Abstract: According to an embodiment of a method performed by an implantable medical device to deliver a neural stimulation therapy to a patient, a lower dose of the neural stimulation therapy is delivered to the patient. The dose of the neural stimulation therapy is automatically increased from the lower dose to a higher dose, and the higher dose of the neural stimulation therapy is delivered to the patient. A trigger that is controlled by the patient is detected, and the dose of the neural stimulation therapy is automatically returned from the higher dose back to the lower dose in response to detecting the trigger.

Abstract: An implantable cardiorenal stimulator delivers cardiorenal stimulation in response to detection of decompensation associated with heart failure. The cardiorenal stimulation includes delivering renal stimulation pulses to promote diuresis and/or natriuresis and delivering cardiac stimulation pulses to enhance the diuretic and/or natriuretic effects of the renal stimulation pulses.

Abstract: A cardiac rhythm management (CRM) system includes an implantable medical device that delivers anti-tachyarrhythmia therapies including anti-tachyarrhythmia pacing (ATP) and at least one hemodynamic sensor that senses a hemodynamic signal. When a tachyarrhythmia episode is detected, the CRM system analyzes the hemodynamic signal to determine whether and/or when to deliver an ATP. In one embodiment, a hemodynamic parameter extracted from the hemodynamic signal is used to predict the potential effectiveness of ATP in terminating the detected tachyarrhythmia episode. In another embodiment, a characteristic feature detected from the hemodynamic signal is used to determine an ATP window during which a delivery of ATP is initiated.

Abstract: A method of and system for collecting patient event information from a cardiac rhythm management system (CRM system) is described, where the CRM system includes a cardiac rhythm management device (CRM device) and an external interface device. The method includes the steps of initiating a transmission session wherein the interface device communicates with the CRM device, prompting a user of the CRM system to select a reason for the transmission session, inputting the selected reason for the transmission session to the interface device, and storing the selected reason for the transmission session and timestamp information for the transmission session.

Abstract: An antitachyarrhythmia system uses vagal nerve stimulation in combination with one or more additional techniques to lower the defibrillation threshold (DFT). Examples of such additional techniques include using electrical shock waveforms each including a plurality of pulses and using defibrillation electrode configurations each including an electrode placed in the coronary sinus or coronary vein.

Abstract: An apparatus and method for terminating atrial and ventricular tachyarrhythmias by delivering a voltage pulse to an electrode arrangement that efficiently terminates the tachyarrhythmia. In one embodiment, a voltage pulse is impressed between an electrode located in the coronary sinus and an electrode located within the superior vena cava or right atrium which is also coupled to an extravascular electrode. In another embodiment, a voltage pulse is impressed between an electrode located within the right ventricle and electrodes located within the coronary sinus and the superior vena cava that are also coupled to an extravascular electrode.

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: An apparatus and method for terminating atrial and ventricular tachyarrhythmias by delivering a voltage pulse to an electrode arrangement that efficiently terminates the tachyarrhythmia. In one embodiment, a voltage pulse is impressed between an electrode located in the coronary sinus and an electrode located within the superior vena cava or right atrium which is also coupled to an extravascular electrode. In another embodiment, a voltage pulse is impressed between an electrode located within the right ventricle and electrodes located within the coronary sinus and the superior vena cava that are also coupled to an extravascular electrode.

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: An implantable system for the cardioversion of the heart of a patient in need of such treatment comprises a plurality of primary electrodes, a power supply, and a control circuit. Preferably, at least one auxiliary electrode is also included. The plurality of primary electrodes are configured for delivering a cardiversion pulse along a predetermined current pathway in a first portion of the heart, the current pathway defining a weak field area in a second portion of the heart.

Abstract: An implantable system for the antitachycardia pacing of the heart of a patient in need of such treatment comprises a plurality of primary electrodes, a power supply, and a control circuit. At least one of the primary electrodes is configured for positioning through the coronary sinus ostium and in a vein on the left surface of the patient's heart.

Abstract: An implantable system for the defibrillation or cardioversion of the heart of a patient in need of such treatment comprises a plurality of primary electrodes, a power supply, and a control circuit. Preferably, at least one auxiliary electrode is also included. The plurality of primary electrodes are configured for delivering a defibrillation pulse along a predetermined current pathway in a first portion of the heart, the current pathway defining a weak field area in a second portion of the heart. The at least one auxiliary electrode is configured for delivering an auxiliary pulse to the a portion of the heart where the primary shock field intensity is at or near a minimum.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.

Abstract: The present invention provides apparatus and methods for delivering an optimum electrical shock in treating cardiac arrhythmias. The invention comprises apparatus for producing an electrical waveform signal at least at 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: A method and apparatus for converting an arrhythmia of a heart using a biphasic truncated exponential waveform wherein the first phase is of shorter duration than the second phase.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.