Abstract: An exemplary method includes detecting arrhythmia, detecting myocardial ischemia, determining whether the myocardial ischemia comprises local ischemia or global ischemia and, in response to the determining, calling for delivery of either a local ischemic anti-arrhythmia therapy or a global ischemic anti-arrhythmia therapy. Various other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes configuring a coil electrode as a cathode, calling for delivery of energy to an electrode configuration that includes the coil cathode wherein the energy exceeds one joule, configuring a coil electrode as an anode and, within 10 seconds of the calling, calling for delivery of energy to an electrode configuration that includes the coil anode wherein the energy exceeds one joule. Such an exemplary method may aim to induce fibrillation and to defibrillate tissue. Various other exemplary methods are disclosed as well as various exemplary devices, systems, etc.

Abstract: An apparatus and related methods for reforming a capacitor. One method includes charging the capacitor to a first voltage value, allowing the capacitor to self discharge, measuring a time it takes for the capacitor to self discharge to a second voltage value, and determining whether to reform the capacitor depending upon the measured self-discharge time.

Abstract: Various techniques are described for preventing pacemaker mediated tachycardia (PMT) within biventricular pacing systems and for detecting and terminating PMT should it nevertheless arise. In a first prevention technique, refractory periods applied to the atrial channel are synchronized to begin with a second of a pair of ventricular pacing pulses to more effectively prevent T-wave oversensing on the atrial channel. In a second prevention technique, the sensitivity of the atrial channel is reduced during T-waves also to prevent T-wave oversensing. In a third prevention technique, template matching is performed on the ventricular channels to prevent T-wave oversensing. In a fourth prevention technique, T-wave detection windows are applied to both the ventricular and atrial channels subsequent to any paced or sensed events.

Abstract: A method and apparatus for treating an arrhythmia is provided. The method includes the steps of: (a) sensing at least one electrical signal from the patient's heart; (b) calculating a frequency spectrum of each electrical signal; (c) calculating a center frequency for each frequency spectrum; and (d) selecting an electro-therapy for delivery to the patient's heart based on the center frequency. The electro-therapy can be a pre-programmed anti-tachycardia pacing (ATP) therapy, a shock therapy, or no therapy at all. The method is performed through the use of an implantable cardioverter defibrillator (ICD). Also provided is a method of determining the optimal location to deliver the electro-therapy.

Abstract: The present invention teaches an economical disposable emergency cellular telephone. A major object of this invention is a shocking self-defense capability. A further object is a cell phone which launches projectiles to deliver the shocking voltage. A further object of the invention is a new technique for having a large number of cellular phones share the same small group of access numbers and serial numbers in order to reduce the monthly charges to zero for the end consumer. This makes it more practical to use cellular phones for data transmission and monitoring applications.

Abstract: An implanted cardioverter defibrillator (ICD) delivers an electrical therapy signal to the heart of a patient. When ventricular fibrillation or another condition of the heart requiring high voltage therapy is sensed, the therapy signal is delivered to the heart. When a partial short-circuit or other low impedance condition occurs, an over-current protection circuit will stop delivery of a shocking pulse. The ICD will then reduce the voltage of the shocking pulse and try again to deliver electrical therapy. This process is repeated until a voltage level is found that is able to deliver the electrical therapy without causing an over-voltage condition. Alternate lead configurations may also be tried in an attempt to find a signal path that is not affected by the low impedance or short-circuit condition.

Abstract: A body-implantable lead suitable for use in conjunction with implantable cardiac devices and method for assembling a body-implantable lead suitable for use in conjunction with implantable cardiac devices. The body-implantable lead includes a lead body having at least one inner lumen and at least one elongated conductor cable residing within the inner lumen. An end portion of the conductor cable is joined by an aligned weld joint directly to an end portion of a lead component. Exemplary lead components include, but are not limited to, an electrode member, an elongated conductive connector pin of a proximal connector, a conductor extending from a proximal end of a distal tip of the lead, and a second elongated conductor cable residing within a second inner lumen of the lead body.

Abstract: A device and methods for automatically evaluating one or more patient physiological parameters and, upon determination that certain therapies are indicated, delivering therapeutic mechanical stimulations to tissue of the patient. The mechanical stimulations generally include vibrations delivered at frequencies somewhat higher or lower than an intrinsic frequency and the therapeutic vibrations are delivered to drive the intrinsic frequency towards a desired value. The device and methods more closely emulate natural physiologic feedback mechanisms and can reduce undesired side effects of other known therapies. The device can include a small and efficient electrical motor which is interconnected with a crank and link mechanism to generate oscillatory motion which is conducted to a flexible wall of a bio-compatible housing of the device.

Abstract: An implantable system applies tiered antitachycardia pacing (ATP) that may be combined with pre-pulsing therapy in order to reduce pain. In one implementation, an exemplary system applies a progression of increasingly potent pacing vectors, progressing in an initial tier from small electrodes inside the heart to later tiers that increasingly use a large electrode surface outside the heart. In the latter tiers, a pre-pulse may be added prior to each ATP pulse to reduce the sensation of pain.

Abstract: An implanted cardioverter defibrillator (ICD) delivers an electrical therapy signal to the heart of a patient. When ventricular fibrillation or another condition of the heart requiring high voltage therapy is sensed, the therapy signal is delivered to the heart. When a partial short-circuit or other low impedance condition occurs, an over-current protection circuit will stop delivery of a shocking pulse. The ICD will then reduce the voltage of the shocking pulse and try again to deliver electrical therapy. This process is repeated until a voltage level is found that is able to deliver the electrical therapy without causing an over-voltage condition. Alternate lead configurations may also be tried in an attempt to find a signal path that is not affected by the low impedance or short-circuit condition.

Abstract: An exemplary controller includes an input for receiving information related to a signal of supraventricular origin, control logic to determine a control signal and an output to deliver the control signal to thereby actively filter the signal of supraventricular origin in the His bundle. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An implantable medical device, such as a pacemaker or implantable cardioverter defibrillator (ICD), is configured to automatically detect ingestion of medications to verify that prescribed medications are taken in a timely manner and at the correct dosage. Briefly, individual pills are provided with miniature radio frequency identification (RFID) devices capable of transmitting RFID tag signals, which identify the medication contained within the pill and its dosage. The implanted device is equipped with an RFID transceiver for receiving tag signals from a pill as it is being ingested. The implanted system decodes the tag to identify the medication and its dosage, then accesses an onboard database to verify that the medication being ingested was in fact prescribed to the patient and to verify that the correct dosage was taken. Warning signals are generated if the wrong medication or the wrong dosage was taken. Therapy may also be automatically adjusted.

Abstract: An implantable medical device includes leads, a segment monitoring module, an impedance detection module and an ischemia module. The leads include electrodes that are configured to be positioned within a heart and that are capable of sensing cardiac signals having a segment of interest. The segment monitoring module determines segment variations of the segment of interest in the cardiac signals. The impedance detection module measures impedance vectors between predetermined combinations of the electrodes. The ischemia detection module monitors ischemia based on changes in the segment variations of the segment of interest and based on changes in the impedance vectors.

Abstract: Provided herein are implantable devices, and methods for use therewith, that independently monitor levels of parasympathetic and sympathetic tone of a patient. In accordance with an embodiment, a cardiac electrogram (EGM) signal is sensed using implanted electrodes, cardiac intervals are measured within a portion of the sensed EGM signal, and levels of parasympathetic tone and sympathetic tone are independently assessed based on the measured cardiac intervals. This abstract is not intended to describe all of the various embodiments of the present invention.

Abstract: An electrical method and apparatus for stimulating cardiac cells causing contraction to force hemodynamic output during fibrillation, hemodynamically compromising tachycardia, or asystole. Forcing fields are applied to the heart to give cardiac output on an emergency basis until the arrhythmia ceases or other intervention takes place. The device is used as a stand alone external or internal device, or as a backup to an ICD, atrial defibrillator, or an anti-tachycardia pacemaker. The method and apparatus maintain some cardiac output and not necessarily defibrillation.

Abstract: A wireless projectile for use with a hand-held electronic control device includes a housing, one or more capacitors disposed within the interior of the housing, and one or more probes in electrical communication with the capacitor(s) The probe(s) are disposed within the housing in the first end region of the housing when the projectile is in a first state, and the probe(s) extend through the first end of the housing when the projectile is in the second state. The projectile does not comprise a battery or an inverter to charge the capacitor.

Abstract: A method of predicting a patient's response to multi-chamber pacing by implanting at least three sensing electrodes, measuring across at least two different impedance vectors of the heart via the three electrodes to obtain at least two impedance signals, and evaluating the at least two impedance signals for indications of contractile dysynchrony. Contractile dysynchrony indicates that the patient is likely to have a positive response to multi-chamber pacing. Also an implantable cardiac stimulation device with an implantable housing, a stimulation pulse generator positioned within the housing, at least two implantable leads, and a controller communicating with the pulse generator to induce the generator to deliver therapeutic stimulation to a patient's heart. The leads are arranged to measure a physiological parameter along at least two different spatial orientations.

Abstract: An implantable cardiac device to induce fibrillation in the heart of a patient to allow testing of the defibrillation capability of the device. The device induces fibrillation using a direct current across the heart. The shock to the heart may be applied in a method to minimize discomfort to the patient. The heart is monitored during application of the shock. The voltage of shock at the heart is gradually increased until fibrillation is induced. Once the fibrillation is detected the shock may be stopped. This results in a minimized voltage level and duration for the shock to the heart, thereby diminishing pain and discomfort to the patient.

Abstract: T-wave amplitude and QT interval are derived from patient cardiac signals. Then blood glucose levels are determined based on a combination of the T-wave amplitude and the QT interval. By using a combination of both T-wave-based and QT interval-based signals, blood glucose levels can be reliably detected throughout a wide range of blood glucose levels. Once the blood glucose level has been detected, the implanted device compares the blood glucose level against upper and lower acceptable bounds and appropriate warning signals are generated if the level falls outside the bounds. In one example, wherein an implantable insulin pump is additionally provided, the pump is controlled based on the detected blood glucose level to maintain glucose levels within an acceptable range. A calibration technique is also provided for determining patient-specific parameters for use in the detection of blood glucose levels.