Abstract: A medical device comprises: a feeding tube (70) including a feeding lumen (80) with an opening (152) at a distal end of the feeding tube and an electrical lumen (84) having access openings (120) spaced apart along the feeding tube; a set of insulated electrical conductors (82) disposed in the electrical lumen, the set of insulated electrical conductors having electrically exposed portions (132, 132a, 132b) proximate to the access openings; and electrodes (72, 73, 74, 75, 78, 79, 140) comprising electrically conductive material portions (140) disposed in the access openings and electrically contacting the proximate electrically exposed portions of the set of insulated electrical conductors disposed in the electrical lumen. The electrodes include at least one upper or proximal electrode (74, 75, 78, 79) disposed above an expected patient heart electrical centerline (CL) and at least one lower or distal electrode (72, 73) disposed below the expected patient heart electrical centerline.

Abstract: An implantable medical device including at least one electrode line having an electrode pole, an electrode feed line, a counter electrode to the at least one electrode line, and an insulation sleeve. The insulation sleeve surrounds the electrode feed line and provides insulation between the electrode feed line and an electrolyte formed by bodily fluid. The electrode feed line and the electrode pole(s) include different materials, wherein the materials are different based on electrochemical series. The implantable medical device includes an insulation test unit having a DC voltage detector arranged between the electrode pole and the counter electrode, in order to detect an electrochemical voltage produced in the event of an insulation fault of the insulation sleeve due to defective contact between the electrolyte and the electrode feed line.

Abstract: A system and method for conservation of battery power in a portable medical device is provided. In one example, a processor arrangement that includes a plurality of processors is implemented. At least one of these processors is configured to execute the critical functions of the medical device, while one or more other processors assume a reduced service level, thereby drawing significantly less power. According to this arrangement, the medical device conserves energy by drawing the additional electrical power needed to activate the additional processing power only when needed.

Abstract: A lifesaving support apparatus includes: a sensor section which is adapted to be attachable to a patient, and which is configured to acquire information of blood flow of the patient; a determining section which, based on the information of blood flow, is configured to determine whether or not a use of an automatic external defibrillator is necessary; and an outputting section which is configured to notify a rescuer of information which is determined by the determining section.

Abstract: A system and method of detecting a loss of electrical contact between a pair of electrodes that are electrically coupled to skin of a subject. The method includes monitoring parameters of a transthoracic impedance between the pair of electrodes in at least one of a low frequency regime and a high frequency regime, detecting an occurrence of chest compressions based on a signal indicative of chest compressions, establishing baseline levels of the parameters in at least one of the low and high frequency regimes, detecting whether changes in at least one parameter exceeds the baseline level by a threshold, determining that at least one electrode of the pair of electrodes is losing electrical contact with the skin responsive to the at least one parameter exceeding the baseline level by the threshold, and issuing an alert in response to a determination that the at least one electrode is losing electrical contact.

Abstract: A current limiter for a defibrillation pulse is powered by the defibrillation pulse and switches the current delivery path open and closed when an excessive current condition exists. The excessive current condition is sensed by a sense resistor of the current limiter. The controlled current is delivered by an inductor which delivers a current which varies in a range about a predetermined current level during excessive current conditions. The current limiter dissipates little energy of the defibrillation pulse so that most of the energy produced by the defibrillator is delivered to the patient.

Abstract: A lifesaving support apparatus includes: a sensor section which is adapted to be attachable to a patient, and which is configured to acquire information of blood flow of the patient; a determining section which, based on the information of blood flow, is configured to determine whether or not a use of an automatic external defibrillator is necessary; and an outputting section which is configured to notify a rescuer of information which is determined by the determining section.

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 system is disclosed that generates and applies a diagnostic signal to the patient in conjunction with defibrillation therapy. The diagnostic signal is designed to elicit a physiologic response from the patient's heart, namely, mechanical cardiac response and electrical cardiac response, electrical cardiac response only, or no cardiac response. Depending upon the type of cardiac response detected, the system selects an appropriate resuscitation protocol that considers the likely responsiveness of the patient to defibrillation therapy. In one practical embodiment, a stimulus signal is applied to patients that show mechanical and electrical capture in response to the diagnostic signal. The stimulus signal maintains the mechanical capture (and, therefore, perfusion) for a period of time prior to the delivery of a defibrillation pulse.

Abstract: Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein.

Abstract: An electrical parameter value indicative of an impedance of an electrical path between a first medical device implanted within a patient and a second medical device implanted within the patient may be determined by generating and delivering an electrical signal between electrodes connected to the first medical device and sensing the electrical signal with two or more sense electrodes connected to the second medical device. In some examples, the electrical parameter value indicative of the impedance may be used to detect a system integrity issue, such as relative movement between the first and second medical devices, such as between leads connected to the medical devices, or a lead-related condition. In other examples, the determined impedance may indicate a transthoracic impedance of the patient.

Abstract: Physiological signals are denoised. In accordance with an example embodiment, a denoised physiological signal is generated from an input signal including a desired physiological signal and noise. The input signal is decomposed from a first domain into subcomponents in a second domain of higher dimension than the first domain. Target subcomponents of the input signal that are associated with the desired physiological signal are identified, based upon the spatial distribution of the subcomponents. A denoised physiological signal is constructed in the first domain from at least one of the identified target subcomponents.

Abstract: Herein is disclosed a probe, including a first electrode disposed at least partially on the probe surface, a second electrode disposed at least partially on the probe surface, a first conductor electrically coupled to the first electrode, a second conductor electrically coupled to the second electrode, and a reactive element electrically coupling the first conductor and the second conductor.

Abstract: An external defibrillator includes patient electrodes (20) for obtaining the patient's electrocardiogram (ECG) and for applying a shock to the patient. A microprocessor (24) analyses the patient's ECU using a diagnostic algorithm to detect if the patient's heart is in a shockable rhythm, and shock delivery circuitry (10) is enabled when a shockable rhythm is detected by the diagnostic algorithm. The patient electrodes also allow obtaining a signal (Z) which is a measure of the patient's transthoracic impedance and the microprocessor is responsive to Z to detect conditions likely to cause the diagnostic algorithm to generate a false detection of a shockable rhythm. If such detection is made, the microprocessor prevents detection of a shockable rhythm by the diagnostic algorithm, at least for a period of time.

Abstract: A typical power switch in a Buck Regulator requires a pre-driver to ensure rapid transition from its ON to OFF states. In this invention, the shoot through current in the pre-driver and the power switch's gate-charge in a Buck regulator is itself recaptured in the capacitor of the buck regulator. The recapturing of this otherwise wasted shoot-through current and gate charge allows for increased efficiency of the regulator. The recapture may be selectively disabled to accommodate high power operations of the system, if such are used; the recapture may in an alternative mode be always performed. As a result, reduced power consumption can be achieved.

Abstract: A method and system for regulating the operation of a cardiac pacemaker or defibrillator are disclosed. A processor receives signals of both an implanted hemodynamic sensor and intracardiac electrograms and digitizes them. The digitized signal of the hemodynamic sensor is used to prevent inappropriate cardiac stimulation and erroneous cardiac detection. The hemodynamic signal is also used to define arrhythmias.

Abstract: Systems, devices and methods described herein can be used to monitor and treat cardiovascular disease, and more specifically, can be used to determine heart rate (HR), determine respiration rate (RR) and classify cardiac rhythms based on atrial intracardiac electrogram (IEGM) and atrial pressure (AP) signals. The atrial IEGM and AP signals are subject to spectrum transforms to obtain an atrial IEGM frequency spectrum and an AP frequency spectrum. Based on peaks in the atrial IEGM and AP frequency spectrums measures of HR and RR are determined, and arrhythmias are detected and/or arrhythmia discrimination is performed.

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: 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 method of treating a patient for ventricular tachycardia using a wearable defibrillator includes monitoring the patient for a predetermined condition via one or more electrodes on the defibrillator, sending a message to the patient in response to the predetermined condition, activating the defibrillator so that the defibrillator delivers defibrillation energy to the patient, and storing at least one of the results of the monitoring, sending and activating steps in a memory on the defibrillator. The method also includes downloading information stored in the memory of the defibrillator to a base station having an external interface, and transmitting the information downloaded from the memory of the base station to an external location via the external interface of the base station.

Abstract: This document relates to cardiac resuscitation, and in particular to systems and techniques for protecting rescuers from electrical shock during defibrillation of a patient.

Abstract: A system and method for use during the administration of CPR chest compressions and defibrillating shock on a cardiac arrest victim. The system analyzes compression waveforms from a compression depth monitor to determine the source of chest compressions, and enables the delivery of defibrillating shock during a compression cycle if the compression waveforms are characteristic of an automated CPR chest compression device.

Abstract: A defibrillator is disclosed for communication with a transmitter associated with a location. The defibrillator is configured to generate an electronic signature for determining a position of the defibrillator within the location. The electronic signature includes electronic data correlating the position of the defibrillator to the transmitter. The electronic data may include GPS data. The defibrillator is configured to generate the electronic signature during a first and a second window of time to define a first and a second electronic signature. A differential between the first and the second electronic signatures corresponds to a positional state of the defibrillator, indicating movement within or between two locations. In a disclosed system, the first electronic signature is stored in a database and a server is configured to generate the differential and to communicate the positional state of the defibrillator to a stakeholder. Methods of use are also disclosed.

Abstract: An exemplary embodiment includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A method detects a biological condition and detects a change in the biological condition of a mammal. The device determines if the change in the biological condition exceeds a predetermined threshold and sends a signal based at least in part on the determination.

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: An electrode structure for use with a monitoring system. A thin flexible body of an electrode material comprising conductive rubber is provided with projections extending externally to a working surface. According to this construction of the working surface of the electrode only the projections make a contact to the recipient's skin. When the projections are provided with a small cross-section, the constant electrode-skin contact is ensured due to the resiliency of the electrode material.

Abstract: A method and device for detecting a cardiac event that includes sensing cardiac electrical signals representative of electrical activity of a heart of a patient, detecting the cardiac event in response to the sensed cardiac signals, determining an indication of signal reliability corresponding to the sensed cardiac signals as being one of a reliable signal and a not reliable signal, and switching operation of the device between a first mode of determining whether the sensed signal is one of treatable and not treatable and a second mode of determining whether the sensed signal is one of treatable and not treatable in response to the determined indication of signal reliability.

Abstract: Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure.

Abstract: An external defibrillator system is disclosed that generates and applies a diagnostic signal to the patient in conjunction with defibrillation therapy. The diagnostic signal is designed to elicit a physiologic response from the patient's heart, namely, mechanical cardiac response and electrical cardiac response, electrical cardiac response only, or no cardiac response. Depending upon the type of cardiac response detected, the system selects an appropriate resuscitation protocol that considers the likely responsiveness of the patient to defibrillation therapy. In one practical embodiment, a stimulus signal is applied to patients that show mechanical and electrical capture in response to the diagnostic signal. The stimulus signal maintains the mechanical capture (and, therefore, perfusion) for a period of time prior to the delivery of a defibrillation pulse.

Abstract: An implantable electronic therapy device, having a therapy unit, a heart rate capturing unit, a contractility determination unit, and an evaluation and control unit. The therapy unit delivers an antitachycardiac therapy. The heart rate capturing unit determines a ventricular heart rate from an input signal, and the contractility determination unit generates from an input signal, a contraction signal reflecting a contractility of a ventricle. The evaluation and control unit is connected to the therapy unit, the heart rate capturing unit, and the contractility determination unit actuates the therapy unit to administer an antitachycardiac therapy when the heart rate capturing unit detects an increase in the heart rate above a specified threshold value and the contractility determination unit supplies a contraction signal which is not physiologically adequate for the increase in the heart rate.

Abstract: Systems and methods include obtaining a measure of cardiac contractility. A cardiac contractility variability is determined from the measure of cardiac contractility. Analyzing the cardiac contractility variability, an indication of cardio-vasculature health is provided.

Abstract: This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module.

Abstract: A system and method for use during the administration of CPR chest compressions and defibrillating shock on a cardiac arrest victim. The system analyzes compression waveforms from a compression depth monitor to determine the source of chest compressions, and enables the delivery of defibrillating shock during a compression cycle if the compression waveforms are characteristic of an automated CPR chest compression device.

Abstract: A system for measuring of cardiac blood flow balance parameter between the right chamber of the heart and the left chamber of the heart includes a sensor device for measuring one of blood pressure and blood flow rate and blood constituent concentration of a patient so as to generate an arterial pulse signal. A processing unit is responsive to the arterial pulse signal for generating a full arterial pulse signal, an arterio-venous pulse signal, and a balance parameter. A computational device is responsive to the balance parameter for further generating a set of physiological parameters. A display station device is responsive to the set of physiological parameters from the computational device for displaying meaningful information.

Abstract: An implantable medical device that includes a first elongated lead body having an outer surface and an opening along the outer surface, a sensor positioned along the lead body and configured to receive acoustic signals through the opening of the first lead body and generate an electrical signal representative of sounds produced at a targeted location along a patient's cardiovascular system. A therapy delivery module is capable of delivering a cardiac therapy via predetermined electrodes of a plurality of electrodes, and a processor is configured to detect a cardiac event in response to the sensed cardiac electrical signals, determine a plurality of time intervals between the electrical signals and acoustic signals, determine a correlation between the electrical signals and the acoustic signals, and control the therapy delivery module to deliver therapy in response to the determined correlation.

Abstract: An automated external defibrillator (AED) 10 has a changeable language placard (20) which enables the AED to instruct the user in one or more languages. The placard includes a controlling element (120) which is sensed by the AED, and causes the AED to automatically switch the language mode into the corresponding placard language. The placard also includes visual guidance instructions (224, 226).

Abstract: Disclosed herein are methods and apparatus including medical devices having features for monitoring sounds and motions indicative of a state of health or administration of CPR to a subject. In one embodiment, a therapeutic device such as a therapy electrode comprises a layer configured to deliver a therapy to a subject and an acoustic sensor on the therapeutic device and coupled to the layer.

Abstract: Devices and methods for providing pacing in multiple modes are provided. One device operates in a dual chamber (DDD or biventricular) mode and in a pacing mode favoring the spontaneous atrioventricular conduction such as an AAI mode (10) with a ventricular sensing or a mode with hysteresis of the atrioventricular delay. The device controls (10-18) the conditional switching from one mode to the other. The device comprises a hemodynamic sensor, including an endocardial acceleration sensor, derives a hemodynamic index representative of the hemodynamic tolerance of the patient to the spontaneous atrioventricular conduction. The device controls inhibiting or (20) forcing the conditional switching of the device to the DDD (or biventricular) mode according to the evolution of the hemodynamic index.

Abstract: A method and device for delivering therapy that includes an electrode to sense cardiac signals and to deliver a therapy, a monitoring module detecting a cardiac event in response to the sensed cardiac signals using first detection criteria, a sensor emitting light and detecting emitted light scattered by a tissue volume adjacent the sensor to generate a corresponding detected light intensity output signal, a control module coupled to the sensor to control light emission of the sensor in response to delivering the therapy, and a controller coupled to the monitoring module, the therapy delivery module and the sensor, the controller configured to determine tissue oxygenation measurements in response to the output signal, determine a tissue oxygenation trend in response to the tissue oxygenation measurements, determine a recovery index in response to the determined tissue oxygenation trend, and control one or both of detecting a cardiac event by the monitoring module and delivery of therapy by the therapy deliver

Abstract: A method of treating a patient for ventricular tachycardia using a wearable defibrillator includes monitoring the patient for a predetermined condition via one or more electrodes on the defibrillator, sending a message to the patient in response to the predetermined condition, activating the defibrillator so that the defibrillator delivers defibrillation energy to the patient, and storing at least one of the results of the monitoring, sending and activating steps in a memory on the defibrillator. The method also includes downloading information stored in the memory of the defibrillator to a base station having an external interface, and transmitting the information downloaded from the memory of the base station to an external location via the external interface of the base station.

Abstract: End-tidal carbon dioxide (ETCO2) measurements may be used alone as a guide to determine when to defibrillate an individual. Alternatively, ETCO2 measurements may be used in combination with amplitude spectral area measurements as a guide to determine when to defibrillate an individual.

Abstract: Techniques are provided for use with implantable devices equipped with programmable voltage multipliers (including voltage dividers.) Candidate pulse widths are determined for selected voltage multipliers and stimulation vectors. Each candidate pulse width corresponds to a lowest pulse energy sufficient to achieve capture within the tissues of the patient (subject to a safety margin) using the selected vector and using the corresponding voltage multiplier. As such, a candidate pulse width represents a preferred or optimal pulse width, at least insofar as energy consumption is concerned. However, depending upon the capabilities of the device, the candidate pulse width might not be achievable. Accordingly, for each programmable vector, the system determines a lowest “operable” voltage multiplier sufficient to generate a pulse at a candidate pulse width subject to the capabilities of the device.

Abstract: An automated external defibrillator (AED) (10) having a treatment decision processor (28) is described which estimates the probability of successful resuscitation made from an analysis of a patient parameter measured in the presence of CPR artifact. The invention may also adjust its analysis protocol and guidance outputs depending on a comparison of the estimate with a subsequent shock analysis. The invention also may use the trend of the measured patient parameter to adjust the CPR protocol either during a CPR pause or after the initial CPR pause. The AED (10) thus enables an improved rescue protocol.

Abstract: An ECG lead system for use with a plurality of unique diverse ECG floor monitors for when a patient is substantially immobile and/or a plurality of unique diverse ECG telemetry monitors, is provided. The ECG lead system includes a plurality of unique adapters, wherein each adapter includes an input receptacle configured for selective electrical connection with a device connector of an ECG lead set assembly; and at least one unique monitor plug electrically connected to the input receptacle. Each monitor plug is configured to selectively electrically connect to a corresponding receptacle of a respective unique diverse ECG floor monitor or unique diverse ECG telemetry monitor.

Abstract: An apparatus, system, and method are disclosed for weighing an individual on a backboard. The backboard is configured to support a supine individual during transportation. An upper surface of the backboard is configured to receive the supine individual. A scale is embedded within the backboard beneath the upper surface. The embedded scale is configured to determine a weight of the supine individual in response to the upper surface receiving the supine individual.

Abstract: Systems and methods related to the field of cardiac resuscitation, and in particular to devices for assisting rescuers in performing cardio-pulmonary resuscitation (CPR) are described herein.

Abstract: A modular external defibrillator system in embodiments of the teachings may include one or more of the following features: a base containing a defibrillator to deliver a defibrillation shock to a patient, (b) one or more pods each connectable to a patient via patient lead cables to collect at least one patient vital sign, the pods operable at a distance from the base, (c) a wireless communications link between the base and a selected one of the two or more pods to carry the at least one vital sign from the selected pod to the base, the selection being based on which pod is associated with the base.

Abstract: A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.

Abstract: Embodiments of the present concept are directed to external defibrillators that include an electrode connection port having multiple connection options, and include a detection device to determine an electrode connection configuration so as to provide an appropriate electrical shock to a patient. The detection device detects the electrode connection configuration of a plug connector for connected electrodes to determine if the plug connector is in an adult orientation or a pediatric orientation. The external defibrillator is configured to a deliver an electrical shock with less energy when the pediatric orientation is detected rather than the adult orientation.