Abstract: An implantable medical device with a notification system. The device monitors itself and an implantee for one or more condition indicating notification and delivers the notification at a time the patient is determined to be wakeful and, optionally, at relative rest. The notification can be repeated periodically until acknowledged by the user or the system is evaluated and reprogrammed by the physician. A user input can be included to provide the device confirmation of receipt of the notification as well as to delay delivery of any indicated subsequent notifications. The notification is provided without requiring any additional or special dedicated hardware.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An implantable cardiac stimulation device provides selective atrial pacing upon detection of a premature ventricular complex (PVC). The device comprises a premature ventricular complex detector that detects premature complexes of the heart, and a sensing circuit that senses atrial events. The device further comprises a P wave discriminator that identifies an atrial event sensed by the sensing circuit following detection of a premature ventricular complex as one of a retrograde P wave and a normal sinus P wave, and an atrial pulse generator that delivers an atrial pacing pulse responsive to the discriminator identifying an atrial event sensed by the sensing circuit following detection of a premature ventricular complex as a retrograde P wave.

Abstract: A system for automatically evaluating the sensing and detection of physiological processes by an implantable medical device, such as an implantable cardiac stimulation device. The system includes an automatic testing algorithm which iteratively adjusts at least one of the threshold and gain settings of the device and evaluates the accuracy of the detection for refining the programming of the device. The algorithm can include sampling the physiological process beginning at a relatively low rate to avoid excessive burden on the processing and battery capacity available and progressively increasing the rate to obtain higher resolution data. The algorithm can also evaluate the observed physiological process for periodicity and can determine repetition of an irregular pattern, such as bigeminy, and use the determined pattern for predictive purposes to refine the programming of the device. The algorithm employs observation of a change in observed pattern as indicia for loss of proper detection.

Abstract: Implantable systems, and methods for use therewith, for monitoring arterial blood pressure on a chronic basis are provided herein. A first signal indicative of electrical activity of a patient's heart, and a second signal indicative of mechanical activity of the patient's heart, are obtained using implanted electrodes and an implanted sensor. By measuring the times between various features of the first signal relative to features of the second signal, values indicative of systolic pressure and diastolic pressure can be determined. In specific embodiments, such features are used to determine a peak pulse arrival time (PPAT), which is used to determine the value indicative of systolic pressure. Additionally, a peak-to-peak amplitude at the maximum peak of the second signal, and the value indicative of systolic pressure, can be used to determine the value indicative of diastolic pressure.

Abstract: An implantable medical device is provided that comprises a pulse generator that provides atrial and ventricular pacing pulses on demand. The pulse generator times delivery of the ventricular pacing pulses based on an AV pacing interval. The device also includes an AV hysteresis module that extends the AV interval from a base AV interval to an extended AV interval to promote intrinsic heart activity. A refractory module establishes a PVARP interval equal to base PVARP interval following at least one of the ventricular pacing pulses. The refractory module lengthens the PVARP interval by adding a PVARP extension to a base PVARP interval to provide an extended PVARP interval.

Abstract: The extended AV interval of an auto intrinsic conduction search of an implantable cardiac stimulation device has premature atrial contraction protection. A timer times a base AV interval and the extended AV interval. If the heart is paced with the extended AV interval and a premature atrial contraction is detected, the extended AV interval is maintained. Once a predetermined number of consecutive premature atrial contractions are detected, the extended AV interval is reset to the base AV interval.

Abstract: A system for automatically evaluating the sensing and detection of physiological processes by an implantable medical device, such as an implantable cardiac stimulation device. The system includes an automatic testing algorithm which iteratively adjusts at least one of the threshold and gain settings of the device and evaluates the accuracy of the detection for refining the programming of the device. The algorithm can include sampling the physiological process beginning at a relatively low rate to avoid excessive burden on the processing and battery capacity available and progressively increasing the rate to obtain higher resolution data. The algorithm can also evaluate the observed physiological process for periodicity and can determine repetition of an irregular pattern, such as bigeminy, and use the determined pattern for predictive purposes to refine the programming of the device. The algorithm employs observation of a change in observed pattern as indicia for loss of proper detection.

Abstract: The extended AV interval of an auto intrinsic conduction search of an implantable cardiac stimulation device has premature atrial contraction protection. A timer times a base AV interval and the extended AV interval. If the heart is paced with the extended AV interval and a premature atrial contraction is detected, the extended AV interval is maintained. Once a predetermined number of consecutive premature atrial contractions are detected, the extended AV interval is reset to the base AV interval.

Abstract: An implantable cardiac stimulation device and associated method perform a true or blanking period ventricular undersensing detection algorithm in response to ventricular loss of capture not associated with fusion or a change in capture threshold. The test identifies an originating cause of loss of capture, which may be ventricular undersensing of intrinsic R-waves or premature ventricular contractions occurring during a ventricular blanking period or atrial undersensing of P-waves resulting in blanking period ventricular undersensing. A corrective action is taken to reduce the likelihood of blanking period ventricular undersensing by automatically adjusting device operating parameters. The corrective action may include automatic adjustment of atrial sensitivity, shortening of the ventricular blanking period, or adjustment of the base stimulation rate.

Abstract: The present invention is a system for and method of providing patient education, and collecting, processing, and reporting patient consumer data. The invention generates reports from information collected from patients, a medical educator, a prescribing physician, and a pharmaceutical manufacturer. A method of collecting, processing, and providing medical data and education includes developing patient survey, collecting patient data, processing patient data, and generating reports to physicians, and pharmaceutical manufacturers that validate the effectiveness of a medical treatment prescribed by the physician.

Abstract: An optical system for detecting ice and water on the surface of an aircraft includes an elongated transparent optical element having first and second end portions. A light source and light detector are disposed in one end of the optical element and a reflective surface is disposed in the opposite end portion. The reflective surface defines a critical angle and reflects light from the light source to the light detector when the critical angle is in contact with air and refracts the light toward the external environment when the reflective surface is in contact with ice or water. The system may also incorporate an optical element wherein the reflective surface includes a continuous array of convex elements extending outwardly from and across one end of the optical element and wherein each of the convex elements defines a critical angle.

Abstract: An implantable cardiac stimulation device prevents pacemaker mediated tachycardias during autocapture. The device includes a refractory circuit that establishes a lengthened post ventricular atrial refractory period (PVARP) in response to a lengthened AV interval. Such a lengthened AV interval may occur as a result of the provision of a back-up pacing pulse or fusion beat evaluation during autocapture.

Abstract: This invention relates to the use of microorganisms for the generation of ethanol from lignocellulosic waste materials. Yeast strains of the genus Kluyveromyces which have the capability to ferment cellulose, hexose sugars to ethanol are provided. Also provided are methods for converting cellulose, hexoses, or mixed hydrolysates of hexoses to ethanol by fermentation with Kluyveromyces strains. The invention also provides methods to isolate yeast strains which metabolize cellulose, pentoses, or hemicelluloses from waste materials.

Abstract: An implantable cardiac stimulation device and associated method perform a true or blanking period ventricular undersensing detection algorithm in response to ventricular loss of capture not associated with fusion or a change in capture threshold. The test identifies an originating cause of loss of capture, which may be ventricular undersensing of intrinsic R-waves or premature ventricular contractions occurring during a ventricular blanking period or atrial undersensing of P-waves resulting in blanking period ventricular undersensing. A corrective action is taken to reduce the likelihood of blanking period ventricular undersensing by automatically adjusting device operating parameters. The corrective action may include automatic adjustment of atrial sensitivity, shortening of the ventricular blanking period, or adjustment of the base stimulation rate.

Abstract: An optical system for detecting ice and water on the surface of an aircraft includes an elongated transparent optical element having first and second end portions. A light source and light detector are disposed in one end of the optical element and a reflective surface is disposed in the opposite end portion. The reflective surface defines a critical angle and reflects light from the light source to the light detector when the critical angle is in contact with air and refracts the light toward the external environment when the reflective surface is in contact with ice or water. The system may also incorporate an optical element wherein the reflective surface includes a continuous array of convex elements extending outwardly from and across one end of the optical element and wherein each of the convex elements defines a critical angle.

Abstract: Various embodiments can reduce mode switching in response to inappropriate but anticipated signals, such as far field R-waves. Additionally, various embodiments can also increase the alert period for detection of true atrial tachyarrhythmias in dual chamber pacing systems. Further, various embodiments can reduce mode switching or tachyarrhythmia response to same chamber delayed signals. In addition, various embodiments can increase the alert period for detection of true tachyarrhythmias in multisite pacing systems arising from the chamber being stimulated or sensed while minimizing repeated detection and counting of the same native depolarization or evoked response to effectively preclude mislabeling and detection of a normal rhythm as a tachycardia.

Abstract: Techniques for enabling both preventive overdrive pacing and antitachycardia pacing (ATP) within an implantable device are provided. The device gains the benefits of overdrive pacing for preventing the onset of a tachycardia and, if one nevertheless occurs, ATP is employed to terminate the tachycardia. In particular, a technique is provided for promptly detecting the onset of atrial tachycardia during preventive overdrive pacing based on loss of capture of atrial pacing pulses. A technique is also provided for using detection of loss of capture of atrial or ventricular pacing pulses to trigger automatic switching from overdrive pacing to ATP. A setup technique determines whether to enable the automatic switching from overdrive pacing to ATP within a particular patient. Also, techniques are provided for verifying loss of capture of atrial or ventricular backup pacing pulses and for detecting low amplitude ventricular fibrillation based on loss of capture of ventricular backup pacing pulses.

Abstract: Exemplary techniques for correlating thoracic impedance values with physiological status are described. One technique involves an implantable medical device (IMD) that includes means for correlating thoracic impedance values with a patient's physiological status and means for interpreting the correlated thoracic impedance values utilizing a patient-based threshold to detect a heart failure condition.

Abstract: A system and related methods for monitoring cardiac disease. The system includes an implantable medical device having a microcontroller that is configured to measure a pacing latency value for a region of a heart, compare the measured pacing latency value to a previously measured pacing latency value for the region of the heart, and determine a change in an amount of cardiac disease in the region of the heart based on the comparison of the measured pacing latency values.