Abstract: A medical device for caring for a patient includes a patient utility for measuring a patient parameter or administering a therapy to the patient and an alarm system that has a receiver to accept status information about the medical device. A use detector of the alarm system is structured to determine when the medical device is being prepared for use and a status detector of the alarm system is adapted to determine from the status information that the medical device is in a ready state. The alarm system further includes an alarm that is activated when the medical device is both being prepared for use and not in the ready state. This description also includes methods of generating an alarm when the medical device is both being prepared for use and not in the ready state.

Abstract: A defibrillator system optimizes the timing and manner of applying a defibrillator charge to a patient based upon data provided to the defibrillator from a utility module or one or more external devices. A parameter module on the utility module provides the defibrillator with patient parameter information. Devices external to the utility module may provide the utility module with coaching data that the utility module may pass through to the defibrillator as a proxy to the external devices. The utility module may also provide external devices with patient data that the utility module may pass through to the external devices as a proxy to the defibrillator on a scheduled or other basis. The utility module may additionally provide a reserve of power to enable defibrillators to be used where power is unavailable and to enable defibrillators to deliver multiple charges more readily anywhere, anytime.

Abstract: A defibrillator system optimizes the timing and manner of applying a defibrillator charge to a patient based upon data provided to the defibrillator from a utility module or one or more external devices. A parameter module on the utility module provides the defibrillator with patient parameter information. Devices external to the utility module may provide the utility module with coaching data that the utility module may pass through to the defibrillator as a proxy to the external devices. The utility module may also provide external devices with patient data that the utility module may pass through to the external devices as a proxy to the defibrillator on a scheduled or other basis. The utility module may additionally provide a reserve of power to enable defibrillators to be used where power is unavailable and to enable defibrillators to deliver multiple charges more readily anywhere, anytime.

Abstract: A defibrillator system optimizes the timing and manner of applying a defibrillator charge to a patient based upon data provided to the defibrillator from a utility module or one or more external devices. A parameter module on the utility module provides the defibrillator with patient parameter information. Devices external to the utility module may provide the utility module with coaching data that the utility module may pass through to the defibrillator as a proxy to the external devices. The utility module may also provide external devices with patient data that the utility module may pass through to the external devices as a proxy to the defibrillator on a scheduled or other basis. The utility module may additionally provide a reserve of power to enable defibrillators to be used where power is unavailable and to enable defibrillators to deliver multiple charges more readily anywhere, anytime.

Abstract: The invention relates to systems, devices, and methods for detecting infections associated with implantable medical devices. In an embodiment, the invention includes a method of detecting infection in a patient including measuring a physiological parameter using a chronically implanted sensor at a plurality of time points and evaluating the physiological parameter measurements to determine if infection is indicated. In an embodiment, the invention includes an implantable medical device including a first chronically implantable sensor configured to generate a first signal corresponding to a physiological parameter and a controller disposed within a housing, the controller configured to evaluate the first physiological parameter signal to determine if an infection is indicated. Other embodiments are also included herein.

Abstract: A Wireless Monitoring Apparatus is used in conjunction with an automated external defibrillator (AED) system for patient rescue in mass-casualty incidents. The rescuer applies the device on each patient. The wireless monitoring apparatus automatically analyzes the patient's heart rhythm and communicates with the AED system. The AED system is therefore is able to display information with regard to each patient, notifies the rescuer on actions to take and can deliver defibrillation therapy if needed.

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 implantable medical device (IMD) is described that automatically detects the presence of an external magnetic field, such as that generated by an MRI device. The IMD includes a torque sensor configured to generate an output signal that varies as a function of a torque imposed on the torque sensor by an external magnetic field and a control module configured to control operation of the implantable medical device based on the signal output of the torque sensor.

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

Abstract: A cardiac electro-stimulatory device and method for operating same in which stimulation pulses are distributed among a plurality of electrodes fixed at different sites of the myocardium in order to reduce myocardial hypertrophy brought about by repeated pacing at a single site and/or increase myocardial contractility. In order to spatially and temporally distribute the stimulation, the pulses are delivered through a switchable pulse output configuration during a single cardiac cycle, with each configuration comprising one or more electrodes fixed to different sites in the myocardium.

Abstract: Embodiments of the present invention generally pertain to implantable medical devices, and methods for use therewith, that detect exposure to magnetic fields produced by magnetic resonance imaging (MRI) systems. In accordance with specific embodiments, a sensor output is produced using an implantable sensor that is configured to detect acceleration, sound and/or vibration, but is not configured to detect a magnetic field. Such a sensor can be an accelerometer sensor, a strain gauge sensor or a microphone sensor, but is not limited thereto. In dependence on the produced sensor output, there is a determination whether of whether the IMD is being exposed to a time-varying gradient magnetic field from an MRI system. In accordance with certain embodiments, when there is a determination that the IMD is being exposed to a time-varying gradient magnetic field from an MRI system, then a mode switch to an MRI safe mode is performed.

Abstract: Methods and devices for modulating heart valve function are provided. In the subject methods, a heart valve is first in structurally modified. Blood flow through the structurally modified heart valve is then monitored, and the heart is paced in response to the monitored blood flow. Also provided are devices, systems and kits that find use in practicing the subject methods. The subject methods find use in a variety of applications.

Abstract: A CPR coaching device is designed for placement on the chest of a patient during CPR. Chest compressions are delivered to the patient by a rescuer by pressing on the device. A force sensor and an accelerometer are located in the device and are responsive to the chest compressions. When the patient's body is stationary there will be a high correlation of a depth signal produced by doubly integrating the acceleration signal of the accelerometer and the force signal, and the depth signal is deemed reliable. When the patient's body is subject to motion such as by the motion of a vehicle transporting the patient, there will be a low correlation of the depth and force signals, with the force signal being relatively immune to this motion. In such cases, the force signal is used in association with the previously determined relationship between depth and force in the absence of motion to produce an indication of chest compression depth.

Abstract: The presence of a cardiac pulse in a patient is determined by evaluating physiological signals in the patient. In one embodiment, a medical device evaluates two or more different physiological signals, such as phonocardiogram (PCG) signals, electrocardiogram (ECG) signals, patient impedance signals, piezoelectric signals, and accelerometer signals for features indicative of the presence of a cardiac pulse. Using these features, the medical device determines whether a cardiac pulse is present in the patient. The medical device may also be configured to report whether the patient is in a VF, VT, asystole, or PEA condition, in addition to being in a pulseless condition, and prompt different therapies, such as chest compressions, rescue breathing, defibrillation, and PEA-specific electrotherapy, depending on the analysis of the physiological signals. Auto-capture of a cardiac pulse using pacing stimuli is further provided.

Abstract: The invention relates to a resuscitation device for humans. The resuscitation device is designed to provide resuscitating stimulation of the respiratory area of the human brain stem, preferably from a location distant from said respiratory area. The invention further relates to a method for providing a resuscitating treatment to a human. Parameters are measured by a number of sensor means and processed by a processing means for providing a response by a number of stimulation means. The stimulation means are electrical, mechanical or chemical stimulation means.

Abstract: An implantable medical system that includes a cardiac therapy module and a neurostimulation therapy module may identify when neurostimulation electrodes have migrated toward a patient's heart. In some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on a physiological response to an electrical signal delivered to the patient via the neurostimulation electrodes. In addition, in some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on an electrical cardiac signal sensed via the neurostimulation electrodes.

Abstract: Embodiments of the present invention relate to monitoring a patient's atrial stretch, heart failure (HF) condition, and/or risk of atrial fibrillation (AF), as well as methods for estimating a change in at least one of a patient's left atrial pressure (LAP), pulmonary capillary wedge pressure (PCWP), and right pulmonary artery pressure (RPAP). Embodiments of the present invention also relate to selecting a pacing energy level. Such embodiments involve determining atrial evoked response metrics when a patient's atrium is paced, and monitoring changes in such metrics.

Abstract: When a defibrillator selects a dosage of energy or current to be delivered to a patient, the defibrillator selects an excitation current frequency and applies the excitation current at the selected frequency to the patient. The frequency of the excitation current is selected as a function of the dosage to be delivered. The patient's response to the excitation current at the selected frequency will accurately reflect the impedance that the defibrillator will “see” when delivering the selected dosage of energy or current.

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.

Abstract: Devices, systems and methods for reducing patent discomfort during defibrillation by synchronizing defibrillation pulse delivery with a patient breathing cycle are described. Embodiments provide for a defibrillator having at least one electrode lead with one or more electrodes, a controller for determining whether fibrillation exists, a voltage generator for producing and discharging one or more electrical pulses to the electrode lead system and at least one breathing sensor for collecting and transmitting information relating to the breathing cycle of the patient to the controller. The controller may process the information from the breathing sensor, determine when one or more phases or instants of the breathing cycle are occurring and emit a command signal to the voltage generator to discharge defibrillation pulses to the electrode lead system in synchronization with the one or more phases or instants of the breathing cycle.

Abstract: An implantable medical device for monitoring tissue perfusion that includes a light source emitting a light signal and a light detector receiving emitted light scattered by a volume of body tissue. The light detector emits a signal having an alternating current component corresponding to the pulsatility of blood flow in the body tissue volume. A processor receives the current signal and determines a patient condition in response to the alternating component of the current signal.

Abstract: This disclosure provides an implantable medical device comprising a power source a therapy module that includes at least one energy storage component, and a charging module coupled between the power source and the therapy module. The charging module is configured to control charging of the at least one energy storage component of the therapy module. The charging module may be further configured to detect a condition indicative of improper charging, to detect a condition indicative of the implantable medical device being subjected to fields generated by an magnetic resonance imaging (MRI) device, and to terminate charging of the at least one energy storage component when both the condition indicative of improper charging and the condition indicative of the implantable medical device being subjected to fields generated by the MRI device are detected.

Abstract: Techniques for controlling charging of a high voltage therapy energy storage component are provided to reduce any undesirable impact from charging during unusual operating conditions. Unusual operating conditions may be caused by any of a number of external factors, including saturation of charging transformer core, circuit failures, capacitor mismatches, or the like, which may result in an unexpected power supply voltage drop or abnormally high currents through device components. An implantable medical device may comprise a power source, a therapy module that includes at least one energy storage component, and a charging module coupled between the power source and the therapy module. The charging module is configured to obtain a measurement representative of an average power drawn from the power source and to terminate charging of the at least one energy storage component based at least on the measurement representative of an average power drawn from the power source.

Abstract: A method and device for delivering ventricular resynchronization pacing therapy in conjunction with electrical stimulation of nerves which alter the activity of the autonomic nervous system is disclosed. Such therapies may be delivered by an implantable device and are useful in preventing the deleterious ventricular remodeling which occurs as a result of a heart attack or heart failure. The device may perform an assessment of cardiac function in order to individually modulate the delivery of the two types of therapy.

Abstract: A method of treating patients in need of heart beat regulation or for preventing the development of cardiac arrhythmias, wherein the patients are not suffering from cardiac illness, by regulating heart beat using a cardiac pacemaker and reducing patient risk of developing a ventricular arrhythmia, wherein the risk is associated with an underlying patient illness, and wherein the patient does not suffer from cardiac illness, by regulating the patient's heart beat using a cardiac pacemaker.

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: 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 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: This invention provides methods for non-invasively monitoring patients with congestive heart failure (CHF) and for reporting and/or warning of changes in the patients' status. The methods gather physiological data and combine the data into parameters by which the severity of CHF can be judged. Preferred parameters include periodic breathing and heart rate variability. This invention also provides systems for carrying out these methods which permit patients to engage in their normal daily activities. Preferably, physiological data analysis is performed by a portable electronic unit carried by the patients.

Abstract: An implantable cardioverter defibrillator evaluates the hemodynamic stability of an arrhythmia to determine whether or not to defibrillate. The device obtains cardiac pressure and cardiac impedance data and evaluates a phase relationship between these parameters. Hemodynamically stable rhythms will result in an out of phase relationship.

Abstract: Vector selection is automatically achieved via a thoracic or intracardiac impedance signal collected in a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

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 invention relates to a service unit (30) having an interface (54) for receiving data from a personal medical device, an analysis unit (52) connected to the interface (54) for analyzing data received from the personal medical device (10), and an aftercare appointment determination unit (54) for determining a particular next aftercare appointment at least on the basis of data received from a particular personal medical device (10).

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: An implantable medical device such as a cardiac pacemaker or implantable cardioverter/defibrillator with the capability of storing body temperature measurements taken periodically and/or when triggered by particular events.

Abstract: A wearable therapeutic device to facilitate care of a subject is provided. The wearable therapeutic device can include a garment having a sensing electrode. The garment includes at least one of an inductive element and a capacitive element, and a controller identifies an inductance of the inductive element or a capacitance of the capacitive element, and determines a confidence level of information received from the sensing electrode based on the inductance or the capacitance. The wearable therapeutic device also includes an alarm module coupled with the controller and configured to provide a notification to a subject based on the confidence level.

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.

Abstract: A system and method provide for detecting atrial arrhythmias within an implantable medical device capable of sensing and pacing at least an atrium of a heart. Arrhythmia of the atrium is detected. In response to detecting atrial arrhythmia, delivery of pacing signals to the atrium is inhibited under certain conditions. While delivery of the pacing signals to the atrium is inhibited, the detected arrhythmia of the atrium is confirmed during a period of further evaluation. Delivery of pacing signals to the atrium is enabled upon ceasing of the atrial arrhythmia. Inhibiting delivery of the pacing signals during atrial arrhythmia evaluation advantageously provides for an increase in the rate at which the detected arrhythmia is confirmed.

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: 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: The presence of a cardiac pulse in a patient is determined by evaluating physiological signals in the patient. In one embodiment, a medical device evaluates optical characteristics of light transmitted into a patient to ascertain physiological signals, such as pulsatile changes in general blood volume proximate a light detector module. Using these features, the medical device determines whether a cardiac pulse is present in the patient. The medical device may also be configured to report whether the patient is in a VF, VT, asystole, or PEA condition, in addition to being in a pulseless condition, and prompt different therapies, such as chest compressions, rescue breathing, defibrillation, and PEA-specific electrotherapy, depending on the analysis of the physiological signals. Auto-capture of a cardiac pulse using pacing stimuli is further provided.

Abstract: An exemplary 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: An active implantable medical device for cardiac resynchronization therapy with effort based rate-responsive pacing is described. The device calculates a rate-responsive stimulation frequency based on output signal of an effort sensor between a base frequency (fbase) and a maximum frequency (fmax). The device determines a target stimulation frequency based on the difference between a first frequency and the maximum frequency (fmax). The first frequency is the higher frequency of the base frequency (fbase) and the spontaneous frequency of the patient. The device calculates a stimulation frequency that has an immediate increase in the pacing rate from the higher of the initial value of the current stimulation frequency, or the spontaneous frequency to the target stimulation frequency, within a predetermined time, or a predetermined number of cardiac cycles. A plurality of consecutive effort zones (Z1-Z4) is defined over the extent of the dynamic range of the output signal of the effort sensor.

Abstract: A medical device includes an energy storage device, a plurality of electrodes, a memory, a switching circuit, and a processing module. The energy storage device stores electrical energy for delivery of defibrillation therapy to a heart. The memory stores N therapy configurations, each of the N therapy configurations defining which of the plurality of electrodes are used to deliver defibrillation therapy and further defining a waveform to be applied during delivery of defibrillation therapy. The switching circuit is configured to connect the plurality of electrodes to the energy storage device.

Abstract: A device includes an energy storage device, a plurality of electrodes, a memory, a switching circuit, and a processing module. The energy storage device stores electrical energy for delivery of defibrillation therapy to a heart. The memory stores N therapy configurations that define which of the plurality of electrodes are used to deliver defibrillation therapy and a waveform to be applied during delivery of defibrillation therapy. The switching circuit connects the plurality of electrodes to the energy storage device.

Abstract: An implantable medical device includes a multi-axial acceleration sensor and an evaluation unit connected thereto. The evaluation unit is configured to (1) split the accelerometer output signal into at least two signal components, one of which is associated with a right-ventricular contraction and another of which is associated with a left-ventricular contraction; (2) detect events in the signal components, and/or determine signal features therein; and (3) determine at least one characteristic value K by evaluating the signal components, and/or the events and/or signal features therein.

Abstract: An implantable cardioverter defibrillator includes a communication interface operable to receive a communication signal from an external programmer. The communication signal includes a command to switch the ICD from a first mode to a second mode. A processor is in electrical communication with the communication interface and configured to switch the ICD between the first and second modes. A battery is configured to supply low DC voltage. A converter is configured to convert the low DC voltage to a high DC voltage. An energy storage capacitor is electrically coupled to the converter and configured to store a therapeutic energy or high DC voltage including at least 15 joules. The second mode includes activating the converter to convert the low DC voltage to the high DC voltage and storing the therapeutic energy or at least 15 joules within the energy storage capacitor during a period of time of the second mode.

Abstract: Systems and methods involve automatic activation, de-activation or modification of therapies or other medical processes based on brain state. A medical system includes a sensor system having one or more sensors configured to sense signals related to the brain state of the patient. A brain state analyzer detects various brain states, including sleep stage and/or brain seizures. A controller uses the brain state detection information to control a medical system configured to perform at least one respiratory or cardiac process. Methods involve sensing signals related to brain state and determining the brain state of a patient based on the sensed signals. At least one respiratory or cardiac medical process is controlled based on the patient's brain state.

Abstract: A computer-assisted method for quantitative characterization and treatment of ventricular fibrillation includes acquiring a time series of a ventricular fibrillation (VF) signal using a probe from a patient experiencing VF, subtracting the mean from the time series of the VF signal, calculating a cumulative VF signal after the mean is subtracted from the time series of the VF signal, segmenting the cumulative VF signal by a plurality of sampling boxes, calculating the root-mean-square of the cumulative VF signal as a function of the sampling box size , extracting an exponent of the root-mean-square of the cumulative VF signal as a function of the sampling box size, applying electrical defibrillation to the patient if the exponent is below a predetermined value, and applying cardiopulmonary resuscitation (CPR) to the patient if the exponent is above a predetermined value.