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: When a medical procedure is performed on a patient in whom an implantable medical device is implanted, the medical procedure may have undesired effects on the medical device, such as triggering a response that initiates therapy by the device that is unnecessary and potentially dangerous to the patient. Systems and methods may facilitate performing of such medical procedures on such patients by automatically reprogramming the medical device, monitoring for one or more detectable characteristics associated with the medical procedure to be performed, and automatically restoring normal operation of the IMD after the medical procedure is completed.

Abstract: A telemetry system is presented for enabling radio-frequency (RF) communications between implantable medical devices and an external device in a manner which increases the effective range over which such communications may take place. Devices are configured to relay communications from one device to another.

Abstract: A medical information communication system and corresponding methods are described. The system can permit monitoring the performance of an implantable medical device (IMD) implanted within a body of a patient, monitoring the health of the patient, and/or remotely delivering a therapy to the patient through the IMD. The IMD can be capable of bi-directional communication with a clinician. Further, the system can comprise a communication availability indicator to indicate whether the IMD is available for communication.

Abstract: An implantable medical device includes a first, short-range telemetry circuit; a second, long-range telemetry circuit; a first power system that powers the first telemetry circuit; and a second power system that powers the second telemetry circuit. The second power system includes an internal charging system and a rechargeable battery coupled to the internal charging system. The internal charging system may be configured for electromagnetic-inductive or RF-transmission coupling with an external charging system. A controller monitors the energy level of the rechargeable battery and provides an signal indicative of the level.

Abstract: When a medical procedure is performed on a patient in whom an implantable medical device is implanted, the medical procedure may have undesired effects on the medical device, such as triggering a response that initiates therapy by the device that is unnecessary and potentially dangerous to the patient. Systems and methods may facilitate performing of such medical procedures on such patients by temporarily reprogramming the medical device, monitoring for one or more detectable characteristics associated with the medical procedure to be performed, and restoring normal programming of the device based on detection and/or lack of detection of the detectable characteristic(s).

Abstract: An implantable medical device includes a lead, a monitoring module, a multi-function conductive (MFC) coil, and a field detection module. The monitoring module identifies cardiac events based on the cardiac signals and directs stimulus pulses to be delivered to the heart through one or more electrodes connected to the lead. The MFC coil has an electric characteristic that varies based on exposure of the coil to an external magnetic field. The field detection module detects exposure of the coil to the external magnetic field by applying a field detection signal to the coil and identifying a change in the electric characteristic of the MFC coil. The field detection module switches operation of the monitoring module to an MR safe mode based on the change that is identified.

Abstract: An external device includes a communication circuit, a programming interface including a display, and a processor. The processor includes a parameter analyzer to apply a rule to a combination of operating parameter values of the IMD to determine operating parameter interaction. The display includes a first warning that is displayed when the parameter analyzer determines that a combination of operating parameter values entered via the programming interface is not allowed, and a second warning that is displayed when the parameter analyzer determines that a combination of operating parameters values entered via the programming interface is allowable but not recommended. The processor is configured to program the operating parameter values associated with the second warning into the IMD only after a user acknowledgement of the second warning is received from a user via the programming interface.

Abstract: A medical device programmer and a method of operation in which a first data value is received and used in the execution of one or more algorithms. One or more suggested pulse generator settings are calculated from the one or more algorithms based on the first data value, and the one or more suggested pulse generator settings are displayed on an interactive display screen of the medical device programmer. In one embodiment, the first data value is a duration interval of a QRS complex. From the duration interval, suggestions are made as to one or more ventricular chambers in which to provide pacing pulses. Additionally, pacing intervals for an AV delay are suggested based on measured P-R intervals, or pacing intervals for an LV offset are suggested based on a measured duration interval of a V-V-interval between a right ventricular event and a left ventricular event.

Abstract: A handheld wireless communication device having a defibrillator integrated therein to be employed in an emergency situation to supply electrical therapy to a victim who is experiencing cardiac distress. The defibrillator being powered by at least one thermally powered battery contained within the wireless communications device. The wireless communication device may also include a cardiac module which will determine whether the victim's heart beat has become irregular and whether defibrillation is necessary. The wireless communication device will guide the user through the use of the defibrillator/cardiac modules. The wireless device may also include a tracking unit that will provide the user's location and wireless two-way voice communication with emergency personnel upon activation of the defibrillator.

Abstract: Methods and systems for constructing a comprehensive history for an IMD are disclosed. The method includes interrogating an implantable medical device (IMD) with an interrogating external programmer device (EPD), and comparing a unique signature associated with the interrogating EPD to a stored signature, associated with a particular programmer device that most immediately previously programmed the IMD, in memory of the IMD. If the unique signature of the interrogating programmer device is not the same as the stored signature, the method includes recording the stored signature in the interrogating EPD. The method may optionally include replacing the stored signature in the IMD memory with the unique signature of the interrogating EPD if the interrogating EPD programs the IMD. A comprehensive history for the IMD may be constructed by tracing the values in the IMD and the programmer databases.

Abstract: The present invention provides, among other things, a sensor system, having (1) a sensor implanted in a body part of the subject, wherein the sensor has a first antenna, and (2) a sensor reader worn on the subject's body part, wherein the sensor reader has a band housing a second antenna, which is inductively coupled with the first antenna, for enabling the sensor reader to communicate with the sensor.

Abstract: The invention relates to a remotely programmable personal medical device, in particular a programmable implantable medical device, e.g., a cardiac pacemaker, a defibrillator, a cardioverter or the like. In addition, the invention relates to an arrangement for remote programming of such a personal medical device and a method for remote programming of a programmable personal medical device.

Abstract: A programmer allows a clinician to identify desirable combinations of electrodes from within an electrode set implanted in a patient that enable delivery of desirable neurostimulation therapy by an implantable medical device. The clinician may create neurostimulation therapy programs that include identified desirable electrode combinations. In some embodiments, the clinician may use the programmer to select a program, such as a program identified during a neurostimulation programming session, and direct the programmer to replicate the selected program. The programmer may change one or more parameters of the selected program, such as pulse amplitude or duty cycle, when generating the copy of the selected program.

Abstract: Unscheduled wireless communication with a medical device is achieved by operating a receiver of the medical device in a series of modes. Each mode provides an increasingly selective evaluation of received RF energy. The receiver, when operating in a first mode, is capable of detecting the presence of RF energy transmitted from a communicating device. The receiver, when operating in a second mode, consumes more energy than the first mode and analyzes the RF energy to determine whether it contains the appropriate type of modulation. When operating in a third mode, the receiver consumes more energy than the second mode, and operates the full receiver to begin communication with the communicating device. The receiver opens a communication session after the RF energy has passed the evaluation by the series of modes to receive an unscheduled communication.

Abstract: A system and method for cardiac rhythm management using a programmable cardiac rhythm management device is described, wherein the method includes storing parameter interaction constraints between different programmable parameters, storing programmable parameters for the device, wherein each programmable parameter has a predefined set of possible values, wherein one programmable parameter is a delay value, and calculating initial seed values for user-set delay range input fields, wherein the seed values do not violate any parameter interaction constraints and maximize the difference between ends of the user-set delay range, wherein the user-set delay range provides the outer limits of a programmed delay value. The method further includes presenting an input screen to the user on a user display device, wherein the input screen comprises user-set delay range input fields containing the initial seed values.

Abstract: Exemplary external medical devices are configurable to communicate with an implantable medical device (IMD). One medical device includes multiple IMD telemetry ports operable to connect IMD telemetry mechanisms to the medical device. The medical device also includes a control unit configured to control the IMD telemetry mechanisms.

Abstract: An implantable cardiac rhythm management system includes a user interface, such as an external programmer, for performing therapy energy threshold tests. The threshold tests allow the caregiver to determine the threshold energy at which paces capture the heart, i.e., cause a resulting contraction of the heart chamber to which the paces are delivered. The programmer provides recorded indications of the energy corresponding to each paced event, so that the caregiver can easily determine the point at which capture was lost. This recorded representation of pacing energy makes it easy for the caregiver to determine proper pacing thresholds to be used to ensure adequate pacing, while minimizing energy drain to prolong the useful life of the implanted device.

Abstract: A method is presented for enabling radio-frequency (RF) communications between an implantable medical device and an external device in a manner which reduces the power requirements of the implantable device by duty cycling its RF circuitry. A wakeup scheme for the implantable device is provided in which the external device transmits a data segment containing a repeating sequence of special wakeup characters and a device ID in order to establish a communications session with the implantable device. The wakeup scheme may be designed to operate using multiple communications channels.

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: An apparatus having at least one of electrical, electronic, pneumatic or hydraulic functions and adapted for use on a person's lap, the apparatus having a front side and a rear side generally opposite to said front side there being a wedge at said rear side generally in a central portion thereof and adapted to fit between the upper sides of a person's thighs when in a seated position and wherein the wedge has a surface spaced from said front side and inclined relative thereto such that, when the apparatus is placed on top of a substantially horizontal surface, said front side being parallel to or preferably inclined relative to the substantially horizontal surface.

Abstract: A system and method for rapidly switching stimulation parameters of a Spinal Cord Stimulation (SCS) system increases the number of stimulation parameter sets that may be tested during a fitting procedure, or alternatively, reduces the time required for the fitting procedure. The switching method comprises selecting a new stimulation parameter set, and setting the initial stimulation levels to levels at or just below an estimated perception threshold of the patient. The estimated perception level is based on previous stimulation results. The stimulation level is then increased to determine a minimum stimulation level for effective stimulation, and/or an optimal stimulation level, and/or a maximum stimulation level, based on patient perception.

Abstract: An ingestible therapy activator system and method are provided. In one aspect, the ingestible therapy activator includes an ingestible device having an effector module to send an effector instruction and a responder module associated with a therapeutic device. The responder module may receive and process the effector instruction, resulting in a response by the therapeutic device. Examples of responses by therapeutic device include activating a therapy, deactivating a therapy, modulating a therapy, and discontinuing a therapy.

Abstract: In one embodiment an implantable cardiac device is provided that includes an implantable cardiac stimulation device with an implantable satellite device coupled to it. The implantable satellite device has a charge storage device. The implantable stimulation device having a refresh generator configured to generate a charge and voltage balanced multi-phasic refresh signal with a duration less than a capacitive time constant of an electrode-electrolyte interface of the implantable cardiac device and transmit the charge and voltage balanced multi-phasic refresh signal to the implantable satellite device for charging the charge storage device. In various embodiments, the charge and voltage balanced multi-phasic refresh signal having alternating phase signs and null durations between the alternating phases. In some embodiments, the refresh generator is configured to modulate the multi-phasic waveform refresh signal.

Abstract: A system and method for repeating radio frequency (RF) transmissions between a programmer and an implantable medical device (IMD) is provided. One aspect of this disclosure relates to an RF repeater. According to various embodiments, the repeater includes a first antenna and a first communication circuit electrically connected to the first antenna. The first communication circuit is adapted to communicate with an IMD, the IMD including a built-in active telemetry transceiver, over a first channel. The device also includes a second antenna and a second communication circuit electrically connected to the second antenna. The second communication circuit is adapted to communicate with a programmer over a second channel different from the first channel. The device also includes a control circuit coupled to the first and second communication circuits. The control circuit is adapted to enable or disable the first and second communication circuits. Other aspects and embodiments are provided herein.

Abstract: This document discusses, among other things, cardiac rhythm management systems, devices, and methods providing an exercise test interface. A patient exercise episode is identified using at least one predetermined criteria. Data associated with the episode is obtained. A summary of the episode is displayed for a user. The displayed summary includes at least one prognostic indicator obtained from the data associated with the episode. Examples of prognostic indicators include, among other things, ectopic beats, runs of ectopic beats, rate of decrease of heart rate during a post-exercise recovery portion of the episode, a maximum attained heart rate for comparison to a maximum age-predicted heart rate, as well as other prognostic indicators.

Abstract: A biostimulator system comprises one or more implantable devices and an external programmer configured for communicating with the implantable device or devices via bidirectional communication pathways comprising a receiving pathway that decodes information encoded on stimulation pulses generated by ones of the implantable device or devices and conducted through body tissue to the external programmer.

Abstract: A leadless cardiac pacemaker comprises a housing, a plurality of electrodes coupled to an outer surface of the housing, and a pulse delivery system hermetically contained within the housing and electrically coupled to the electrode plurality, the pulse delivery system configured for sourcing energy internal to the housing, generating and delivering electrical pulses to the electrode plurality. The pacemaker further comprises an activity sensor hermetically contained within the housing and adapted to sense activity and a processor hermetically contained within the housing and communicatively coupled to the pulse delivery system, the activity sensor, and the electrode plurality, the processor configured to control electrical pulse delivery at least partly based on the sensed activity.

Abstract: An implanted device is equipped with a flag that indicates to a remote monitoring unit that an event such as a patient medical emergency or device failure has occurred. The remote monitoring unit is configured in some embodiments to maintain a low power communication link with the implanted device when they are within range. When the flag indicates an event has occurred, the remote monitoring unit quickly downloads sensed data collected by the implanted device and transfers it over a network so that it can be utilized by a medical practitioner. The remote monitoring unit is further configured in some embodiments to query the implanted device at regular intervals. The remote monitoring unit may read a subset of the data stored by the implanted device and, based on that data, determine whether to complete a full or partial download.

Abstract: An implantable medical device that is configured to be exposed to magnetic fields includes a lead, a detection module, a field measurement sensor, and a control module. The lead includes electrodes that are positioned within a heart to sense cardiac signals of the heart. The detection module monitors the cardiac signals to identify cardiac events based on the cardiac signals. The field measurement sensor measures a magnetic field. The sensor generates a field measurement based on the measured magnetic field. The sensor remains in an unsaturated state when exposed to the magnetic field of at least 0.2 Tesla. The control module identifies a presence of the magnetic field based on the field measurement of the sensor and switches operation of the detection module to an MR safe mode based on the field measurement.

Abstract: A system and method for providing closely-followed cardiac therapy management through automated patient care is presented. A patient under remote care is enrolled in a monitoring program following commencement of a cardiac therapy regimen to be undertaken by the patient. A wearable monitor, including one or more patient physiology sensors and a wireless interface providing enabling bi-directional data exchange, is provided to the patient. Patient physiometry, including quantitative physiological measures, is periodically collected from the wearable monitor over the wireless interface concomitant to performance of the cardiac therapy regimen. The patient physiometry is evaluated to determine a trend indicating an onset, progression, regression, absence of, and status quo of patient health status.

Abstract: The invention relates to a remotely-programmable personal device, in particular a programmable implantable medical device, such as a cardiac pacemaker, a defibrillator, a cardioverter, or the like. In addition, the invention relates to a configuration for the remote programming of such a personal medical device and a method for remotely programming a programmable personal device.

Abstract: A method comprising providing a programmable non-volatile memory (PNVM) circuit fabricated together with a processor on an integrated circuit chip (IC) in an implantable medical device (IMD), partitioning the PNVM circuit into a plurality of portions based on how often that the processor accesses a portion, and selectively providing power or selectively restricting power to one or more of the portions according to how often that the processor accesses a portion.

Abstract: A method for limiting patient-initiated electrical signal therapy to a cranial nerve of a patient is provided. An electrical signal therapy limit is selected from the group consisting of; a maximum number of patient-initiated signals, a maximum dose of electrical signals, a maximum duration of electrical signal, a maximum rate of change of the number of patient-initiated signals, a maximum rate of change of the dose of electrical signals, and a maximum rate of change of the duration of the electrical signals all per unit of time. If the electrical signal therapy limit is exceeded a therapy is delivered to the cranial nerve selected from the group consisting of; providing therapy, providing reduced therapy, providing enhanced therapy, inhibiting therapy, providing background therapy, and inhibiting background therapy.

Abstract: An external programming system and method for implantable medical devices (IMDs) is disclosed. The external programming system includes a communication circuit, a display device, an input device, and a processor. The communication circuit is configured to link to an IMD to transmit or monitor IMD timing parameter settings. The display device is configured to display a textual representation of an IMD timing parameter setting and a specified IMD timing parameter limit, a graphical slide control comprising a movable feature indicating the IMD timing parameter setting, a graphical slide-control limit corresponding to the specified IMD timing parameter limit, and a graphical representation of physiologic information including a portion of said graphical representation aligned with the slide control movable feature. The input device is configured to adjust the movable feature in response to user input. The processor is configured to monitor or store an IMD timing parameter setting.

Abstract: An implantable medical device such as a cardiac pacemaker or implantable cardioverter/defibrillator with the capability of receiving communications in the form of speech spoken by the patient. An acoustic transducer is incorporated within the device which along with associated filtering circuitry enables the voice communication to be used to affect the operation of the device or recorded for later playback.

Abstract: Waveforms are digitally sampled and compressed for storage in memory. The compression of the data includes generating a truncated entropy encoding map and using the values within the map to obtain good compression. An encoder further sub-selects values to be encoded and values to remain unencoded to provide an overall compression of the data.

Abstract: Waveforms are digitally sampled and compressed for storage in memory. The compression of the data includes generating a truncated entropy encoding map and using the values within the map to obtain good compression. An encoder further sub-selects values to be encoded and values to remain unencoded to provide an overall compression of the data.

Abstract: An implantable medical device having a transceiver for transmitting/receiving wirelessly transmitted data, which is turned off or switched into an energy-saving rest state between individual data transmissions via the transceiver and having a waking unit which is implemented to switch the transceiver by a waking signal from its turned-off state or its rest state into its fully operational state, the waking unit having a low-power receiver and a waking control unit of which the low-power receiver is implemented to monitor multiple predefined frequency ranges in such a way that in case of a transmission of sufficient signal strength in one of the frequency ranges, it generates an output signal and outputs it to the waking control unit and of which the waking control unit is implemented to analyze output signals of the low-power receiver and output a waking signal to the transceiver which switches it on or to fully operational.

Abstract: A biostimulator system comprises one or more implantable devices and an external programmer configured for communicating with the implantable device or devices via bidirectional communication pathways comprising a receiving pathway that decodes information encoded on stimulation pulses generated by ones of the implantable device or devices and conducted through body tissue to the external programmer.

Abstract: An implantable medical device (IMD) configures one or more operating parameters of the IMD based on a type of source of a disruptive energy field to which the IMD is exposed. The disruptive energy field may, in one example, include magnetic and/or radio frequency (RF) fields generated by an MRI scanner. In one aspect, the IMD may distinguish between different types of MRI scanners and select an exposure operating mode tailored to reduce the effects of the particular type of MRI scanner. In another aspect, the IMD may adjust one or more operating parameters that will be used when the IMD returns to a normal operating mode after exposure to the MRI scanner based on the type of MRI scanner to which the IMD is exposed.

Abstract: A system comprising an implantable medical device (IMD). The IMD includes a processor fabricated on an integrated circuit chip (IC), a random access memory (RAM) circuit fabricated on the same IC, and a programmable non-volatile memory (PNVM) circuit also fabricated on the same IC.

Abstract: An implantable pulse generator includes a current steering capability that allows a clinician or patient to quickly determine a desired electrode stimulation pattern, including which electrodes of a group of electrodes within an electrode array should receive a stimulation current, including the amplitude, width and pulse repetition rate of such current. Movement of the selected group of electrodes is facilitated through the use of remotely generated directional signals, generated by a pointing device, such as a joystick. As movement of the selected group of electrodes occurs, current redistribution amongst the various electrode contacts takes place. The redistribution of stimulus amplitudes utilizes re-normalization of amplitudes so that the perceptual level remains fairly constant. This prevents the resulting paresthesia from falling below the perceptual threshold or above the comfort threshold.

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: Methods are provided for treating a subject for a condition. In accordance with the subject methods, at least a portion of a subject's autonomic nervous system is modulated during at least one predetermined phase of the subject's menstrual cycle to alter the parasympathetic activity/sympathetic activity ratio in a manner that is effective to treat the subject for the condition. The subject methods find use in the treatment of a variety of different conditions, including various disease conditions, that increase in severity and/or occurrence during one or more phases of the menstrual cycle. Also provided are systems and kits for use in practicing the subject methods.

Abstract: An embodiment includes a main lead assembly having a proximal portion adapted for connection to a device and a distal portion adapted for placement in a coronary sinus, the distal portion terminating in a distal end for placement proximal a left ventricle. Additionally, the main lead assembly includes a left ventricular electrode located at its distal end which is adapted to deliver cardiac resynchronization therapy to reduce ventricular wall stress. The main lead assembly also includes a fat pad electrode disposed along the main lead assembly a distance from the distal end to position the fat pad electrode proximal to at least one parasympathetic ganglia located in a fat pad bounded by an inferior vena cava and a left atrium. The fat pad electrode is adapted to stimulate the parasympathetic ganglia to reduce ventricular wall stress.

Abstract: Techniques for increasing the safety of medical device programming using general purpose hardware, such as a general purpose personal computer, are described. In some embodiments, a system includes an intermediate computing device comprising an applications module. Information from the applications module, such as instructions for an implantable medical device (IMD), may be presented to a user via a user input terminal that is separate from the intermediate computing device. A user may interact with the user input terminal to select an instruction from the applications module, and the intermediate computing device may transmit the selected instruction to the IMD. In some embodiments, the intermediate computing device comprises a web server and the user input terminal comprises a web browser configured to access the web server. In other embodiments, the intermediate computing device comprises a client server and the user input terminal comprises a client.

Abstract: A method for transitioning electrical energy in steps between electrodes implanted within a patient to stimulate tissue (e.g., spinal cord tissue) is provided. The method comprises determining a maximum comfortable step size, determining a minimum step size, selecting one or more step sizes between the maximum comfortable step size and the minimize step size, and transitioning the electrical energy between the electrodes using the selected one or more step sizes.

Abstract: Methods and systems for programming a plurality of leads under at least two distinct modalities are provided. The leads may be grouped within satellites and multiple satellites may be configured within a single lead. Each lead includes a power and communications bus providing commands, and information and pulses to the satellites. The leads may be connected to at least two different command and pulse sources, optionally a cardiac pacemaker and/or a cardiac pulse analyzer system. A command may include or be preceded by a wake-up pulse that facilitates identification of a modality applicable to the associated command and data. A command may further optionally include a reference pulse or series of reference pulses, whereby the satellite references data pulses in relation to one or more aspects of the associated reference pulse. A data pulse may deliver two bits of information.

Abstract: A system for communicating with a medical device implanted in an ambulatory patient and for locating the patient in order to selectively monitor device function, alter device operating parameters and modes and provide emergency assistance to and communications with a patient. The implanted device includes a telemetry transceiver for communicating data and operating instructions between the implanted device and an external patient communications control device that is either worn by or located in proximity to the patient within the implanted device tranceiving range. The control device preferably includes a communication link with a remote medical support network, a global positioning satellite receiver for receiving positioning data identifying the global position of the control device, and a patient activated link for permitting patient initiated personal communication with the medical support network.