Abstract: An implantable medical device applies an electric signal over two electrodes and measures the resulting electric signal over a candidate pair of neighboring electrodes on a lead for a first heart ventricle or over a candidate electrode of the lead and a case electrode. An impedance signal is determined for each candidate pair or electrode based on the applied signal and the measured resulting signal. A time difference between start of contraction in a second ventricle and the timing of local myocardial contraction as identified from the impedance signal at the site of the candidate pair or electrode is determined for each candidate pair or electrode. An optimal pacing electrode is selected to correspond to one of the electrodes of the candidate pair having the largest time difference or the candidate electrode having largest time difference.

Abstract: An ischemia monitoring system has detectors for detecting the onset of an ischemic event of a tissue in subject, the end of the ischemic event and the end of a following recovery from the ischemic event, respectively. A time processor determines the duration of the ischemic event and the recovery period based on the detected onset and end times. A status processor co-processes the two determined time durations for the purpose of monitoring the ischemic status of the subject and detecting any deterioration in ischemic status for the latest ischemic event as compared to previous ischemic events that have occurred in the subject's tissue.

Abstract: In a system and method for monitoring cardiac synchrony in a human heart, a first sensor is positioned at a first cardiac wall location of a heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the first sensor measures said cardiac wall movements at the first cardiac wall location and emits a first sensor output signal corresponding thereto, a second sensor is positioned at a second cardiac wall location of the heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the second sensor measures the cardiac wall movements at the second cardiac wall location and emits a second sensor output signal corresponding thereto.

Abstract: An implantable medical device has an impedance determiner for determining a cardiogenic impedance signal based on electric signals sensed by connected electrodes. A parameter calculator processes the impedance signal to calculate an impedance parameter representative of the cardiogenic impedance in connection with the diastolic phase of a heart cycle. This parameter is then employed by the device for monitoring acute decompensated heart failure status of a subject.

Abstract: A medical system has an implantable heart stimulator with sensing and stimulating pairs of electrodes, with an electric field through the heart being generated by the respective pairs by the application of alternating voltages at a preset frequency to the respective pairs. A signal receiver receives a signal representing the voltage potential difference between the voltage potential at one of the electrodes in the pair, and a reference electrode. The detected voltage is related to the generated electric field, and the signal receiver generates a potential different signal that is supplied to a control unit to determine parameters therefrom representing cardiac activity.

Abstract: Implantable heart stimulator connectable to an electrode arrangement has a pulse generator adapted to deliver stimulation pulses to a heart of a subject; an impedance measurement unit adapted monitor at least one heart chamber of the heart of the subject to measure the impedance in the at least one monitored heart chamber for generating an impedance signal corresponding to the measured impedance. The impedance signal is applied to a processor where the signal is processed, according to specified criteria, and a fractionation index value is determined represented by the curve length of the impedance signal during a predetermined measurement period. The fractionation index value is a measure of different degrees of mechanical dyssynchrony of the heart.

Abstract: In an implantable heart monitoring device and a monitoring method, an impedance is measured across at least part of an atrium, such that variation of the impedance is related to the volume change of the atrium. Values are stored at different occasions that indicate the rate of change of the measured impedance. The stored values are determined such that, when the device is used in a living being, the variation of the stored values will be related to the variation of the speed with which the atrium is filled with blood during the atrial diastole.

Abstract: In a method and implantable medical device for ventricular tachyarrhythmia detection and classification, upon detection of a ventricular tachyarrhythmia based on an electrocardiogram signal, cardiogenic impedance data representative of ventricular volume dynamics are collected and used for classifying the detected tachyarrhythmia as stable or unstable. In the latter case but typically not in the former case, defibrillation shocks or other forms of therapy are applied to combat the unstable ventricular tachyarrhythmia.

Abstract: In a medical system and a method for operating such a system, the system includes an implantable medical device of a patient, a programmer device, and an extracorporeal stress equipment adapted to exert a physiological stress on the patient, for automatically determining settings of a sensor for sensing a physiological parameter of the patient or for automatically determining a pacing setting of the device over a broad range of workloads of the equipment. The ingoing units and/or devices of the medical system, i.e. the implantable medical device of the patient, the programmer device, and the extracorporeal stress equipment, communicate bi-directionally with each other and form a closed loop.

Abstract: An implantable medical system for detecting incipient edema has an implantable medical lead including an optical sensor having a light source and a light detector. The medical system further has an edema detection circuit that activates the light source to emit light, the light being directed into lung tissue of a patient and that obtains a light intensity value corresponding to an intensity of light received by the light detector, and that evaluates the light intensity value to detect a consistency with incipient edema.

Abstract: An implantable heart analyzing device has a housing and a control circuit located within said housing. The control circuit generates an output signal adapted to actuate an activator, which is able to make a wall of the heart deflect or vibrate. The control circuit also communicates with a sensor, which can be identical with the activator, with which the movement of the heart wall can be sensed. The control circuit executes a procedure that involves the generation of an output signal and sensing a corresponding sensor signal, and to be able to derive information concerning the tension of the heart wall. An implantable heart analyzing includes the aforementioned heart analyzing device, as well as the activator and the sensor. The heart analyzing device and the system implement a method that results in generation of the aforementioned information concerning the tension of the heart wall.

Abstract: An implantable medical device that is physically connectable to the body of a user has an information manager that manages sensitive information associated with the user or the device. A sensor is connected to the device that senses whether the device is physically connected to the body of the user, and generates a signal indicating whether the device is actually connected to the body of the user. The information manager is connected to the sensor, and is responsive to the sensor signal so as to perform information managing functions based on the signal. Among other things, fraudulent retrieval of sensitive data from the device is prevented if the device is not connected to or implanted in the body of the user.

Abstract: An implantable medical device has an oxygen sensor adapted to measure the level of oxygen in oxygenized blood, and to generate an oxygen measurement signal in dependence of the level of oxygen. The oxygen sensor is adapted to perform measurements inside the heart, of blood entering the left atrium of a patient's heart. The obtained oxygen measurement signal is compared to a predetermined threshold level and an indication signal is generated in dependence of the comparison. The, indication signal is indicative of the lung functionality of the patient.

Abstract: In a piezoelectric sensor, a method for the manufacture thereof, and an implantable lead embodying such a piezoelectric sensor, a layer of piezoelectric material, having aligned, polarized dipoles, is applied to a tubular supporting substrate, the layer of piezoelectric material having at least one electrode at an outer surface thereof and at least one electrode at an inner surface thereof. The piezoelectric material is applied on the inner circumference of the tubular supporting substrate.

Abstract: A medical system has an implantable heart stimulator with sensing and stimulating pairs of electrodes, with an electric field through the heart being generated by the respective pairs by the application of alternating voltages at a preset frequency to the respective pairs. A signal receiver receives a signal representing the voltage potential difference between the voltage potential at one of the electrodes in the pair, and a reference electrode. The detected voltage is related to the generated electric field, and the signal receiver generates a potential different signal that is supplied to a control unit to determine parameters therefrom representing cardiac activity.

Abstract: Functions of a clinician's workstation, which is a part of an implantable medical system that also includes an implantable medical device, are dynamically adapted dependent on collected patient data and/or collected data relating to operation of the implantable medical device. The adaptation can take place based on instructions provided to the workstation from a server, that is supplied with the collected data, and that processes the collected data to produce the instructions.

Abstract: An implantable medical apparatus for detecting diastolic heart failure, DHF, has a DHF determining device for determining at least one blood pressure parameter for detecting a DHF state of the heart of a patient. The DHF determining device includes a pressure measuring unit for measuring pulse pressure in a cardiac cycle for a predetermined workload situation of the patient as the blood pressure parameter, and a comparator compares the measured pulse pressure with a predetermined reference value. A pacemaker includes such an apparatus and a control unit that optimizes pacing therapy depending on the result of the comparison of the measured pulse pressures with the predetermined reference values.

Abstract: In a method and implantable medical apparatus for detecting diastolic heart failure (DHF), and a pacemaker embodying such an apparatus, movement of the valve plane of the heart is measured and analyzed to identify a slowing of the movement of the valve plane as an indication of a DHF state of the heart. A signal indicative of this DHF state is emitted and, in the pacemaker, is used to control the administration of a pacing pulse therapy to the heart.

Abstract: In a system and method for monitoring cardiac synchrony in a human heart, a first sensor is positioned at a first cardiac wall location of a heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the first sensor measures said cardiac wall movements at the first cardiac wall location and emits a first sensor output signal corresponding thereto, a second sensor is positioned at a second cardiac wall location of the heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the second sensor measures the cardiac wall movements at the second cardiac wall location and emits a second sensor output signal corresponding thereto.

Abstract: An implantable medical apparatus for detecting diastolic heart failure, DHF, has a DHF determining device for determining at least one blood pressure parameter for detecting a DHF state of the heart of a patient. The DHF determining device has a pressure measuring unit for measuring the absolute value of left atrial pressure during the diastasis phase just before atrial contraction, or the absolute value of the pressure in the pulmonary vein when the pulmonary valve is closed, for a predetermined workload situation and a rest situation of the patient. A comparator compares the difference between left atrial pressure or pulmonary vein pressure, in the workload and rest situations, with a predetermined pressure difference reference value. A pacemaker includes such an apparatus and a control unit that optimizes pacing therapy depending on the result of the comparisons with the reference values.