Abstract: Methods, systems and computer program products for reducing a risk of pulseless electrical activity (PEA) include detecting a first post-defibrillation blood flow of a subject and detecting a second post-defibrillation blood flow of the subject after the first post-defibrillation blood flow. If the first post-defibrillation blood flow of the subject is above a first threshold value and the second post-defibrillation blood flow is below a second threshold value, a plurality of electrical pulses that reduces a risk of PEA.

Abstract: The present invention provides systems, methods and computer program products for detecting the presence of cardiac activity in a patient. The present invention includes a detector circuit that is configured to detect the influence of a first defibrillation shock on the patient immediately subsequent to termination of a first defibrillation shock.

Abstract: Methods, systems and computer program products for selecting a shock profile for a defibrillator based on patient discomfort to a plurality of different defibrillating shocks include delivering a first defibrillating shock having an associated first shock profile to a patient, and measuring the associated physical displacement of a selected region in the patient. A second defibrillating shock having an associated second shock profile is delivered to the patient, and the associated physical displacement of the selected region in measured. One of the first or second shock profiles is selected based on which shock profile has the lesser amount of measured physical displacement.

Abstract: Methods, systems and computer program products for cardiac pacing are provided. For pacing using biventricular synchronization in a patient, a first stimulation signal is applied to a first region of a heart of the patient at a first time and a second stimulation signal applied to a second region of the heart of the patient at a second time to provide biventricular synchronization stimulation of the heart. Cardiac function of the patient associated with application of the first and the second stimulation signals is sensed and a timing relationship of the first stimulation signal to the second stimulation signal is adjusted based on the sensed cardiac function.

Abstract: This invention is a passive conductor assembly for use with an implanted device having an intra-cavitarily or trans-venously disposed electrode. The assembly can include electrical components in electrical communication therewith which provide for the manipulation, and/or modification of the electrical stimulus or waveform generated by the implanted stimulus generator, which can be designed, for example, to selectively stimulate only neural tissue, not cardiac tissue or vice versa through the same passive conductor assembly.

Abstract: An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart, preferably without extending into the right ventricle of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein.

Abstract: An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned to stimulate Bachmann's bundle, or positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein.

Abstract: A method of reducing the likelihood of pulseless electrical activity (PEA) after defibrillation in a subject comprises administering to a subject afflicted with fibrillation a first treatment waveform, the first treatment waveform insufficient to defibrillate the heart; and then administering to the subject a second treatment waveform that defibrillates the heart and restores organized electrical activity in the heart. The first treatment waveform reduces the likelihood of onset of PEA following the second treatment waveform, as compared to that likelihood which would be present in the absence of the first treatment waveform.

Abstract: Methods, systems, and computer program products measure electrical activity of the cardiac tissue proximate the lesion site during an ablation treatment, and then compare the measurements to determine whether the lesion is clinically efficacious so as to be able to block myocardial propagation. The methods can include obtaining the measurements and performing the ablation therapy while the subject is experiencing atrial fibrillation and may measure the standard deviation of the electrogram signal.

Abstract: An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart, preferably without extending into the right ventricle of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein.

Abstract: The present invention provides systems, methods and computer program products for detecting the presence of cardiac activity in a patient. The present invention includes a detector circuit that is configured to detect the influence of a first defibrillation shock on the patient immediately subsequent to termination of a first defibrillation shock.

Abstract: Methods, systems and computer program products for cardiac pacing are provided. A defibrillation shock is applied to a heart of the patient and a pacing stimulation signal is automatically applied to the heart of the patient subsequent to termination of the delivery of the defibrillation shock. The pacing stimulation may be applied to the heart of the patient within about two seconds of termination of the defibrillation shock. The pacing stimulation signal may be applied to the heart of the patient subsequent to termination of the defibrillation shock irrespective of a characterization of electrical activity detected in the heart. The pacing stimulation may be single and/or paired pacing stimulation.

Abstract: Methods, systems and computer program products are provided for treating a patient experiencing fibrillation by administering a first defibrillation shock having a first shock value to the patient at a first time and determining if cardiac activity in the patient is influenced by the first defibrillation shock immediately after termination of the first defibrillation shock. An alternate treatment is administered at a second time if the cardiac activity is influenced by the first defibrillation shock immediately after termination of the first defibrillation shock.

Abstract: Methods, systems and computer program products for selecting a shock profile for a defibrillator based on patient discomfort to a plurality of different defibrillating shocks include delivering a first defibrillating shock having an associated first shock profile to a patient, and measuring the associated physical displacement of a selected region in the patient. A second defibrillating shock having an associated second shock profile is delivered to the patient, and the associated physical displacement of the selected region in measured. One of the first or second shock profiles is selected based on which shock profile has the lesser amount of measured physical displacement.

Abstract: Methods, systems and computer program products for cardiac pacing are provided. For pacing using biventricular synchronization in a patient, a first stimulation signal is applied to a first region of a heart of the patient at a first time and a second stimulation signal applied to a second region of the heart of the patient at a second time to provide biventricular synchronization stimulation of the heart. Cardiac function of the patient associated with application of the first and the second stimulation signals is sensed and a timing relationship of the first stimulation signal to the second stimulation signal is adjusted based on the sensed cardiac function.

Abstract: An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart, preferably without extending into the right ventricle of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient.

Abstract: The present invention provides apparatus and methods for delivering an optimum electrical shock in treating cardiac arrhythmias. The apparatus comprises means for producing an electrical waveform signal at least two electrodes The voltage or current of the signal is then detected to determine the signal time constant. The signal time constant is then used in conjunction with a model time constant to determine when the peak amplitude is reached. The waveform is then interrupted when the peak amplitude is reached. Also provided are methods of selecting a cardiac defibrillator by measuring the impedance of implanted electrodes and then selecting a defibrillator having a capacitor which provides an RC time constant equal to that of a model time constant.

Abstract: The present invention includes both methods and apparatus for improving defibrillation. In particular, the present invention includes methods and devices for administering a calcium channel blocker and/or calmodulin kinase inhibitor that prevents afterdepolarizations and antiarrhythmic drugs to decrease the threshold shock from a therapeutic threshold shock.

Abstract: A conformable catheter comprising a catheter handle, an elongated catheter tube, and a distal tip portion of the catheter tube, capable of assuming a desired pre-programmed shape. A wire member is disposed within the core of the catheter's tip portion and is formed of a material, such as, for example, a shape-memory binary nickel-titanium alloy, that will assume a pre-programmed shape after pre-shaping, heat treatment, cooling and subsequent heating. To pre-program the shape of the wire member, prior to assembly of the catheter, the wire member is wound around a shaped, heat resistant fixture, heated until the temperature of the wire member exceeds the temperature at which the shape of the wire member on the fixture becomes programmed into the wire member, and cooled.

Abstract: A method of reducing the likelihood of pulseless electrical activity (PEA) after defibrillation in a subject comprises administering to a subject afflicted with fibrillation a first treatment waveform, the first treatment waveform insufficient to defibrillate the heart; and then administering to the subject a second treatment waveform that defibrillates the heart and restores organized electrical activity in the heart. The first treatment waveform reduces the likelihood of onset of PEA following the second treatment waveform, as compared to that likelihood which would be present in the absence of the first treatment waveform.