Abstract: A method includes selecting an electrode located in a patient; acquiring position information with respect to time for the electrode where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating a stability metric for the electrode based on the acquired position information with respect to time; and deciding if the selected electrode, as located in the patient, has a stable location for sensing biological electrical activity, for delivering electrical energy or for sensing biological electrical activity and delivering electrical energy. Position information may be acquired during one or both of intrinsic or paced activation of a heart and respective stability indexes calculated for each activation type.

Abstract: A method includes selecting an electrode located in a patient; acquiring position information with respect to time for the electrode, during both acute and chronic states of the electrode, where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating an acute state stability metric and a chronic state stability metric for the electrode based on the acquired position information with respect to time; and comparing the acute state stability metric to the chronic state stability metric to decide whether the electrode, as located in the patient in the chronic state, comprises a stable location for delivery of a therapy. The chronic state stability metric of an electrode may be monitored over time to decide whether stability of the electrode has changed.

Abstract: A method includes selecting an electrode located in a patient wherein the electrode comprises a lead-based electrode; acquiring position information with respect to time for the electrode, during both loaded and unloaded conditions of the lead, where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating a both loaded and unloaded stability metrics for the electrode based on the acquired position information with respect to time; and comparing the unloaded and loaded stability metrics to decide whether the electrode, as located in the patient, comprises a stable location for delivery of therapy.

Abstract: An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed.

Abstract: An implantable medical device comprises a signal generator for generating a current signal having a frequency in a frequency window slightly less than the ?-dispersion frequency of a tissue and applying the signal over the tissue. A signal measurer measures the resulting voltage signal and an impedance parameter is calculated from the applied and measured signal by a parameter determiner. A status monitor monitors the permeability status of cell membranes in the tissue based on this impedance parameter.

Abstract: In a method and device for detecting the intake of food in a subject at least one parameter related to the blood flow and/or perfusion of a blood vessel and/or an organ in the digestive system of a patient is monitored by a sensor attached to, or in, a blood vessel or organ of the digestive system. The value of each monitored parameter is analyzed and may be used to control the activity of a gastric stimulator.

Abstract: An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient where the cardiac information comprises position information, electrical information and mechanical information; mapping local electrical activation times to anatomic positions to generate an electrical activation time map; mapping local mechanical activation times to anatomic positions to generate a mechanical activation time map; generating an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and rendering at least the electromechanical delay map to a display. Various other methods, devices, systems, etc., are also disclosed.

Abstract: An apparatus for determining variation over time of a medical parameter of a human being obtained from a sensed signal has a sensor implantable in the human being for sensing the signal. A comparator compares at least one characteristic property, derived from the sensed signal obtained for at least one predetermined first level of activity of the human being, with corresponding reference property of a sensed reference signal, obtained for a predetermined reference level of activity of the human being, for determining a relation between the characteristic property of the sensed signal and the reference property. A trend determining unit determines trends in the medical parameter by analyzing the relation between the characteristic property of the sensed signal obtained at different times and the reference property. A corresponding method also function an implant for heart failure diagnostics also function as described.

Abstract: In an ischemia detection method, and in an ischemia detector and a cardiac stimulator embodying an ischemia detector, a workload of a patient is measured, as is an ejection fraction (EF) associated with the heart of the patient is determined. A predetermined reference relation between EF and workload for the patient is stored, and an analysis unit detects a state of ischemia of the patient from deviation in the determined EF for various workloads from the stored reference relation.

Abstract: In a device and method for a medical implant for monitoring progression of heart failure in a human heart, an activity sensor provides information related to the activity level of a patient and an oxygen sensor provides information related to the level of oxygen content in venous blood. A determined level of venous oxygen content at a determined activity level is obtained, and that level of venous oxygen content is compared to stored values at a corresponding activity level. The result of the comparison is used as a basis for determining a degree of heart failure.

Abstract: An implantable cardiac device has a heart stimulator for electrically stimulating the heart of a patient, detector that measures a physiologic parameter that is affected by the status of a cardiovascular disease associated with sympathetic activation, a signal processor that determines at least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the measured parameter, and analyzer that automatically analyzes the determined Mayer wave component in relation to a predetermined reference value to determine the status of the cardiovascular disease. The detector is a cardio-mechanical parameter detector that measures, as said physiologic parameter, a mechanical change in at least one of the four chambers of the heart. In a corresponding method for monitoring the status of a cardiovascular disease associated with sympathetic activation of a patient having an implantable electric heart stimulator a physiologic parameter affected by the cardiac disease is measured.

Abstract: An implantable medical device for monitoring the movements of the valve planes of the heart to determine at least one hemodynamic measure reflecting a mechanical functioning of a heart of a patient, includes an impedance measuring circuit that measures impedance between at least electrode pairs including at least one electrode placed substantially at the level of the valve plane. The measured impedances reflect valve plane movements. A hemodynamic parameter determining circuit determines at least one hemodynamic parameter based on the impedances reflecting the mechanical functioning of the heart.

Abstract: The present invention relates to a method for determining the posture of a patient. The method comprises the steps of: initiating (50, 52) a patient posture determining session by performing an electrical bio-impedance measurement session in at least one of a number of different electrode configurations in order to measure an impedance value for the at least one configuration; obtaining reference impedance values (54) stored in advance for the at least one configuration and for at least one potential posture of the patient; comparing (54) the measured impedance value for the at least one configuration with corresponding stored reference impedance values for at least one potential posture of the patient; and determining (56) the present posture of the patient by using results from the comparison between measured impedance values and the stored reference impedance values.

Abstract: In a system and method for controlling an implantable stimulator capable of producing pacing pulses to be delivered to cardiac tissue, as well as vagal stimulation pulses to be delivered to vagus nerve sites, upon detection of a premature cardiac event, such as a premature ventricular or atrial contraction, a simulated heart rate turbulence (HRT) procedure is applied if the intrinsic heart rate turbulence is weakened or absent. The simulated HRT includes a first phase in which the heart rate is increased, from the existing level, for a number of heart beats, a second phase in which the heart rate is decreased for a number of heart beats, and an optional third phase in which the heart rate is returned to said existing level.

Abstract: Therapy optimization includes tracking electrode motion using an electroanatomic mapping system and generating, based on tracked electrode motion, one or more mechanical dyssynchrony metrics to thereby guide a clinician in therapy optimization (e.g., via optimal electrode sites, optimal therapy parameters, etc.). Such a method may include a vector analysis of electrode motion with respect to factors such as times in cardiac cycle, phases of a cardiac cycle, and therapy conditions, e.g., pacing sites, pacing parameters and pacing or no pacing. Differences in position-with-respect-to-time data for electrodes may also be used to provide measurements of mechanical dyssynchrony.

Abstract: A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.

Abstract: An exemplary method includes providing a mechanical activation time (MA time) for a myocardial location, the location defined at least in part by an electrode and the mechanical activation time determined at least in part by movement of the electrode; providing an electrical activation time (EA time) for the myocardial location; and determining an electromechanical delay (EMD) for the myocardial location based on the difference between the mechanical activation time (MA time) and the electrical activation time (EA time).

Abstract: An exemplary method includes providing at least two-dimensional position information, for at least two points in time, for an electrode located in a cardiac space; determining a local estimator based on the position information; and, based at least in part on the determined local estimator, selecting a configuration for delivering a cardiac pacing therapy or diagnosing a cardiac condition. Exemplary methods for regional estimators and exemplary methods for global estimators are also disclosed along with devices and systems configured to perform various methods.

Abstract: An implantable heart stimulating device has a stimulation pulse generator that emits stimulation pulses at an adjustable stimulation rate, an activity sensor that emits an activity signal in response to detected activity of the patient, and a physiological parameter sensor that generates a physiological sensor signal in response to a detected physiological parameter. The activity and physiological sensor signals are supplied to a control arrangement that sets the stimulation rate for the stimulation pulse generator by executing a stimulation rate algorithm dependent on those signals. In the stimulation rate algorithm, if the physiological signal indicates an emotional stress on the part of the patient, the stimulation rate is increased to an adjustable emotional stress rate level, and if no increase in the activity signal occurs during a predetermined time period following the stimulation rate increase, the stimulation rate is decreased.