The measured electrode impedance is compared to a predetermined impedance range to detect the presence of a high-energy shocking electrode. If a high-energy shocking electrode is present, a lead electrode status indicator is set. Based on the state of the lead electrode status indicator, a processor prevents or allows the use of various electrode combinations to deliver high energy therapy. Since the increase in automaticity allows the system to change the programmed therapy based on the status of the leads, patient safety is increased.

Abstract: An apparatus and method of automatically measuring the lead impedance of a high energy shock lead before delivery of high energy therapy used to treat heart arrhythmia. In one example, an impedance measurement circuit measures the impedance between electrodes in a plurality of pairs of electrodes. The measured lead electrode impedance is compared to a predetermined value to detect if the lead is shorted to another lead. If a high-energy shock electrode is shorted to another lead, a shorted lead indicator is set to a fault state. Based on the state of the shorted lead indicator, a processor prevents or allows the delivery of high energy therapy. By checking for a lead short before delivery of the therapy, all of the energy of the therapy is delivered to the patient rather than being bypassed by a shorted lead connection.