Abstract: This invention provides pacemaker systems comprising (1) an electronic pacemaker, and (2) a biological pacemaker, wherein the biological pacemaker comprises a cell that functionally expresses a chimeric hyperpolarization-activated, cyclic nucleotide-gated (HCN) ion channel at a level effective to induce pacemaker current in the cell. The invention also provides related biological pacemakers, atrioventricular bridges, methods of making same, and methods of treating a subject afflicted with a cardiac rhythm disorder.

Abstract: A cooling device includes a heat sink (110) having a plurality of fins (111) and a piezoelectric assembly (120) having an actuator (121) and a plurality of blades (122) coupled to the actuator. The actuator includes a plurality of metal electrodes (227) and a plurality of piezoelectric layers (228). The fins of the heat sink are intertwined with the blades of the piezoelectric assembly.

Abstract: A biologic agent preparation system is provided for producing one or more biologic agents in vitro including pro-growth factors and/or pro-survival factors from cells. The one or more biologic agents are produced in response to exposure of mammalian cells to light. A biologic agent delivery system is also provided that delivers the pro-growth factors and/or pro-survival factors to an injured tissue region, or delivers cells treated with the pro-growth factors and/or pro-survival factors to the injured tissue region.

Abstract: A cardiac rhythm management device is configured to detect oscillations in cardiac rhythm by comparing electrogram signals during successive heart beats. Upon detection of electrical alternans, the device may adjust its operating behavior to compensate for the deleterious effects of the condition.

Abstract: An aspect relates to an implantable medical system. An embodiment of the system comprises a baroreflex stimulator, a cardiac event detector, and communication circuitry. The stimulator includes a pulse generator to apply baroreflex stimulation therapy. The detector includes a sensor to detect electrical signals indicative of cardiac events, and a controller connected to the sensor to determine an occurrence of a cardiac event from the electrical signals using an event detection routine. The communication circuitry communicates between the baroreflex stimulator and the cardiac event detector to account for applied baroreflex stimulation therapy and enable the cardiac event detector to discriminate the electrical signals indicative of the cardiac event from the applied baroreflex stimulation therapy.

Abstract: A cardiac rhythm management system includes a lead assembly for intracardiac mapping, pacing, and drug delivery. The lead assembly includes an implantable endocardial lead having a proximal end for connection to an implantable cardiac rhythm management device and a distal end for disposal in an intracardiac region. The lead includes a pacing-sensing electrode and a drug delivery device, both located at or near the distal end. A lumen is within and extends throughout the lead, with an opening at or near the proximal end and another opening at or near the distal end. The lumen provides for access to the intracardiac region by a steerable stylet and a hollow needle, one at a time. The steerable stylet allows for electrophysiological mapping of the intracardiac region. The hollow needle allows for delivery of chemical, biochemical, and/or biological substance to the intracardiac region.

Abstract: A system and device are provided which include a gene regulatory system controlling expression of one or more expression cassettes present in or released by the device, by emitting one or more stimulations. An expression cassette includes a regulatable transcription control element that is responsive to the emitted stimulations linked to an open reading frame of interest. The system optionally includes a sensor to sense a parameter indicative of a need, a telemetry module to receive an external command, or a programmable device, for regulating gene expression of the open reading frame.

Abstract: A system and device are provided which include a gene regulatory system controlling expression of one or more expression cassettes present in or released by the device, by emitting one or more stimulations. An expression cassette includes a regulatable transcription control element that is responsive to the emitted stimulations linked to an open reading frame of interest. The system optionally includes a sensor to sense a parameter indicative of a need, a telemetry module to receive an external command, or a programmable device, for regulating gene expression of the open reading frame.

Abstract: An implantable medical device in which an electrogram is recorded and analyzed in order to detect changes indicative of cardiac ischemia. Cardiac ischemia may be detected by recording an electrogram from a sensing channel of the device and comparing the recorded electrogram with a reference electrogram. If cardiac ischemia is detected, a cardiac drug such as a thrombolytic agent is delivered.

Abstract: A method and system to enhance cell, gene and/or cytokine therapy for cardiac repair in a mammal.

Abstract: A passive conductor assembly for use with an implanted stimulating device having an intracavitarily or transvenously disposed electrode is disclosed. The passive conductor assembly used in combination with the implanted stimulus generator having an intracavitarily or intravenously disposed electrode includes at least one conductive element having a first end and a second end, and/or other contacting sites for contacting a portion of a heart of a subject to be stimulated. The passive conductor is disposed in proximity to the intracavitarily or transvenous electrode which is connected to the implanted stimulus generator such as a pacemaker or defibrillator.

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 which includes a gene/protein delivery device and a pulse generator, as well as method of preparing the gene/protein delivery device and using the system, are provided. In one embodiment, the implantable system detects a predetermined condition or event and, in response, delivers gene(s) and/or protein(s) in conjunction with delivering pacing and/or defibrillation pulses.

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 catheter with a tissue property sensor provides for localization of myocardial infarction (MI) by utilizing one or more differences between properties of infarcted myocardial tissue and properties of normal myocardial tissue. The tissue property sensor is to be placed on endocardial wall or epicardial wall during catheterization to sense at least one tissue property allowing for detection of MI. Examples of the tissue property sensor include, but are not limited to, an optical sensor, an acoustic sensor, a contractility sensor, a temperature sensor, and a drug response sensor. In one embodiment, the tissue property sensor senses a tissue property in various locations on endocardial wall or epicardial wall and detects substantial changes in the tissue property that indicate a boundary between infarcted tissue and normal tissue.

Abstract: A system and method of treating an adverse cardiac condition, such as cardiac arrhythmia or a non-arrhythmic event, involves producing, by use of a patient actuatable non-implanted activator, an activation signal in response to a patient sensing a perceived adverse cardiac condition. The method further involves confirming, by an implantable medical device provided within the patient, that the patient is experiencing an actual adverse cardiac condition. A perceivable initiating signal instructing the patient or a physician to commence with a drug delivery regimen to treat the actual cardiac adverse condition is generated by the non-implanted activator. In one approach, the implantable medical device operates in a safe mode of pacing during drug treatment of the actual adverse cardiac condition. In another approach, an appropriate pacing, cardioversion or defibrillation regimen is initiated to treat the actual adverse cardiac condition.

Abstract: A cardiac rhythm management device is configured to detect oscillations in cardiac rhythm by comparing electrogram signals during successive heart beats. Upon detection of electrical alternans, the device may adjust its operating behavior to compensate for the deleterious effects of the condition.

Abstract: A gene regulatory system controls gene therapy by emitting one or more forms of energy that regulate gene expression by triggering promoters. The system includes a sensor to sense a signal indicative of a need for the gene therapy as well as responses to the gene therapy. The regulation of the gene expression is controlled based on the sensed signal and/or a user command. In one embodiment, the system delivers one or more electrical therapies in conjunction with the gene therapy.

Abstract: An aspect of the present subject matter relates to an implantable medical system. An embodiment of the system comprises a baroreflex stimulator, a cardiac event detector, and communication circuitry. The stimulator includes a pulse generator to apply baroreflex stimulation therapy. The detector includes a sensor to detect electrical signals indicative of cardiac events, and a controller connected to the sensor to determine an occurrence of a cardiac event from the electrical signals using an event detection routine. The communication circuitry communicates between the baroreflex stimulator and the cardiac event detector to account for applied baroreflex stimulation therapy and enable the cardiac event detector to discriminate the electrical signals indicative of the cardiac event from the applied baroreflex stimulation therapy. Other aspects are provided herein.

Abstract: An implantable device for delivering cardiac pacing therapy in order to improve cardiac function is programmed to allow some amount of intrinsic activity to occur without otherwise the disturbing the pacing algorithm used to deliver therapy. Intrinsic cardiac cycles utilize the heart's native conduction system and thus serve to prevent the atrophy which may otherwise result from continuous pacing.