Abstract: Methods and apparatus for a three-stage atrial cardioversion therapy that treats atrial arrhythmias within pain tolerance thresholds of a patient. An implantable therapy generator adapted to generate and selectively deliver a three-stage atrial cardioversion therapy and at least two leads, each having at least one electrode adapted to be positioned proximate the atrium of the patient. The device is programmed for delivering a three-stage atrial cardioversion therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of an atrial arrhythmia. The three-stage atrial cardioversion therapy includes a first stage for unpinning of one or more singularities associated with an atrial arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities delivered via the near-field configuration of the electrodes.

Abstract: An electronic medical person access to a medical professional (MP) who can monitor, diagnose and treat the person from a remote site. The apparatus includes a plurality of medical treatment devices coupled to an electronic adapter designed to communicate with (A) each treatment device and (B) a local, first transmitting/receiving device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving device used by the MP. Signals representing physiologic information of the person via the adapter to the MP and, in response, the MP may transmit a control signal to one or more treatment devices. The treatment devices may communicate via the adapter.

Abstract: A method of automatically determining which type of treatment is most appropriate for a cardiac arrest victim, the method comprising transforming one or more time domain electrocardiogram (ECG) signals into a frequency domain representation comprising a plurality of discrete frequency bands, combining the discrete frequency bands into a plurality of analysis bands, wherein there are fewer analysis bands than discrete frequency bands, determining the content of the analysis bands, and determining the type of treatment based on the content of the analysis bands.

Abstract: Approaches for determining threshold values for one or more arrhythmia rate zones and/or the number of rate zones are described. A probability function for heart rate is determined using collected and measured heart rate values. One or more heart rate probability values are selected. Thresholds for arrhythmia rate zones are determined from the probability function based on the selected probability values. Determining the rate zone thresholds may involve determining a threshold for a lower rate limit and/or determining one or more tachyarrhythmia rate zone thresholds. The number of rate zones may also be determined based on the probability function.

Abstract: An implantable medical device, IMD, comprises atrial and ventricular sensing units for sensing atrial or ventricular electric events. The IMD also comprises atrial and ventricular pulse generators for generating atrial or ventricular pacing pulses. A controller controls the operation of the IMD (100) according to a first mode, in which the ventricular pulse generator is prevented from generating a back-up pulse if an evoked response detector fails to detect evoked response to a delivered ventricular pacing pulse, and a second mode, in which the ventricular pulse generator is controlled to generate a back-up pulse if no evoked response is detected following delivery of a ventricular stimulating pulse. The controller switches operation from the first mode to the second mode based on the evoked response detector failing to detect an evoked response to a delivered ventricular pacing pulse.

Abstract: An exemplary method includes delivering a cardiac pacing therapy using an electrode configuration for left ventricular, single site pacing or left ventricular, multi-site pacing, measuring a series of interventricular conduction delays using the left ventricular pacing and right ventricular sensing (IVCD-LR), comparing the interventricular conduction delay values to a limit and, based on the comparison, deciding whether to change the electrode configuration for the left ventricular pacing. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An external defibrillator can have a synchronous shock operating mode and an asynchronous shock operating mode and include a controller to set the defibrillator in the synchronous shock operating mode or the asynchronous shock operating mode. The defibrillator can also include a shock module to cause the defibrillator to deliver shock therapy to the patient according to the operating mode of the defibrillator, and a prompt module to transmit a prompt, after delivery of the shock therapy, that includes the operating mode of the defibrillator.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: An embodiment in accordance with the present invention provides an automatic external defibrillator including an anterior pad designed such that it can be used during an endoscopic or surgical procedure that may generate electromagnetic interference. The anterior pad has a first arm adhered longitudinally along and substantially parallel to a left side of a sternum of the subject and a second arm adhered along a 5th intercostal space of the subject. The device also includes a posterior pad. Both the anterior and posterior pads include electrodes for delivering a shock to the subject. The device can also include a wearable component containing sensing electrodes for measuring heart rhythms and a transmitting them to a monitor. The monitor monitors these heart rhythms and alerts the subject or medical care providers to irregularities in the rhythms.

Abstract: A system level scheme for networking of implantable devices, electronic patch devices/sensors coupled to the body, and wearable sensors/devices with cellular telephone/mobile devices, peripheral devices and remote servers is described.

Abstract: According to an aspect of the present disclosure, an automated external defibrillator is configured to deliver one or both of electrical pulses and shocks to a heart of a patient during a cardiac emergency. The defibrillator includes a defibrillator electrode delivery system and a hydrating system. The defibrillator electrode delivery system includes a pair of defibrillation electrode pads. Each pad supports a hydrogel to facilitate the deliverance of one or both of electrical pulses and shocks to a patient. The hydrating system includes a fluid container that maintains a fluid that hydrates the hydrogel over a predetermined time period to prolong the effectiveness of the hydrogel.

Abstract: A single-chamber heart stimulator has an electrically conductive housing, first and second detection units, and a VT/SVT discrimination unit. The first detection unit is connected to an electrode pair of a ventricular electrode lead for obtaining a first electrocardiogram signal recorded in bipolar fashion, and is designed to sense and classify ventricular heartbeats. The second detection unit is connected on one side to an electrode of the ventricular electrode lead, and on the other side to the electrically conductive housing, for obtaining a second electrocardiogram signal containing signal features characteristic of atrial heartbeats.

Abstract: A method for mapping abnormal electrical activity, including obtaining electrical signal data from respective locations in a heart of a living subject, and automatically analyzing the signal data to identify complex fractionated electrograms (CFEs) therein. The method further includes analyzing the CFEs so as to identify reentry locations comprised in the respective locations, and displaying information derived from the identification in relation to a map of the heart.

Abstract: An electrode package for use with a defibrillator, the electrode package comprising an outer shell providing a vapor barrier between an interior space inside the outer shell and an exterior environment, one or more defibrillation electrodes positioned in the interior space inside the outer shell, each of the defibrillation electrodes including a metallic layer in electrical contact with a conductive liquid-containing layer through which electrical current is delivered to a patient when the defibrillation electrodes have been applied to the patient, the conductive a liquid-containing layer being subject to drying out as liquid from the water-containing layer vaporizes and travels from the interior space to the external environment, and one or more electrical conductors extending from inside of the outer shell to a package electrical connector outside of the shell, the package electrical connector being configured to be connected to a mating defibrillator electrical connector connected to the defibrillator, and

Abstract: A device for detecting cardiac ischemia is disclosed. The device includes a processor that is configured to distinguish between two different heart beats types such as left bundle branch block beats and normal sinus beats. The processor applies different ischemia tests to the two different beat types, and generates alert when it detects ischemia.

Abstract: Systems and methods define an index of risk for cardiac disease by detecting cellular derangements that may lead to cardiomyopathy, heart rhythm disorders or ischemic heart disease. The markers include fluctuations or abnormal rate-behavior of electrical, mechanical or other measurable biosignals. The invention operates in modes that can be applied to prevent atrial fibrillation or the risk for ventricular arrhythmias. Alternative embodiments are applied to tissue outside the heart such as skeletal muscle, smooth muscle, the central nervous system, the respiratory system, the urogenital system and the gastrointestinal system.

Abstract: An implantable medical device (IMD) may include a battery dedicated to providing cardiac stimulation therapy and a separate power source that provides power for electrical stimulation therapy. Such a configuration preserves the battery dedicated for providing cardiac stimulation therapy even if the second power source is depleted. As an example, the IMD may comprise a cardiac stimulation module configured to deliver at least one stimulation therapy selected from a group consisting of pacing, cardioversion and defibrillation. The IMD further comprises a electrical stimulation module configured to deliver electrical stimulation therapy, a first power source including a battery, wherein the first power source is configured to supply power to the cardiac stimulation module and not to the electrical stimulation module, and a second power source. The second power source is configured to supply power to at least the electrical stimulation module.

Abstract: A wearable defibrillator consists of a vest (or belt) which is worn by the patient. The device monitors the patient's ECG with sensing electrodes and can monitor other patient conditions and in appropriate cases can treat certain conditions. An accelerometer(s) in the wearable defibrillator can allow for the device to determine the position, movements, forces applied to the patient, and/or the device. The device can use a least one patient motion detector generating a signal indicative of patient activity. Analysis of the signal can be indicative of patient activity appropriate for treatment or indication of device condition.

Abstract: An external defibrillator can receive wirelessly a data signal transmitted by a transmitting device over a communication link. The defibrillator can include a processor configured to monitor a reception parameter of the communication link while the data signal is being received and to set an alert flag if the processor determines from the reception parameter that reception of the data signal may be discontinued prematurely. The defibrillator can also include a user interface capable of outputting an alerting user notification responsive to the alert flag being set.

Abstract: A novel wearable electronic skin patch sensor device configured for the real time acquisition, processing and communicating of cardiac activity and other types of biological information within a wired or wireless network is disclosed. A system level scheme for networking the sensor device with client devices that include intelligent personal health management appliances, cellular telephones, PDAs, portable computers, personal computers, RFID Tags and servers is disclosed. The sensor device and the system enable distributed processing, archival and correlation of the biological information with biometrics, gastronomic information, user profiles and health factors that include height, weight, blood pressure and physical activity facilitating real time personal health management at any time and any place.

Abstract: Methods and systems are provided for discriminating heart arrhythmias. The methods and systems include identifying an arrhythmia, recording a predetermined number of beats during the arrhythmia as a base arrhythmia (BA) beats; delivering anti-tachy pacing (ATP) therapy to at least one chamber of the heart. After delivering the ATP therapy, the methods and system record at least one return beat representing cardiac activity following the ATP therapy, determines whether the return beat originated in a reference chamber of the heart, compares a morphology of the return beat to a morphology of the BA beat; and declares a VT or SVT based on the comparing operation.

Abstract: Adaptive methods for initiating charging of the high power capacitors of an implantable medical device for therapy delivery after the patient experiences a non-sustained arrhythmia, and devices that perform such methods. The adaptive methods and devices adjust persistence criteria used to analyze an arrhythmia prior to initiating a charging sequence to deliver therapy. Some embodiments apply a specific sequence of X-out-of-Y criteria, persistence criteria, and last event criteria before starting charging for therapy delivery.

Abstract: Patient data is stored in a medical device, such as an external defibrillator, and may be transferred, or downloaded, from the medical device to a computing device for storage or analysis. In response to the transfer, the medical device protects the patient data so that at least a subset of users cannot access the patient data from the medical device. The other device to which patient data is transferred from the medical device may be remote from the medical device or may be configured to be part of the medical device. The device to which the patient data is transferred from the medical device can be a remote computing device like a computer or server and/or may include or may be an intermediary data management device (DMD). The medical device may be a wearable medical device, such as a wearable defibrillator or a wearable automatic external defibrillator (AED).

Abstract: An implantable medical device is powered by a battery to deliver one or more therapies including at least one non-life-sustaining therapy such as neural stimulation for enhancing quality of life of a patient. When the battery approaches its end of life, the implantable medical device reduces power consumption of the neural stimulation (e.g., intensity of the neural stimulation) for extending the remaining battery life while maintaining a certain amount of therapeutic benefits for the patient. In one embodiment, the intensity of the neural stimulation is reduced in a tiered manner. In one embodiment in which the implantable medical device also delivers at least one life-sustaining cardiac stimulation therapy, the neural stimulation is disabled or adjusted to reduce its power consumption (e.g., intensity) while the intensity of the cardiac stimulation therapy is maintained when the battery is near its end of life.

Abstract: An apparatus comprises an external device for communication with an implantable device. The external device includes a communication circuit configured to receive a communication signal from at least one other device different from the implantable device, a locating circuit configured to determine a location of the external device using the received communication signal, and a control circuit electrically coupled to the communication circuit and the locating circuit. The control circuit is configured to determine whether the determined location imposes a limit on functionality of an implantable device, and provide user access to an implantable device feature according to the determined location.

Abstract: An apparatus comprises an external device for communication with an implantable device. The external device includes a communication circuit configured to receive a communication signal from at least a third device separate from the external device and the implantable device, a locating circuit configured to determine a location of the external device using the received communication signal, a port configured to receive user identity information into the external device, and a control circuit electrically coupled to the communication circuit, the locating circuit, and the port. The control circuit is configured to allow user access to an implantable device feature according to the determined location and received user identity information.

Abstract: A system and method to deliver a therapeutic quantity of energy to a patient. The system includes a capacitor having a rated energy storage capacity substantially equal to the therapeutic quantity of energy, a boost converter coupled with the capacitor and constructed to release energy from the capacitor at a substantially constant current for a time interval, and an H-bridge circuit coupled with the boost converter and constructed to apply the substantially constant current in a biphasic voltage waveform to the patient. The method includes storing a quantity of energy substantially equal to the therapeutic quantity of energy in a capacitor, releasing the quantity of energy at a relatively constant current during a time interval using a boost converter coupled with the capacitor, and delivering a portion of the quantity energy in a direction to the patient using an H-bridge circuit coupled with the boost converter.

Abstract: Medical devices and methods of operating medical devices that treat and monitor patients include a housing and a module located within the housing. The module is configured to perform the treating and monitoring parameters of the patient. A screen is also attached to the housing. The screen is viewable by the user outside of the housing. The medical device also includes a door that is coupled with the housing. The door is movable between a closed position that covers at least some portion of the coverable portion of the screen so as to prevent the coverable portion of the screen from being viewed and an open position that does not cover the coverable portion of the screen.

Abstract: An implantable electrical lead that, upon implantation in an animal, is biocompatible and compatible with a magnetic resonance imaging scanner. The upon implantation in an animal has a body of dielectric material with a plurality of lumens and a plurality of insulated conductive helical coils embedded in one or more layers of dielectric material and placed within the plurality of lumens. Each helical coil is formed by one or more conductive wires having a predefined and controlled pitch and diameter. A layer of dielectric material separates the plurality of lumens, wherein the separation distance and properties of the dielectric material create a high impedance at the Larmor frequency of the magnetic resonance imaging scanner. A mechanically flexible, biocompatible layer forms an external layer of the electrical lead and is adapted to contact bodily tissue and bodily fluids of the animal.

Abstract: Medical devices and methods in which a user can treat a patient or monitor a parameter of the patient or both may include a housing, a patient module located within the housing that is used for treating the patient, monitoring the patient or both, and a control panel. The control panel is attached to the housing and has a first surface and a second surface and is positionable between a first position and a second position with respect to the housing. The first position exposes a user to a first surface of the control panel and the second position exposes the user to a second surface of the control panel. A first set of user controls are located on one or the other of the first surface and the second surface and are structured to allow the user to interact with the patient module.

Abstract: A wearable defibrillation system can establish a local comlink with a mobile communication device, such as a smartphone, tablet-type computer and the like. The mobile communication device can in turn establish a remote comlink with other devices in a network such as the internet. Accordingly, communication tasks relating to the wearable defibrillation system can be performed via the local and the remote comlinks, with or without the participation of the patient, who is wearing the system. The wearer can thus use the familiar interface of a mobile communication device for interacting with his defibrillator system. Moreover, he can do so while keeping on his regular clothes, which could conceal completely the wearable defibrillator system. The patient can thus preserve his dignity and privacy.

Abstract: A medical device such as an external defibrillator delivers electrical therapy using a special ascending, biphasic waveform. The special waveform is characterized by a set of at least two peaks. The amplitude of the second peak is greater than the amplitude of the first peak. The waveform is generated by switching capacitance configuration in the defibrillator from a parallel configuration to a series configuration while the defibrillator is delivering the defibrillation shock to the patient. Because of the switching capacitances and/or the waveform, the external defibrillator can be made physically smaller and weigh less, without sacrificing the therapeutic effect of a larger external defibrillator that would deliver a defibrillation shock of higher energy. As such, the defibrillator is easier to configure for transporting, handling, and even wearing.

Abstract: Monitoring physiological parameter using an implantable physiological monitor in order to detect a condition predictive of a possible future pathological episode and collecting additional physiological data associated with the condition predictive of a possible future pathological episode. Monitoring another physiological parameter in order to detect a condition indicative of the beginning of a present pathological episode and collecting additional pathological data in response to the condition. Determining that the condition predictive of a future episode and the condition indicative of a present episode are associated and, in response thereto, storing all the collected physiological data.

Abstract: A medical device for intracorporeal use formed at least in part from aerographite.

Abstract: Implantable shock electrode line having a proximal end for connection to an implantable device which generates shock pulses, and a distal segment which has a shock electrode, wherein an area ratio of the shock electrode area to the surface area of the shock electrode line is not constant over the longitudinal extent of the shock electrode.

Abstract: The disclosure relates to a device and a method for detecting electromagnetic fields, in particular fields occurring in imaging magnetic resonance tomography.

Abstract: An embodiment of the invention provides an apparatus for the detection and treatment of atrial arrhythmia comprising an electrical lead having proximal and distal portions. The distal portion is positionable in an atrial chamber and the end of the proximal portion is configured to be coupled to a pacemaker. The lead comprises a plurality of conductive wires clad with an insulative coating and has sufficient flexibility to be positioned in the atria from a percutaneous introductory site. The conductive wires are coupled to a plurality of pairs of bipolar electrodes positioned on a membrane attachable to an endocardial wall. The electrode pairs are distributed in a pattern defining an area for detecting a location of a foci of aberrant electrical activity located within or adjacent the area and sending a pacing signal to that location to prevent or stop an occurrence of atrial fibrillation caused by that foci.

Abstract: Systems and techniques for configuring an Automated External Defibrillators are described herein.

Abstract: Systems and techniques for centralized management and servicing of medical equipment such as automated external defibrillators (AEDs) are described herein.

Abstract: Systems and techniques for providing text-based communications from medical equipment such as automated external defibrillators (AEDs) are described herein.

Abstract: An integrated bipolar implantable medical electrical lead, which may be employed by a cardiac defibrillator, has a single low voltage electrode and a single high voltage electrode and employs a relatively robust and fail-safe configuration of three conductors. Each of the three conductors extends within an individual lumen of a tri-lumen insulative body of the lead. First and second conductors of the three connect, in parallel, the low voltage electrode to a first contact of a connector terminal assembly of the lead, and a third conductor of the three connects the high voltage electrode to a second and a third contact of the connector terminal assembly. A configuration of the third conductor differs from that of the first and second conductors in order to make the third conductor more susceptible to fracture, relative to the first and second conductors, after many years of chronic implant under extreme loading conditions.

Abstract: Devices, systems, and methods for treating a heart of a patient may make use of structures which limit a size of a chamber of the heart, such as by deploying a tensile member to bring a wall of the heart toward (optionally into contact with) a septum of the heart. The implant may include an electrode or other structure for applying pacing signals to one or both ventricles of the heart, for defibrillating the heart, for sensing beating of the heart or the like. A wireless telemetry and control system may allowing the implant to treat congestive heart failure, monitor the results of the treatment, and apply appropriate electrical stimulation.

Abstract: An implantable or ambulatory medical device can include a cardiac signal sensing circuit configured to provide a sensed cardiac depolarization signal of a heart of a subject, a respiration sensing circuit configured to provide a signal representative of respiration of the subject, and a control circuit communicatively coupled to the cardiac signal sensing circuit and the respiration circuit. The control circuit includes a tachyarrhythmia detection circuit configured to determine heart rate using the depolarization signal, determine a respiration parameter of the subject using the respiration signal, calculate a ratio using the determined heart rate and the determined respiration parameter, generate an indication of tachyarrhythmia when the calculated ratio satisfies a specified detection ratio threshold value, and provide the indication of tachyarrhythmia to a user or process.

Abstract: An implantable medical device operates to promote intrinsic ventricular depolarization according to a pacing protocol. When a cardiac rate exceeds a predetermined threshold, the implantable medical device modifies the pacing protocol parameters to promote AV synchrony.

Abstract: A method for extinguishing a cardiac arrhythmia utilizes destructive interference of the passing of the reentry wave tip of an anatomical reentry through a depolarized region created by a relatively low voltage electric field in such a way as to effectively unpin the anatomical reentry. Preferably, the relatively low voltage electric field is defined by at least one unpinning shock(s) that are lower than an expected lower limit of vulnerability as established, for example, by a defibrillation threshold test. By understanding the physics of the electric field distribution between cardiac cells, the method permits the delivery of an electric field sufficient to unpin the core of the anatomical reentry, whether the precise or estimated location of the reentry is known or unknown and without the risk of inducting ventricular fibrillation. A number of embodiments for performing the method are disclosed.

Abstract: An external medical device can include a housing, an energy storage module within the housing for storing an electrical charge, and a defibrillation port for guiding via electrodes the stored electrical charge to a person. The device can also include a user interface to deliver prompts to a user during a defibrillation session and a locale detector in the housing to determine a present locale of the device. The prompts delivered by the user interface to the user during the defibrillation session can be in accordance with a protocol that is selected based on the present locale.

Abstract: A medical device having a unit in communication with ancillary components wherein the unit and the ancillary components each have a sensory output through which communication with a user of the medical device may be accomplished and the user's attention directed. In one aspect, the medical device is an AED unit with associated pads, which are an ancillary component electrically connected to the AED unit. In this illustrative example, the unit has a unit sensory output (e.g., a speaker or a display), and the pads, and/or their associated packaging, have an ancillary sensory output (e.g. a speaker or display). Programming in the AED unit controls output to the sensory outputs such that the user's attention is directed between the unit and the ancillary components.

Abstract: An external medical device such as a wearable defibrillator can include a housing, an energy storage module within the housing for storing an electrical charge, and a defibrillation port within the housing for guiding via electrodes the stored electrical charge to a person.

Abstract: An external medical device can include a housing, an energy storage module within the housing for storing an electrical charge, and a defibrillation port for guiding via electrodes the stored electrical charge to a person. The device can also include a user interface to deliver prompts to a user during a defibrillation session and a language detector in the housing to determine a vicinity language. The prompts can be in a language that is selected based on the determined vicinity language.

Abstract: An implantable cardiac rhythm/function management system integrates cardiac contractility modulation (CCM) and one or more other therapies, such as to preserve device safety, improve efficacy, enhance sensing and detection, or enhance therapy effectiveness and delivery. Examples of the one or more other therapies can include pacing, defibrillation/cardioversion, cardiac resynchronization therapy (CRT), or neurostimulation.