Abstract: A drug delivery device is provided comprising a housing comprising a distal end and a proximal end and a cartridge adapted and arranged to contain at least one dose of a drug, a bung being movably arranged within the cartridge. In an initial state of the device, the bung is arranged in a proximal end position with respect to the cartridge. The device further comprises a piston rod adapted and arranged to move the bung in the distal direction with respect to the cartridge for delivering a dose of the drug. The device further comprises a mechanism operable such that, after a dose delivery operation was completed, the piston rod is moved into the proximal direction with respect to the bung by a back off distance (D), wherein in the initial state, a distance between a distal end of the piston rod and a proximal end of the bung is greater than zero, with the distance between the piston rod and the bung in the initial state being defined by the back off distance (D).

Abstract: A medical injector is provided herein having a body with a displaceable plunger. The plunger includes a plurality of spaced-apart ratchet teeth disposed along the length thereof. At least one indexer is provided formed to engage the plunger, wherein the indexer is configured to allow the plunger to displace distally towards a distal end of the body but not proximally towards a proximal end of the body. The medical injector also includes an actuator having an engagement portion formed to engage one or more of the ratchet teeth. The actuator is displaceable to a ready state, the engagement portion being displaced proximally relative to the plunger with the actuator being displaced to the ready state. The indexer prevents proximal movement of the plunger thereby allowing the engagement portion to by-pass one or more of the ratchet teeth with the actuator being displaced to the ready state. In addition, the actuator is displaceable from the ready state to cause actuation of the medical injector.

Abstract: A dispensing mechanism for delivering a dosage of medicament including a housing, a push button, a crank arm that is slideably engageable with the push button, a ram, and a ratchet gear releasably engageable with the crank arm and ram, translation of the push button along an axis causing the crank arm to engage and rotate the ratchet gear which causes the ram to distally advance relative to the housing.

Abstract: A method of coating an exterior surface of the elongate object with the coating material includes holding the elongate object lengthwise in the elongate chamber, mixing the pressurized air and the coating material to form a mist, and coating the exterior surface while directing the mist around the exterior surface and toward the outlet of the elongate chamber.

Abstract: An auto-injector comprising a housing containing a syringe with a hollow needle and a stopper for sealing the syringe and displacing the medicament. A spring capable of, upon activation: pushing the needle from a covered position inside the housing into an advanced position through the orifice and past the proximal end, operating the syringe to supply the dose of medicament, and retracting the syringe with the needle into the covered position after delivering the medicament. A trigger locks the spring in a pressurized state prior to operation and, upon manual operation, releasing the spring for injection. An interlock sleeve telescoped in the housing and translatable in longitudinal direction, wherein in a proximal position the interlock sleeve is arranged to be coupled to the syringe in the syringe's retracted position and wherein the interlock sleeve in its distal position is arranged to allow decoupling of the syringe.

Abstract: An autoinjector that receives a pre-filled syringe, having a central body and an actuator sleeve provided with one end that comes into contact with the user. The actuator sleeve can be moved between projecting and actuation positions and it is in the projecting position prior to and following the actuation of the autoinjector. An injection mechanism is provided to inject the product when the needle is inserted into the user's body. The autoinjector also includes a barrel movement device to move the needle into the injection position and retract the needle from the body following injection. The movement device includes a control ring rotatably mounted in the central body, the ring having an inclined internal profile that engages with an internal projection of a control sleeve that can move axially in the central body, such that the sleeve moves axially when the ring is rotated.

Abstract: The invention relates to a dispense interface for use with a drug delivery device with an inner body and with a lockout element, wherein the lockout element is coupled to the inner body, wherein the lockout element is movable from a receptive condition to a locked condition, wherein in the receptive condition the dispense interface is attachable to the drug delivery device, wherein in the locked condition the dispense interface is not-attachable to the drug delivery device and wherein the lockout element is configured to move from the receptive condition to the locked condition when said dispense interface is attached to and detached from said drug delivery device. The invention solves the technical problem of reducing the risk of reuse of a dispense interface, after it has already been used with a drug delivery device.

Abstract: The invention is configured so that pressurized gas from a pressurized gas supply source passes through a pressurized gas channel provided in a main body of a powder spraying device and is sprayed out. A powder container containing powder such as medical agents is provided on the main body. The powder within the powder container is supplied to the pressurized gas channel and is sprayed together with the pressurized gas. An eccentric rotor with a center of gravity deviated from a center of rotation is provided in the main body. When spraying the powder together with the pressurized gas, vibrations are applied to the main body and the powder container by a rotation of the eccentric rotor. The powder can be thereby mixed more evenly with the pressurized gas.

Abstract: A source of gaseous, gas borne or droplet substance having: an inner pressurized container (1), a substance-release valve (2) device sealed across an end of the container (1), a spout (4) displaceable inwards of the container (1) against a spring of the valve (2) device for substance release; the source also includes: an outer enclosure enclosing the inner container along its length (12), at least partially its end (14) remote from the spout (4) and partially at its spout end (19), the outer enclosure and the inner container (1) being arranged to react force for displacement of the spout (4) on substance release; a counter (20) accommodated within the outer enclosure for counting substance release displacements of the spout (4); and a window (22) in the outer enclosure for viewing the count of the counter (20).

Abstract: CPAP treatment apparatus (10), as one form of positive pressure ventilatory assistance, is disclosed. A turbine/blower (14), operated by a mechanically coupled electrical motor (16), receives air or breathable gas at an inlet (18) thereof, and supplies the breathable gas at a delivery pressure to a delivery tube/hose (20) having connection at the other end thereof with a nose mask (12). A microcontroller (38) has an operational “Mask-Fit” mode. An initial constant pressure level is applied by the blower (14) to the mask (12). If the functional mode is a Manual mode, then the mask-fit test pressure is the current ‘set’ pressure. If the functional mode is the Automatic Titration mode, the mask-fit test pressure is the 95th percentile pressure of the previous session, otherwise it is the base treatment pressure, e.g. 10-12 cm H2O. This constant pressure is applied for a period of time, typically 1-3 minutes.

Abstract: The present disclosure relates to a system and method for use of acoustic reflectometry information in ventilation devices. The system and method includes a speaker to emit sound waves into an intubated endotracheal tube (“ETT”) and a microphone to detect returning acoustic reflections. In addition, the system and method includes a reflectometry device in communication with a ventilation device for analyzing timings and amplitudes of the returning acoustic reflections to determine a size of a passageway around an ETT tip, location and size of ETT obstructions, and relative movement of the ETT tip within a trachea. The reflectometry device is also configured to determine a resistance parameter representative of resistance to actual flow of air through the ETT based upon a function of the diameter of the ETT, length of the ETT, and percent obstruction of the ETT, where the resistance parameter is used to calculate the tracheal pressure.

Abstract: A device for securing an oral airway device in place with a patient's oral cavity. The device comprises a V-clamp which is slid along its upper edge in the direction of the oral airway device. After making contact with the oral airway device with the V-clamp, the user may choose to manipulate a screw disposed on the device and bring its corresponding distal end into physical contact with the opposing surface or side of the oral airway device, thereby creating a compressive force on the oral airway device. Alternatively, the device may comprise a V-clamp on a first portion which is disposed on a sliding track. The first portion may be manipulated with the addition of a screw in order to create a compressive force on the oral airway device. Alternatively, the device may comprise two rotating portions coupled together via a pivot point.

Abstract: Condensation management techniques for a gas flow delivery system. The techniques include providing a radiant barrier associated with patient circuit and/or a patient interface, providing a water trap and/or an absorbent insert in the patient interface device, or a combination of these techniques. The radiant barrier prevents condensation from forming in the patient circuit and/or the patient interface. The water trap and absorbent insert in the patient interface control condensation that reaches or forms in the interior of the patient interface to prevent it from interfering the user of the gas delivery system.

Abstract: A fluid delivery system provides fluid, such as supplementary oxygen, to a patient in response to inhalation. The fluid delivery system includes a valve assembly that is triggered by sensing nasal flow. The system includes a sensor configured to detect flow either directly through the nose and to detect any “flow leakage” through a patient's nasal cavity while mouth breathing. A method for conserved delivery of fluid to a patient that includes sensing such nasal flow is also provided.

Abstract: A forehead support for a facial mask is adapted to be moveable between a first position with respect to a frame of the mask and a second position with respect to the frame. The forehead support includes a biasing mechanism that urges the forehead support in the second position. A method of positioning a forehead support with respect to a frame of a patient interface includes positioning the forehead support and patient interface assembly on a face; disengaging a forehead support locking mechanism; allowing the forehead support to move from a first position to a second position; and engaging a forehead support locking mechanism.

Abstract: A CPAP system for supplying humidified gases to a user is disclosed in which various interfaces are described for gas delivery. A mask cushion including a deformable cushion and thin sheath is described.

Abstract: A flow cassette has a housing with an inlet and an outlet and a passage therebetween. The flow cassette also has a temperature sensor disposed within the passage and configured to measure the temperature of a fluid flowing through the passage, a flow rate sensor disposed within the passage and configured to measure a flow rate of the fluid flowing through the passage, and a processor coupled to the temperature sensor and flow rate sensor. The processor is configured to accept measurements of temperature and flow rate from the temperature sensor and flow rate sensor, respectively, and provide a compensated flow rate.

Abstract: A humidifier includes a humidifier tub including an air inlet and an air outlet. The air outlet may have an exit port positioned in a plane disposed below the air inlet. A base plate is provided to the bottom of the humidifier tub. The base plate and humidifier tub define a water chamber adapted to receive a volume of water. The humidifier tub may include a guidance structure adapted to direct air entering the humidifier tub via the air inlet to swirl downwardly and around within the humidifier tub reaching the water surface before exiting the exit port. The tub may include a structure to prevent the inadvertent entry of water from the tub to the flow generator.

Abstract: A ventilator includes a compressor, a storage vessel, a valve assembly communicating with the compressor, the storage vessel, and an inhalation line. A controller directs the valve assembly between a storage configuration where ventilation gas is delivered from the compressor into the storage vessel, and a delivery configuration where ventilation gas is delivered from the storage vessel to the inhalation line. The controller is coupled to a pressure sensor for detecting a first pressure within the storage vessel when the valve assembly is directed to the delivery configuration, and detecting subsequent pressure while ventilation gas is delivered from the storage vessel to the inhalation line, the controller determining the volume of ventilation gas delivered to the patient based at least in part on the difference between the first pressure and the subsequent pressure.

Abstract: A technique for influencing the human brain can be applied to treat PTSD through stimulating the brain with a beat in, for example, the theta (?) frequency to influence the brain to relax. Alternatively, the human brain can be stimulated with a beat in the alpha (?) frequency to stimulate active thinking. Over a series of treatments the brain of an individual suffering from PTSD can be influenced to operate at a normal frequency. Advantageously, as the frequency is adjusted, the symptoms of PTSD recur less often until the individual ceases to experience the symptoms or has at least experienced a decreased recurrence of the symptoms.

Abstract: A catheter (40) or sheath (14) is provided with a strengthening element (30) embedded within the walls of the catheter (40). The strengthening element (30) is formed of a plurality of short strengthening members (32) arranged in longitudinally overlapping manner but which are radially spaced from one another and fixed to one another by annular coupling elements (36). The strengthening element (32) is made of a metal or metallic material, whereas the coupling elements (36) are made of a non-conductive material. The coupling elements (36) prevent electrical conduction through the length of the catheter (40) but retain a strengthening structure which provides torque strength and kink resistance. The short sections of conductive strengthening members (32) provide shielding of electromagnetic waves but prevent the strengthening element (30) acting as an aerial.

Abstract: An infusion system includes an infusion catheter defining a fluid passage extending between a proximal catheter end and a distal catheter end, and having a plurality of infusion ports in communication with the fluid passage and defining an infusion zone. A filtration device is provided which may be retrofitted upon the infusion catheter and includes a filter sleeve coupled to a slidable control sleeve. The filter sleeve is deformable between a first configuration having a radially contracted footprint and a second configuration having a radially expanded footprint, responsive to sliding the control sleeve over the infusion catheter such that the deformable filter sleeve buckles outwardly from the infusion catheter.

Abstract: The present invention includes an apparatus for gripping a catheter and methods employing it. The catheter grip can be configured to surround a shaft of a catheter and allow a person to manipulate the catheter without the person touching the insertable length of the catheter. The method includes grasping the gripping apparatus for removing the catheter from its package and for inserting the catheter into an urethra.

Abstract: A torque-transmitting, locking instrument holder, includes a hollow body having a proximal end for receiving an instrument, a distal end for protrusion of the instrument, and a handle to be gripped by an operator. A device is provided for locking the handle to and unlocking the handle from the instrument at least partly disposed within the hollow body. A method for operating the instrument holder includes providing a hollow body having a proximal end for receiving an instrument, a distal end for protrusion of the instrument, and a handle to be gripped by an operator. The instrument is placed at least partly within the hollow body and the handle is locked to and unlocked from the instrument.

Abstract: Embodiment methods of treating a human or animal patient using a remotely controlled robotic catheter device inserting a handle of a catheter into a handle controller, inserting the catheter tubular portion into a resealable delivery channel forming a sterile barrier to a sled base, engaging a tip of the catheter with a sterile introducer disposed at an end of the sled base and engaged with the patient's body, positioning the catheter into the patient's body by remotely sending commands to the tele-robotic device to cause the sled member to advance toward the patient's body, and performing a diagnostic or therapeutic procedure on the patient using the catheter. Diagnostic or therapeutic procedures may include a mapping procedure, an ablation procedure, an angioplasty procedure, a drug delivery procedure; an electrophysiology procedure, a radiological procedure, and a medical device implantation or positioning procedure.

Abstract: A catheter integral with a valved needle-free connector provides a safety catheter device configured to receive a blunt cannula and sharp needle forming an insertion mechanism. The sharp needle is mounted within a needle tube and a control handle is used to slide the sharp needle out of and into the protective needle tube. When the insertion mechanism is mounted to the connector and the control handle is used to slide the sharp needle out of the tube, a blunt cannula first moves into contact with and enters the bore of the valve mechanism of the connector opening it and protecting it from damage that may be caused by the sharp needle. The sharp needle is then extended through the connector and extends out the distal end of the catheter so that a venipuncture procedure may be performed to properly locate the catheter in the patient's circulatory system. Once located, the needle may be retracted into the insertion mechanism, the insertion mechanism disconnected from the connector, and discarded.

Abstract: A prostate immobilizing balloon that on full inflation cups the prostate to hold it during treatment is combined with a locking member so that the balloon does not shift during use. Methods of using same are also provided.

Abstract: Multi-lumen catheter having a monolithic elongate tubular shaft member having a proximal end, a distal end and a longitudinal length therebetween. The tubular shaft member has an outer cross-sectional dimension that varies along the length of the tubular shaft member. The tubular shaft member has an inner core made of a first material and an outer layer made of a second material. The inner core has a first lumen and a second lumen defined therein, the first lumen having a first lumen cross-section and a length extending at least along a portion of the length of the tubular shaft member. The first lumen cross-section is substantially uniform along the length of the first lumen. The second lumen has a second lumen cross-section and a length extending along the length of tubular shaft member. The second lumen cross-section is substantially uniform along the length of the second lumen.

Abstract: Balloon catheter comprises an elongate catheter shaft having a proximal section, a distal section, and an inflation lumen, and a multilayer balloon on the distal section of the shaft. The multilayer balloon comprises a first layer made of a first polymer material having a first Shore durometer hardness, a second layer made of a second polymer material having a second Shore durometer hardness lower than the first shore durometer hardness, wherein the second layer is an inner layer relative to the first layer, and an outer-most layer made of a third polymer material having a third Shore durometer hardness lower than the second Shore durometer hardness.

Abstract: A device for regulating blood pressure in a heart chamber is provided. The device includes a shunt positionable within a septum of the heart. The shunt is designed for enabling blood flow between a left heart chamber and a right heart chamber, wherein the flow rate capacity of the device is mostly a function of pressure in the left heart chamber.

Abstract: The proposed invention is a ureteral stent (2) comprising a kidney end part (200) and a bladder end part (210), the kidney end part (200) being tubular and curved, said stent (2) being characterized in that the bladder end part (210) has at least one thread, and in that the stent additionally comprises a tubular intermediate portion (220) extending between the kidney end part and the bladder end part, said portion having an external diameter decreasing towards the bladder end part, and the minimal external diameter of said portion (220), at the connection to the thread of the bladder end part (210), is substantially equal to the diameter of the thread, said portion having a length of between 0.5 cm and 12 cm.

Abstract: The present invention relates to a needle module, which comprises a piercing means on a mounting, which can be releasably coupled to the drive unit so that, as a result of a driving force exerted by the drive unit on the mounting, a repeated pushing movement moving the piercing means in and out is transmitted, wherein, according to the invention, the mounting has a safety device which mechanically irreversibly blocks the piercing means after the needle module has been released from the drive unit so that it can no longer be moved out of the needle module. The invention also relates to a device, in particular a hand device, for piercing the skin, comprising a drive unit and the needle module according to the invention.

Abstract: An adapter for fixing a traditional tattoo needle tube and grip with a tattoo machine of the type having a threaded collar includes a tube holder having a longitudinal bore, a nut-retaining flange at a proximal end thereof, and a tube retaining mechanism at a distal end thereof. A first threaded nut is retained by the nut-retaining flange at the proximal end of the tube holder and adapted for fixing with the threaded collar of the tattoo machine. As such, with the first threaded nut fixed with the threaded collar of the tattoo machine, and with the tattoo needle tube and grip fixed with the tube holder by the tube retaining mechanism, the tattoo needle tube and grip are fixed with the tattoo machine.

Abstract: A valved connector configured to control the leakage of bodily fluid from within a patient. The valved connector including a seal positioned within a lumen of the body of the valved connector. The distal end of the valved connector is adapted to permit access to, or coupling of an apparatus. A proximal end is adapted to be threadably coupled to a secondary device. The needless connector valve being configured to be openable by a dilator or post of an apparatus which is connected to the proximal end of the needleless connector. In the event that a luer coupler or other secondary apparatus is not available, a needle, cannula, trocar, or other instrument can be threaded through the main lumen of the valved connector opening the valve and allowing the passage of fluid directly through the needle, trocar, cannula, or other instrument.

Abstract: Methods and devices are described for preventing diastolic flow reversal and/or reducing peripheral vascular resistance in a patient. Also described are methods of cosmetic treatment, and methods of promoting delivery of therapeutic agents or contrast agents to bones and related tissues.

Abstract: An electrode for use with a cochlear implant system includes an electrode array with at least one electrode contact, and an electrode lead adjacent to the electrode array. The electrode lead has a flexible region configured to allow the electrode lead to bend and has an attachment mechanism with an internal portion positioned within the electrode lead and an external portion configured to be bent and secured to bone. A method of securing the electrode to bone is also disclosed.

Abstract: A lead receptacle having a lumen configured to traverse from an outer side of an outermost intercostal muscle to an inner side of an innermost intercostal muscle of an intercostal space of a patient and to support a lead traversing through the lumen. The lumen being configured to support one or more cardiac leads traversing through the intercostal space.

Abstract: Modulation of target effector organs in vertebrate beings using direct current stimulation for stimulation of spinal cord at regions of autonomic innervation, using direct current for peripheral nerve stimulation, by modulating central autonomic outflow and combinations thereof.

Abstract: Modulation of target effector organs in vertebrate beings using direct current stimulation for stimulation of spinal cord at regions of autonomic innervation, using direct current for peripheral nerve stimulation, by modulating central autonomic outflow and combinations thereof.

Abstract: Neural Gastric Electrical Stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. An apparatus and method are provided for inducing controlled gastro paresis. The apparatus comprises a contraction sensor, a stomach contraction generator, and a controller. The contraction sensor is responsive to circumferential contractions of the stomach, and outputs a signal indicative of a circumferential contraction. The stomach contraction generator induces a circumferential contraction upon receipt of an electrical signal from the controller. The controller sends the electrical signal to the generator upon receipt of the output signal from the sensor.

Abstract: A feedback-control wearable upper-limb electrical stimulation device includes a plurality of electrical stimulation electrodes (10), a plurality of electromyography signal sensors (20), an electrical stimulation output unit (30), an electromyography signal acquisition unit (35), an electromyography signal operation unit (40), and a control module (50). Each electrical stimulation electrode (10) is adhered to or fixed in contact with a human trunk and applies an electrical stimulation signal to the neuromuscular system of the human trunk. Each electromyography signal sensor (20) is adhered to or fixed in contact with the human trunk at a corresponding position of the neuromuscular system of the human trunk where each electrical stimulation electrode (10) is disposed in an adhered manner. The electrical stimulation output unit (30) is connected to each electrical stimulation electrode (10) and provides an electrical stimulation signal.

Abstract: Embodiments of the present invention provide systems and methods for the treatment of pain through activation of select neural fibers. The neural fibers may comprise one or more afferent neural fibers and/or one or more efferent neural fibers. If afferent fibers are stimulated, alone or in combination with efferent fibers, a therapeutically effective amount of electrical stimulation is applied to activate afferent pathways in a manner approximating natural afferent activity. The afferent fibers may be associated with primary receptors of muscle spindles, golgi tendon organs, secondary receptors of muscle spindles, joint receptors, touch receptors, and other types of mechanoreceptors and/or proprioceptors. If efferent fibers are stimulated, alone or in combination with afferent fibers, a therapeutically effective amount of electrical stimulation is applied to activate intrafusal and/or extrafusal muscle fibers, which results in an indirect activation of afferent fibers associated therewith.

Abstract: An algorithm programmed into the control circuitry of a rechargeable-battery Implantable Medical Device (IMD) is disclosed that can adjust the charging current (Ibat) provided to the rechargeable battery over time (e.g., the life of the IMD) in accordance with one or more of the parameters having an effect on rechargeable battery capacity, such as number of charging cycles, charging current, discharge depth, load current, and battery calendar age. The algorithm consults such parameters as stored over the history of the operation of the IMD in a parameter log, and in conjunction with a battery capacity database reflective of the effect of these parameters on battery capacity, estimates a change in the capacity of the battery, and adjust the charging current in one or both of trickle and active charging paths to slow the loss of battery capacity and extend the life of the IMD.

Abstract: Techniques, devices, and systems may include screening effective therapies using cortical evoked potentials. In one example, a system may be configured to receive a first sensed cortical evoked potential of a patient that occurred in response to an induced sensation at an anatomical region different from a brain region of the patient and receive a second sensed cortical evoked potential that occurred in response to electrical stimulation delivered to one or more nerves associated with the anatomical region. The electrical stimulation may be at least partially defined by a set of therapy parameter values. The system may also compare a first value of a characteristic of the first sensed cortical evoked potential to a second value of the characteristic of the second sensed cortical evoked potential and determine, based on the comparison, efficacy of a therapy configured to treat a condition associated with the anatomical region.

Abstract: Systems and methods for stimulation of neurological tissue apply a stimulation waveform that is derived by a developed genetic algorithm (GA), which may be coupled to a computational model of extracellular stimulation of a mammalian myelinated axon. The waveform is optimized for energy efficiency.

Abstract: The present disclosure relates to methods and apparatus for the treatment of spasmodic dysphonia, such as methods of treating spasmodic dysphonia that include providing a system that includes a stimulating electrode operably connected with a processor configured to set one or more stimulation parameters for an electrical impulse deliverable by said electrode, placing the electrode in electrical contact with the superior laryngeal nerve, using the processor to set the stimulation parameters such that the electrical impulse causes a level of stimulation that does not exceed the excitability threshold of one or more alpha motor neurons located within the thyroarytenoid muscle; and delivering the electrical impulse to the superior laryngeal nerve.

Abstract: Methods and/or devices used in delivering cardiac resynchronization therapy based on a plurality of device parameters (e.g., A-V delay, V-V delay, etc.) are optimized by setting a device parameter based on selection data. The selection data may be acquired by acquiring temporal fiducial points (e.g., heart sounds) associated with at least a part of a systolic portion of at least one cardiac cycle and/or temporal fiducial points associated with at least a part of a diastolic portion of the at least one cardiac cycle for each of a plurality of electrode vector configurations, and extracting measurements from the intracardiac impedance signal acquired for each of a plurality of electrode vector configurations based on the temporal fiducial points. The acquired selection data may be scored and used to optimize the device parameter.

Abstract: Systems, methods, and interfaces are described herein for assisting in a user in configuring cardiac therapy. A projection of a phrenic nerve stimulation map may be projected on a graphical depiction of a portion of a patient's heart. The phrenic nerve stimulation map may indicate to a user the regions of the patient's heart that may have a likelihood of stimulating the patient's phrenic nerve.

Abstract: An apparatus comprises a cardiac signal sensing circuit configured to sense a plurality of intrinsic cardiac signals using a plurality of cardiac pacing sites, a heart sound sensing circuit, a stimulus circuit configured to provide an electrical cardiac pacing stimulus to the plurality of pacing sites, and a control circuit electrically coupled to the cardiac signal sensing circuit and the stimulus circuit. The control circuit includes a pacing site locating circuit configured to generate an indication of a preferred pacing site as one of a) a subset of the respective cardiac pacing sites selected using the intrinsic ventricular activation time interval value, from which subset the preferred pacing site is selected using the heart sound characteristic value; or b) a subset of the respective cardiac pacing sites selected using the heart sound characteristic value, from which subset the preferred pacing site is selected using the ventricular activation time interval value.

Abstract: Disclosed is a plug-in accessory for operating a mobile device as an external controller for an Implantable Medical Device (IMD). The accessory includes a connector insertable into a port on the mobile device. Accessory circuitry can be powered by a battery or by the mobile device. An application on the mobile device in conjunction with the accessory configures the mobile phone for immediate use as an IMD external controller. When the accessory is inserted into the port or a switch on the accessory pressed, the application operates to validate the accessory; to unlock the phone; to secure the mobile device; and to render a graphical user interface on the mobile device for communicating with the IMD. The accessory can additionally include telemetry circuitry and an antenna for communicating with the IMD, rather than using short-range communication means provided in the mobile device itself.