Abstract: A system for treating a wide-neck aneurysm comprising a mesh-like sleeve fabricated from a class of polymer filaments that carry conductive particles therein to provide the filaments with a specified resistivity. The releasable mesh-like sleeve is introduced to the site of a targeted vascular malformation by the working end of a catheter that carries an electrode arrangement at its distal terminus. The system further provides an electrical source and controller (i) that modulates power delivery to the polymer matrix which can then fuse the sleeve to the wall of a blood vessel to span across the vascular malformation.

Abstract: An elongated probe having a temperature sensor at its distal tip is coupled to a monitoring/display unit. Using a cannulated introduction device, the probe is positioned with its distal tip in the intra-articular space such that the temperature sensor is submerged in fluid affected by the electrosurgical procedure. The temperature detected by the sensor is displayed by the monitoring/display unit. A temperature signal from the sensor is compared to a predetermined temperature value, and, if the value is equaled or exceeded, the surgeon is alerted. Similarly, the rate of temperature increase is monitored and compared to a predetermined value of temperature increase, and, if the value is equaled or exceeded, the surgeon is alerted. In another embodiment the temperature sensor is submerged in a fluid stream exiting the joint.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. In one aspect, a method is provided for reducing the volume of enlarge swollen tissue in the patient's nose, such as swollen nasal tissue, mucus membranes, turbinates, polyps, neoplasms, cartilage (e.g., the nasal septum) or the like. In particular, the turbinates are treated by positioning one or more electrode terminal(s) adjacent to the turbinates, and delivering electrically conductive fluid, such as isotonic saline, to the nasal cavity to substantially surround the electrode terminal(s) with the fluid.

Abstract: Ablation systems comprise a support body, an energy transmitting element supported by the support body and an insulating member covering a portion of the support body and energy transmitting member. Ablation energy is transmitted from an uncovered, exposed portion of the energy transmitting element. The insulating member may be a distal portion of an introducer sheath. An open segment may be provided in the distal portion to expose a portion of the energy transmitting element. When used in cardiac ablation therapy, for example, the insulating member decreases the amount of ablation energy dissipated in the blood circulating through the heart and thermally insulates the energy transmitting member and the tissue at the ablation site, enabling better control of the ablation process.

Abstract: This relates generally to limited use devices. More particularly, the invention relates to a control system for limited use devices, particularly, medical devices and instruments which can detect utilization history and compare the history to utilization factors to disable the device.

Abstract: A device and method for radiofrequency treatment of tissue is disclosed. The device includes an introducer, a plurality of RF electrodes positionable in a nondeployed state within the introducer, and an electrode advancement element. In the nondeployed state, the RF electrodes are contained within the introducer, and separated from the subject's tissue by a plug which substantially occludes the distal end of the introducer. In the method for RF tissue treatment, the introducer is introduced into the tissue of a subject. The RF electrodes are then positioned in the deployed state when the electrode advancement element advances the RF electrodes through the distal end of the introducer, thereby displacing the plug. The electrode advancement element may be a spring-loaded element, and may be actuated by a triggering device on the introducer.

Abstract: A catheter includes a steering mechanism for manipulating the distal end of the catheter to obtain a plurality of deflection profiles, a torque transfer system to enhance torque transfer from the handle to the distal tip, and a support system to reduce undesirable deformation of the distal-end region during steering. The torque transfer system includes a flat ribbon within the relatively flexible distal-end region to enhance torque transfer through the distal-end region of the catheter. The support system includes a compression cage and longitudinal struts that are located within the distal-end region of the catheter. The support system can support axial loads and deflect laterally in the direction of the steering, thereby reducing the amount of stretching and compression of the catheter sheath within the deflecting region.

Abstract: A cardiac ablation catheter includes a coil-like ablating element that is deployable from an elongate, flexible sheath. The ablating element, while in the deployed position, has a shape with at least one revolution oriented in a plane that is orthogonal to a longitudinal axis of the sheath. The catheter system is well-suited to ablate a circumferential region of tissue about a pulmonary vein or the posterior wall of the left atrium proximate the pulmonary vein os. The treated tissue region electrically isolates the atria from the pulmonary vein.

Abstract: An apparatus and method for cutting a material including conducting and non-conducting materials such as biological tissue, cellulose or plastic while the material is submerged in a conductive liquid medium. The apparatus has a cutting electrode with an elongate cutting portion having an aspect ratio (length to width) of 1 or more and a return electrode. The two electrodes are immersed in the conductive medium and a voltage is applied between them to heat the medium, thus producing a vapor cavity around the elongate cutting portion and ionizing a gas inside the vapor cavity to produce a plasma. The voltage applied between the electrodes is modulated in pulses having a modulation format selected to minimize the size of the vapor cavity, its rate of formation and heat diffusion into the material while the latter is cut with an edge of the elongate cutting portion. The modulation format includes pulses ranging in duration from 10 &mgr;s to 10 ms, as well as minipulses and micropulses, as necessary.

Abstract: The therapeutic device for treating a living tissue, has jaws and serving as a pair of openable/closable holding portions each having a distal end portion configured to hold the living tissue, and a heating plate provided on at least one of the jaws and, and used to treat the living tissue, wherein a plurality of heat generating mechanism provided independently controllable are provided on the heating plate.

Abstract: A minimally invasive surgical screw fixation system and method are used in conjunction with fluoroscopy (i.e., C-arm), for percutaneous fixation of the facet joints of the spine through small incision ports. The approach is generally based on a right-triangle guidance system, positioned via the use of the C-arm and secured to the operative site. This particular configuration allows for percutaneous placement of screws across facet joints via known angles and pathways. The inventive instrumentation allows for the targeting of drill hole and, ultimately, the placement of the screws associated with the procedure.

Abstract: Instruments and methods for inserting one or more implants to a surgical site in a patient in a surgical procedure, including minimally invasive surgical procedures are provided. The implant is mountable to the instrument in a reduced profile orientation and after insertion is manipulated with the insertion instrument to the desired orientation.

Abstract: An anterior cervical plating system for securing multiple bone segments relative to each other includes a plate member having multiple pairs of nodes. Each node defines a bone screw aperture. Linking segments connect the pairs of nodes to one another. Between adjacent linking segments are elongated viewing windows. The bone screw apertures each include an integral locking mechanism to ensure that the bone screws do not back out of the plate member. The locking mechanisms and the bone screw apertures allow for angular freedom of insertion of the bone screws into a vertebral body or other bone portion.

Abstract: An apparatus (10) for attachment to bone (18) comprises a plate (12) having a lower surface (28) for abutting against the bone (18) and an upper surface (30) opposite the lower surface (28). The plate (12) further includes a plurality of through-holes (32) extending between the lower and upper surfaces (28 and 30). Each through-hole (32) has an associated countersink (34). Each through-hole (32) defines a substantially square opening in the lower surface (28) of the plate (12) and each associated countersink (34) defines a circular opening in the upper surface (30) of the plate (12).

Abstract: A multiportal device for percutaneous surgery consists of a guiding device with a radial arm that supports an auxiliary guiding device, which can slide along the arm and can be fixed in a require angular position on the arm. The device also includes a first cannula, which can be inserted into the patient's body through the guiding device and can be fixed in a required axial position, and a second cannula, which can be inserted into the second guiding unit and fixed therein. The arch-shaped form of the arm ensures intersection of distal ends of both cannulae in one point aimed at the symptomatic site where surgery has to be done. The device is provided with a linking mechanism that links the distal ends of both cannulae in their position inside the body of a patient. In the engaged state of the linking device, the cannulae still have some freedom of relative movements that may be required for manipulation with cannulae during the surgery.

Abstract: An apparatus for receiving and positioning a medical instrument relative to the body of a patient when the instrument is positioned partially within the body or completely outside the body. The apparatus comprises a housing and a motor assembly positioned within the housing. The motor assembly includes a motor and a first medical instrument engaging member operatively connected to the motor and moveable relative to the housing in response to the operation of the motor. A second medical instrument engaging member cooperates with the first medical instrument engaging member to drive the medical instrument within the housing when the medical instrument is positioned within the housing between the first and second medical instrument engaging members. The apparatus can form a portion of a trocar, a structure secured to a trocar or a structure that is free of a connection to a trocar or other medical instrument support.

Abstract: A suture knot can be tied during a medical procedure by use of a suture retainer ring in connection with a suturing instrument. The retainer ring allows a user to orient a suture about the instrument, such that a knot in the suture is automatically advanced and tightened by withdrawing the instrument from a surgical site after placing the suture. The retainer ring can be an integral part of the suturing instrument, or it can be removably coupled to the suturing instrument to facilitate use of the retainer ring with other suturing instruments.

Abstract: An improved endoscopic tissue apposition device (50) having multiple suction ports (86) permits multiple folds of tissue to be captured in the suction ports (86) with a single positioning of the device (50) and attached together by a tissue securement mechanism such as a suture (14), staple or other form of tissue bonding. The improvement reduces the number of intubations required during an endoscopic procedure to suture tissue or join areas of tissue together. The suction ports (86) may be arranged in a variety of configurations on the apposition device (50) to best suit the desired resulting tissue orientation. The tissue apposition device (50) may also incorporate tissue abrasion means (852) to activate the healing process on surfaces of tissue areas that are to be joined by operation of the device to promote a more secure attachment by permanent tissue bonding.

Abstract: A device for tensioning suture which includes two telescopically slidable cannulated tubes. An adjustment wheel is coupled to and turns a threaded post which is threadingly engaged with the proximal end of one of the slidable tubes. A suture end is passed through the cannulated tubes of the suture tensioning device and secured to the adjustment wheel. Rotating the adjustment wheel counterclockwise increases the overall length of the suture tensioning device and increases tension on the suture.

Abstract: The invention in certain aspects relates to a one-piece coil-shaped surgical fastener for fastening tissue segments, especially suitable for fastening segments of the lower esophogeal sphincter and fundus in an endoscopic procedure for the treatment of GERD. The invention also relates to related methods and devices for insertion of such a fastener, especially along a juncture of the surfaces of such tissue segments.

Abstract: A removable gastric band is provided which can be used to control obesity by allowing control and/or modification of the diameter of a patient's stomach. More specifically, the present removable gastric band comprises an elongated body having a first or distal zone, a second or middle zone, a third or proximal zone and a closure mechanism, wherein the closure mechanism allows the elongated body to close around a portion of the stomach, preferably the proximal tract of the stomach, wherein the closure mechanism comprises at least one aperture in the first zone and a button in the second zone, and where the button can be inserted into the aperture to close the elongated body around, and hold it to, the portion of the stomach. The removable gastric band can be easily paired with the use of a gastric electrostimulator and may be useful, therefore, for inducing forced slimming in the initial phase of treatment for morbigenous obesity.

Abstract: A surgical instrument for creating an anastomosis includes a housing, a handle extending from the housing and a fastener support member extending distally from the housing. The fastener support member is configured and dimensioned to releasably support a plurality of surgical fasteners. The instrument further includes a tissue retaining mechanism which is selectively movable from a first position relative to the fastener support member to a second position in closer proximity with the fastener support member such that tissue disposed adjacent to the fastener support member is retained thereagainst. Upon actuation of the handle, a fastener firing mechanism simultaneously deforms the plurality of surgical fasteners to complete the anastomosis.

Abstract: An anastomotic connector device (102) for mounting a graft (100) in which the connector has spikes (106) defining a periphery around the base ring (104). Also a graft expander (900) having a body (906), a lower diameter tube portion (908) connected by truncated cone (910) and a finger rest (902) and plunger (904).

Abstract: An intraluminal cutter having an expandable, rotary cutter with a plurality of cutting blades designed to cut and remove tissue proliferation within a stent and also to reopen stents. The intraluminal cutter is placed within the lumen of the clogged stent and expanded. By rotary movement of the expanded cutter blades, the device cuts and removes the material within the lumen. It is emphasized that this abstract is provided to comply with the rules requiring an abstract that will allow a searcher or other reader to quickly ascertain the subject matter of the technical disclosure. It is submitted with the understanding that it will not be used to limit the scope or meaning of the claims.

Abstract: Scleral plug system for occluding a hole in the eye and for controlling irrigation during vitreo-retinal surgery in order to maintain a closed system during the procedure, and angled forceps for handling a scleral plug.

Abstract: The present invention is concerned with methods and equipment for the treatment of the eye and more particularly with an instrument to increase eye filtration and treat glaucoma. The instrument is surgical tool operated entirely by the surgeon's hands and is composed of a hand-piece and an eye-penetrating intraocular segment each having two opponent and reciprocally operating fork-like arms and blade-sharp leaves, respectively. The eye-penetrating segment is a rigid embodiment of a size to create a limbus-pointing tunnel in the cornea, penetrate the eye of a patient through a water tight incision and, in a five step dissect and extract procedure, remove from within the eye a trabecular tissue block leaving the incision to self-seal by intraocular pressure. In the same “modus operandi”, a sample tissue can be extracted from any other hollowed or parenchimatous organ.

Abstract: A phacoemulsification handpiece that includes a vibrated needle for emulsification of tissue and a hub interconnecting the needle with a sonic power source. Apparatus, including a cover, is provided and sized for enveloping the hub and a proximal end of the needle for preventing wicked by the needle to the hub, from being outwardly sprayed by the hub during surgical operation.

Abstract: The present invention provides steerable biliary catheters and methods for their use. Biliary catheters such as ERCP cannulas, papillatomes, stone balloon catheters and balloon dilatation catheters may be configured to have steering capability. Two or four-way steering capability is described. Methods for performing biliary procedures such as cannulating a papilla are also provided.

Abstract: An introducer system is used for implantation of pacemaker leads into the venous system of the human heart through the coronary sinus. The system is comprised of three telescopic components, an inner telescoping core, a precurved inner telescoping sheath, and an outer telescoping sheath, introducer, guide or catheter. In an embodiment where a core is used it is torsionally stiff. In an embodiment where no core is used, the inner sheath is torsionally stiff. In either case, the member which is torsionally stiff is torqueable. In general, the inner sheath and outer guide will be both laterally and torsionally flexible, while the core will be torsionally stiff. The core and inner sheath, when curved together in the venous system and proximally coupled, will be sufficiently bound to each other that proximal rotation of the core will be coupled to and cause distal rotation of the inner sheath.

Abstract: A catheter having an elongated shaft with a proximal shaft section and a distal shaft section, and having a support member with a proximal end within the proximal shaft section, a distal end within the distal shaft section, and at least a section which is coiled. In a presently preferred embodiment, the support member is a wire, and preferably a solid wire formed of a metal such as a stainless steel or super elastic alloy such as a nickel-titanium (Nitinol) alloy. In a presently preferred embodiment, the proximal shaft section comprises a high strength tubular member, such as a metallic tubular member. The catheter of the invention is highly pushable, flexible, trackable and kink resistant with the support member extending from the distal end of the relatively stiff proximal shaft section at the junction between the proximal and distal shaft sections.

Abstract: Disclosed herein is a catheter for use in an emboli containment system. In one embodiment, the catheter has a tubular body with a metallic braid construction. Two lumens extend through the tubular body, the lumen being in a side-by-side configuration. One of the lumens functions as an inflation lumen, and is in fluid communication with an inflatable balloon mounted on the distal end of the catheter. The second lumen is adapted to receive other therapeutic catheters which comprise the emboli containment system. In another embodiment, apparatus is provided for treatment of a stenosis in a lumen in a blood-carrying vessel comprising a main catheter and a therapeutic catheter. The main catheter comprises a first flexible elongate tubular member having proximal and distal extremities. A sealing element is carried on the distal extremity of the first flexible elongate tubular member.

Abstract: There is provided apparatus (14) incorporating an elongate hollow element (22) for being positioned along a body cavity of a patient. The hollow element has a leading region and a trailing region and is arranged for being progressively everted along the hollow element from the leading region to thereby be increasingly extended for progressively lining the body cavity as the trailing region follows along. The apparatus generally further comprises an enclosure comprising an insertion head (16) for being inserted into an entrance of the body cavity and a flexible bag (18) in which the hollow element is housed. The hollow element is extended from the insertion head by increasing pressure within the enclosure. Methods for positioning the hollow element along the body are disclosed. The apparatus is particularly suitable for use as a tamponade device for use in the lower gastrointestinal tract for stemming internal bleeding.

Abstract: An embolic protection filter having an inverted membrane with improved blood perfusion characteristics is disclosed. An embolic protection filter in accordance with the present invention comprises a filter frame disposable about a guidewire, a support hoop coupled to a plurality of expandable struts, and an inverted membrane for filtering embolic debris. The inverted membrane has a tapered proximal section and an enlarged diameter distal section. Features of the present invention permit the perfusion of blood through the filter irrespective of embolic debris entrained therein.

Abstract: The present invention relates generally to perfusion catheters and distal protection devices. According to an embodiment, the present invention includes a distal protection filter comprising an elongate shaft having a proximal end and a distal end, a distal protection device disposed at the distal end, a coupling member that couples the elongate shaft to the distal protection device, and a first space between the coupling member and the elongate shaft. A method of filtering debris from a blood vessel is also disclosed.

Abstract: An intravascular filter includes at least one elongated support member configured to assume a retention configuration, such as a generally helical form about a central axis, and at least one flexible elongated filter member supported by the support member. The filter member is configured to assume a predefined filter form in such a manner as to form an obstacle to passage through the vessel, in a direction parallel to central axis, of particles having dimensions greater than the predefined value. The support member and the filter member are preferably prepared in a generally straight configuration to facilitate minimally invasive deployment.

Abstract: Blood filters (10a, 10b) sized and configured to be positioned within a vascular vessel include a plurality of anchoring arms (22) having a removable sleeve (22-2) for temporarily anchoring the blood filter to a vessel wall. In especially preferred embodiments, the removable sleeve (22-2) is formed of a bioabsorbable material when the filter (10a, 10b) is deployed, it is this removable sleeve (22-2) which comes into contact with the inner tissue wall of the patient's blood vessel (typically the inferior vena cava). When it is desired to remove the filter, endothelization of the sleeve (12-2) has typically occurred but since the sleeves are a removable (separable) component part of the anchoring arms (22), the entire filter device (10a, 10b) can be retrieved thereby leaving the endothelized sleeves (22-2) remaining in place on the interior wall of the patient's vascular vesse.

Abstract: An embolic protection device has a collapsible filter element (105) mounted on a carrier such as a guidewire (101). The filter element (105) collapses into the outer end of a catheter (118) for deployment and retrieval through a vascular system of a patient. The filter element (105) has a collapsible filter body with a proximal inlet end and a distal outlet end. The proximal inlet end has inlet openings sized to allow blood and embolic material enter the filter body. The outlet end has outlet openings which allow through passage of blood but retain embolic material within the filter body. After use, the catheter (118) is movable along the guidewire (101) to engage the proximal end of the filter element and close the inlet openings before sliding over the filter element from the proximal end to the distal end to progressively collapse the filter body on the guidewire (101) for retrieval.

Abstract: An embolic protection device for use in medical, veterinary, non-medical or industrial applications where removal of an obstruction from a small diameter vessel or vessel-like structure could produce particles, which, if allowed to remain in the vessel, could cause undesirable complications and results. One embodiment comprises a catheter for insertion into a vessel and a trap operably connected to the catheter and to a rotatable member. Rotating the rotatable member relative to the catheter actuates the trap. One embodiment comprises a rotatable member that actuates a flexible strut between an arcuately expanded position and a helically twisted position, and a membrane operably connected to the flexible strut.

Abstract: A novel solid sticker to unfold the vertical wrinkles between the eyebrows on human face. The solid sticker of this invention consists of solid support layer and adhesive sticker layer. The solid support of this invention is comprised of, including but not limited to, wood, plastic, rubber and metal to maintain the unfolded wrinkles. The exposed surface of the solid support has skin color, which is developed by, including, but not limited to, painting and covering with skin color tape. The adhesive sticker layer consists of a polymer film and adhesives coated on the one side thereof. The other side of polymer film is strongly adhered to the solid layer. The surface of adhesive coated layer, to be attached to the user's face, is covered with a peel off film. The peel is removed before use. The solid sticker of this invention unfolds the vertical eyebrow wrinkles on user's face when a user attaches it for at least 30 days, while replacing it every 24 hour.

Abstract: A clamping and fluid delivery device (50) for occluding a vessel (12) during a surgical procedure. Generally, the device (50) includes an internal core portion (52) having a distal end (52a) with a sealing surface and opposite side surfaces comprising sealing surfaces. The core portion (52) is inserted transversely into the vessel (12). Opposed, external clamping arms (62, 64) move together outside the vessel (12) and clamp the vessel (12) against the core portion (52). Padding (124) the sealing surfaces on opposite sides of the core portion (52), as well as on the distal end (52a) engage the internal walls (12a) of the vessel (12) and are opposed by padded clamping surfaces (120, 122) of the arms (62, 64). The core portion moves distally simultaneously with the clamping action of the arms to provide a distal seal. A bypass cannula (58) and cardioplegia cannula (60) fluidly couple the core portion (52) to deliver blood and cardioplegia fluid to opposite sides of the core portion (52).

Abstract: Devices and methods for sealing a passageway formed by a patent foramen ovale (PFO track) in the heart are provided. One method includes providing an abrading device to the PFO track and abrading the tissue within the PFO track. The abraded tissue forming the PFO track is then held together under pressure, either via lowering right atrial pressure or via applying suction to the septum primum to pull it into apposition against the septum secundum. After a sufficient period of time, the pressure is released and the abraded tissue heals to form a robust seal over the PFO track. Additionally, several devices are provided which can be placed into the PFO track to apply adhesive to the walls of the PFO track. The devices may or may not be left within the PFO track. If the devices are not left within the PFO track, the walls of the PFO track, covered with adhesive, are brought into apposition with one another and adhered together.

Abstract: A method for terminating bleeding from a portion of a bone, which portion has been opened so as to be subject to bleeding, including the steps of extending a covering over the opened portion of the bone, and fixing the covering to the bone such that the covering is in snug engagement with the opened portion of the bone so as to terminate bleeding from the bone.

Abstract: An infant pacifier has a temperature sensitive material mounted on the front forming a “mood stone.”. The front of the pacifier would change color based on the body temperature of the infant using the pacifier. The pacifier includes a metal strip or other temperature conductive material that connects to the metal frame of the mood stone and wraps around to come in contact with the baby's lips when the baby is sucking on the pacifier. The metal strip carries the heat from the baby to the stone, facilitating color change as the child's temperature changes.

Abstract: The invention provides a device for iontophoretically transporting a compound through a localized region of an individual's body tissue. The device comprises first and second iontophoretic electrodes, a reference electrode, a current source, and a monitoring means. The first electrode is placed in ion-conducting relation with the localized region to allow iontophoretic transport of a compound therethrough. The second and transport electrodes are each placed in contact with the individual's body tissue, and all electrodes are spaced apart from each other. The current source is electrically connected to the first and second electrodes and applies a current to the localized region of body tissue to effect iontophoretic transport. The monitoring means monitors the electrical resistance of the localized region by measuring any voltage difference between the reference electrode and the first and/or second electrodes. Methods for using a reference electrode to monitor and control iontophoresis are also provided.

Abstract: A system and method for stimulating a human heart including a sensing module coupled through a lead to an electrode associated with a tissue of the human heart for sensing electrical activity of the heart. A controller module may be coupled to the sensing module. The controller module may select between a temporary stimulation therapy and a chronic stimulation therapy. Also include is a therapy module coupled to the controller, the therapy module communicating a plurality of anodic pulses to the heart through the lead when providing the temporary stimulation therapy. The amplitude, frequency, and duration of the anodic pulses may be varied, and biphasic pacing may also be used. The electrode may be a drug-eluting electrode for delivery of a drug. After an event occurs, the controller module may transition to the chronic stimulation therapy that may include cathodic stimulation.

Abstract: The invention provides a method for sequentially activating a medical device and exposing at least a portion of the user interface of the medical device to an operator, in a single action to be performed by the operator. The medical device, for example, an automated external defibrillator (AED), includes a housing having a user interface and a lid that is coupled to the housing. The lid, when closed, is covering at least a portion of the user interface. In one embodiment, the medical device further includes an on/off button. The button is configured such that, when an operator depresses the button, it causes a switch to close to thereby activate the medical device, and further causes the lid to open via a latch mechanism.

Abstract: An implantable cardiac device returns activations of corresponding right and left chambers of a heart to inter-chamber synchrony. A sensing circuit senses intracardiac signals representing right and left chamber ventricular electrical activity. A detector determines if a predetermined characteristic of the electrogram signals indicates dissociation of the corresponding right and left chambers. If dissociation is indicated, a pulse generator stimulates at least one of the corresponding chambers to restore inter-chamber synchrony.

Abstract: An implantable cardiac stimulation device provides a stimulation therapy or an atrial ablation recommendation responsive to detection of atrial flutter of a heart. The device includes a sensing circuit that senses electrical activity of a heart and generates electrical signals representing electrical activity of the heart, an arrhythmia detector that detects atrial flutter of the heart, and a data processor that measures cardiac data responsive to the electrical signals. A therapy control responsive to the detection of atrial flutter recommends atrial ablation of the heart when the cardiac data satisfies a predetermined criteria and atrial flutter suppression when the cardiac data fails to satisfy the predetermined criteria. The device may further include a pulse generator that provides stimulation therapy to at least one atrium to terminate the atrial flutter.

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

Abstract: Techniques for providing capture verification during overdrive pacing are described. If an overdrive pacing pulse fails to evoke capture (i.e. a loss of capture occurs), a high voltage backup pulse is automatically delivered. Once a second loss of capture occurs during a single sequence of overdrive pacing pulses, an overdrive pulse capture threshold detection search, described herein, is performed while overdrive pacing continues. Various techniques for providing rate recovery are also described herein. The rate recovery techniques are designed to avoid problems that might arise from possible fusion of intrinsic beats and overdrive pacing pulses that fail to evoke capture. In a first rate recovery technique, capture detection is suspended during rate recovery due to the possibility of fusion. Instead, an extra safety margin is added to the overdrive pulses.