Abstract: A high-speed atherectomy device is disclosed, for abrading a blockage (stenosis) in the interior of a lumen (artery). The device uses a rapidly rotating drive shaft that includes an eccentric abrasive element that has its center of mass laterally offset from the rotational axis of the drive shaft. As the drive shaft rotates, centrifugal force drives the eccentric abrasive element outward, so that it traces an abrading diameter at high rotational speeds that is larger than its rest diameter. The drive shaft includes counterweights on both sides of the abrasive element, which may stabilize operation at high rotational speeds. In some cases, the counterweights are also eccentric, with their centers of mass laterally offset from the rotational axis in the opposite direction as that of the abrasive element. The counterweights are longitudinally separated from the abrasive element, and in some cases, the separations are adjustable and/or controllable.

Abstract: A high-speed atherectomy device is disclosed, for abrading a blockage (stenosis) in the interior of a lumen (artery). The device uses a rapidly rotating drive shaft that includes an eccentric abrasive element that has its center of mass laterally offset from the rotational axis of the drive shaft. As the drive shaft rotates, centrifugal force drives the eccentric abrasive element outward, so that it traces an abrading diameter at high rotational speeds that is larger than its rest diameter. The drive shaft includes counterweights on both sides of the abrasive element, which may stabilize operation at high rotational speeds. In some cases, the counterweights are also eccentric, with their centers of mass laterally offset from the rotational axis in the opposite direction as that of the abrasive element. The counterweights are longitudinally separated from the abrasive element, and in some cases, the separations are adjustable and/or controllable.

Abstract: Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Abstract: An electrical lead includes an elongate body having a proximal end, and a sensing unit capable of resolving a change in a spatial configuration of the electrical lead. A medical device includes a control unit, an elongate body having a proximal end coupled with the control unit, and a sensing unit capable of resolving a change in a spatial configuration of the electrical lead and relating it to the amount of blood ejected from the heart. A method includes receiving a signal transmitted from a lead disposed within a heart and determining a change in a dimension of the heart, due to the heart beating, based upon the signal.

Abstract: Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Abstract: Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Abstract: An electrical lead includes an elongate body having a proximal end, and a sensing unit capable of resolving a change in a spatial configuration of the electrical lead. A medical device includes a control unit, an elongate body having a proximal end coupled with the control unit, and a sensing unit capable of resolving a change in a spatial configuration of the electrical lead and relating it to the amount of blood ejected from the heart. A method includes receiving a signal transmitted from a lead disposed within a heart and determining a change in a dimension of the heart, due to the heart beating, based upon the signal.

Abstract: Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Abstract: Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Abstract: A method and apparatus for cardioversion and defibrillation. The apparatus is provided with two pairs of cardioversion or defibrillation electrodes, and delivers pulses sequentially between said first and second pairs of electrodes, such that the first pulse overlaps the second pulse for a time interval of at least about one millisecond. During the overlap time of the first and second pulses, a defibrillation pulse vector intermediate that defined by the two electrode pairs individually is provided.

Abstract: A method of and apparatus for controlling one or more parameters of an electrical stimulation generator in response to measured results of the stimulation. In the preferred mode, this technique is employed in a system for the treatment of obstructive sleep apnea. Sensors are used to determine the effectiveness of the stimulation. Amplitude and pulse width are modified in response to the measurements from the sensors.

Abstract: A technique for reducing fatigue associated with artificially stimulated contractions of muscle tissue. The stimulation of the muscle tissue is associated with treatment of a particular medical condition, such as obstructive sleep apnea. For this application, the muscles of the upper airway are stimulated to relieve or prevent obstruction to normal respiratory activity during sleep.Fatigue is reduced by stimulating the subject muscles from multiple rather than a single electrode. This ensures that successive depolarizations are not produced from the same focus, and that different motor units are successively depolarized.Each electrode is placed at the muscle nerve interface to recruit the assistance of the nerve tissue in conducting the stimulation signals throughout the muscle. The conductors coupling the individual electrodes share a common cable structure to produce ease in the implant procedure. The electronics of the stimulation pulse generator is conveniently demultiplexed to eliminate excess hardware.

Abstract: An implantable system for the treatment of obstructive sleep apnea by electrical stimulation of the musculature of the upper airway. The system employs one or more sensors to determine the onset of an apnea event. Upon sensing of the onset of an apnea event, the stimulation generator provides a signal for stimulating the muscles of the upper airway at a varying intensity wherein the intensity is gradually increased during the course of the stimulation. The signal is coupled to the muscles to be stimulated by an electrode connected to the stimulation generator by an insulated lead.

Abstract: A method of and apparatus for controlling one or more parameters of an electrical stimulation generator in response to measured results of the stimulation. In the preferred mode, this technique is employed in a system for the treatment of obstructive sleep apnea. Sensors are used to determine the effectiveness of the stimulation. Amplitude and pulse width are modified in response to the measurements from the sensors.

Abstract: An improved apparatus for and method of providing feedback to an implantable pulse generator to treat obstructive sleep apnea. Sensors monitor the electrical activity associated with contractions of the diaphragm. The pressure within the thorax and the upper airway are also measured. Whenever electrical activity of the diaphragm suggests that an inspiration cycle is in progress and the pressure sensors show an abnormal pressure differential across the airway, the presence of obstructive sleep apenea is assumed and electrical stimulation is applied to the musculature of the upper airway.

Abstract: An apparatus for and method of improving muscle tone of a patient using chronic sub-tetanic electrical stimulation. For patients suffering from obstructive sleep apnea, for example, the muscles of the upper airway are provided the chronic stimulation to mitigate or prevent the adverse medical condition caused in part by excessively flaccid muscle tissue around and in the airway.A stimulation generator supplies pulses to the muscle to be treated through insulated leads which are coupled to electrodes directly in contact with the appropriate neuro-muscular tissue. The output of the stimulation generator is adjusted to a frequency of sufficiently low level as to prevent fused tetanic contraction of the stimulated muscle. The adjustment may be made manually by attending medical personnel or may be done automatically using electrodes to sense the tension of the stimulated muscle. In the automatic mode, the sensing system insures the stimulation frequency level is decreased below the threshold of muscle tetanus.

Abstract: An apparatus and method for the control of both central and obstructive sleep apnea using electrical stimulation on a demand basis. Implantable sensors monitor the respiration cycle and determine the occurrence of apnea events. Central apnea is sensed by the passage of an escape interval of time without the sensing of an inspiratory event and a concurrent decrease in blood oxygen saturation. Obstructive sleep apnea is sensed as an abnormal pressure differential across the airway. The diaphragm is electrically stimulated upon sensing of central apnea. The musculature of the upper airway is electrically stimulated upon sensing of an occurrence of obstructive sleep apnea. Stimulation of the upper airway is provided whenever central apnea is sensed.

Abstract: An apparatus for and method of improving muscle tone of a patient using chronic sub-tetanic electrical stimulation. For patients suffering from obstructive sleep apnea, for example, the muscles of the upper airway are provided the chronic stimulation to mitigate or prevent the adverse medical condition caused in part by excessively flaccid muscle tissue around and in the airway.A stimulation generator supplies pulses to the muscle to be treated through insulated leads which are coupled to electrodes directly in contact with the appropriate neuro-muscular tissue. The output of the stimulation generator is adjusted to a frequency of sufficiently low level as to prevent fused tetanic contraction of the stimulated muscle. The adjustment may be made manually by attending medical personnel or may be done automatically using electrodes to sense the tension of the stimulated muscle. In the automatic mode, the sensing system insures the stimulation frequency level is decreased below the threshold of muscle tetanus.

Abstract: An improved hydrogel adhesive, particularly adapted for adhesion and contact to tissue. It is especially useful in attaching electrical leads to tissue, for example in attaching pacemaker leads to the heart, interiorly or exteriorly.

Abstract: Ventricular fibrillation and other tachyarrhythmias are controlled by delivery of two sequential impulses to two pairs of electrodes placed partially within or adjacent to the heart. One electrode pair is provided by an endocardial lead which includes a distal electrode adapted to reside in the apex of the right ventricle and a proximal electrode designed to lie in the superior vena cava. The second electrode pair comprises the distal electrode within the right ventricle and a further electrode lodged in or adjacent to the coronary sinus. The metal case of the implantable pulse generator which supplies pulses to the electrode pairs may be substituted for the coronary sinus electrode if the pulse generator is implanted above and to the left of the heart in the left pectoral region of the patient's body. Alternatively, a subcutaneous plate electrode may be substituted for the can, obviating the need for implanting the generator in the left pectoral region.