Abstract: Disclosed is a bioimpedance measurement system: A stabilized high frequency current generator is connected to PadSet electrodes via a Patient Cable. Electrodes are connected to an adaptive circuit that conditions the resulting voltage signal and converts it to digital form. Firmware performs signal acquisition and relays data to the device.

Abstract: A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes monitoring one or more parameters in response to a delivered cardiac remodeling pacing, determining whether the cardiac remodeling pacing has an effect on cardiac normalization in response to the monitoring, and adjusting the cardiac remodeling pacing in response to the determined effect on cardiac normalization. The method and device may also perform short-term monitoring of one or more parameters in response to the delivered cardiac remodeling pacing, monitor one or more long-term parameter indicative of a long-term effect of the delivered cardiac remodeling pacing, determine the long-term effect of the delivered cardiac remodeling pacing on cardiac normalization in response to the monitoring, and adjust the cardiac remodeling pacing in response to one or both of the short-term monitoring and the determined long-term effect on cardiac normalization.

Abstract: This document describes methods and devices for using electrical stimulation to control physiological functions such as breathing of patients suffering from respiratory impairment. For example, this document describes methods and devices for generating effective breaths and airway protection by determining times and depths of breaths in accordance with physiological demand, and coordinating respiratory muscle stimulation with the breaths to control breathing.

Abstract: A percutaneous electrical phrenic nerve stimulation (PEPNS) system that measures the patient Work of Breathing (WOB) of each type of ventilator breath and determines when to deliver electrical stimulus based upon the measured WOB. The PEPNS system alters its behavior based upon the type and origin of the ventilator breath delivered and provides warnings for certain identified interactions between the ventilator and the patient.

Abstract: A patient monitoring system includes a heart rate monitor that monitors the physiological parameter from a patient and provides a heart rate indicator based on the physiological parameter, an impedance respiration monitor that measures impedance of the patient's chest and provides a respiration rate, a processor, and an interference detection module. The interference detection module is executable to determine a baseline heart rate while the impedance respiration monitor is not active. The impedance respiration monitor is then activated to measure impedance of the patient's chest to provide the respiration rate. Upon activating the impedance respiration monitor, the interference detection module is executable to assess the heart rate indicator for an interference check period and detect a threshold change in the heart indicator compared to the baseline heart rate during the interference check period.

Abstract: A device, for the pressure-supported or pressure-controlled ventilation of a patient with reduced spontaneous breathing, has a ventilator unit to supply a breathing air flow composed of cyclical ventilation strokes and a control unit generating a control signal to set a pressure and/or a volume flow of the breathing air flow. An EMG unit generates an EMG signal, which may be used as a basis for generating the control signal as a function of a breath of the patient. A unit for analyzing an EMG signal is provided, which analyzes at least one EMG signal recorded during an already concluded breath of the patient. The control unit is configured such that the ventilator unit control signal can be generated, at least at times, by taking into account the analysis of the EMG signal recorded during an already concluded breath of the patient.

Abstract: Techniques for performing lead functionality tests, e.g., lead impedance tests, for implantable electrical leads are described. In some of the described embodiments, an implantable medical device determines whether a patient is in a target activity state, e.g., an activity state in which lead impedance testing will be unobtrusive, such as when a patient is asleep, or capture information of particular interest, such as when the patient is active, in a particular posture, or changing postures. The implantable medical device performs the lead functionality test based on this determination. Additionally, in some embodiments, the implantable medical device may group a plurality of measurements for a single lead functionality test into a plurality of sessions, and perform the measurement sessions interleaved with delivery of therapeutic stimulation.

Abstract: The application provides an ink cartridge chip applied in an ink cartridge which is detachably installed in an imaging device. The ink cartridge chip includes an interface unit and a control unit. The interface unit receives a light control command from the imaging device, which may be a light-lighting-up or a light-extinguishing command. The control unit is connected to a light-emitting unit, and lights up the light-emitting unit on detecting that the ink cartridge chip is in a power-up initialization stage. And the control unit is also connected to the interface unit, and determines, in a case that the light control command is a light-extinguishing command, whether a preset extinguishing condition is satisfied, extinguishes the light-emitting unit if the preset extinguishing condition is satisfied, and maintains a current state of the light-emitting unit if the light control command is a light-lighting-up command.

Abstract: An ink cartridge chip includes an interface unit, a control unit, and a storage unit, wherein the interface unit is configured to receive a light control command sent from an imaging device, and the light control command includes ink cartridge identification information; the storage unit is configured to store autogenic identification information and a state flag, and the state flag includes an executable state or a non-executable state; the control unit is configured to execute the light control command; and the control unit is is configured to, when the interface unit receives the light control command, control the light-emitting unit to execute the light control command based on the type of the light control command and the state flag in the storage unit to re-determined the state flag.

Abstract: An apnea classification system provides for apnea monitoring and differentiation based on several sleep apnea related parameters for diagnostic and therapeutic purposes. Monitoring of such sleep apnea related parameters allows the apnea classification system to differentiate among the different types of apnea and hypopnea and to identify an occurrence of periodic respiration. This information may then be used to determine the best method of therapy, or adjust current therapy parameters to more effectively treat a subject.

Abstract: A biometric monitoring device is used to determine a user's heart rate by using a heartbeat waveform sensor and a motion detecting sensor. In some embodiments, the device collects collecting concurrent output data from the heartbeat waveform sensor and output data from the motion detecting sensor, detects a periodic component of the output data from the motion detecting sensor, and uses the periodic component of the output data from the motion detecting sensor to remove a corresponding periodic component from the output data from the heartbeat waveform sensor. From this result, the device may determine and present the user's heart rate.

Abstract: An example of a system includes an implantable medical device (IMD) for implantation in a patient, where the IMD includes a cardiac pace generator, phrenic nerve stimulation (PS) sensor, a memory, and a controller, and where the controller is operably connected to the cardiac pace generator to generate cardiac paces. The controller is configured to provide a trigger for conducting a PS detection procedure and perform the PS detection procedure in response to the trigger. In performing the PS detection procedure the controller is configured to receive a signal from the sensor, detect PS using the signal from the sensor, and record the PS detection in storage within the IMD.

Abstract: An apparatus for measuring complex electrical admittance and/or complex electrical impedance in animal or human patients includes a first electrode and at least a second electrode which are adapted to be disposed in the patient. The apparatus includes a housing adapted to be disposed in the patient. The housing has disposed in it a stimulator in electrical communication with at least the first electrode to stimulate the first electrode with either current or voltage, a sensor in electrical communication with at least the second electrode to sense a response from the second electrode based on the stimulation of the first electrode, and a signal processor in electrical communication with the sensor to determine the complex electrical admittance or impedance of the patient.

Abstract: In one embodiment, a pressure sensor assembly includes an accelerometer configured to produce a first current upon movement of the accelerometer, a capacitor configured to receive the first current thereby charging the capacitor, a gate element operably connected to the capacitor and configured to discharge a second current from the capacitor upon the capacitor attaining a threshold voltage, a pressure sensor configured to receive the discharged current to produce a first signal corresponding to at least one pressure reading of the pressure sensor, and a transmitter operably connected to the pressure sensor and configured to transmit a second signal based upon the first signal to an external device configured to store data corresponding to the second signal.

Abstract: The present invention provides a method for controlling an ink cartridge chip, the ink cartridge chip and an ink cartridge. The ink cartridge chip comprises an interface unit and a control unit, wherein the interface unit is connected to an image forming apparatus and used for receiving a light control instruction sent by the image forming apparatus; the light control instruction includes a light-on instruction used for indicating the illumination of a light-emitting unit on the ink cartridge chip; and the control unit is used for controlling whether to execute the light control instruction according to the state of the ink cartridge chip when the interface unit receives the light control instruction, and updating the state of the ink cartridge chip according to the light control instruction. The present invention also provides a corresponding control method and an ink cartridge.

Abstract: An implantable cardiac device includes a sensor for sensing patient activity and detecting phrenic nerve activation. A first filter channel attenuates first frequencies of the sensor signal to produce a first filtered output. A second filter channel attenuates second frequencies of the accelerometer signal to produce a second filtered output. Patient activity is evaluated using the first filtered output and phrenic nerve activation caused by cardiac pacing is detected using the second filtered output.

Abstract: A cardiac rhythm management (CRM) device can extract ventilation information from thoracic impedance or other information, and adjust a delivery rate of the CRM therapy. A tidal volume of a patient is measured and used to adjust a ventilation rate response factor. The measured tidal volume can optionally be adjusted using a ventilation rate dependent adjustment factor. The ventilation rate response factor can also be adjusted using a maximum voluntary ventilation (MVV), an age predicted maximum heart rate, a resting heart rate, and a resting ventilation determined for the patient. In various examples, a global ventilation sensor rate response factor (for a population) can be programmed into the CRM device, and automatically tailored to be appropriate for a particular patient.

Abstract: A system comprising implantable device, the implantable medical device including an intrinsic cardiac signal sensor, an impedance measurement circuit configured to apply a specified current to a transthoracic region of a subject and to sample a transthoracic voltage resulting from the specified current, and a processor coupled to the intrinsic cardiac signal sensor and the impedance measurement circuit. The processor is configured to initiate sampling of a transthoracic voltage signal in a specified time relation to a fiducial marker in a sensed intrinsic cardiac signal, wherein the sampling attenuates or removes variation with cardiac stroke volume from the transthoracic voltage signal, and determine lung respiration using the sampled transthoracic voltage signal.

Abstract: A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.

Abstract: Implantable element having an elongate main body, a functional conductor which extends in the longitudinal direction of the main body or forms it, and which acts to implement a medical function of the element and has an inductive section, and magnetic flux generation means for generating a magnetic flux in the surroundings of the functional conductor, in particular of its inductive section, which are magnetically coupled to the functional conductor in such a way that the magnetic flux generated upon a current flux through the functional conductor is counteracted and the current flux density through the functional conductor is thus reduced.

Abstract: A medical device and associated method detect ischemia using stimulation delivered to induce respiration. A spontaneous breathing response to the stimulation-induced respiration is determined. Ischemia is detected in response to the spontaneous breathing response. The spontaneous breathing response is measured as a response to adjusting a parameter controlling the stimulation.

Abstract: The invention relates to methods and systems for determining phase-specific parameters of a physiological variable, and a related computer program and a related machine-readable storage medium, which are usable in particular to determine parameters of physiological variables that are subject to circadian variation. To this end, phase-specific parameters of a physiological variable X(t) are determined by calculating, at least for a portion of values x lying in a specifiable time period, a mean g(x|?) in each case of values X(t+?) for which X(t)=x applies for their predecessors, ? describing a time interval, and determining the phase-specific parameters by evaluating the mean g(x|?).

Abstract: A lead system for an implantable medical device and applications for the lead system. Also includes therapeutic systems, devices, and processes for detecting and treating disordered breathing and treating cardiac and breathing issues together with an implantable device.

Abstract: A system comprising implantable device, the implantable medical device including an intrinsic cardiac signal sensor, an impedance measurement circuit configured to apply a specified current to a transthoracic region of a subject and to sample a transthoracic voltage resulting from the specified current, and a processor coupled to the intrinsic cardiac signal sensor and the impedance measurement circuit. The processor is configured to initiate sampling of a transthoracic voltage signal in a specified time relation to a fiducial marker in a sensed intrinsic cardiac signal, wherein the sampling attenuates or removes variation with cardiac stroke volume from the transthoracic voltage signal, and determine lung respiration using the sampled transthoracic voltage signal.

Abstract: Methods and systems involve adjusting cardiac pacing based on information acquired via a respiratory therapy device. A medical system includes a respiratory therapy device having one or more sensors and a therapy delivery unit. The one or more sensors are configured to sense respiration cycles. The therapy delivery unit is configured to deliver an external respiratory therapy to the patient. The medical system also includes a pulse generator configured to deliver cardiac pacing pulses to the patient. A controller is coupled to the one or more sensors and the pulse generator. The control unit configured to adjust a cardiac pacing rate based on the patient's respiration cycles.

Abstract: Systems, devices and methods for defining, identifying and utilizing composite parameter indices from health-related parameters are disclosed. One aspect is a programmable device having machine executable instructions for performing a method to assist with managing a patient's health. In various embodiments, a first set of at least two health-related parameters is acquired. A first composite parameter is generated using the first set of at least two health-related parameters. Other aspects and embodiments are provided herein.

Abstract: An implantable cardiac device includes a sensor for sensing patient activity and detecting phrenic nerve activation. A first filter channel attenuates first frequencies of the sensor signal to produce a first filtered output. A second filter channel attenuates second frequencies of the accelerometer signal to produce a second filtered output. Patient activity is evaluated using the first filtered output and phrenic nerve activation caused by cardiac pacing is detected using the second filtered output.

Abstract: Systems and Methods for predicting patient health and patient relative well-being within a patient management system are disclosed. A preferred embodiment utilizes an implantable medical device comprising an analysis component and a sensing component further comprising a three-dimensional accelerometer, a transthoracic impedance sensor, a cardio-activity sensor, an oxygen saturation sensor and a blood glucose sensor. Some embodiments of a system disclosed herein also can be configured as an Advanced Patient Management System that helps better monitor, predict and manage chronic diseases.

Abstract: The current technology is relevant to a system having a programming device capable of communication with an implantable medical device, where the a programming device is configured to identify a patient condition comprising the patient's inability to exercise to a desired capacity, configured to notify a clinical user of the identified condition and configured to identify a therapy appropriate for the identified condition.

Abstract: An implantable cardiac device includes a sensor for sensing patient respiration and detecting phrenic nerve activation. A first filter channel attenuates first frequencies of the sensor signal to produce a first filtered output. A second filter channel attenuates second frequencies of the respiration signal to produce a second filtered output. Patient activity is evaluated using the first filtered output and phrenic nerve activation caused by cardiac pacing is detected using the second filtered output.

Abstract: A method and apparatus for treatment of hypertension and heart failure by increasing secretion of endogenous atrial hormones by pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in premature atrial contraction that does not result in ventricular contraction. Pacing results in the atrial wall stress, peripheral vasodilation, ANP secretion. Concomitant reduction of the heart rate is monitored and controlled as needed with backup pacing.

Abstract: Systems and methods for sleep state classification involve detecting conditions related to sleep, including at least one condition associated with rapid eye movement (REM) sleep. Additionally, a condition modulated by the sleep-wake status of the patient may be detected. A medical system that is partially or fully implantable incorporates sensors and circuitry for detecting and processing the sleep-related signals. A sleep state processor classifies the patient's sleep state based on the sleep-related signals. Sleep state classification may be used in connection with the delivery of sleep state appropriate therapy, diagnostic testing, or patient monitoring.

Abstract: An implantable device monitors and treats heart failure, pulmonary edema, and hemodynamic conditions and in some cases applies therapy. In one implementation, the implantable device applies a high-frequency multi-phasic pulse waveform over multiple-vectors through tissue. The waveform has a duration less than the charging time constant of electrode-electrolyte interfaces in vivo to reduce intrusiveness while increasing sensitivity and specificity for trending parameters. The waveform can be multiplexed over multiple vectors and the results cross-correlated or subjected to probabilistic analysis or thresholding schemata to stage heart failure or pulmonary edema. In one implementation, a fractionation morphology of a sensed impedance waveform is used to trend intracardiac pressure to stage heart failure and to regulate cardiac resynchronization therapy. The waveform also provides unintrusive electrode integrity checks and 3-D impedancegrams.

Abstract: A cardiac electro-stimulatory device and method for operating same in which stimulation pulses are distributed among a plurality of electrodes fixed at different sites of the myocardium in order to reduce myocardial hypertrophy brought about by repeated pacing at a single site and/or increase myocardial contractility. In order to spatially and temporally distribute the stimulation, the pulses are delivered through a switchable pulse output configuration during a single cardiac cycle, with each configuration comprising one or more electrodes fixed to different sites in the myocardium.

Abstract: A rate-adaptive pacemaker and a method for its operation in which the response factor for a minute ventilation sensor or other type of exertion level sensor is automatically set during a parameter adjustment mode that utilizes an activity level measurement to determine when the patient is at a target activity level with which is associated an appropriate target pacing rate. In a preferred embodiment, the target activity level corresponds to casual walking (e.g., 2 mph at a 4% grade) with a target pacing rate selected as appropriate for that level of activity in the individual patient.

Abstract: A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

Abstract: Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

Abstract: Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.

Abstract: A method includes controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient and determining that the patient is in a resting state. The method further includes modifying the pacing rate of the IMD for N cardiac cycles in response to determining that the patient is in the resting state. N is an integer greater than 1. Modifying the pacing rate includes incrementally increasing the pacing rate for a first portion of the N cardiac cycles, and incrementally decreasing the pacing rate for a second portion of the N cardiac cycles.

Abstract: Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein.

Abstract: An approach to providing disordered breathing therapy includes delivering electrical stimulation therapy modifying a patient's baroreflex response. Disordered breathing therapy may be delivered in response to prediction or detection of disordered breathing events. Various conditions affecting the patient may be evaluated and the baroreflex therapy modified. The therapy may be modified to improve therapy efficacy, to reduce an impact to the patient and/or to mitigate therapy interactions.

Abstract: A system comprising implantable device, the implantable medical device including an intrinsic cardiac signal sensor, an impedance measurement circuit configured to apply a specified current to a transthoracic region of a subject and to sample a transthoracic voltage resulting from the specified current, and a processor coupled to the intrinsic cardiac signal sensor and the impedance measurement circuit. The processor is configured to initiate sampling of a transthoracic voltage signal in a specified time relation to a fiducial marker in a sensed intrinsic cardiac signal, wherein the sampling attenuates or removes variation with cardiac stroke volume from the transthoracic voltage signal, and determine lung respiration using the sampled transthoracic voltage signal.

Abstract: Systems and techniques for applying an electromagnetic field to bodily tissue include a self-contained and portable electromagnetic field generating device disposed over a surface of bodily tissue such that the radiated electromagnetic fields impinge upon the bodily tissue. The device includes an electromagnetic field generator, which is coupled to an antenna that is arranged to radiate the electromagnetic field. A power source is coupled to the generator to provide power for the device and an activator is used to initiate radiation of the electromagnetic field. Methods of inducing electrical current in bodily tissues and treating disorders, such as pain-related disorders, are also disclosed.

Abstract: In general, the disclosure describes techniques for modifying therapy provided to a patient by a medical device. The techniques may be applicable to electrical stimulation therapy or other therapies. Modification of therapy may include adjustment of one or more therapy parameter values that define one or more characteristics of stimulation therapy delivered to a patient. The therapy modification may be based on activity of a patient that is detected by an IMD, such as a change in a detected posture state occupied by the patient. Different therapy modifications may be applied for different changes in detected posture state. An IMD may modify therapy based on a transition from one posture state to another posture state, and apply different modifications for different transitions. In some aspects, the modification may include a profile, such as a ramp up or ramp down in a parameter value over a period of time. The profile may be different for different posture transitions.

Abstract: An implantable medical device includes a multi-axial acceleration sensor and an evaluation unit connected thereto. The evaluation unit is configured to (1) split the accelerometer output signal into at least two signal components, one of which is associated with a right-ventricular contraction and another of which is associated with a left-ventricular contraction; (2) detect events in the signal components, and/or determine signal features therein; and (3) determine at least one characteristic value K by evaluating the signal components, and/or the events and/or signal features therein.

Abstract: Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.

Abstract: An external defibrillator having a battery; a capacitor electrically communicable with the battery; at least two electrodes electrically communicable with the capacitor and with the skin of a patient; a controller configured to charge the capacitor from the battery and to discharge the capacitor through the electrodes; and a support supporting the battery, capacitor, electrodes and controller in a deployment configuration, the defibrillator having a maximum weight per unit area in the deployment configuration of 0.1 lb/in2 and/or a maximum thickness of 1 inch. The support may be a waterproof housing.

Abstract: A method is presented for evaluating whether an episode of sleep apnea is occurring in a patient suffering from chronic sleep apnea disorder, for delivery of appropriate therapy. The method, performed by an implantable device, includes sensing the patient's EKG signal and using electrical energy generated by the heart to power subsequent signal processing. This signal is applied as the sole input to a differential signal processing circuit for passage through both a high impedance path and a substantially lower impedance path and amplification of the difference in magnitude between the resulting two signals, to determine changes in the patient's thoracic impedance. Based on such changes, the presence or absence of patient ventilation is detected, to enable an assessment of whether an episode of sleep apnea is occurring. An actual episode of sleep apnea is deemed to have occurred if lack of ventilation exceeds a predetermined interval of time between otherwise regular respiratory cycles.

Abstract: An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter.

Abstract: A method of identifying a potential cause of pulmonary edema is provided. The method includes obtaining one or more impedance vectors between predetermined combinations of the electrodes positioned proximate the heart. At least one of the impedance vectors is representative of a thoracic fluid level. The method also includes applying a stimulation pulse to the heart and sensing cardiac signals of the heart that are representative of an electrophysiological response to the stimulation pulse. The method further includes monitoring the cardiac signals and at least one of the impedance vectors with respect to time to identify the potential cause of pulmonary edema.