Abstract: An antenna for an implantable medical device (IMD) is provided including a monolithic structure derived from a plurality of discrete dielectric layers having an antenna embedded within the plurality of dielectric layers. The antenna includes antenna portions formed within different layers of the monolithic structure with at least one conductive via formed to extend through the dielectric layers in order to provide a conductive pathway between the portions of the antenna formed on different layers, such that an antenna is formed that extends between different vertical layers. The dielectric layers may comprise layers of ceramic material that can be co-fired together with the antenna to form a hermetically sealed monolithic antenna structure. The antenna embedded within the monolithic structure can be arranged to have a substantially spiral, helical, fractal, meandering or planer serpentine spiral shape.

Abstract: An external control device for use with a programmable implantable medical device coupled to an operative element. The external control device comprises a user interface comprising a control element and a display screen configured for displaying a graphical representation of the operative element. The external control device further comprises control circuitry configured for prompting the display screen to superimpose a graphical programmer control over the graphical representation of the operative element when the control element is actuated, and modifying an operational parameter for the operative element in response to actuation of the graphical programmer control. The external control device further comprises output circuitry configured for transmitting the modified operational parameter to the programmable implantable medical device.

Abstract: Transducer-based systems and methods may be configured to display a graphical representation of a transducer-based device, the graphical representation including graphical elements corresponding to transducers of the transducer-based device, and also including between graphical elements respectively associated with a set of the transducers and respectively associated with a region of space between the transducers of the transducer-based device. Selection of graphical elements and/or between graphical elements can cause activation of the set of transducers associated with the selected elements. Transducer activation characteristics, such as initiation time, activation duration, activation sequence, and energy delivery characteristics, can vary based on numerous factors. Visual characteristics of graphical elements and between graphical elements can change based on an activation-status of the corresponding transducers.

Abstract: A method of determining pacing therapy for an individual patient including determining representative electromechanical physiologic characteristics for a plurality of normal patients having a range of anatomical dimensions and developing a plurality of normal templates. Each template indicates the representative electromechanical physiologic characteristics of a group of normal patients having similar anatomical dimensions.

Abstract: An implantable medical device (IMD) may include a communication module, a therapy control module, a firmware control module, and a service application. The communication module is configured to wirelessly communicate over an RF link with an external device. The therapy control module is configured to deliver therapy to the patient, and may include a reprogrammable therapy logic circuit configured to operate the therapy control module in a reprogrammable mode of operation, and base-therapy state machine (BTSM) logic circuit configured to operate the therapy control module in a base therapy mode of operation. The firmware control module may include CPU and a memory. The service application may be stored in the memory. The firmware control module is configured to launch the service application, and the BTSM logic circuit provides a base level of sensing and pacing therapy while the communications module in parallel maintains the RF link with the external device.

Abstract: Medical monitoring and treatment apparatus, which is controlled by a plurality of control sources, includes a “personal medical device” (PMD) or an “implantable medical device” (IMD), respectively carried by, or implanted in, a patient. The PMD/IMD is alternatively self-controlled or controlled by one or more local external control stations, at or near the location of the patient, and/or one or more remote external control stations, remote from the patient. Either or both of the local and remote stations may be operated by a person, such as the patient, a patient facilitator and/or a medical professional, or the stations may operate automatically. Since the device is controlled by multiple sources, hierarchies are used to select the source of control.

Abstract: Disclosed is a remote controller for an implantable medical device having stored contraindication information, which includes information which a patient or clinician might wish to review when assessing the compatibility of a given therapeutic or diagnostic technique or activity with the patient's implant. The stored contraindication information is available through a display of the remote controller or via a wired, wireless, or portable drive connection with an external device. By storing contraindication information with the implant's remote controller, patient and clinician can more easily determine the safety of a particular therapeutic or diagnostic technique or physical activity with the patient's implant, perhaps without the need to contact the manufacturer's service representative.

Abstract: Devices, systems, and methods incorporate the most-used functions of a electrical stimulator's controller into a small, thin pocket controller that is not only comfortable to carry in a pocket, but can also be attached to a key ring, lanyard, or other such carrying device for ease of daily use. A separate patient controller charger is used to charge and control the implanted medical device.

Abstract: A communication pathway is established between an implanted medical device (IMD) and a proximate electronic device. Performance of one or more functions by the electronic device is known to have a potential to cause at least one adverse effect on the implanted medical device. The implanted medical device can wirelessly conveying a message over the communication pathway to the electronic device detailing an existence of the implanted medical device (IMD) within wireless communication range of the electronic device and detailing a safety requirement or operational data specific to the implanted medical device. The conveyance of the message from the implanted medical device can place the proximate electronic device on notice to minimize the adverse effects on the implanted medical device resulting from executing the one or more functions.

Abstract: A system and method are described for delivering an implantable medical device in a patient and through a catheter. The delivery catheter comprises telemetry means for communicatively coupling the implantable medical device with an external instrumentation during implantation.

Abstract: A medical transceiver device for radio-based communication with an implantable medical device has circuitry for transmitting radio-frequency signals to, and/or receiving radio-frequency signals from, the implantable medical device, first and second electrically conductive structures, and an antenna feed network operatively interconnected between the circuitry and the first and second conductive structures. Each of the first and second conductive structures is operable as a transmitting and/or receiving antenna for the radio-frequency signals. The first and second conductive structures emit and/or receive radio waves of different polarizations, and the first and second conductive structures are disposed adjacent each other at a single location in space, thereby providing spatial diversity that is independent of the polarization diversity.

Abstract: An implantable electroacupuncture device (IEAD) treats heart failure, coronary artery disease, myocardial ischemia or angina through application of stimulation pulses applied at acupoints GV20 and/or EXHN3. The IEAD comprises an implantable, coin-sized, self-contained, leadless electroacupuncture device having at least two electrodes attached to an outside surface of its housing. The device generates stimulation pulses in accordance with a specified stimulation regimen. Power management circuitry within the device allows a primary battery, having a high internal impedance, to be used to power the device. The stimulation regimen generates stimulation pulses during a stimulation session of duration T3 minutes applied every T4 minutes. The duty cycle, or ratio of T3/T4, is very low, no greater than 0.05. The low duty cycle and careful power management allow the IEAD to perform its intended function for several years.

Abstract: Methods, devices, kits and compositions to treat a myocardial infarction. In one embodiment, the method includes the prevention of remodeling of the infarct zone of the ventricle using a combination of therapies. The method may include the introduction of structurally reinforcing agents. In other embodiments, agents may be introduced into a ventricle to increase compliance of the ventricle. The prevention of remodeling may include the prevention of thinning of the ventricular infarct zone. Another embodiment includes the reversing or prevention of ventricular remodeling with electro-stimulatory therapy. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling. These therapies may be combined with structurally reinforcing therapies. In other embodiments, the structurally reinforcing component may be accompanied by other therapeutic agents. These agents may include but are not limited to pro-fibroblastic and angiogenic agents.

Abstract: A clinician programming system operable to control an implantable medical device includes a clinician programmer and a secondary unit. The clinician programmer has a housing, and includes a first display configured to display information indicative of the inputs by the clinician or display information indicative of status of an implantable pulse generator, the first display having a first display size. The secondary unit is separate from the housing of the clinician programmer and includes a secondary display. The secondary display is configured to communicate with the clinician programmer via the secondary display communication interface and configured to display information received via the secondary display communication interface.

Abstract: Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient's heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.

Abstract: A transvenously implantable medical device (TIMD) includes an electrical lead and a control module. The electrical lead includes one or more electrodes and is adapted for transvenous implantation. The electrical lead is also pre-biased to expand from a collapsed state to an expanded state to mechanically engage an internal wall of a blood vessel. The control module is secured to and in electrical communication with the electrical lead. The control module includes a signal management component and a power component disposed in a housing adapted for implantation into the blood vessel. The control module is adapted for at least one of stimulating and sensing a physiologic response using the one or more electrodes of the electrical lead.

Abstract: Methods and systems are directed to selecting from a variety of capture verification modes. A plurality of capture verification modes, including a beat by beat capture detection mode and a capture threshold testing mode without intervening beat by beat capture detection is provided. An efficacy of at least one of the capture verification modes is evaluated, and based on the evaluation, a capture verification mode is selected.

Abstract: The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data to determine whether T-wave oversensing has occurred. The T-wave oversensing analysis may include, for example, identifying beat runs within the cardiac episode whether the beats within the run have at least one characteristic that alternates beat to be or clustering beats within the cardiac episode based on beat to beat interval length. The T-wave oversensing determination may be based on probabilistic analysis in some examples.

Abstract: An apparatus comprises a medical device configured for implantation into a living organism. The medical device comprises processing circuitry, a memory and interface circuitry configured for communication with a monitoring device. The medical device is configured to receive a request for access from the monitoring device, to measure a physiological value of the living organism, to perform a pairing protocol with the monitoring device, the pairing protocol comprising a secure channel set-up phase followed by an authentication phase, and to permit access by the monitoring device responsive to a successful pairing in accordance with the pairing protocol, the successful pairing being based at least in part on a determination that a physiological value supplied by the monitoring device substantially matches the measured physiological value. The medical device performs the secure channel set-up phase before sending the measured physiological value to the monitoring device.

Abstract: A neuromodulation system comprises a sensor configured for sensing a blood pressure of a patient, modulation output circuitry configured for conveying electrical modulation energy to at least one electrode, and a controller/processor coupled to the sensor and the modulation output circuitry. The controller/processor is configured for comparing the blood pressure sensed by the sensor to a first threshold blood pressure, and instructing the modulation output circuitry to convey the electrical modulation energy to the at least one electrode if the sensed blood pressure is greater than the first threshold blood pressure. A method for treating chronic hypertension comprises applying electrical modulation energy to a neural target site, thereby modulating an afferent nerve innervating a patient's kidney, thereby treating the chronic hypertension.

Abstract: In general, the disclosure is related to characterization of implanted electrical stimulation electrode arrays using post-implant imaging. The electrode arrays may be carried by implanted leads. Characterization of implanted electrode arrays may include identification of the type or types of leads implanted within a patient and/or determination of positions of the implanted leads or electrodes carried by the leads relative to one another or relative to anatomical structures within the patient. In addition, the disclosure relates to techniques for specifying or modifying patient therapy parameters based on the characterization of the implanted electrode arrays.

Abstract: A system and method for selection of stimulation parameters for Deep Brain Stimulation (DBS) may include a processor that displays in a display device and in relation to a displayed model of a leadwire including model electrodes, a current field corresponding to a first stimulation parameter set, provides a user interface for receipt of user input representing a shift of the current field, in response to the user input, moves, in the display device, the current field with respect to the displayed model, determines a second stimulation parameter set that results in the moved current field, and outputs the second stimulation parameter set and/or sets a stimulation device with the second stimulation parameter set, where the stimulation device is configured for performing a stimulation using the leadwire in accordance with the second stimulation parameter set.

Abstract: A remotely programmable personal device, in particular a programmable implantable medical device, e.g., a cardiac pacemaker, a defibrillator, a cardioverter or the like. A system for remote programming of such a personal medical device and a method for remote programming of a programmable personal device.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: A method and device to enable a medical or surgical procedure using electro-cautery on a patient with an implantable device in a cautery-safe mode of operation. In one embodiment, the invention provides an electronic implantable device programmer having a computer processor, and a display screen configured to display information based on signals from the computer processor. The programmer also includes an input device, and a wireless transmitter controlled by the computer processor. The programmer display and input give the operator the option of programming an implanted electronic device in a cautery-safe mode.

Abstract: An electronic medical monitoring and treatment apparatus allows a victim of a medical emergency person access to a medical professional (MP) who can monitor, diagnose and treat the person from a remote site. The apparatus includes a cardiac medical monitoring and treatment device (MMTD) coupled to an electronic adapter designed to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving (T/R) device used by the MP. The MMTD may comprise a cardiac treatment circuit for effecting cardiac pacing and/or defibrillation and a cardiac signal circuit for receiving cardiac signals. The cardiac signals are (1) transmitted from the signal circuit to the second T/R device for evaluation by the MP, (2) the MP may transmit a control signal to the treatment circuit, and (3), in response thereto, the treatment circuit may generate one or more electrical pulses for treatment of the person.

Abstract: For supplying energy to a medical implant (100) in a patient's body a receiver (102) cooperates with an external energizer (104) so that energy is wirelessly transferred. A feedback communication system (109) sends feedback information from the receiver to the energizer, the feedback information being related to the transfer of energy to the receiver. The feedback communication system communicates using the patient's body as an electrical signal line. In particular, the communication path between the receiver and the external energizer can be established using a capacitive coupling, i.e. the feedback information can be capacitively transferred over a capacitor having parts outside and inside the patient's body. An energy balance between the amount of energy received in the receiver and the energy used by the medical implant can be followed over time, and then the feedback information is related to the energy balance.

Abstract: Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient's heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.

Abstract: A method and apparatus for selection of one or more ventricular chambers to stimulate for ventricular resynchronization therapy. Intrinsic intracardia electrograms that include QRS complexes, are recorded from a left and right ventricle. A timing relationship between the intrinsic intracardia electrograms recorded from the left and right ventricle is then determined. In one embodiment, the timing relationship is determined using a delay between a left ventricular and a right ventricular sensed intrinsic ventricular depolarizations and a duration interval of one or more QRS complexes. In one embodiment, the duration of QRS complexes is determined from either intracardiac electrograms or from surface ECG recordings. One or more ventricular chambers in which to provide pacing pulses are then selected based on the timing relationship between intrinsic intracardia electrograms recorded from the right and left ventricle, and the duration of one or more QRS complexes.

Abstract: A portable housing supports a processor coupled to memory for storing medical firmware and wireless radio firmware, first and second radios, a processor, and a power source. Communications are effected between an implantable medical device and the first radio in accordance with program instructions of the medical firmware, and between the second radio and the wireless network in accordance with program instructions of the wireless radio firmware. The first and second radios are configured to operate cooperatively in a first testing configuration, by which the first radio operates as a transmitter and the second radio operates as a receiver, and cooperatively in a second testing configuration, by which the second radio operates as a transmitter and the first radio operates as a receiver. Functional testing of the first and second radios is implemented using one or both of the first and second testing configurations.

Abstract: Disclosed is a remote controller for an implantable medical device having stored contraindication information, which includes information which a patient or clinician might wish to review when assessing the compatibility of a given therapeutic or diagnostic technique or activity with the patient's implant. The stored contraindication information is available through a display of the remote controller or via a wired, wireless, or portable drive connection with an external device. By storing contraindication information with the implant's remote controller, patient and clinician can more easily determine the safety of a particular therapeutic or diagnostic technique or physical activity with the patient's implant, perhaps without the need to contact the manufacturer's service representative.

Abstract: An implantable medical device (IMD) that can be wirelessly connected to user interface by which a patient can enter values of selected control parameters for controlling the IMD whereas other control parameters are not accessible via said user interface and can only be modified by a physician or other authorized personnel.

Abstract: A cardiac rhythm management (CRM) system includes a programming device that determines parameters for programming an implantable medical device based on patient-specific information including indications for use of the implantable medical device. By executing an indication-based programming algorithm, the programming device substantially automates the process between the diagnosis of a patient and the programming of an implantable medical device using parameters individually determined for that patient.

Abstract: A system for programming a plurality of different models, or generations, of neurostimulation devices includes a plurality of plug in software drivers stored on a hard drive of the system, wherein the plurality of plug-in software drivers are respectively configured for facilitating communication between the plurality of different models of neurostimulation devices and the system processor via a transceiver. In a method of programming a plurality of different models of neurostimulation devices, the system processor dynamically identifies the model of an interrogated neurostimulator and determines which plug-in software driver to use for programming the interrogated neurostimulator. The plug-in software drivers are cached into memory upon start-up of the system.

Abstract: A leadless intra-cardiac medical device (LIMD) includes a housing configured to be implanted entirely within a single local chamber of the heart.

Abstract: A medical device communication system includes a receiver adapted to receive radio frequency (RF) signals and configured to operate in a first mode to poll for an RF signal for a first time interval to detect an element of a valid input signal during the first time interval. In response to detecting the element of a valid input signal in the first time interval, the receiver operates in a second mode to poll for the RF signal for a second time interval to analyze the RF signal over the second time interval to detect a valid modulation of the RF signal. In response to detecting a valid modulation of the RF signal during the second time interval, the receiver is enabled to establish a communication session with a transmitting device.

Abstract: An implantable electroacupuncture device (IEAD) treats heart failure, coronary artery disease, myocardial ischemia or angina through application of stimulation pulses applied at acupoints GV20 and/or EXHN3. The IEAD comprises an implantable, coin-sized, self-contained, leadless electroacupuncture device having at least two electrodes attached to an outside surface of its housing. The device generates stimulation pulses in accordance with a specified stimulation regimen. Power management circuitry within the device allows a primary battery, having a high internal impedance, to be used to power the device. The stimulation regimen generates stimulation pulses during a stimulation session of duration T3 minutes applied every T4 minutes. The duty cycle, or ratio of T3/T4, is very low, no greater than 0.05. The low duty cycle and careful power management allow the IEAD to perform its intended function for several years.

Abstract: Apparatus for monitoring vital signs of one or more living subjects comprises a monitoring station and at least one sensor in communication with the monitoring station. The sensor comprises an antenna system, an ultra wideband radar system coupled to the antenna system, a signal processor and a communication system. The signal processor is connected to receive a signal from the ultra wideband radar system and configured to extract from the signal information about one or more vital signs of a person or animal in a sensing volume corresponding to the antenna system. The communication system is configured to transmit the information to the monitoring station.

Abstract: A programmer for cardiac implantable medical devices, including an accelerated test mode of the operating parameters. The programmer includes a user interface (10) that is used to define the tests to be performed on the implant and display the results thereof. These tests includes: ventricular and atrial sensing sensitivity, ventricular and atrial lead impedance, and ventricular and atrial capture threshold. Each test step involves (i) a predetermined setting of the operating mode, pacing rate and atrio-ventricular delay of the implantable device, (ii) collection of the operating data of the implantable device according said predetermined settings, and (iii) processing and display of thus collected data. There further exists one test step of time compression along which at least some of the ventricular and atrial tests for a same parameter are executed simultaneously during a common step, preferably the tests of sensing sensitivity and lead impedance.

Abstract: A remote external interface for an implantable cardiac function management device is configured to be communicatively coupled to the implantable cardiac function management device via a network to a local external interface and via telemetry between the local external interface and the implantable cardiac function management device. The remote external interface includes a communication circuit and a processor circuit. The communication circuit is configured to communicate with the implantable cardiac function management device. The processor circuit is configured to perform an analysis of physiologic data received from the implantable cardiac function management device in response to operation of the implantable cardiac function management device using a plurality of therapy control parameter sets. The processor circuit can be further configured to select a particular therapy control parameter set using the analysis.

Abstract: An implanted medical device can be detected within an effective proximity of an electronic device by an IMD safety control module coupled with the electronic device, in response to the performance of a function by the electronic device. Performance of the function by the electronic device can be known to have the potential to cause adverse effects to operation of and/or a treatment provided by the implanted medical device within the effective proximity. The implanted medical device can be an active implanted medical device having wireless communication capabilities. Performance of the function by the electronic device can be disabled. Resolution from an operator of the electronic device can be requested. Upon receipt of the resolution, performance of the function by the electronic device can be enabled.

Abstract: The present disclosure involves a method of providing graphical representations of medical devices and connections between the medical devices. A graphical representation of a lead is displayed. The lead is configured to deliver electrical stimulation to a patient via one or more of a plurality of electrode contacts. A graphical representation of one of: an implantable pulse generator (IPG) or a lead connector block is displayed. The IPG and the lead connector block are each configured for coupling with the lead. In response to a user input, a graphical representation of a connection is generated. The connection is between the lead and one of: the IPG or the lead connector block. An actual connection between the lead and one of: the IPG or the lead connector block is monitored. A status of the actual connection between the lead and one of: the IPG or the connector block is then reported.

Abstract: A telemetry wake-up circuit is electrically disposed between a telemetry transceiver associated with an AIMD, and an RF tag. The RF tag may be remotely interrogated to generate a signal to which the telemetry wake-up circuit is responsive to switch the telemetry transceiver from a sleep mode to an active telemetry mode. In the sleep mode, the telemetry transceiver draws less than 25,000 nanoamperes from the AIMD, and preferably less than 500 nanoamperes.

Abstract: An implantable cardiac monitor upgradeable to an implantable pacemaker or an implantable cardiac resynchronization device allows the use of a single implantable medical device for monitoring cardiac conditions and later, if needed, for cardiac pacing. The implantable medical device includes a circuit that can be configured, by programming through an external programmer, to either the implantable cardiac monitor or the implantable pacemaker. The implantable medical device is first configured to and used as the implantable cardiac monitor for acquisition of physiological data indicative of a need for a pacing therapy if the pacing therapy is to follow, the implantable medical device is reconfigured from the implantable cardiac monitor to the implantable pacemaker, thus eliminating the need of using two implantable medical devices.

Abstract: The present disclosure involves a medical system. The medical system includes a medical device configured to deliver a medical therapy to a patient, a clinician programmer configured to program the medical device, and a manufacturing database configured to store and maintain an electronic inventory of a plurality of types of medical devices. The clinician programmer is configured to acquire a visual representation of the medical device, generate an electronic ticket identifying the medical device based on the visual representation, and send the electronic ticket to the manufacturing database. The manufacturing database is configured to receive the electronic ticket from the clinician programmer and perform at least one of the following tasks in response to the received electronic ticket: updating the electronic inventory, analyzing a usage trend of the medical device, predicting a potential shortage of the medical device, and suggesting a production schedule for the medical device.

Abstract: The invention relates to medical devices such as pacemakers, pulse generators, cardioverter-defibrillators and the like and more particularly relates to modular and reconfigurable medical system platforms and methods of designing, testing, controlling and implementing diverse therapies, diagnostics, physiologic sensors and related instrumentation using said medical system platforms. Methods, systems and devices provide a new design platform for implantable and external medical devices such as pacemakers, defibrillators, neurostimulators, heart monitors, etc. A real-time, highly flexible system of software and hardware modules enables both prototypes and products to respond to patient and customer needs with greater design and manufacturing efficiency. Certain embodiments integrate a general-purpose processor with interface circuitry to provide a standard platform for implementing new and conventional therapies with software models rather than custom circuitry.

Abstract: A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.

Abstract: A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

Abstract: The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include an external programmer comprising a user interface that receives user input defining therapy parameter values for delivery of therapy to a patient, and user input associating one or more of the therapy parameter values with a plurality of posture states based on user input, a processor that automatically defines therapy parameter values for delivery of therapy to a patient when the patient occupies the posture states based on the association, and an implantable medical device that delivers the therapy to the patient in response to detection of the posture states.

Abstract: An implantable heart stimulating device for indicating congestive heart failure (CHF) has a processor and a sensor combination that senses at least two heart events during one heart cycle at different locations of the heart. The processor is supplied with signals from the sensor combination relating to the sensed events, and determines therefrom at least one heart time interval between the sensed events in the same heart cycle. The processor determines a CHF indicator value representing a degree of CHF based on a variability measure calculated from at least two heart time intervals from at least two different heart cycles. The processor determines the CHF indicator value in relation to previous CHF indicator values.