Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients. A titration process is used to gradually increase the stimulation intensity to a desired therapeutic level. Between titration sessions one or more parameters, such as, for example, an acclimation interval, may be adjusted based on the patient's response to the stimulation. This personalized titration process can minimize the amount of time required to complete titration so as to begin delivery of the stimulation at therapeutically desirable levels.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients. Stimulation from an implantable medical device (IMD) may be suspended in response to detecting a patient discomfort event, such as a cough, throat irritation, or voice alteration. The suspension period may be based on at least one of a severity level of the patient discomfort event and a patient physical state, such as being asleep or lying down. Detection of a patient discomfort event may be calibrated.

Abstract: An implantable device, such as a pacer, defibrillator, or other cardiac rhythm management device, can include an automatic testing and adjusting of cardiac signal sensing after an MRI scanning procedure, such as to accommodate an MRI-induced physiological change in sensed cardiac depolarization amplitude or in lead impedance such as at an electrode/tissue interface.

Abstract: Energy delivered from an implantable medical device to stimulate tissue within a patient's body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients. A titration process is used to gradually increase the stimulation intensity to a desired therapeutic level. Between titration sessions one or more parameters, such as, for example, an acclimation interval, may be adjusted based on the patient's response to the stimulation. This personalized titration process can minimize the amount of time required to complete titration so as to begin delivery of the stimulation at therapeutically desirable levels.

Abstract: An implantable medical device (IMD) includes a lead having one or more sensing electrodes and one or more therapy delivery electrodes, and a sensor configured to detect the presence of static and time-varying scan fields in a magnetic resonance imaging (MRI) environment. A controller, in electrical communication with the lead and the sensor, is configured to process signals related to tachycardia events sensed via the one or more sensing electrodes and to deliver pacing and shock therapy signals via the one or more therapy delivery electrodes. The controller compares the sensed static and time-varying scan fields to static and time-varying scan field thresholds. The controller controls delivery of anti-tachycardia pacing and shock therapy signals as a function of the detected tachycardia events, the comparison of the sensed static scan field to the static scan field threshold, and the comparison of the time-varying scan fields to the time-varying scan field thresholds.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients. A titration process is used to gradually increase the stimulation intensity to a desired therapeutic level. Between titration sessions one or more parameters, such as, for example, an acclimation interval, may be adjusted based on the patient's response to the stimulation. This personalized titration process can minimize the amount of time required to complete titration so as to begin delivery of the stimulation at therapeutically desirable levels.

Abstract: Systems and methods are provided for delivering vagus nerve stimulation and cardioversion/defibrillation therapies to patients for treating chronic heart failure. The vagus nerve stimulation and cardioversion/defibrillation therapies may be provided using a single implantable pulse generator, which can coordinate delivery of the therapies to provide an acute vagus nerve stimulation therapy in advance of delivering cardioversion-defibrillation energy.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: A medical device lead includes a lead body having a proximal end and a distal end. The proximal end is configured for connection to a pulse generator. One or more electrodes are at a distal end of the lead body, and a lead conductor extends through the lead body and is electrically coupled to at least one of the one or more electrodes. The conductor is configured to deliver electrical signals between the proximal end and the at least one of the one or more electrodes. A sacrificial conductor extends through the lead body adjacent to lead conductor and is configured to fail at a lower stress than the lead conductor.

Abstract: Systems and methods for arrhythmia therapy in MRI environments are disclosed. Various systems disclosed utilize ATP therapy rather than ventricular shocks when patients are subjected to electromagnetic fields in an MRI scanner bore and shock therapy is not available. As the patient is moved out from within the scanner bore and away from the MRI scanner, the magnetic fields diminish in strength eventually allowing a high voltage capacitor within the IMD to charge if necessary. The system may detect when the electromagnetic fields no longer interfere with the shock therapy and will transition the IMD back to a normal operational mode where shock therapy can be delivered. Then, if the arrhythmia still exists, the system will carry out all of the system's prescribed operations, including the delivery of electric shocks to treat the arrhythmia.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: Systems and methods for arrhythmia therapy in MRI environments are disclosed. Various systems disclosed utilize ATP therapy rather than ventricular shocks when patients are subjected to electromagnetic fields in an MRI scanner bore and shock therapy is not available. As the patient is moved out from within the scanner bore and away from the MRI scanner, the magnetic fields diminish in strength eventually allowing a high voltage capacitor within the IMD to charge if necessary. The system may detect when the electromagnetic fields no longer interfere with the shock therapy and will transition the IMD back to a normal operational mode where shock therapy can be delivered. Then, if the arrhythmia still exists, the system will carry out all of the system's prescribed operations, including the delivery of electric shocks to treat the arrhythmia.

Abstract: Physiologic information can be received from a subject during a portion of a magnetic resonance imaging (MRI) session using a sensing circuit of an implantable medical device (IMD). An indication of an active MRI scan can be received, and a time period to inhibit use of physiological information from the subject can be determined following the received indication of the active MRI scan.

Abstract: This document discusses, among other things, an inductive component that can include a core having two portions: (1) a first portion composed of a first material having a first magnetic saturation level; and (2) a second portion composed of a second material selected to provide inductance for the inductive component when an external magnetic field is greater than the first magnetic saturation level. In an example, the first portion can be composed of a material having a relatively low magnetic saturation level (e.g., a ferrite), and the second portion can be composed of a material having a relatively high magnetic saturation level (e.g., a high permeability iron alloy).

Abstract: Energy delivered from an implantable medical device to stimulate tissue within a patient's body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue.

Abstract: An implantable medical device (IMD) includes a lead having one or more sensing electrodes and one or more therapy delivery electrodes, and a sensor configured to detect the presence of static and time-varying scan fields in a magnetic resonance imaging (MRI) environment. A controller, in electrical communication with the lead and the sensor, is configured to process signals related to tachycardia events sensed via the one or more sensing electrodes and to deliver pacing and shock therapy signals via the one or more therapy delivery electrodes. The controller compares the sensed static and time-varying scan fields to static and time-varying scan field thresholds. The controller controls delivery of anti-tachycardia pacing and shock therapy signals as a function of the detected tachycardia events, the comparison of the sensed static scan field to the static scan field threshold, and the comparison of the time-varying scan fields to the time-varying scan field thresholds.

Abstract: A medical device can include a therapy circuit configured to provide a specified electrostimulation therapy to a tissue site, the specified electrostimulation therapy including a scheduled completion, the therapy circuit including a protection circuit configured to adjust specification of the electrostimulation therapy being provided so as to provide an adjusted electrostimulation therapy before the scheduled completion. The medical device can include a monitoring circuit comprising a comparator. The monitoring circuit can be configured to trigger the protection circuit to inhibit the therapy circuit when the therapy circuit output parameter exceeds the specified threshold as indicated by the comparator.

Abstract: Systems and methods for arrhythmia therapy in MRI environments are disclosed. Various systems disclosed utilize ATP therapy rather than ventricular shocks when patients are subjected to electromagnetic fields in an MRI scanner bore and shock therapy is not available. As the patient is moved out from within the scanner bore and away from the MRI scanner, the magnetic fields diminish in strength eventually allowing a high voltage capacitor within the IMD to charge if necessary. The system may detect when the electromagnetic fields no longer interfere with the shock therapy and will transition the IMD back to a normal operational mode where shock therapy can be delivered. Then, if the arrhythmia still exists, the system will carry out all of the system's prescribed operations, including the delivery of electric shocks to treat the arrhythmia.