Abstract: Certain embodiments provide systems, methods, and computer program products that administer pain management treatments remotely, according to a dynamic prescription. In some embodiments, the dynamic prescription provides for changes in a dosage of a medication or electrical stimulation, based for instance upon changes in the patient's pain tolerance level, biological indicators, or behavioral characteristics. In some embodiments, if it is determined that a dosage change is needed, the dosage change can be compared against the dynamic prescription to determine whether the dosage change is permitted within the scope of the dynamic prescription. In some embodiments, if the dosage change is determined to be outside what is permitted by the scope of the dynamic prescription, the updated dosage information can be provided to the patient's physician for authorization of the updated dosage.

Abstract: An approach for determining an estimated pressure curve for the ventricle of the heart, the method comprising: using data from a motion sensor that has been implanted at the heart to determine the timing of heart cycle events; scaling a reference pressure-time curve including timing of reference heart cycle events in order to fit the reference pressure-time curve to the motion sensor data, the scaling comprising scaling the reference curve along the time axis to fit it to the measured timing of the heart cycle events; and thereby obtaining an estimated pressure-time curve in the form of the scaled reference pressure-time curve.

Abstract: A blood pressure related information display apparatus includes a blood pressure measurement cuff configured to be worn by being wrapped around a measurement site of a measurement subject. An acceleration sensor attached integrally to the cuff is included. An orientation detection unit for detecting an orientation of the measurement subject during blood pressure measurement based on an output of the acceleration sensor is included. A display control unit for performing control for displaying an orientation of the measurement subject detected by the orientation detection unit as an illustration on a display screen is included.

Abstract: Methods and systems for treating cardiac malfunction are disclosed, which according to an embodiment, may involve delivering a stimulation pattern of stimulation pulses to at least one cardiac chamber of a heart, with at least one of the stimulation pulses having a first stimulation setting configured to reduce at least one of end systolic volume (ESV) and end diastolic volume (EDV) in the heart and at least one of the stimulation pulses having a second stimulation setting different from the first stimulation setting, and with the stimulation pattern being configured to reduce the at least one of end systolic volume (ESV) and end diastolic volume (EDV) by at least 5% and maintain the at least one of end systolic volume (ESV) and end diastolic volume (EDV) on average at such reduced volume for a time period of at least one hour.

Abstract: Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

Abstract: Systems and methods are provided for managing patient activated capture of transient data by an implantable medical device (IMD). The systems and methods collect transient data using the IMD. The collected transient data is stored in a temporary memory section of the IMD. The IMD receives a patient activated storage request including activation information related to a patient designated trigger point from an external device. The IMD transfers a segment of the transient data from the temporary memory section to a long-term memory, wherein the segment of transferred transient data is based on the trigger point. The activation information includes an elapsed time corresponding to a duration of time between entry of the trigger point and issuance of the patient activated storage request by an external activation device.

Abstract: A method for extracting power from intraluminal pressure changes may comprise one or more of the following steps: (a) receiving an intraluminal pressure change; (b) converting the intraluminal pressure change into energy with an intraluminal generator; and (c) storing the energy in an energy storage apparatus.

Abstract: A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.

Abstract: A system for utilizing power extracted from intraluminal pressure changes may comprise: (a) an intraluminal generator; (b) an intraluminal pressure change-receiving structure operably coupled to the intraluminal generator; and (c) a power utilization device. A system for utilizing power extracted from intraluminal pressure changes may comprise: (a) means for receiving an intraluminal pressure change; (b) means for converting an intraluminal pressure change into energy with an intraluminal generator; and (c) means for providing, the energy to a power utilization device.

Abstract: A method for generating power from intraluminal pressure changes may comprise one or more of the following steps: (a) receiving an intraluminal pressure change; and (b) converting the intraluminal pressure change into energy with an intraluminal generator.

Abstract: An implantable medical device includes a pressure input, an excitation source, a detector module, and a processor. The pressure input is configured to be joined to a pressure sensor located proximate to a cardiac chamber of the heart. The pressure input receives pressure measurements representative of a pressure in the cardiac chamber. The excitation source is configured to deliver stimulation pulses to the heart. The detector module communicates with the pressure sensor to receive and compare the pressure measurements to a pressure threshold. The processor instructs the excitation source to deliver the stimulation pulses at a pressure-based rate based on the comparison of the pressure measurements to the pressure threshold.

Abstract: A device for storing power generated from intraluminal pressure changes may comprise: (a) an intraluminal pressure change-receiving structure operably coupled to the generator; (b) a intraluminal generator; and (c) an energy storage apparatus. A system for storing power generated from intraluminal pressure changes may comprise: (a) means for receiving an intraluminal pressure change; (b) means for converting the intraluminal pressure change into energy with an intraluminal generator; and (c) means for storing the energy in an energy storage apparatus.

Abstract: Various system embodiments comprise a medical device, comprising a flexible tether, a neural stimulation circuit, and a controller. The flexible tether is adapted to be fed into a patient's throat. The flexible tether includes a plurality of electrodes. The neural stimulation circuit is adapted to deliver neural stimulation. The controller is adapted to control the neural stimulation circuit to provide a neural stimulation therapy using at least one electrode from the plurality of electrodes, and to implement a neural stimulation test routine. The neural stimulation test routine is adapted to assess neural stimulation efficacy for electrode subsets of the plurality of electrodes to identify a desired electrode subset for use in delivering the neural stimulation therapy to elicit a desired response.

Abstract: What is disclosed is a method for monitoring a subject for cardiac arrhythmia such as atrial fibrillation using an apparatus that can be comfortably worn by the subject around an area of exposed skin where a photoplethysmographic (PPG) signal can be registered. In one embodiment, the apparatus is a reflective or transmissive wrist-worn device with emitter/detector pairs fixed to an inner side of a band with at least one illuminator emitting source light at a specified wavelength band. The illuminator is paired to a respective photodetector comprising one or more sensors that are sensitive to a wavelength band of its paired illuminator. The photodetector measures intensity of sensed light emitted by a respective illuminator. The signal obtained by the sensors comprises a continuous PPG signal. The continuous PPG signal analyzed for peak-to-peak pulse points from which the existence of cardiac arrhythmia such as atrial fibrillation event can be determined.

Abstract: Systems and methods for prediction and detection of circulatory shock using estimates or measurements of arterial blood pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, cardiac ejection fraction, cardiac contractility and ventricular end-diastolic volume are provided. These estimates and measurements are used to determine a type of circulatory shock. In some embodiments, the type of circulatory shock is determined to be one of septic shock, hypovolemic shock, anaphylactic shock, hemorrhagic shock, and cardiogenic shock.

Abstract: Various techniques for measuring cardiac cycle length and pressure metrics based on pulmonary artery pressures are described. One example method described includes identifying a point within a derivative signal of a cardiovascular pressure signal without reference to electrical activity of a heart, initiating a time window from the identified point in the derivative signal, identifying a point within the cardiovascular signal within the time window, and determining at least one of a systolic pressure or diastolic pressure based on the identified point.

Abstract: A neural stimulation system senses autonomic activities and applies neural stimulation to sympathetic and parasympathetic nerves to control autonomic balance. The neural stimulation system is capable of delivering neural stimulation pulses for sympathetic excitation, sympathetic inhibition, parasympathetic excitation, and parasympathetic inhibition.

Abstract: Methods, systems and devices described herein can be used for automatically adjusting one or more cardiac resynchronization therapy (CRT) pacing parameters (and more generally stimulation parameters), to achieve a long term reduction in left ventricular (LV) diastolic pressure (and more generally, preload) of a heart failure (HF) patient. A reduction in LV diastolic pressure is indicative of a reduction in preload (the force of blood the fills the left ventricle), which is typically indicative of an improvement in a patient's HF condition. In accordance with certain embodiments, when a set of stimulation parameters is tested, the set is tested for a period that is sufficiently long enough to allow the patient's compensatory mechanisms to react to the set of stimulation parameters and achieve a substantially steady-state LV diastolic pressure corresponding to the using the set of stimulation parameters.

Abstract: Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

Abstract: Techniques are provided for detecting pulmonary congestion based on an increase in right ventricular (RV) stroke volume over left ventricular (LV) stroke volume. In one example, the device generates an index based on accumulated differences between RV stroke volume and LV stroke volume while RV stroke volume exceeds LV stroke volume, such that the index is indicative of an ongoing imbalance between RV and LV stroke volume. The index is compared to a suitable threshold to detect a severe imbalance indicative of pulmonary edema. Additionally, techniques are described for estimating RV and LV stroke volumes based on pulmonary artery pressure, left atrial pressure, aortic pressure, LV strain or on various intracardiac or extracardiac impedance measurements.

Abstract: An embodiment of a baroreflex stimulator comprises a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template.

Abstract: Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

Abstract: Methods, systems and devices described herein can be used for automatically adjusting one or more cardiac resynchronization therapy (CRT) pacing parameters (and more generally stimulation parameters), to achieve a long term reduction in left ventricular (LV) diastolic pressure (and more generally, preload) of a heart failure (HF) patient. A reduction in LV diastolic pressure is indicative of a reduction in preload (the force of blood the fills the left ventricle), which is typically indicative of an improvement in a patient's HF condition. In accordance with certain embodiments, when a set of stimulation parameters is tested, the set is tested for a period that is sufficiently long enough to allow the patient's compensatory mechanisms to react to the set of stimulation parameters and achieve a substantially steady-state LV diastolic pressure corresponding to the using the set of stimulation parameters.

Abstract: A real time, heart rate monitor and a hemodynamic monitoring system are operably integrated with the programmer system for an implantable hypertension treatment device. A series of tests are automatically performed to set programmable parameters for the implantable hypertension treatment device without clinician intervention. In one embodiment, a predetermined level of a dose-response evaluation is initiated for each test in the series. Preferably, the programmer system monitors the heart rate to determine whether a hemodynamic measurement should be initiated at all for a given test, as well as whether the hemodynamic measurement should be initiated earlier or later than a predetermined settling period for assessing the sympathetic nervous response to the test dose. In one embodiment, this determination is based on heart rate stability/instability.

Abstract: A cardiac pressure monitoring device includes a fixation member defining a central opening to facilitate slidably positioning the fixation device about a pacemaker lead wire. At least one sensor is coupled to the fixation member. The at least one sensor is configured to sense a physical, chemical, and/or physiological parameter within a cardiac chamber.

Abstract: A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. The device may be configured to deliver high-output pacing upon detection of cardiac decompensation.

Abstract: Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein.

Abstract: The present disclosure refers to a heart stimulator comprising a stimulation control unit, a stimulation unit, an impedance measurement unit and an impedance evaluation unit. The stimulation control unit is operatively connected to the stimulation unit to control timing of stimulation pulses by said stimulation unit. The impedance measurement unit is configured to determine an impedance signal reflecting intracardiac impedance. The impedance evaluation unit is operatively connected to the impedance measurement unit and to the stimulation control unit and is configured to evaluate the impedance signal so as to determine an isovolumic contraction time, an isovolumic relaxation time, an ejection time and a filling time from said impedance signal. The stimulation control unit is further configured to control timing of stimulation pulses depending on a performance index.

Abstract: Pacing parameters may be adjusted to increase the cardiac output of a patient's heart while a patient is awake and/or active and the demand placed on the heart may be greatest, and to decrease or hemodynamic efficiency while a patient is at rest so that the heart itself has time to rest before the next period of higher demand for efficiency begins. This may aid in lessening the strain placed on the heart by making the heart work hard when needed such as when the patient is active, and by permitting the heart to “rest” when the patient is relatively inactive.

Abstract: A method and device for delivering ventricular resynchronization pacing therapy in conjunction with electrical stimulation of nerves which alter the activity of the autonomic nervous system is disclosed. Such therapies may be delivered by an implantable device and are useful in preventing the deleterious ventricular remodeling which occurs as a result of a heart attack or heart failure. The device may perform an assessment of cardiac function in order to individually modulate the delivery of the two types of therapy.

Abstract: In an implantable medical device and a method for stimulating a heart of a patient, at least one left atrial pressure (LAP) signal over a cardiac cycle is obtained. The A-wave is identified using the LAP signal and a maximum positive rate of change of the A-wave of the LAP signal is determined. The maximum positive rate of change of the A-wave corresponds to the rate which the pressure in the atrium raises as the atria contraction forces more blood into the ventricle during the very last stage of diastole. Further, AV and/or VV delay is adjusted in response to the maximum positive rate of change of the A-wave, wherein a reduction of the maximum positive rate of change of the A-wave indicates an AV and/or VV delay providing an enhanced hemodynamic performance.

Abstract: Methods, systems and devices efficiently identify cardiac resynchronization therapy (CRT) pacing parameter set(s) that provide improved hemodynamic response relative to an initial CRT pacing parameter set, wherein each CRT pacing parameter set includes at least two CRT pacing parameters. User input(s) are accepted that specify a maximum amount of time and/or parameter sets that can be used to perform testing, and specify relative importance of parameters within the sets. Based on the accepted user input(s), there is a determination of how many different variations of each of the CRT pacing parameters can be tested, and based on this determination different CRT pacing parameter sets are selected and tested to obtain a hemodynamic response measure corresponding to each of the different sets tested. Additionally, one or more of the tested CRT pacing parameter sets, if any, that provide improved hemodynamic response relative to the initial CRT pacing parameter set is/are identified.

Abstract: Various techniques for facilitating selection of a pacing vector for pacing a chamber of a heart are described. One example method described includes, for each of a plurality of vectors, delivering a pacing pulse to capture a first heart chamber, determining a first time interval between the pacing pulse and a sensed event in a second heart chamber, determining a capture detection window in response to the determined first time interval, and enabling a capture detection module to iteratively decrease a pacing pulse magnitude delivered in the first heart chamber until an event in the second heart chamber is not sensed during the determined capture detection window.

Abstract: Various aspects of the present disclosure are directed toward an implantable electrostimulation device, a plurality of sensing and pacing elements, and a fine wire lead extending in a sealed relationship from the electrostimulation device and to the plurality of sensing and pacing elements. The fine wire lead includes multiple discrete conductors and a drawn silica or glass fiber core, a polymer cladding on the drawn silica or glass fiber core, and a conductive metal cladding over the polymer cladding. Additionally, the fine wire lead simultaneously delivers different electrical signals or optical signals between the sensing and pacing elements and the electrostimulation device.

Abstract: Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects peaks within the PAP signal corresponding to valvular regurgitation within the heart, then detects mitral regurgitation (MR) based on the peaks. In other examples, the PAP monitor optimizes pacing parameters based on the PAP signal and corresponding electrical cardiac signals. Examples are provided where the PAP monitor is an external system and other examples are provided where the PAP monitor is a component of an implantable cardiac rhythm management device.

Abstract: A method and device for delivering pre-excitation pacing to prevent or reduce cardiac remodeling following a myocardial infarction is described. The pre-excitation pacing is modulated in accordance with an assessment of cardiac function in order to balance the beneficial effects of stress reduction with hemodynamic compromise.

Abstract: A delivery device for implanting a medical device that includes an expandable fixation member adapted to fix the position of the medical device within a lumen of a human body. The delivery device has an inner shaft rotatably disposed in a tubular outer shaft. A retention member is secured to and rotatable with the inner shaft and has a free end and a retainer portion adapted to protrude outwardly through an exit aperture in the outer shaft to extend circumferentially about the exterior of the outer shaft. The fixation member of the medical device may be retained on the tubular shaft in a low profile configuration by the outwardly protruding retainer portion and may be released to expand upon retraction of the retainer portion in response to rotation of the inner shaft.

Abstract: A method that electrically stimulates a heart muscle to alter the ejection profile of the heart, to control the mechanical function of the heart and reduce the observed blood pressure of the patient. The therapy may be invoked by an implantable blood pressure sensor associated with a pacemaker like device. In some cases, where a measured pretreatment blood pressure exceeds a treatment threshold, a patient's heart may be stimulated with an electrical stimulus timed relative to the patient's cardiac ejection cycle. This is done to cause dyssynchrony between at least two cardiac chambers or within a cardiac chamber, which alters the patient's cardiac ejection profile from a pretreatment cardiac ejection profile. This has the effect of reducing the patient's blood pressure from the measured pretreatment blood pressure.

Abstract: A real time, heart rate monitor and a hemodynamic monitoring system are operably integrated with the programmer system for an implantable hypertension treatment device. A series of tests are automatically performed to set programmable parameters for the implantable hypertension treatment device without clinician intervention. In one embodiment, a predetermined level of a dose-response evaluation is initiated for each test in the series. Preferably, the programmer system monitors the heart rate to determine whether a hemodynamic measurement should be initiated at all for a given test, as well as whether the hemodynamic measurement should be initiated earlier or later than a predetermined settling period for assessing the sympathetic nervous response to the test dose. In one embodiment, this determination is based on heart rate stability/instability.

Abstract: Techniques for pacing the heart of a patient as a function of a pressure value make use of a pressure monitor that receives a signal from a pressure sensor in the heart. The pressure monitor measures a pressure value. The pressure monitor may, for example, estimate the pulmonary artery diastolic pressure if the pressure sensor is located in the right ventricle, or calculate the mean central venous pressure if pressure sensor is located in the right atrium. The energy level of the pacing pulses delivered to the patient's heart by a pacemaker is modulated as a function of the pressure value. Modulating the energy level of the pacing pulses modulates the cardiac output of the patient's heart.

Abstract: A pacemaker optimising apparatus comprising: a component (4) which noninvasively or invasively monitors a haemodynamic measurement continuously in an individual and a processor (15) for receiving the haemodynamic measure and generating a pacemaker programming signal in response to this. There is also provided a communication device (17) for sending the pacemaker programming signal to the control system of the pacemaker (2). There is also a method for an efficient process by which this apparatus can automatically use the haemodynamic measurements to determine the ideal settings for a particular pacemaker in a particular individual, and to updates the pacemaker's settings accordingly.

Abstract: Exemplary methods are described for providing responsive vascular control with or without cardiac pacing. An implantable device with responsive vascular and cardiac controllers interprets physiological conditions and responds with an appropriate degree of vascular therapy applied as electrical pulses to a sympathetic nerve. In one implementation, an implantable device is programmed to deliver the vascular therapy in response to low blood pressure or orthostatic hypotension. The device may stimulate the greater splanchnic nerve, to effect therapeutic vasoconstriction. The vascular therapy is dynamically adjusted as the condition improves. In one implementation to benefit impaired physical mobility, vascular therapy comprises vasoconstriction and is timed to coincide with a recurring segment of the cardiac cycle. The vasoconstriction assists circulation and venous return in the lower limbs of inactive and bedridden individuals.

Abstract: Techniques are provided for use with an implantable cardiac rhythm management (CRMD) system equipped to deliver neurostimulation to acupuncture sites within anterior regions of the neck, thorax or abdomen of the patient. Parameters associated with the health of the patient are detected, such as parameters indicative of arrhythmia, heart failure and hypertension.

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: A rate smoothing function used in implantable pulse generators uses detected triggering events, which cause the rate smoothing function to be activated or deactivated, and detected parameter adjusting events, which cause parameter(s) of the rate smoothing function to be changed. In one example, the activation/deactivation and/or change to the parameters of the rate smoothing function are temporary, and the pre-event state of the rate smoothing function is set to a post-adjusting state, such as after a first time interval. Rate smoothing may be selected, activated or deactivated, or adjusted based on a cardiac signal state, or based on an activity or other physiological sensor signal. The adjusted rate smoothing parameters may include an up-smoothing percentage to limit a speed of pacing rate increase and a down-smoothing percentage to limit a speed of pacing rate drop.

Abstract: Techniques are provided for assessing left atrial pressure (LAP) based on atrial electrocardiac signal parameters, particularly intra-atrial conduction delay (IACD) and P-wave duration. In one example, a pacemaker or other implantable device senses an intracardiac electrogram (IEGM) or a subcutaneous electrocardiogram (ECG), from which IACD and P-wave duration are derived. The device tracks changes, if any, in the parameters. A significant increase in either IACD or P-wave duration is associated with an increase in LAP. In some examples, conversion factors are calibrated for use with a particular patient to relate IACD and/or P-wave duration values to LAP values to provide an estimate of actual LAP. The conversion factors are pre-calibrated using LAP measurements obtained using a wedge pressure sensor. In other examples, IACD and P-wave duration are instead used to confirm the detection of an elevation in LAP initially made using impedance signals. Other confirmation parameters are described as well.

Abstract: A cardiac rhythm management system comprises a medical electrical lead, a pressure sensing element, and an implantable pulse generator. The lead is sized to be advanced through the right atrium and coronary sinus into a coronary vein adjacent to the left ventricle. The lead includes an opening intermediate its proximal and distal ends, and a lumen extending longitudinally within the body in communication with the opening. The pressure sensing element is movably disposed in lead lumen and is dimensioned to extend through the opening in the lead, and includes a flexible, elongated conductive member having a distal end, and a pressure transducer coupled to the distal end of the conductive member. The pulse generator is configured to receive cardiac rhythm signals from the electrode and fluid pressure signals from the pressure transducer.

Abstract: Described herein are methods and apparatus for treating hypertension with electrical pre-excitation pacing therapy. Electrical pre-excitation of a hypertrophic region advances the timing of the regional contraction and reduces its contribution to the overall contraction. Such pre-excitation pacing therapy may be beneficial to hypertensive patients with an abnormal distribution of ventricular wall stress/strain.

Abstract: A medical device monitors a patient to predict worsening heart failure. An input circuit of the medical device receives a pressure signal representative of a pressure sensed within a ventricle of the patient's heart as a function of time. A processor derives from the pressure signal a ventricular pressure index for a ventricular contraction based upon pressures in the ventricle. The processor then provides an output based upon the ventricular pressure index.

Abstract: Described are methods and devices for improving diastolic function with electrostimulation in heart failure patients who exhibit relatively normal systolic function. Such patients are characterized by impaired myocardial relaxation during diastole that prevents adequate filling of the ventricles during diastole to thereby reduce cardiac output. An implantable device is described for effecting strategic and periodic stimulation of the sympathetic nervous system to elicit myocardial adrenergic activation for improved myocardial relaxation.