Abstract: A cardiac harness assembly for treating congestive heart failure and for use in defibrillation and/or pacing/sensing is provided. The cardiac harness includes a number of longitudinal ribs spaced apart by connectors, the longitudinal ribs extending from the base to the apex of the heart. The longitudinal ribs have a high degree of longitudinal flexibility so that when the cardiac harness is mounted on the heart, the longitudinal ribs flex along the longitudinal axis of the ribs as the heart expands and contracts circumferentially. The cardiac harness provides a uniform and continuous compressive force on the heart throughout the cardiac cycle.

Abstract: A system for treating the heart including a cardiac harness configured to conform generally to at least a portion of a patient's heart. The system also includes an electrode associated with the cardiac harness and positioned on or proximate to the epicardial surface of the heart. In order to ensure that the electrode will operate with a pulse generator, the system has an impedance between approximately 10 ohms and approximately 120 ohms.

Abstract: A cardiac harness for treating or preventing congestive heart failure is configured to be placed about at least a portion of a patient's heart so as to apply a mild compressive force on the heart. In one embodiment, the cardiac harness comprises a plurality of spaced apart conductive panels arranged so that there is no electrical continuity circumferentially around the harness. In an additional embodiment, a cardiac harness is provided that is insulated so as not to conduct electricity circumferentially about the harness.

Abstract: A delivery system for providing and deploying a cardiac harness over a heart. The delivery system includes an introducer tube having a plurality of distal fingers biased into a compressed delivery diameter. A dilator tube is slidably mounted within the introducer tube for dilating the fingers into an expanded diameter for deploying a suction cup into secure attachment with the heart. The suction cup is used to manipulate the heart as the cardiac harness is also deployed from the dilator tube over the suction cup, and over the heart. The suction cup is shaped to securely attach to the apex of the heart in one embodiment.

Abstract: A cardiac harness for treating or preventing congestive heart failure is configured to be placed about at least a portion of a patient's heart so as to apply a mild compressive force on the heart. In one embodiment, the cardiac harness comprises a plurality of spaced apart conductive panels arranged so that there is no electrical continuity circumferentially around the harness. In an additional embodiment, a cardiac harness is provided that is insulated so as not to conduct electricity circumferentially about the harness.

Abstract: A system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock to the heart for defibrillation and/or can be used for pacing/sensing. The cardiac harness and electrodes are delivered and implanted on the heart by minimally invasive access.

Abstract: A system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock to the heart for defibrillation and/or can be used for pacing/sensing. The cardiac harness and electrodes are delivered and implanted on the heart by minimally invasive access.

Abstract: A system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock to the heart for defibrillation and/or can be used for pacing/sensing. The cardiac harness and electrodes are delivered and implanted on the heart by minimally invasive access.

Abstract: A system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock to the heart for defibrillation and/or can be used for pacing/sensing. The cardiac harness and electrodes are delivered and implanted on the heart by minimally invasive access.

Abstract: A system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock to the heart for defibrillation and/or can be used for pacing/sensing. The cardiac harness and electrodes are delivered and implanted on the heart by minimally invasive access.

Abstract: A system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock to the heart for defibrillation and/or can be used for pacing/sensing. The cardiac harness and electrodes are delivered and implanted on the heart by minimally invasive access.

Abstract: An implantable cardiac device and method provides for monitoring a progression or regression in heart disease during an extended time period. A sensor generates an electrogram signal representing electrical activity of a patient's heart. From the generated electrogram signal, a processor determines morphology measurements wherein the morphology measurements indicate a progression or regression in the heart disease. The morphology measurements are stored in a memory during the extended period of time. A telemetry circuit transmits the stored morphology measurements to an external receiver for retrieval or display. The morphology measurements may be of electrogram intrinsic activity or evoked response activity characteristics.

Abstract: Increased myocardial voltage is achieved by configuring a shocking circuit of an ICD to generate a defibrillation pulse waveform having a positive phase with three distinct voltage peaks. The shocking circuit employs three capacitors along with switching circuitry for selectively discharging the capacitors so as to generate the defibrillation pulse waveform. More specifically, the switching circuitry generates a first step of the pulse waveform by discharging the capacitors while connected in parallel, then generates a second step of the pulse waveform by discharging the capacitors while the two of the three capacitors are connected in parallel and the third is connected in series, and finally generates a third step of the pulse waveform by discharging the capacitors while connected in series.

Abstract: A cardiac harness configured to be fit around at least a portion of a patient's heart, including a conductive material that is coated with a dielectric coating to electrically insulate at least the heart tissue from the conductive material. The cardiac harness applies a compressive force on the heart during diastole and systole. The cardiac harness includes an arrangement that provides no electrical continuity circumferentially about the harness, so that if an electric current created by a defibrillation device is applied to a patient who has a harness that is placed on their heart, the electric current will pass through the heart unimpeded instead of being conducted around the heart through the harness.

Abstract: A cardiac harness for treating or preventing congestive heart failure is configured to be placed about at least a portion of a patient's heart so as to apply a mild compressive force on the heart. In one embodiment, the cardiac harness comprises a plurality of spaced apart conductive panels arranged so that there is no electrical continuity circumferentially around the harness. In an additional embodiment, a cardiac harness is provided that is insulated so as not to conduct electricity circumferentially about the harness.

Abstract: An implantable stimulation device and associated method allow for the selection of an inter-ventricular or inter-atrial delay which results in optimal hemodynamic benefit for the patient. The stimulation device monitors and measures the width of the QRS complex, or a P wave in response to different interpulse delays during biventricular or biatrial stimulation. The stimulation device then selects the optimal interpulse delay that results in the minimum QRS or P width. The present method allows for the adaptive adjustment of the interpulse interval over time, caused for example, by changes in disease state, medical therapy, physical activity or other factors may cause changes in the electromechanical response of the heart.

Abstract: Increased myocardial voltage is achieved by configuring a shocking circuit of an ICD to generate a defibrillation pulse waveform having a positive phase with three distinct voltage peaks. The shocking circuit employs three capacitors along with switching circuitry for selectively discharging the capacitors so as to generate the defibrillation pulse waveform. More specifically, the switching circuitry generates a first step of the pulse waveform by discharging the capacitors while connected in parallel, then generates a second step of the pulse waveform by discharging the capacitors while the two of the three capacitors are connected in parallel and the third is connected in series, and finally generates a third step of the pulse waveform by discharging the capacitors while connected in series.

Abstract: Detection and monitoring of periodic breathing (PB) to provide an indication of changes in the hemodynamic status of a heart failure patient is accomplished by monitoring at least one of four independent physiologic parameters. The physiologic parameters are respiratory tidal volume, respiratory rate (B-B interval), arterial oxygen saturation (SaO2) and heart rate (R-R interval). The data collected of these physiologic measures may then be analyzed by performing power spectral analysis or thresholding/binning. Each analysis method can be applied to each measure or combination thereof. In the preferred embodiment, the physiologic measures are made when the patient has been identified as being at rest or asleep to prevent interference from activity-related respiratory variations.

Abstract: An implantable stimulation device and associated method allow for the selection of an inter-ventricular or inter-atrial delay which results in optimal hemodynamic benefit for the patient. The stimulation device monitors and measures the width of the QRS complex, or a P wave in response to different interpulse delays during biventricular or biatrial stimulation. The stimulation device then selects the optimal interpulse delay that results in the minimum QRS or P width. The present method allows for the adaptive adjustment of the interpulse interval over time, caused for example, by changes in disease state, medical therapy, physical activity or other factors may cause changes in the electromechanical response of the heart.

Abstract: A circuit for sequentially discharging two capacitors configured for independent discharge into heart electrodes to create a biphasic electrical shock. Upon determination that a therapeutic shock needs to be applied to a heart, the capacitors are charged. Once the capacitors are sufficiently charged, one of the capacitors is switched such that it begins to discharge into the heart. At an appropriate time, this capacitor is switched again such that it no longer discharges into the heart. At this time, the other capacitor is switched such that it begins to discharge into the heart, and at an appropriate time, it is switched such that is stops discharging into the heart. The two capacitors are preferably configured with opposite polarities so that the waveform applied to the heart by the sequential discharging of the two capacitors is biphasic.