Abstract: An improved system and method for performing autocapture/autothreshold detection in an implantable cardiac stimulation device or any device capable of stimulating some organ or tissue in the body. In some existing systems, loss-of-capture and capture decisions are based upon two consecutive cardiac events. However, such systems may be subject to subthreshold stimulation pulses that capture and lose capture on alternating pulses, trigeminy PVC sequences, or the like that require a higher stimulation pulse amplitude but cannot make this determination due to the two consecutive event requirement. Accordingly, in the present invention, the determination of whether there is a loss-of-capture is determined only according to paced events, i.e., ignoring intrinsic and PVC beats. Furthermore, the loss-of-capture determination is based upon X out of the last Y beats, where Y is greater than 2 and X is less than Y. Accordingly, consecutive loss-of-capture events are no longer required in determining the threshold level.

Abstract: A helicopter of the type having an electrical system, a landing light, a master switch and a power supply of between about 18-32 V for operating the electrical system when the master switch is in an on position also includes a landing light fault detector. The landing light fault detector includes a light switch for turning the landing lights on and off and circuit means for detecting a fault in the landing light and for providing a signal indicative of a fault whether or not the light switch is in an on or off position.

Abstract: Techniques for improving the specificity of automatic mode switching (AMS) are provided to prevent inappropriate mode switching and to ensure that mode switching is performed when needed. In one example, improved techniques for calculating a filtered rate interval (FARI) are provided, which help avoid inappropriate mode switching within devices that employ FARI in connection with the determination of the atrial rate. Also, techniques are provided for detecting atrial tachycardia and for distinguishing between a true tachycardia and a false tachycardia (such as pacemaker mediated tachycardia). The techniques described herein for detecting atrial tachycardia and for distinguishing between true and false tachycardia are advantageously employed in connection with AMS but may be used in other circumstances as well. Techniques employed in conjunction with dynamic atrial overdrive (DAO) pacing are also discussed.

Abstract: An implantable, bipolar or multipolar pacing lead comprises a lead body having a proximal end and a distal end portion. A tip electrode is disposed at a distal extremity of the distal end portion of the lead body, the tip electrode being electrically coupled to a first terminal contact on a connector assembly attached to the proximal end of the lead body. The lead further comprises one or more ring electrodes positioned along the distal end portion of the lead body proximally of the tip electrode, with each ring electrode being electrically coupled to a terminal contact on the connector assembly and each ring electrode having distal and proximal ends. The electrical resistance of each ring electrode adjacent each of the ends is greater than that of the portion of the ring electrode between the ends.

Abstract: Methods and systems for employment recruiting are provided. In one aspect, a remote call center is used to make initial contact with the candidates to obtain information regarding their placeability and urgency in changing jobs, and to provide an initial screening (107), and a local candidate specialist may then personally interview the candidate. In another aspect, compensation is set for recruiters by adjusting a base compensation based on individual and group performance. In another aspect, candidates are assigned to candidate specialists, and client employers are assigned to client specialists. In another aspect, job candidates and job openings are independently obtained so that candidates will be available immediately to fill the openings. In another aspect, in a team-oriented method of matching candidates with jobs, candidates are matched to jobs by corporation among candidate specialists and client specialists. In another aspect, candidates are matched with jobs using candidate and employer ratings.

Abstract: An implantable cardiac stimulation system provides capture threshold stability assessment. The system includes an implantable pulse generator that provides pacing stimulation pulses, an implantable lead system that couples the pulse generator to a patient's heart, and a capture threshold test circuit that performs capture threshold tests with the pulse generator and provides capture thresholds at spaced apart times. A capture threshold processor responsive to the capture thresholds provides capture threshold stability indicia. The capture threshold stability indicia may be a threshold stability index equal to the ratio of the peak-to-peak threshold fluctuation and the mean capture threshold. The threshold stability index may be compared to a given standard to determine if the capture thresholds are unstable.

Abstract: An implantable cardiac stimulation system provides autocapture assessment and lead impedance surveillance. The system includes a pulse generator that provides pacing stimulation pulses and a lead system including a plurality of electrodes that provide a plurality of different electrode configurations. The system further includes a switch that selectively couples the pulse generator to any one of the plurality of pacing electrode configurations and an autocapture circuit that performs autocapture tests with the pulse generator. The autocapture circuit includes a capture detector that detects evoked responses with an evoked response electrode configuration. When there is a failure to detect an evoked response, an impedance measuring circuit measures the lead impedance of the evoked response electrode configuration. If the measured lead impedance is outside of a given range, the switch couples the pulse generator to an electrode configuration other than the evoked response electrode configuration.

Abstract: An implantable medical device provides atrial arrhythmia prevention pacing when an interatrial conduction disturbance is detected. The implantable medical device includes a signal processor that detects the interatrial conduction disturbance and a pulse generator circuit coupled to the detector that delivers the atrial arrhythmia prevention pacing pulses to the heart when the processor detects the interatrial conduction disturbance. The interatrial conduction disturbance may be a P-wave duration, a difference between odd and even P-waves, or a predetermined P-wave spectral energy distribution.

Abstract: Techniques are provided for estimating optimal atrioventricular delay values for use in pacing the ventricles. Both the intrinsic inter-atrial conduction delay and the intrinsic atrioventricular conduction delay are determined for the patient and then the preferred atrioventricular pacing delay is derived therefrom. By taking into account intrinsic inter-atrial delay along with intrinsic atrioventricular delay, it is believed that a more reliable estimate of the true optimal atrioventricular delay values for the patient can be achieved than with techniques that only take into account intrinsic atrioventricular delay values. In one example, the technique uses intracardiac electrogram (IEGM) signals and surface electrocardiogram (EKG) signals and hence can be performed by an external programmer without requiring Doppler echocardiography or other cardiac performance monitoring techniques.

Abstract: Exemplary methods and devices for determining whether atrial fusion, atrial pseudofusion and/or atrial native activity have occurred. Various methods and/or devices are suitable for use with atrial autocapture. Other methods, devices and/or systems are also disclosed.

Abstract: An implantable cardiac stimulation device provides long QT interval therapy for preventing abnormal ventricular activation-recovery time and ultimately ventricular arrhythmias. The device includes a sensing circuit that senses intracardiac activity of a heart and that generates electrical signals representing electrical activity of the heart. The device includes a physiologic sensor, such as body motion, or other diurnally varying sensor that reliably detects a diurnal state of the patient (i.e., not the QT interval itself). The device further includes a measuring circuit that measures a QT interval of the electrical signals, a control circuit that determines whether the QT interval is appropriate for the diurnal state, and a pulse generator that delivers pacing pulses to at least one chamber of the heart at a pacing rate when the QT Interval is pathologically too long.

Abstract: An implantable cardiac stimulation system capable of automatic capture verification is provided with an associated method for performing automatic testing functions using programmable, or automatically determined, AV delays. Automatic threshold testing and evoked response sensitivity testing performed at a user-specified AV delay setting, rather than a preset setting, allows assessment of automatic capture verification based on an AV delay relevant to daily system function. Further features of the present invention are an adjustable frequency with which automatic threshold tests are performed and an adjustable frequency with which threshold test results are stored in memory in a threshold record for better monitoring of lead stability or impending clinical problems. The frequency of performing threshold tests and the frequency of storing threshold test results may be varied according to the threshold stability.

Abstract: An implantable dual chamber stimulation device provides a novel detection scheme for automatically detecting atrial capture and performing an atrial pacing threshold assessment. The stimulation device preferably waits until the patient is at or near rest and monitors the patient's P-wave activity to determine a detection window where a next P-wave is expected to occur. The stimulation device then delivers an atrial pulse prior to the next detection window, and monitors the window to determine whether a P-wave occurs therein. If a P-wave does not occur, then atrial capture is present, while occurrence of a P-wave indicates absence of atrial capture. If atrial capture is absent, the stimulation device automatically determines an appropriate atrial pacing threshold by monitoring the detection window while adjusting the stimulation pulse energy level.

Abstract: Methods and apparatus for stimulating the right vagal nerve within a living body via positioning an electrode portion of a lead proximate to the portion of the vagus nerve where the right cardiac branch is located (e.g., near or within an azygos vein, or the superior vena cava near the opening of the azygos vein) and delivering an electrical signal to an electrode portion adapted to be implanted therein. Stimulation of the right vagus nerve and/or the cardiac branch thereof act to slow the atrial heart rate. Exemplary embodiments include deploying an expandable or self-oriented electrode (e.g., a basket, an electrode umbrella, and/or an electrode spiral electrode, electrode pairs, etc). Various dedicated and single-pass leads are disclosed, as well as, various electrodes, and stabilization means.

Abstract: Exemplary methods and devices for determining whether fusion or pseudofusion have occurred. An exemplary method includes delivering a stimulus, sensing cardiac activity, determining whether the stimulus resulted in capture, and if the determining indicates that the stimulus did not result in capture, then, determining whether the sensed cardiac activity includes characteristics of native cardiac activity by comparing at least some of the sensed cardiac activity to a template. Accordingly, if the sensed activity includes native activity, then a diagnosis is made that the stimulus resulted in fusion or pseudofusion. Another exemplary method includes determining whether a stimulus resulted in capture, and if the determining indicates that the stimulus did not result in capture, then, adjusting sensitivity of a sensor and sensing cardiac activity using the sensor. According to this method, if cardiac activity is sensed, then a diagnosis is made that the stimulus resulted in fusion or pseudofusion.

Abstract: An implantable cardiac stimulation device and method measure atrioventricular conduction times and automatically adjust an atrioventricular delay time based on the measured conduction time values.

Abstract: A cardiac stimulation device uses dynamic overdrive pacing to prevent sleep apnea. In another aspect, the device can use dynamic overdrive pacing to terminate sleep apnea after detection. An implantable cardiac stimulation device comprises a sensor and one or more pulse generators. The sensor senses intrinsic cardiac electrical phenomena. The pulse generators can generate cardiac pacing pulses with timing based on the sensed intrinsic cardiac electrical phenomena to dynamically overdrive the intrinsic cardiac electrical phenomena. The timed cardiac pacing pulses can prevent a sleep apnea condition.

Abstract: An implantable cardiac stimulation device applies defibrillating electrical energy to the atria of a heart at a time which avoids inducing ventricular fibrillation of the heart. The device includes an atrial fibrillation detector that detects atrial fibrillation of the heart, a pacing pulse generator that applies a ventricular pacing pulse to the heart responsive to detection of atrial fibrillation, a timer that times a time period through an evoked response and a T-wave caused by the pacing pulse, and a defibrillation pulse generator that applies defibrillating electrical energy to the atria of the heart after the timer completes the timing of the time period.

Abstract: An implantable programmable cardiac stimulation device and associated method for differentiating between normal sinus events and ectopic beats. The stimulation device monitors the sensing thresholds of sinus and non-sinus cardiac events, and stores a history of these sensing thresholds along with temporal data for accurate event detection. The stimulation device further provides accurate and appropriate detection of sensed events including P-waves, non-conducted PACs, and conducted PACs and thus verifies correct detection of PVCs and R-waves. Furthermore, the present invention provides a history record of ectopic events, distinguished by sensing thresholds and timing intervals, giving a valuable diagnostic tool to the physician in optimizing rhythm management therapy. In addition, the stimulation device allows the sensitivity threshold to be set based on a single cardiac cycle and past history.

Abstract: An implantable cardiac stimulation device and method provides reliable sensing of cardiac events to support cardiac pacing or fibrillation detection. The device comprises a sensing circuit that senses the cardiac events in accordance with a plurality of threshold characterizing parameters. A parameter control adjusts the threshold parameters responsive to the rate of the sensed cardiac events in a manner which precludes positive feedback to prevent continued oversensing, undersensing, or noise sensing.