Abstract: A gene regulatory system detects ischemia events and is capable of delivering a biologic therapy in response to the detection of an ischemic event or the reception of a command. The biologic therapy protects the heart from ischemic damage by regulating the expression of an exogenously introduced gene product. In one embodiment, the gene regulatory system includes an implantable system that emits at least one gene regulatory signal in response to the detection of the ischemic event or the reception of the command. The gene regulatory signal directly or indirectly regulates gene expression of the gene product.

Abstract: A system delivers cardiac pacing therapy and chemical and/or biological therapy to modulate myocardial tissue growth in a heart after myocardial infarction (MI). The system includes an agent delivery device to release one or more agents to an MI region to modulate myocardial tissue growth in that region, and a cardiac rhythm management (CRM) device to deliver pacing pulses to enhance the effects of the one or more agents by altering myocardial wall stress and cardiac workload. In one embodiment, the system is an implantable system including an implantable agent delivery device and an implantable CRM device.

Abstract: A method and device for delivering pre-excitation pacing to prevent or reduce cardiac remodeling following a myocardial infarction is described. The pre-excitation pacing is modulated in accordance with an assessment of cardiac function in order to balance the beneficial effects of stress reduction with hemodynamic compromise.

Abstract: Various system embodiments comprise a neural stimulator, a pulse generator, and a controller. The neural stimulator is adapted to generate a neural stimulation signal. The pulse generator is adapted to generate a pacing signal to provide myocardium pacing. The controller is adapted to control the neural stimulator and the pulse generator to provide a cardioprotective conditioning therapy. The conditioning therapy includes neural stimulation to elicit a parasympathetic response and myocardium pacing. Other aspects and embodiments are provided herein.

Abstract: A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used to evaluate a plurality of parameter values for selecting an approximately optimal parameter value.

Abstract: A method of optimizing inter-site delay is disclosed for a cardiac rhythm management device that includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. A microcontroller is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used as a safety check to stop an electrical therapy when it is believed to be potentially harmful to continue the therapy.

Abstract: An implantable cardiac rhythm management (CRM) device delivers a chronic therapy while detecting an ischemic state. When the ischemic state indicates the occurrence of an ischemic event, the implantable CRM device delivers a post-ischemia therapy. The post-ischemia therapy and the chronic therapy are adjusted using feedback control with the ischemic state and parameters indicative of the effectiveness of the post-ischemic therapy and the effectiveness of the chronic therapy as inputs.

Abstract: Various system embodiments comprise a neural stimulator, a pulse generator, and a controller. The neural stimulator is adapted to generate a neural stimulation signal. The pulse generator is adapted to generate a pacing signal to provide myocardium pacing. The controller is adapted to control the neural stimulator and the pulse generator to provide a cardioprotective conditioning therapy. The conditioning therapy includes neural stimulation to elicit a parasympathetic response and myocardium pacing. Other aspects and embodiments are provided herein.

Abstract: A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used as a safety check to stop an electrical therapy when it is believed to be potentially harmful to continue the therapy.

Abstract: A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used to evaluate a plurality of parameter values for selecting an approximately optimal parameter value.

Abstract: An implantable cardiac rhythm management (CRM) device delivers a chronic therapy while detecting an ischemic state. When the ischemic state indicates the occurrence of an ischemic event, the implantable CRM device delivers a post-ischemia therapy. The post-ischemia therapy and the chronic therapy are adjusted using feedback control with the ischemic state and parameters indicative of the effectiveness of the post-ischemic therapy and the effectiveness of the chronic therapy as inputs.

Abstract: A method of optimizing inter-site delay is disclosed for a cardiac rhythm management device that includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. A microcontroller is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A sensing system including a collection catheter and a sensing device. The sensing system can be used in determining an optimal location of a collection catheter for the removal of a medium from coronary circulation. The sensing system can also be used in determining the optimal time for the collection of blood containing a medium. The sensing system can further be used to maintain a baseline flow rate through at least a portion of the coronary circulation system during a medical procedure.

Abstract: A biologic agent delivery system provides for delivery of a biologic agent to a stimulation site to which electrical stimulation pulses are to be delivered from an electrical stimulation device. Examples of the electrical stimulation device include cardiac pacemakers and neural stimulators. The biologic agent modifies tissue property to lower the stimulation threshold of the stimulation site. The genetic modification of the tissue property improves efficacy and/or energy efficiency of an electrical stimulation therapy.

Abstract: A method for cell and electrical therapy of living tissue including administration of exogenous cells into a region of injured tissue and application of electrical energy. In one application the combined cell and electrical therapy is applied in vivo to damaged heart tissue. In such applications, minimally invasive procedures are used to apply the cell therapy and the electrical therapy is provided via an implantable pulse generator. In one application an implantable pacemaker is used in the VDD mode with an atrioventricular delay kept relatively short when compared to the intrinsic atrioventricular delay.

Abstract: Embodiments of the invention are related to an implantable medical system, amongst other things. In an embodiment, the invention includes a processor, an electrical sensor, and a temperature sensor. The processor is configured to monitor myocardial electrical activity with input from the electrical sensor; identify myocardial electrical activity indicative of an arrhythmia, measure temperature of blood in the coronary venous system with input from the temperature sensor; determine if the arrhythmia is hemodynamically stable or hemodynamically unstable based on the temperature of blood in the coronary venous system, and initiate high-voltage shock therapy if the arrhythmia is hemodynamically unstable. Other embodiments are also included herein.

Abstract: An apparatus and method for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling.

Abstract: A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used to adjust a maximum tracking rate in an atrial tracking pacing mode.

Abstract: A cardiac rhythm management device for in which pre-excitation pacing is applied to one or more sites in proximity to an infarcted region of the ventricular myocardium. Such pacing servers to either prevent or minimize post-infarct remodeling.