Abstract: System and method for estimating a remaining capacity of a battery of an implantable medical device. The implantable medical device has a battery producing a current and having a remaining battery capacity, the implantable medical device being configured to utilize a relatively low amount of the current and, in specific instances, a relatively large pulse of the current. The processor is coupled to the battery and configured to calculate an estimate of the remaining battery capacity based, at least in part, on a measured battery parameter and occurrences of the specific instances of delivery of the relatively large pulse of the current.

Abstract: An apparatus example comprises a cardiac signal sensing circuit configured to provide a sensed cardiac signal representative of cardiac depolarization events of a subject, a sampling circuit coupled to the cardiac signal sensing circuit, a therapy circuit, and a controller communicatively coupled to the sampling circuit and the therapy circuit. The controller includes a detection module configured to detect tachyarrhythmia using the cardiac signal and a signal analysis module configured to establish significant points (SPs) of the sampled cardiac signal, estimate heart rate during the tachyarrhythmia using the SPs, and provide an indication of whether noise is present in the cardiac signal using the SPs. The controller is configured to select a therapy for delivery by the therapy circuit in response to the tachyarrhythmia detection and to modify the selected therapy according to the heart rate estimation and the noise indication.

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. One lead includes a telescopic microcable including multiple distinct bare areas that form a network of stimulation electrodes. The microcable includes a diameter providing for insertion of the microcable within smaller portions of the coronary vein system. The diameter may be selected from between 0.5 and 2 French. The microcable includes multiple strands twisted together. At least some strands incorporate either a core of radiopaque material wrapped by a sheath of mechanically durable material, or vice-versa. The bare areas that form the network of stimulation electrodes are provided on outward-facing portions of at least some of the strands.

Abstract: The invention involves a system and method for an esophageal cooling system suitable for use during surgical procedures associated with the left atrium of the heart and most particularly ablation procedures associated with atrial fibrillation. The esophageal cooling system is suitable for use irrespective of whether the ablation procedure is intraoperative or catheter based. The system includes an esophageal catheter constructed and arranged to fit within the patients esophagus. Suitably located along the esophageal catheter is a phoximal balloon for occluding an upper portion of the esophagus. The phoximal balloon includes a coolant lumen for transferring temperature controlled liquid to the area where the esophagus may be in contact with the atrium of the heart. The liquid is expelled through a nozzle which directs the liquid to the inner surface of the esophagus.

Abstract: System, implantable medical device and method for communicating between an implantable medical device and an external communication device. The implantable medical device has a physical connector, a medical module and a communication module. The medical module is configured to at least one of deliver a therapeutic output by way of the physical connector and/or sense data indicative of a physiologic condition of a patient by way of the physical connector. The external communication device is configured to communicate with the communication module by way of the physical connector. In an embodiment, electronic communication may be by way of a differential pair of connectors.

Abstract: Methods for treating atrial arrhythmias can involve configuring an implantable arrhythmia treatment device. A device can be configured after implantation when the patient is fully conscious and after any pain suppression medication has worn off. The device is caused to apply a phased unpinning far field therapy to the patient in response to detection of an arrhythmia via a far field configuration of electrodes. An indication of a pain sensation of the patient and the effectiveness of the treatment in response to the therapy can then be received. In response, at least one of a set of therapy parameters is adjusted and the steps are repeated until it is determined that an effective treatment is provide at a pain sensation that is tolerable to the patient. The device is then programmed to automatically treat arrhythmias detected in the patient with the determined set of therapy parameters.

Abstract: A multi-function defibrillator having an improved mode selection switch (200). When the switch is rotated to select the desired mode of operation, such as defibrillation, cardio-version, pacing, or monitoring, the positioning of those modes related to the Off position (205) is based on the time-criticality of the corresponding therapy. The most time-critical therapy is located closest to the Off position, and the least time-critical therapy is located furthest away from the Off position.

Abstract: Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein.

Abstract: An atrial fibrillation classification system collects celectrocardiogram signals and converts them to a frequency, time, or phase domain representation for analysis. An evaluation stage extracts energy density profile over a range of frequencies, time intervals, or phases, which is then summed and normalized to form dispersion metrics. The system then analyzes the dispersion metrics, in their respective domains, to determine whether a patient is experiencing an arrhythmia and then to classify the type of arrhythmia being experienced.

Abstract: A disposable electrode paddle assembly is provided and includes a shaft having a proximal end and a distal end; a handle assembly supported at the proximal end of the shaft; a spoon supported at the distal end of the shaft; an electrical conductor extending from the handle assembly and establishing an electrical connection at the spoon; and an electrode assembly selectively, electrically connectable to the electrical connection provided at the spoon; wherein the electrode assembly includes a layer of silver/silver-chloride (Ag/AgCl) having one of an increasing and decreasing density extending in a radially outward direction.

Abstract: An AED includes defibrillation circuitry housed within an enclosure, a first processor programmed to periodically test the operability of the defibrillation circuitry and a second processor in communication with the first processor. The AED further includes a visual indicator, such as a red/green LED, positioned at the exterior of the enclosure that is operatively connected to the second processor. The second processor is programmed to control the visual indicator in response to the periodic test results provided to it by the first processor.

Abstract: Devices, systems and methods for reducing patent discomfort during defibrillation by delivering pulses to electrode configurations that create electric fields confined to and/or concentrated in an area of fibrillation are described. Embodiments provide for an implantable defibrillator having an electrode lead system having at least one electrode lead and at least one three electrodes, a controller for determining whether fibrillation exists and a voltage generator for discharging one or more defibrillation pulses to the at least three electrodes to create electric fields having different directions and high electric field concentrations in areas of the heart needing defibrillation and low electric field concentrations outside those areas.

Abstract: An AED includes defibrillation circuitry housed within an enclosure, a first processor programmed to periodically test the operability of the defibrillation circuitry and a second processor in communication with the first processor. The AED further includes a visual indicator, such as a red/green LED, positioned at the exterior of the enclosure that is operatively connected to the second processor. The second processor is programmed to control the visual indicator in response to the periodic test results provided to it by the first processor.

Abstract: Provided are devices and methods for treating a subject having a myocardial condition using sub-threshold electrical stimulation.

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 to which 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: This document discusses, among other things, techniques for generating and delivering a high voltage defibrillation shock using an implantable cardiac rhythm management device. An output energy delivery bridge can be programmed to provide desired shock vectors or polarities. A bootstrapped fully solid-state switch control voltage generation circuit is described. Automatic polarity or vector reconfiguration embodiments are described, such as in response to an unsuccessful attempt to convert the heart to a normal rhythm.

Abstract: An electrocardiogram (ECG) analyzing system for analyzing electrocardiogram (ECG) signals, the system including: a computing device including: a transformer for transforming an ECG signal into a time-frequency representation over a plurality of frequencies over a period of time; a calculator for calculating a magnitude of the time-frequency representation; an analyzer for analyzing a degree of clustering of a plurality of low-magnitude values in the time-frequency representation; and a diagnosing system for diagnosing whether ventricular fibrillation is present based on the degree of clustering.

Abstract: Methods and implantable cardiac stimulus devices that include leads designed to avoid post-shock afterpotentials. Some examples are directed toward lead-electrode designs that reduce the impact of an applied stimulus on sensing attributes. These examples may find particular use in systems that provide both sensing and therapy delivery from subcutaneous location.

Abstract: A first fluid status indicator of a pulmonary fluid status associated with pulmonary edema and a second fluid status indicator of a non-pulmonary fluid status can be used to provide an alert or to control a therapy for pulmonary edema. Additionally, intermittent cardiac blood volume redistribution therapy can be used to provide cardiac conditioning in heart failure patients.

Abstract: Aspects of the invention are directed to advanced monitoring and control of medium voltage therapy (MVT) in implantable and external devices. Apparatus and methods are disclosed that facilitate dynamic adjustment of MVT parameter values in response to new and changing circumstances such as the patient's condition before, during, and after administration of MVT. Administration of MVT is automatically and dynamically adjusted to achieve specific treatment or life-support objectives, such as prolongation of the body's ability to endure and respond to MVT, specifically addressing the type of arrhythmia or other pathologic state of the patient with targeted treatment, a tiered-intensity MVT treatment strategy, and supporting patients in non life-critical conditions where the heart may nevertheless benefit from a certain level of assistance.

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: A method is provided of tissue ablation during a tissue ablation procedure. Ablation energy is applied by using a tissue ablation device to create an ablation at a tissue site. An ablation endpoint at the tissue site is detected by using an ablation endpoint device with one or more sensors that are positioned to monitor the ablation. The one or more sensors are selected from at least one of, a piezoelectric and a silicon MEMS sensor. Upon detecting the ablation endpoint, delivery of ablation energy to the tissue site ceases.

Abstract: Embodiments of the present concept are directed to external defibrillators that include a utility light for use by one or more rescuers using the defibrillator. In one implementation, an external defibrillator has a housing, an energy storage module for storing an electrical charge, a defibrillation port for guiding the stored electrical charge to a person, and a processor for determining when to guide the electrical charge. The defibrillator also includes a user interface that includes a screen showing indications by light, and a separate utility light coupled to the housing via a light-coupling structure. The utility light is structured to generate and cast a beam of light with a beam divergence angle of no more than 160 degrees in order to illuminate a certain point of the local environment. This illumination capability may help rescuers reach a person in need of medical attention and apply medical assistance to the person.

Abstract: A method is provided of tissue ablation during a tissue ablation procedure. Ablation energy is applied by using a tissue ablation device to create an ablation at a tissue site. An ablation endpoint at the tissue site is detected by using an ablation endpoint device with one or more sensors that are positioned to monitor the ablation. The one or more sensors are selected from at least one of, a piezoelectric and a silicon MEMS sensor. Upon detecting the ablation endpoint, delivery of ablation energy to the tissue site ceases.

Abstract: An implantable medical device and method are provided for determining if a patient is in a substantially horizontal position and delaying a programmed cardioversion/defibrillation shock therapy in response to determining the patient is in a substantially horizontal position. In various embodiments, the shock therapy may be delayed by adjusting tachycardia detection criteria or scheduling the shock therapy after a maximum tachycardia episode duration.

Abstract: A resuscitation system for use by a rescuer for resuscitating a patient having a ventricular arrhythmia, comprising circuitry and processing configured for detection of chest compression/phase timing information indicative of the start of the decompression phase, circuitry and processing configured for delivery of electromagnetic therapy for the termination of ventricular arrhythmias, wherein the circuitry and processing for the delivery of electromagnetic therapy utilizes the chest compression phase timing information to initiate delivery of the electromagnetic therapy within 300 milliseconds of the start of the decompression phase.

Abstract: An EMI filtered terminal assembly including at least one conductive terminal pin, a feedthrough capacitor, and a counter-bore associated with a passageway through the capacitor is described. Preferably, the feedthrough capacitor having counter-drilled or counter-bored holes on its top side is first bonded to a hermetic insulator. The counter-drilled or counter-bore holes in the capacitor provide greater volume for the electro-mechanical attachment between the capacitor and the terminal pin or lead wire, permitting robotic dispensing of, for example, thermal-setting conductive adhesive.

Abstract: An implantable medical device (IMD) having a hermetic housing formed from a case and a cover each having an exterior surface and an interior surface. An IMD component is mounted to the interior surface of the cover and has an electrical contact. A hybrid circuit is assembled in the case. The IMD component electrical contact is electrically coupled to the to the hybrid circuit assembled in the case.

Abstract: The invention relates to two independently operating electrical cardioverters, each having an integrated stimulator for heart therapy. The cardioverters and stimulators have two separate final stages, which can deliver shock pulses or stimulation pulses at a time offset from each other, but can also be controlled by the ventricular ECG and synchronized accordingly.

Abstract: Devices, systems and methods relating to defibrillation and, more specifically, pulse parameters and electrode configurations for reducing patient discomfort are disclosed. Embodiments provide for an implantable defibrillator having an electrode lead system, at least one sensor for sensing a heart condition and emitting a condition signal, a controller in communication with the at least one sensor and configured to determine from the condition signal whether the heart is fibrillating and emitting a command signal if fibrillation is detected and a voltage generator communicating with the controller and the electrode system to communicate at least one defibrillation pulse to the electrode system, wherein the at least one defibrillation pulse includes at least one pulse having a voltage greater than 80 volts and a time duration up to 1000 microseconds.

Abstract: The present subject matter includes a method of producing an apparatus for use in a patient, the method including etching an anode foil, anodizing the anode foil, assembling the anode foil, at least one cathode foil and one or more separators into a capacitor stack adapted to deliver from about 5.3 joules per cubic centimeter of capacitor stack volume to about 6.3 joules per cubic centimeter of capacitor stack volume at a voltage of between about 465 volts to about 620 volts, inserting the stack into a capacitor case, inserting the capacitor case into a device housing adapted for implant in a patient, connecting the capacitor to a component and sealing the device housing.

Abstract: Systems, methods and devices relating to atrial defibrillation and, more specifically, modes of operation for automatically and/or remotely causing the delivery of one or more atrial defibrillation pulses are disclosed. Embodiments provide for wireless communication between an implanted atrial defibrillator, external communication devices and/or servers to detect atrial fibrillation states, communicate with patients and/or initiate the delivery of atrial defibrillation pulses.

Abstract: A wearable defibrillator and method of monitoring the condition of a patient. The wearable defibrillator includes at least one therapy pad, at least one sensor and at least one processing unit operatively connected to the one or more therapy pads and the one or more sensors. The wearable defibrillator also includes at least one audio device operatively connected to the one or more processing units. The one or more audio devices are configured to receive audio input from a patient.

Abstract: In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameters such as rate, QRS pulse width, cardiac QRS slew rate, amplitude and stability measures of these parameters from the filtered cardiac signal information are measured, processed and integrated to determine if the cardioverter/defibrillator needs to initiate therapeutic action.

Abstract: A system and method for performing independent, off-line evaluation of event sensing for collected electrograms, comprising: sensing an electrogram using an implantable medical device (IMD); determining locations of heart beats on at least one channel of the electrogram using a multi-pass process, resulting in a group of multi-pass beat locations; storing the electrogram and device-identified beat locations in a memory location; and retrieving the electrogram and device-identified beat locations from the memory location. The multi-pass process determines locations of heart beats on at least a first channel of the electrogram. The device-identified group of beat locations are then compared to the multi-pass group of beat locations identified using the multi-pass method. Based on the comparing step, oversensing of beats, undersensing of beats, or noise from the device can be detected.

Abstract: Systems and techniques that enable a user to selectively extend the time prior to providing an indication of power source depletion, e.g., allow an extended the recommended replacement time (RRT) prior to providing an elective replacement indication (ERI), are described. The user provides input, which may indicate an acceptable level of implantable medical device performance, e.g., that lesser performance for a period between a default RRT and an extended RRT is acceptable. In response to the input, the time until providing an RRT/ERI notification, or some other indication of depletion of the implantable medical device power source, may be extended.

Abstract: Some embodiments provide a system, comprising a peripheral nerve field modulation (PNFM) therapy delivery system, PNFM electrodes configured to be implanted subcutaneously, and a controller. The PNFM electrodes are electrically connected to the PNFM therapy system. The PNFM therapy delivery system and the PNFM electrodes are configured to deliver current and/or control the field potentials at one or more peripheral nerve fields. The controller is configured to control the PNFM therapy delivery system to deliver a PNFM therapy to the one or more peripheral nerve fields. The controller includes a scheduler configured to control timing of the PNFM therapy.

Abstract: A method for managing care of a person receiving emergency cardiac is disclosed and involves monitoring, with an external defibrillator, multiple parameters of the person receiving emergency cardiac assistance; determining from at least one of the parameters, an indication of trans-thoracic impedance of the person receiving emergency cardiac care; determining, from at least one of the parameters corresponding to an electrocardiogram of the person receiving emergency cardiac assistance, an initial indication of likely shock effectiveness; determining, as a function of at least the indication of trans-thoracic impedance and the initial indication of likely shock effectiveness, an indication of whether a shock provided to the person receiving emergency medical assistance will be effective; and affecting control of the defibrillator by a caregiver as a result of determining the indication of whether a shock will be effective.

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: A defibrillation system that utilizes a unique defibrillator paddle assembly. The defibrillator paddle assembly has a handle and a paddle head. The paddle head contains the conductive surface that is used to contact the muscle tissue of the heart during a defibrillation attempt. The paddle head is connected to the handle by a flexible connection. The flexible connection enables the relative orientation between the handle and the paddle head to be selectively adjusted. Accordingly, a physician can selectively change the orientation of the paddle head in relation to the handle in order to more effectively utilize the paddle assembly during a specific circumstance. The flexible connection between the handle and the paddle head can be adjusted either by manual bending or by utilizing adjustment controls that are present on the handle of the paddle assembly.

Abstract: Medical devices and therapeutic methods for use in the field of cardiology, cardiac rhythm management and interventional cardiology, and more specifically to catheter-based systems for implantation of pacing leads and electrodes, or intramural myocardial reinforcement devices, within the myocardial wall of the heart, such as the ventricles, to provide improved cardiac function.

Abstract: Systems and methods are described for analyzing a plurality of beats after detection of a suspected cardiac arrhythmia to determine a beat discriminator, identify a beat subsequent to completion of charging of an implantable medical device by applying the beat discriminator, and synchronize delivery of a shock from the medical device to the identified beat. In some examples, identifying the beat using the beat discriminator may help to accurately synchronize the shock with a beat representative of physiological cardiac events instead of an oversensed beat, e.g., noise sensed signal that is misclassified as a cardiac beat.

Abstract: A method and apparatus for delivering therapy to treat ventricular tachyarrhythmias is described. In one embodiment, neural stimulation, anti-tachycardia pacing, and shock therapy are employed in a progressive sequence upon detection of a ventricular tachycardia.

Abstract: System and method for estimating a remaining capacity of a battery of an implantable medical device. The implantable medical device has a battery producing a current and having a remaining battery capacity, the implantable medical device being configured to utilize a relatively low amount of the current and, in specific instances, a relatively large pulse of the current. The processor is coupled to the battery and configured to calculate an estimate of the remaining battery capacity based, at least in part, on a measured battery parameter and occurrences of the specific instances of delivery of the relatively large pulse of the current.

Abstract: The disclosure includes an electrochemical cell comprising a first cathode and a second cathodes are adjacent one another in a stacked arrangement to form a cathode stack in the electrochemical cell. The first cathode includes a first current collector and a first cathode form of active material covering the first current collector, and the second cathode includes a second current collector and a second cathode form of active material covering the second current collector. The second current collector is in electrical contact with the first current collector. The electrochemical cell further comprises an anode adjacent to the cathode stack, and a separator located between the cathode stack and the anode.

Abstract: Embodiments of the present invention include a portable medical device with an integrated web server. The portable medical device is configured to establish a communication session with a user device. The integrated web server is configured to load software onto the user computing device for exchanging data with the portable medical device.

Abstract: A subcutaneous cardiac device includes two electrodes and a stimulator that generates a pulse to the electrodes. The electrodes are implanted between the skin and the rib cage of the patient and are adapted to generate an electric field corresponding to the pulse, the electric field having a substantially uniform voltage gradient as it passes through the heart. The shapes, sizes, positions and structures of the electrodes are selected to optimize the voltage gradient of the electric field, and to minimize the energy dissipated by the electric field outside the heart. More specifically, the electrodes have contact surfaces that contact the patient tissues, said contact surfaces having a total contact area of less than 100 cm2. In one embodiment, one or both electrodes are physically separated from the stimulator. In another embodiment, a unitary housing holds the both electrodes and the stimulator.

Abstract: A system and method for long-term monitoring of cardiac conditions such as arrhythmias is disclosed. The invention includes a pulse generator including means for sensing an arrhythmia. The pulse generator is coupled to at least one subcutaneous electrode or electrode array for providing electrical stimulation such as cardioversion/defibrillation shocks and/or pacing pulses. The electrical stimulation may be provided between multiple subcutaneous electrodes, or between one or more such electrodes and the housing of the pulse generator. In one embodiment, the pulse generator includes one or more electrodes that are isolated from the can. These electrodes may be used to sense cardiac signals.

Abstract: A pacemaker comprising a battery compartment displaceable between a removal position and an operating position along a first direction of displacement for receiving a replaceable battery having a first and a second battery pole disposed on a battery face. The battery compartment comprises an electrically isolating partial cover, which is disposed on a second side opposite the first side and designed to cover a base of the battery directed toward the second side in the direction of the removal side of the battery compartment.

Abstract: A resuscitation device for automatic compression of victim's chest using a compression belt which exerts force evenly over the entire thoracic cavity. The belt is constricted and relaxed through a motorized spool assembly which repeatedly tightens the belt and relaxes the belt to provide repeated and rapid chest compression. An assembly includes various resuscitation devices including chest compression devices, defibrillation devices, and airway management devices, along with communications devices and senses with initiate communications with emergency medical personnel automatically upon use of the device.