Abstract: Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change.

Abstract: A system and method for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy delivery, or a clinician warning. Assessment of cardiac function may be made based on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.

Abstract: Impedance, e.g. sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change. Other methods vary the AA interval to maximize impedance change over the entire cardiac cycle or during the atrial cycle.

Abstract: The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., “CRT”). The invention also provides ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the stimulus captured. If a loss-of-capture (LOC) signal results from the capture management testing, then the applied pacing pulses are modified and the conduction test repeated. If LOC, an alert message can issue.

Abstract: An implantable device is described that collects and aggregates data from non-implanted medical devices external from a body of a patient. The device may also collect and aggregate data from medical devices implanted within the body. The implantable device includes a wireless transceiver to acquire physiological data from the external medical devices, and a storage medium to store the physiological data. A processor retrieves the physiological data and communicates the physiological data to a remote patient management system. The device may collect the physiologic data from the various external data sources, possibly over an extended period of time, and stores the data for subsequent upload to a common patient management system. In addition, the implantable device may collect physiological data from other medical devices implanted within the patient. In this manner, the device provides a central point for collection and aggregation of physiological data relating to the patient.

Abstract: The present invention provides a remote patient monitoring system including a graphical user interface (GUI) that displays a summary table of categorized parameter values for multiple patients simultaneously. The remote patient monitoring system further includes a central database for receiving data from remote medical devices via a communications network and a processor for parameterizing and categorizing summary data to be displayed by the GUI. The displayed summary parameter values are formatted according to category to allow a parameter value category to be visually recognized. In one embodiment, parameter values are categorized according to a need for clinical attention such that a clinician may view a summary table of categorized parameter values and recognize which patients may require clinical attention as indicated by the formatted parameter values.

Abstract: A method for managing data from remotely located patients features batch processing. Patient files are batched in groups to increase workflow efficiency of a caregiver clinic. Scheduling of remote data transmission; accessing, reviewing and evaluating the data; and billing are carried out using a batch processing approach.

Abstract: Delivery of genetic material to a stimulation site causes transgene expression by tissue at the stimulation site. In some embodiments, the delivered genetic material causes increased expression of proteins, such as connexins, gap junctions, and ion channels, to increase the conductivity of the tissue at the stimulation site. In some embodiments, the delivered genetic material causes expression of a metalloproteinase, an anti-inflammatory agent, or an immunosuppressant agent. Genetic material is delivered to the stimulation site via a stimulation lead. A stimulation lead for delivering genetic material to a stimulation site includes a chamber that contains a polymeric matrix. The matrix absorbs the genetic material and elutes the genetic material to the stimulation site.