Abstract: The present invention is directed toward devices configured to perform an adaptive method for initiating the charging and delivering therapy to treat patient's experiencing recurrent non-sustained arrhythmic events. The adaptive methods of the allow accounting for the persistence of an arrhythmia prior to initiating the charging sequence to deliver therapy.

Abstract: The present invention is directed toward template formation methods for use in cardiac rhythm management devices. The template formation methods of the present invention provide for creating a robust template to compare with sensed cardiac complexes.

Abstract: Methods of using a template having a template data set and template parameters to provide improved alignment of captured cardiac signal data to a stored template. More particularly, in an illustrative method, a captured cardiac signal is first configured using template parameters for a stored template. Then, once configured, the captured cardiac signal is then compared to the stored template. Other embodiments include implantable cardiac treatment devices including operational circuitry configured to perform the illustrative method. In a further embodiment, more than one stored templates may be used. Each template can have independently constructed templates, such that a single captured cardiac signal may be configured using first parameters for comparison to a first template, and using second parameters for comparison to a second template.

Abstract: A method for operating a cardiac rhythm management device in which a clinical state vector is computed as a combination of a plurality of parameters related to a patient's heart failure status and compared to a previously computed clinical state vector to determine a clinical trajectory indicative of changes in the patient's heart failure status. Such detected changes in status can be used both as a clinical tool to evaluate treatment and to automatically adjust the operation of the device.

Abstract: A cardiac rhythm management device capable of delivering multiple uni-chamber stimulation pulses to a patient's heart and suitable for verifying capture independently for each uni-chamber stimulation pulse. The uni-chamber capture verification mode of the cardiac rhythm management device may be activated via telemetry or by applying a magnetic field proximate the device. During the capture verification mode, bi-chamber pacing, for example, may precede or follow uni-chamber pacing to allow for pacing support. Also, the energy levels of the pacing stimulus over several beats may be varied, thereby verifying the programmed safety margins.

Abstract: A method for operating a cardiac rhythm management device in which a clinical state vector is computed as a combination of a plurality of parameters related to a patient's heart failure status and compared to a previously computed clinical state vector to determine a clinical trajectory indicative of changes in the patient's heart failure status. Such detected changes in status can be used both as a clinical tool to evaluate treatment and to automatically adjust the operation of the device.

Abstract: A first electrode is positioned within an artery proximate an implanted intravascular stent. A second electrode is positioned at a separate location relative the position of the first electrode. Electrical energy is then delivered between the first and the second electrodes to produce an electrical field adjacent the implanted intravascular stent. When a intravascular stent is implanted in a coronary artery, the delivery of the electrical energy is coordinated to cardiac cycles detected in sensed cardiac signals, where the delivery of the electrical energy between the first electrode and the second electrode occurs during a predetermined portion of the cardiac cycle.

Abstract: The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.

Abstract: The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector.

Abstract: An electric power monitoring system includes a source monitor for measuring momentary power output of an electric source supplying electric power to a power distribution system having at least one electric load. The momentary power output is compared with a reference load capability for the electric source to determine the ability of the electric source to support additional load, and load capability data is transmitted based on the load capability. At least one load control receives the transmitted load capability data and controls the supply of power to the at least one corresponding electric load based on the load capability data.

Abstract: The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation in which the energy stored in a capacitor used to deliver a shock pulse is monitored and adjusted. A charging circuit is used to charge the capacitor from a supply voltage upon detection of an atrial arrhythmia, and a controller monitors sensed ventricular depolarizations until R-wave synchrony requirements are met so that an atrial shock pulse can be safely delivered. The controller also attempts to maintain the voltage of the capacitor at a specified voltage before delivery of the shock pulse by operation of the charging circuit.

Abstract: The present invention is directed toward a sensing architecture for use in cardiac rhythm management devices. The sensing architecture of the present invention provides a method and means for certifying detected events by the cardiac rhythm management device. Moreover, by exploiting the enhanced capability to accurately identifying only those sensed events that are desirable, and preventing the use of events marked as suspect, the sensing architecture of the present invention can better discriminate between rhythms appropriate for device therapy and those that are not.

Abstract: The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.

Abstract: A cardiac rhythm management system includes a time-dependent frequency response for sensed heart signals. A change in the frequency response of a sensing circuit is triggered by a sensed or evoked event to make it less sensitive to the detection of a subsequent event for a period of time. For example, a passband bandwidth is reduced, then increased during the time period triggered by the event. For even more event-triggered selectivity, a gain is reduced, then increased during the time period triggered by the event. This provides better discrimination between particular events included in a heart signal so that appropriate therapy can be delivered to the patient based such events.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation in which the energy stored in a capacitor used to deliver a shock pulse is monitored and adjusted. A charging circuit is used to charge the capacitor from a supply voltage upon detection of an atrial arrhythmia, and a controller monitors sensed ventricular depolarizations until R-wave synchrony requirements are met so that an atrial shock pulse can be safely delivered. The controller also attempts to maintain the voltage of the capacitor at a specified voltage before delivery of the shock pulse by operation of the charging circuit.

Abstract: A first electrode is positioned within an artery proximate an implanted intravascular stent. A second electrode is positioned at a separate location relative the position of the first electrode. Electrical energy is then delivered between the first and the second electrodes to produce an electrical field adjacent the implanted intravascular stent. When a intravascular stent is implanted in a coronary artery, the delivery of the electrical energy is coordinated to cardiac cycles detected in sensed cardiac signals, where the delivery of the electrical energy between the first electrode and the second electrode occurs during a predetermined portion of the cardiac cycle.

Abstract: A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall. A method for implanting the lead into the coronary vasculature is also provided, the method comprising the steps of inserting a stylet into the lead, inserting the lead into the coronary sinus, advancing the lead from the coronary sinus toward the toward the left atrium and into a coronary vein, removing the stylet, and sensing and pacing the heart.

Abstract: A cardiac rhythm management system, such as an implantable cardioverter-defibrillator (ICD), provides atrial anti-tachyarrhythmia therapy, such as a bipolar or unipolar electrical cardioversion countershock, or provides both atrial and ventricular anti-tachyarrhythmia therapy. The atrial and ventricular anti-tachyarrhythmia therapies have independent cardioversion-defibrillation energy levels and other parameters. The system provides an endocardial lead that is convenient to implant for providing the anti-tachyarrhythmia therapy. The endocardial lead includes a first supraventricular electrode disposed in the atrium and superior vena cava, and optionally includes a first ventricular electrode and ICD housing electrode.

Abstract: A first electrode is positioned within an artery proximate an implanted intravascular stent. A second electrode is positioned at a separate location relative the position of the first electrode. Electrical energy is then delivered between the first and the second electrodes to produce an electrical field adjacent the implanted intravascular stent. When a intravascular stent is implanted in a coronary artery, the delivery of the electrical energy is coordinated to cardiac cycles detected in sensed cardiac signals, where the delivery of the electrical energy between the first electrode and the second electrode occurs during a predetermined portion of the cardiac cycle.