Abstract: A defibrillator system is disclosed including an operational state input, a user-operated information request input, and a user guidance output. The defibrillator system can be implemented as an AED, a manual defibrillator, or as a defibrillator trainer. The defibrillator system further utilizes the state and request inputs to determine a context-sensitive rescue information which is provided to the output.

Abstract: An automatic external defibrillator produces audible prompts for a user by providing the audible information with default audio characteristics in response to a first ambient noise condition and providing the audible information having different audio characteristics than the default audio characteristics in response to a second ambient noise condition. An automatic external defibrillator provides voice prompts by selecting one of a plurality of different levels of sound quality at which to playback the voice prompts and playing back the voice prompts at the selected level of sound quality.

Abstract: EMI shields for use in implantable medical devices that include inner and outer metal layers separated by a dielectric layer. When assembled as medical devices, the outer metal layer of an illustrative EMI shield is placed into electrical contact with a conductive inner surface of an associated canister for an implantable medical device.

Abstract: A medical device such as a defibrillator that incorporates corrective voice prompts that navigate users around operator errors. The voice prompts may, for example, address errors of readiness (e.g., failing to connect the defibrillator to an AC power source, failing to pre-connect electrodes, etc.), errors of omission (i.e., forgetting to do something, such as attempting to deliver a shock before the defibrillator is charged), and errors of commission (i.e., doing the wrong thing, such as attempting to shock VF when in the synchronization mode). The voice prompts may address errors in the delivery of therapy (e.g., attempting to shock VF when in the synchronization mode) or they may address errors other than in the delivery of therapy (e.g., failing to connect to an AC power source).

Abstract: A method of modifying the force of contraction of at least a portion of a heart chamber is provided. A non-excitatory electric field of given duration is applied, at a delay after an activation of the heart, which increase the force of contraction by at least 5%. Apparatus is also provided for pacing with hemodynamic improvement. Circuitry applies an extended pacing signal to electrodes to pace the heart, the extended pacing signal having an overall duration greater than 8 ms from a time of initiation of application of that portion of the signal that initiates action potential propagation. The signal includes a train of biphasic pulses having pulse durations of at least 1 ms, and the signal has an amplitude that is at least three times as great as a threshold for pacing the heart and that is sufficient neither for cardioversion nor for defibrillation. Other embodiments are also described.

Abstract: External portable medical devices, such as portable external defibrillators (PEDs), have long standby times and may be required to indicate their operational status to a user while conserving battery power. Frequently, numerous PEDs are scattered throughout one or more large facility, which may make identifying a PED that is indicating an operational status that requires attention more difficult. To conserve power and provide more effective notice, a PED may use a broadcast transmitter, which minimizes power usage, to communicate the PED's status to a remote monitor that is connected to a relatively unlimited power supply. The remote monitor may then provide a wide variety of sensory alerts to indicate the status of the PED without concern for the power consumption associated with the sensory alert.

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: Biodegradable polymer-coated surgical meshes formed into pouches are described for use with cardiac rhythm management devices (CRMs) and other implantable medical devices. Such meshes are formed into a receptacle, e.g., a pouch or other covering, capable of encasing, surrounding and/or holding the cardiac rhythm management device or other implantable medical device and preventing or retarding the formation of a biofilm.

Abstract: Exemplary versions of the invention include methods and apparatuses for assessing ventricular activation time by determining a point in time t1 of an initial positive deflection on a far-field electrogram and a point in time t2 of a first peak of the negative deflection on a near-field electrogram of a same heart cycle. They also determine a time difference between points in time t1 and t2 said time difference representing the ventricular activation time. A progression of ventricular conduction disorders such as the left bundle branch block (LBBB) and the right bundle branch block (RBBB) can be monitored. Trending analysis of the ventricular activation time provides a means for monitoring the progression of ventricular conduction diseases.

Abstract: The invention provides a cardiac rhythm management system which includes a tachyarrhythmia detection and classification circuit programmed to detect and classify a tachyarrhythmia, a biologic therapy delivery device configured to deliver or regulate an expression cassette suitable for terminating or preventing atrial fibrillation (AF), and a control circuit coupled to the tachyarrhythmia detection and classification circuit and the biologic therapy delivery device. Also provided is an implantable medical device for use in a body having a cardiovascular system, which includes an implantable device body including at least a cardiovascular portion configured to be in the cardiovascular system, and an expression cassette incorporated into the cardiovascular portion of the implantable device body, the expression cassette selected to express a gene product that terminates or prevents AF. Further provided are methods which employ particular expression cassettes to prevent, inhibit or treat AF.

Abstract: A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.

Abstract: A support garment for a patient-worn energy delivery apparatus. A vest-type garment holds an electrode belt in contact with a wearer's ribcage. A removable electrode harness may be attachable to the support garment to accurately position sensing electrodes on the body of the wearer and energy delivery electrodes for transfer of an electrode therapy pulse to the wearer of the garment. The chest garment includes adjustable shoulder straps and a band to accommodate any body size or shape. One-sided assembly and coding of components facilitates use by a patient. A technique for sizing the support garment is also disclosed.

Abstract: An adhesive magnetic system for modifying an implantable device is provided. The system may include at least one magnet, an enclosure configured to receive the magnet, and an adhesive layer positioned on the enclosure for adhering the enclosure to a patient.

Abstract: There is provided an energy delivery device comprising a storage device, a discharge circuit and a disarm circuit. The discharge circuit comprises a switch electrically connected to the storage device, and is selectively operable to deliver energy from the storage device to a load, e.g., a patient needing defibrillation, preferably in a multiphasic waveform. The disarm circuit comprises the switch. Preferably, the discharge circuit comprises an H-bridge circuit. There are also provided delivery devices: which comprise a shoot-through elimination circuit; which include housing elements which, when assembled, cause electrical connection between respective components; which include a housing having a small volume and an energy storage device having a large capacitance; which comprise a shunt circuit which, when activated, prevents switching of a switch. There are also provided methods of assembly and disassembly of an energy delivery unit and methods of delivering energy to a load.

Abstract: A defibrillator locating system and method enables would-be responders to quickly identify defibrillator location for effecting prompt defibrillation. The system may be said to comprise a number of spaced heart-shaped signal-transmitting devices, a signal-receiving/alarm device, and an automatic external defibrillator pair-positioned in visual proximity to the signal-receiving/alarm device. A responder may send a signal from any of the transmitter devices for activating the nearest receiving/alarm device, the latter of which activates an alarm signal for guiding the responder toward the automatic external defibrillator. The alarm signal is preferably auditory and has sufficient intensity whereby the responder may be able to aurally perceive the auditory signal and follow the same to the defibrillator site along an unobstructed pathway. The removably attached defibrillator enables the responder to quickly carry said defibrillator to a cardiac emergency site.

Abstract: A system for recharging medical instruments comprises a medical instrument tray defining a plurality of recesses therein for receiving and storing a corresponding plurality of medical instruments. At least one of the medical instruments includes a secondary coil coupled to a rechargeable voltage source. The medical instrument tray includes a primary coil positioned at least partially about one or more of the recesses configured to receive and store one of the medical instruments. The primary coil couples to the secondary coil to charge the rechargeable voltage source when the corresponding medical instrument is received in the recess. A storage container is provided for receiving and storing one or more such medical instrument trays. The storage container includes an electrical routing system for routing voltage from an external voltage source to the primary coils.

Abstract: An embodiment includes a cardiac resuscitation system with first and second electrodes in a source electrode pad and a return electrode in a return electrode pad. After the source and return electrode pads are applied to a patient the layperson may put a switch in a first position to create a first electrical path to communicate a first shock between the first and return electrodes via a first vector. If the first shock fails the user may move the switch to a second position to create a second electrical path to communicate a second shock between the second and return electrodes via a second vector. As a result, the system allows a layperson to easily flip a switch to produce a first shock via a first vector and a second shock via a second vector thereby improving therapy outcomes. Other embodiments are described herein.

Abstract: The disclosure includes methods and systems for treating ventricular arrhythmias. Embodiments include an implantable cardiac device or system including a determining module that determines a value of a parameter indicative of a rate of an intrinsic pacemaker of a heart of a patient experiencing fast ventricular arrhythmia (FVA) and a delivery module, programmed to deliver therapy for ventricular arrhythmias to a patient. Some methods include determining a value of a parameter indicative of a rate of an intrinsic pacemaker of a heart of a patient experiencing an FVA; if the value indicates the rate is about equal to or higher than a threshold, delivering a first therapy to the patient for terminating the FVA, and if the value indicates the rate is lower than the threshold, delivering a second therapy, different from the first therapy, to the patient for terminating the FVA.

Abstract: One embodiment of the present invention provides a lead electrode assembly for use with an implantable cardioverter-defibrillator subcutaneously implanted outside the ribcage between the third and twelfth ribs comprising the electrode.

Abstract: Wet-tantalum capacitors used in a medical device are charged to and maintained at a maintenance voltage between full energy charges so that deformation in the wet-tantalum capacitor is substantially inhibited.

Abstract: An implantable antitachycardiac cardiac stimulator has at least one right-ventricular sensing unit, a defibrillation shock generator and a control unit, as well as an additional detection unit for detecting ventricular events which operates independently of the right-ventricular detection electrode, and an evaluation unit (e.g., as an additional component of the control unit) which suppresses the delivery of a defibrillation shock on reliable detection of the normal rhythm via the additional detection unit.

Abstract: The connector between the patient electrode pads and the base unit of an automatic external defibrillator (AED) system can be formed by capturing a printed circuit board (PCB) within a connector housing. The PCB can have conductive metal traces that serve as the contact points between the wires from the patient electrodes and the electronics within the AED base unit. The PCB in combination with the conductive metal traces can be shaped similar to a conventional two-prong or two-blade connector. Employing such a PCB-based connector may result in AED pads which are less complex and less costly to manufacture. The PCB can also support a configuration circuit that is positioned between the conductive metal traces and that allows the AED to read and store information about the attached pads. For example, the AED can use this data storage feature to check the expiration date of the pads.

Abstract: A device and method for programming an implantable pulse generator. In one embodiment, commands are entered designating implantable pulse generator programming variables into programmer memory. At least some of the commands are transformed into an executable macro. The macro is stored in the programmer memory. The macro is executed to transmit the programming variables to the implantable pulse generator.

Abstract: Techniques are provided for detecting heart failure or other medical conditions within a patient using an implantable medical device, such as pacemaker or implantable cardioverter/defibrillator, or external system. In one example, physiological signals, such as immittance-based signals, are sensed within the patient along a plurality of different vectors, and the amount of independent informational content among the physiological signals of the different vectors is determined. Heart failure is then detected by the implantable device based on a significant increase in the amount of independent informational content among the physiological signals. In response, therapy may be controlled, diagnostic information stored, and/or warning signals generated. In other examples, at least some of these functions are performed by an external system.

Abstract: Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a lead, a sensor, and a controller. The pulse generator generates a baroreflex stimulation signal as part of a baroreflex therapy. The lead is adapted to be electrically connected to the pulse generator and to be intravascularly fed into a heart. The lead includes an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart. The sensor senses a physiological parameter regarding an efficacy of the baroreflex therapy and provides a signal indicative of the efficacy. The controller is connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy. Other aspects are provided herein.

Abstract: Techniques are described for discriminating ventricular tachycardia (VT) from supraventricular tachycardia (SVT) in circumstances when the ventricular rate exceeds the atrial rate (i.e. V>A). In one example, an initial atrial rate is detected while employing adjustable atrial channel detection parameters that can affect the detection of the true atrial rate—such as a post-ventricular atrial blanking (PVAB) interval or an atrial channel sensitivity level. If the ventricular rate exceeds a VT rate zone threshold with V>A, the device does not immediately deliver high voltage shock therapy as done in other devices. Rather, the device instead selectively adjusts the atrial channel detection parameter(s) to determine if the true atrial rate is equal to the ventricular rate. If so, then such is an indication that the arrhythmia might be SVT rather than VT and various discrimination procedures are employed to distinguish SVT from VT before therapy is delivered.

Abstract: Techniques are provided for use by implantable medical devices for controlling ventricular pacing using a multi-pole left ventricular (LV) lead. In one example, a single “V sense” test is performed to determine intrinsic interventricular conduction time delays (?n) between the RV electrode and each of the LV electrodes of the multi-pole lead. Likewise, a single “RV pace” test is performed to determine paced interventricular conduction time delays (IVCD_RLn) between the RV electrode and each of the LV electrodes. A set of “LV pace” tests is then performed to determine paced interventricular conduction time delays (IVCD_LRn) between individual LV electrodes and the RV electrode. Optimal or preferred interventricular pacing delays are determined using the intrinsic interventricular conduction delay (?n) values and a set of interventricular correction terms (?n) determined from the results of the RV pace test and the set of LV pace tests. With these techniques, overall test time can be reduced.

Abstract: A defibrillator includes a defibrillator mainframe and a defibrillating electrode. The defibrillator mainframe includes a main control unit and a master device electrically connected to the main control unit. The defibrillating electrode comprises a slave device supporting a bus protocol, the master device and slave device being interconnected through a bus.

Abstract: A device and method for defrosting a defibrillation electrode are provided. This includes an automated external defibrillator that is capable of defrosting one or more frozen electrodes. The device is includes a portable housing containing a battery powered energy source and a controller as well as at least a pair of electrodes which are operably coupled to the housing. The electrodes are designed for attachment to the chest of a patient in need of resuscitation and contain a conductive interface medium that has temperature dependent properties. A controller is configured to selectively heat the conductive interface medium by applying limited electrical impulses and raise the electrode temperature to a desired temperature range.

Abstract: A method of applying electrotherapy to the heart of a patient includes positioning electrodes in communication with the heart of the patient; monitoring the patient's heart to determine if its fibrillating; and providing a first signal with a current generator to the heart through the electrodes in response to an indication that the heart is fibrillating. The first stimulus signal reduces the amount of fibrillation.

Abstract: An electrode pad packaging system including an electrode pouch, an electrode pad (e.g., a defibrillation electrode pad), a wire and a shell is disclosed. The electrode pad is disposed at least partially within the electrode pouch. The wire extends from the electrode pad and, in a disclosed embodiment, at least a portion of the wire is attached to the shell. The shell is disposed in mechanical cooperation with the electrode pouch (e.g., the shell is secured to a portion of the electrode pouch). The shell includes a valve thereon that is configured to allow air to exit the electrode pouch. The valve may be configured to prevent air from entering the electrode pouch. A method of packaging an electrode pad is also disclosed. The method includes providing an electrode pouch, an electrode pad, a wire and a shell. A valve on the shell allows air to exit the electrode pouch.

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: The invention relates to an intracardial implantable electrode line for connection to an implantable medical device, in particular a cardiac pacemaker or cardioverter/defibrillator or the like, which has an acceleration sensor in the area of its distal end, which is implemented to record and differentiate acceleration values in at least two different directions. The invention additionally relates to a cardiac stimulation configuration which also has a cardiac stimulator in addition to such an electrode line.

Abstract: An automated external defibrillator including: a reserve power source for providing power to defibrillate a patient, the reserve power source including: a reserve battery which requires activation to produce power; an activator for activating the reserve power upon one of an electrical or mechanical activation; a pair of terminals operatively connected to the reserve battery for outputting the produced power to electrode pads configured to supply the produced power to a surface of the patient; and a stop for preventing the activator from activating the reserve power source, the stop being selectively removable when activation is desired.

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. The adaptive methods adjust persistence criteria used to analyze an arrhythmia prior to initiating a charging sequence to deliver therapy.

Abstract: A method embodiment comprises generating a neural stimulation signal for a neural stimulation therapy. The signal is generated during a duty cycle of a stimulation period to provide the neural stimulation therapy with an intensity at a therapy level for a portion of the duty cycle. In various embodiments, a ramp up protocol is implemented to begin the duty cycle, a ramp down protocol is implemented to end the duty cycle, or both the ramp up protocol and the ramp down protocol are implemented. The ramp up protocol includes ramping up the intensity from a non-zero first subthreshold level for the neural stimulation therapy at the beginning of the duty cycle to the therapy level. The ramp down protocol includes ramping down the intensity from the therapy intensity level to a non-zero second subthreshold level for the neural stimulation therapy at the end of the duty cycle.

Abstract: An implantable medical device includes an acoustic transducer for intra-body communication with another medical device via an acoustic couple. The acoustic transducer includes one or more piezoelectric transducers. In one embodiment, an implantable medical device housing contains a cardiac rhythm management (CRM) device and an acoustic communication circuit. The acoustic transducer is electrically connected to the acoustic communication circuit to function as an acoustic coupler and physically fastened to a wall of the implantable housing, directly or via a supporting structure.

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 implantable cardioverter/defibrillator (ICD) includes a tachyarrhythmia detection and classification system that classifies tachyarrhythmias based on a morphological analysis of arrhythmic waveforms and a template waveform. Correlation coefficients each computed between morphological features of an arrhythmic waveform and morphological features of the template waveform provide for the basis for classifying the tachyarrhythmia. In one embodiment, a correlation analysis takes into account the uncertainty associated with the production of the template waveform by using a template band that includes confidence intervals.

Abstract: Methods and devices that are configured to deliver cardiac stimuli in a particular fashion. In an illustrative embodiment, a method is used wherein a first stimulus is delivered using a first polarity, and, if the first stimulus fails to successfully convert an arrhythmia, a second stimulus having a second polarity that is different from or opposite of the first polarity is then delivered. Subsequent stimuli, if needed, are delivered in a continuing alternating-polarity manner. The first polarity may be determined by observing whether successfully-converting stimulus has been delivered previously and, if so, the polarity of the most recent stimulus that resulted in successful conversion is used as the first polarity. In additional embodiments, electrode configuration may be changed instead of or in addition to polarity, following unsuccessful stimulus delivery. Devices configured to perform such methods are included in additional illustrative embodiments.

Abstract: A system and method can sense a tachyarrhythmia, compare the sensed tachyarrhythmia with a ventricular tachyarrhythmia criterion, provide a ventricular tachyarrhythmia therapy when the sensed tachyarrhythmia satisfies the ventricular tachyarrhythmia criterion, provide a neural stimulation when the sensed tachyarrhythmia does not satisfy the ventricular tachyarrhythmia criterion, determine whether the tachyarrhythmia continues during or after the neural stimulation when the tachyarrhythmia is sustained, compare the tachyarrhythmia sensed during or after the neural stimulation with a supraventricular tachyarrhythmia (SVT) criterion, and provide a ventricular tachyarrhythmia therapy when the sensed tachyarrhythmia does not satisfy the SVT criterion.

Abstract: An implantable cardiac stimulator includes a cardioversion/defibrillation unit connected to at least one electrode pair for generation and delivery of cardioversion or defibrillation shocks; an atrial sensing unit detecting atrial contraction, and outputting an atrial sensing signal indicating a atrial event when an atrial contraction is detected; a ventricular sensing unit detecting ventricular contraction, and outputting a ventricular sensing signal when a ventricular contraction is detected; a tachycardia detection unit connected to the atrial and ventricular sensing units and detecting a tachycardia, and classifying it as a ventricular tachycardia (VT) or as a supraventricular tachycardia (SVT); and a treatment control unit designed to trigger at least one atrial cardioversion shock when a ventricular rhythm detected by the ventricular sensing unit is faster than a programmed frequency limit, and the tachycardia detection unit classifies an SVT as an atrial fibrillation (AFib).

Abstract: One aspect relates to an electrical bushing for use in a housing of an implantable medical device. The electrical bushing includes at least one electrically insulating base body and at least one electrical conducting element. The conducting element is set-up to establish, through the base body, at least one electrically conductive connection between an internal space of the housing and an external space. The conducting element is hermetically sealed with respect to the base body. The at least one conducting element includes at least one cermet. The at least one conducting element has a cross-section, a length, and a resistivity which provide the electrically conductive connection to have an ohmic series resistance of less than or equal to 1 Ohm. One aspect also relates to and implantable medical device and a use of at least one cermet-comprising conducting element in an electrical bushing for an implantable medical device.

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: One embodiment of the present invention provides an implantable cardioverter defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator including a housing; an electrical circuit located within the housing; a first electrode coupled to the electrical circuit and located on the housing; and a second electrode coupled to the electrical circuit. Some embodiments also include a physiologic sensor. Other embodiments comprise methods of implanting and subcutaneously positioning an implantable defibrillator.

Abstract: Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In illustrative examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. New methods for organizing the use of morphology and rate analysis in an overall architecture for rhythm classification and cardiac signal analysis are also discussed.

Abstract: Embodiments are directed to a medical device, such as a defibrillator, for use with an accessory capable of collecting a parameter of a patient. The medical device is capable of at least performing a basic functionality, an advanced functionality, and of defibrillating the patient. The medical device includes an energy storage module within a housing for storing an electrical charge that is to be delivered to the patient for the defibrillating. The medical device includes a processor structured to determine whether a data set received from the accessory confirms or not a preset authentication criterion about the accessory. Although when the accessory is coupled to the housing the medical device is capable of the defibrillating and the basic functionality, the medical device is capable of the advanced functionality only when the accessory is coupled to the housing and it is determined that the preset authentication criterion is confirmed. Embodiments also include methods of operation and a programmed solution.

Abstract: One aspect relates to an electrical bushing for use in a housing of an implantable medical device. The electrical bushing includes at least one electrically insulating base body and at least one electrical conducting element. The electrical bushing includes a holding element to hold the electrical bushing in or on the housing. The conducting element is set-up to establish, through the base body, at least one electrically conductive connection between an internal space of the housing and an external space. The conducting element is hermetically sealed with respect to the base body. The at least one conducting element includes at least one cermet. The holding element is made, to at least 80% by weight with respect to the holding element, from a material selected from the group consisting of a metal from any of the subgroups IV, V, VI, VIII, IX, and X of the periodic system.

Abstract: High frequency cardiac arrhythmias and fibrillations are terminated by electric field pacing pulses having an order of magnitude less energy than a conventional cardioversion or defibrillation energy. The frequency and number of the pulses are selected based on a frequency analysis of a present high frequency cardiac arrhythmia or fibrillation. The energy of the pulses is selected from 1/400 to ½ of the conventional defibrillation energy, and the amplitude of the electric field pacing pulses are selected such as to activate a multitude of effective pacing sites in the heart tissue per each pacing electrode. The number and locations of the effective pacing sites in the heart tissue are regulated by the amplitude of the electric field pacing pulses, and by an orientation of the electric field of the pulses.

Abstract: One aspect relates to an electrical bushing for use in a housing of an implantable medical device. The electrical bushing includes at least one electrically insulating base body and at least one electrical conducting element. The conducting element is set-up to establish, through the base body, at least one electrically conductive connection between an internal space of the housing and an external space. The conducting element is hermetically sealed with respect to the base body. The at least one conducting element includes at least one cermet. The cermet has a metal fraction in a range from 30% by volume to 60% by volume.