Abstract: Disclosed is a device, method and computer readable media for determining the adequacy of Cardiopulmonary Resuscitation (CPR). The device comprises an electrical source generator, an electrical signal sensor receiving a signal from the electrical source generator and a microprocessor. The microprocessor determines changes in impedance of the patient based on the signal received from the electrical signal sensor. Software executing on the microprocessor determines at least one of intrathoracic volume, change in intrathoracic volume, rate of compression, depth of compression, respiratory volume, and respiratory rate based on the change of impedance of the patient and outputs a signal indicating the adequacy of ventilation and compressions.

Abstract: Provided herein are implantable systems that include an implantable photoplethysmography (PPG) sensor, which can be used to obtain an arterial PPG waveform. In an embodiment, a metric of a terminal portion of an arterial PPG waveform is determined, and a metric of an initial portion of the arterial PPG waveform is determined, and a surrogate of mean arterial pressure is determined based on the metric of the terminal portion and the metric of the initial portion. In another embodiment, a surrogate of diastolic pressure is determined based on a metric of a terminal portion of an arterial PPG waveform. In a further embodiment, a surrogate of cardiac afterload is determined based on a metric of a terminal portion of an arterial PPG waveform.

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: Waveforms are digitally sampled and compressed for storage in memory. The compression of the data includes generating a truncated entropy encoding map and using the values within the map to obtain good compression. An encoder further sub-selects values to be encoded and values to remain unencoded to provide an overall compression of the data.

Abstract: An exemplary implantable medical device includes an electrode lead connector having at least one electrical contact for connection of an electrode lead, and an analyzing unit which is connected to the electrode lead connector and is designed to detect and evaluate a response signal present at the at least one electrical connector in response to known electromagnetic irradiation. The analyzing unit may compare a signal modulation resulting from an electromagnetic irradiation of the electrode lead with a reference signal modulation. The electrode lead may be classified as defective if the deviation exceeds a threshold deviation. If a second antenna is available, the analyzing unit may compare response signals resulting from electromagnetic irradiation of the electrode lead and the second antenna. If the ratio of response signals exceeds a threshold, the electrode lead may be classified as defective.

Abstract: An implantable cardiac rhythm management (CRM) device delivers a chronic therapy while detecting an ischemic state. When the ischemic state indicates the occurrence of an ischemic event, the implantable CRM device delivers a post-ischemia therapy. The post-ischemia therapy and the chronic therapy are adjusted using feedback control with the ischemic state and parameters indicative of the effectiveness of the post-ischemic therapy and the effectiveness of the chronic therapy as inputs.

Abstract: An inventive system and method de-passivates a direct current (DC) power source of an Automatic External Defibrillator (AED), such as an AED lithium battery. The system includes a main processor and standby processor. The standby processor monitors the age and usage of the battery. Based on the status of the monitored parameters, the system executes a conditioning discharge to remove a layer of salt crystals on the DC power source.

Abstract: This document relates to systems and techniques for the treatment of a cardiac arrest victim via electromagnetic stimulation of physiologic tissue.

Abstract: This document relates to systems and techniques for the treatment of a cardiac arrest victim via electromagnetic stimulation of physiologic tissue.

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: 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: An implanted electrical signal generator delivers a novel exogenous electrical signal to a vagus nerve of a patient. The vagus nerve conducts action potentials originating in the heart and lungs to various structures of the brain, thereby eliciting a vagal evoked potential in those structures. The exogenous electrical signal simulates and/or augments the endogenous afferent activity originating from the heart and/or lungs of the patient, thereby enhancing the vagal evoked potential in the various structures of the brain. The exogenous electrical signal includes a series of electrical pulses organized or patterned into a series of microbursts including 2 to 20 pulses each. No pulses are sent between the microbursts. Each of the microbursts may be synchronized with the QRS wave portion of an ECG. The enhanced vagal evoked potential in the various structures of the brain may be used to treat various medical conditions including epilepsy and depression.

Abstract: A medical device is disclosed that includes one or more treatment electrodes, one or more sensors, and one or more controllers connected to the one or more treatment electrodes and one or more sensors. The medical device also includes one or more response mechanisms connected to the one or more controllers. The one or more controllers are configured to receive input from the one or more response mechanism and are also configured to determine whether a patient wearing the medical device actuated the one or more response mechanisms based, at least in part, on the input received from the one or more response mechanisms. In some disclosed embodiments, the medical device is a wearable defibrillator.

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: 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: 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: Embodiments of the invention are related to an implantable medical system, amongst other things. In an embodiment, the invention includes a processor, an electrical sensor, and a temperature sensor. The processor is configured to monitor myocardial electrical activity with input from the electrical sensor; identify myocardial electrical activity indicative of an arrhythmia, measure temperature of blood in the coronary venous system with input from the temperature sensor; determine if the arrhythmia is hemodynamically stable or hemodynamically unstable based on the temperature of blood in the coronary venous system, and initiate high-voltage shock therapy if the arrhythmia is hemodynamically unstable. Other embodiments are also included herein.

Abstract: Systems and methods are provided for reducing heating within pacing/sensing leads of a pacemaker or implantable, cardioverter-defibrillator that occurs due to induced loop currents during a magnetic resonance imaging (MRI) procedure, or in the presence of other sources of strong radio frequency (RF) fields. For example, bipolar coaxial leads are described herein wherein the ring conductor of the lead is disconnected from the ring electrode in response to detection of MRI fields so as to convert the ring conductor into an RF shield for shielding the inner tip conductor of the lead so as to reduce the strength of loop currents induced therein and hence reduce tip heating.

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 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: Embodiments relate to an implantable cardiac system, including a housing, electronic circuitry for controlling one or more of power management, processing unit, information memory and management circuit, sensing and simulation output. The system also includes diagnosis and treatment software for diagnosing health issues, diagnosing mechanical issues, determining therapy output and manage patient health indicators over time, a power supply system including at least one rechargeable battery, a recharging system, an alarm (or alert) system to inform patient of energy level and integrity of system, communication circuitry, one or more electrodes for delivering therapeutic signal to a heart and one or more electrodes for from delivering electrocardiogram signal from the heart to the electronic circuitry. The present embodiments further include a body orientation unit to determine body position and use same to control therapy.

Abstract: A resuscitation system that includes at least two defibrillation electrodes configured to be applied to the exterior of the chest of a patient for delivering a defibrillation shock, a source of one or more ECG signals from the patient, a defibrillation circuit for delivering a defibrillation shock to the defibrillation electrodes, a control box that receives and processes the ECG signals to determine whether a defibrillation shock should be delivered or whether CPR should be performed, and that issues instructions to the user either to deliver a defibrillation shock or to perform CPR, wherein the determination of whether CPR should be performed and the instructions to perform CPR can occur at substantially any point during a rescue.

Abstract: Apparatus for diastole trimming including a controller for producing a diastole ending signal, and one or more leads connected to the controller, for carrying the signal to lead connections to a heart, characterized by the controller detecting when a left ventricle (LV) of the heart is mostly full, and producing the diastole ending signal such that the diastole duration is trimmed. Apparatus for diastole trimming including a controller for producing a diastole ending signal, and a connection to a pacemaker, characterized by the controller having decision rules for indicating to the pacemaker when to fire and end the diastole. A method of programming a pacemaker characterized by increasing cardiac output by trimming duration of diastole. A method for increasing cardiac output including producing a signal to trim diastole duration, thereby increasing heart rate (HR) and increasing a product of stroke volume (SV) times HR. Related apparatus and methods are also described.

Abstract: A system for regulating or modulating cardiac therapy using brain state information. The modulation may include suppressing standard, prescribed cardiac therapy for a period of time or it may involve modulating the type of cardiac therapy delivered In another embodiment, a system is provided for determining whether a cardiac event is categorized as neurologically matched, and, if so, modulating the therapeutic output to the heart.

Abstract: A system for regulating or modulating cardiac therapy using brain state information. The modulation may include suppressing standard, prescribed cardiac therapy for a period of time or it may involve modulating the type of cardiac therapy delivered In another embodiment, a system is provided for determining whether a cardiac event is categorized as neurologically matched, and, if so, modulating the therapeutic output to the heart.

Abstract: A device for assisting a caregiver in delivering therapy to a patient, the device comprising a user interface configured to deliver prompts to a caregiver to assist the caregiver in delivering therapy to a patient; at least one sensor configured to detect the caregiver's progress in delivering the therapy, wherein the sensor is other than an electrode in an electrical contact with the body; a memory in which a plurality of different prompts are stored; a processor configured to determine which of the different prompts should be selected for delivery based on the progress detected by the sensor.

Abstract: Methods for evaluating tissue motion of a tissue location, e.g., a cardiac location, via external continuous field tomography are provided. Aspects of the methods include generating at least one substantially linear continuous field gradient across the tissue location of interest, and using a resultant signal from a sensing element stably associated with the tissue location to evaluate motion of the tissue location. Also provided are systems, devices and related compositions for practicing the subject methods. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.

Abstract: A medical device for use with a patient is described. The medical device includes a component for administering a treatment to the patient or receiving data of the patient. The component is configured to operate according to an internal setting. The medical device also includes a user interface through which a user can modify the internal setting, as well as a settings signature generator for generating a settings signature that represents a present state of the internal setting. A gateway is also provided for communicating a version of the settings signature out of the medical device.

Abstract: A defibrillator for external application to a patient. The defibrillator includes a power storage unit for supplying a defibrillation shock. The power storage unit has a capacitor unit encompassing at least one capacitor. In order to adjust a defibrillation treatment to different patients, the defibrillator advantageously comprises several different capacitor units which have a capacity adapted to various patient impedances and are or can be coupled in a replaceable manner to the defibrillator.

Abstract: Electrocardiogram wave data in which a component of cardiac massage is removed from the electrocardiogram wave data is generated, so that the electrocardiogram wave at the time of cardiopulmonary resuscitation is identified. An electrocardiogram wave processing system of obtaining and processing the electrocardiogram wave data includes a wave identification unit that identifies an electrocardiogram wave from the obtained electrocardiogram wave data, a feature selection unit that selects a feature pattern including a feature when a cardiac massage has been performed with respect to the electrocardiogram wave data identified by the wave identification unit, a generation unit that generates a component of the cardiac massage using the feature pattern selected by the feature selection unit, and a removal unit that removes, from the obtained electrocardiogram wave data, the component of the cardiac massage generated by the generation unit.

Abstract: Methods and/or devices for initiating an automatic adjustment of arrhythmia detection parameters (e.g., upon delivery of cardiac therapy after detection of VT/VF).

Abstract: An implantable medical device for monitoring tissue perfusion that includes a light source emitting light having a light wavelength corresponding to a blue to ultraviolet light spectrum and a light detector receiving light emitted by the light source and scattered by a volume of body tissue. The light detector emits a signal correlated to the received light wavelength, and a processor receives the signal from the light detector and determines a patient condition in response to the signal.

Abstract: A method of automatically determining which type of treatment is most appropriate for (or the physiological state of) a patient. The method comprises transforming one or more time domain measurements from the patient into frequency domain data representative of the frequency content of the time domain measurements; processing the frequency domain data to form a plurality of spectral bands, the content of a spectral band representing the frequency content of the measurements within a frequency band; forming a weighted sum of the content of the spectral bands, with different weighting coefficients applied to at least some of the spectral bands; determining the type of treatment (or physiological state) based on the weighted sum.

Abstract: An automatic external defibrillator including: a sensor for detecting when a rescuer is delivering a CPR chest compression to the patient; electrodes for application to the thorax of the patient for delivering a defibrillation shock to the patient and for detecting an ECG signal; defibrillation circuitry for delivering a defibrillation shock to the electrodes; and a processor and associated memory for executing software that controls operation of the defibrillator. The software provides: ECG analysis for analyzing the ECG signal to determine if the cardiac rhythm is shockable; CPR detection for analyzing the output of the sensor to determine when a CPR chest compression has been delivered, and integration of the ECG analysis and CPR detection so that the determination of whether the cardiac rhythm is shockable is based only on time periods of the ECG signal during which there has not been a CPR chest compression delivered.

Abstract: This disclosure relates to fault tolerant instantiations of a cardiac therapy delivery device such as an implantable cardiac stimulator (e.g., an implantable pulse generator, IPG, and/or an implantable cardioverter-defibrillator, ICD) coupled to an implantable physiologic sensor (IPS). According to the disclosure delivery of cardiac pacing and/or cardioversion-defibrillator therapy delivery can cause errors in output signals from an IPS. Resolution of such errors involves selectively energizing (or disconnecting the output signal from) the IPS during pacing and/or defibrillation therapy delivery. Programmable signal “blanking” in lieu of or in addition to the foregoing also improves the integrity of the output signal (i.e., continuously energize the IPS and ignore parts of the output signal). An ICD having a transient weakness in an insulated conductor used for the IPS signal can likewise have the IPS de-energized and/or blank the IPS output signal during high voltage therapy delivery.

Abstract: An implanted electrical signal generator delivers a novel exogenous electrical signal to a vagus nerve of a patient. The vagus nerve conducts action potentials originating in the heart and lungs to various structures of the brain, thereby eliciting a vagal evoked potential in those structures. The exogenous electrical signal simulates and/or augments the endogenous afferent activity originating from the heart and/or lungs of the patient, thereby enhancing the vagal evoked potential in the various structures of the brain. The exogenous electrical signal includes a series of electrical pulses organized or patterned into a series of microbursts including 2 to 20 pulses each. No pulses are sent between the microbursts. Each of the microbursts may be synchronized with the QRS wave portion of an ECG. The enhanced vagal evoked potential in the various structures of the brain may be used to treat various medical conditions including epilepsy and depression.

Abstract: The invention relates to methods and systems for determining phase-specific parameters of a physiological variable, and a related computer program and a related machine-readable storage medium, which are usable in particular to determine parameters of physiological variables that are subject to circadian variation. To this end, phase-specific parameters of a physiological variable X(t) are determined by calculating, at least for a portion of values x lying in a specifiable time period, a mean g(x|?) in each case of values X(t+?) for which X(t)=x applies for their predecessors, ? describing a time interval, and determining the phase-specific parameters by evaluating the mean g(x|?).

Abstract: Embodiments include a cardiac rhythm management system having a lead that includes an omni-directional pressure sensor that is configured to resist tissue in-growth and provide reliable and consistent pressure readings from within a patient's vasculature. Embodiments of the cardiac rhythm management lead may also include a variety of pacing and shocking electrodes.

Abstract: At least one aspect is directed to a wearable treatment device that includes a cardiac sensing electrode, a treatment electrode, a user interface, and a sensor. The cardiac sensing electrode detects cardiac information, and the treatment electrode applies treatment to the subject. The user interface receives quality of life information from the subject, and the sensor detects subject activity and wellness information. A controller coupled with the cardiac sensing electrode, the treatment electrode, the user interface, and the sensor receives the detected cardiac information, the quality of life information, and the detected subject activity and wellness information, and determines that treatment is to be applied to the body of the subject based upon the detected cardiac information.

Abstract: A sterile device immersed in a sterile buffer and a method for providing same. The sterile device may be a medical device such as a biosensor having a biomolecule as a sensing element such as, for example, a glucose oxidase enzyme. The buffer may be a bicarbonate solution. Both the device and the buffer may be packaged and stored over long term while maintaining sterilization. The sterilization method may comprise a combination of gaseous, liquid and light sterilization.

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: Systems and methods for sensing external magnetic fields in implantable medical devices are provided. One aspect of this disclosure relates to an apparatus for sensing magnetic fields. An apparatus embodiment includes a sensing circuit with at least one inductor having a magnetic core that saturates in the presence of a magnetic field having a prescribed flux density. The apparatus embodiment also includes an impedance measuring circuit connected to the sensing circuit. The impedance measuring circuit is adapted to measure impedance of the sensing circuit and to provide a signal when the impedance changes by a prescribed amount. According to an embodiment, the sensing circuit includes a resistor-inductor-capacitor (RLC) circuit. The impedance measuring circuit includes a transthoracic impedance measurement module (TIMM), according to an embodiment. Other aspects and embodiments are provided herein.

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: An external automatic defibrillator including an attachment device that can be externally attached and carried by a patient, an identification device for detecting an abnormal event in the cardiac activity, which can be treated by an electric shock, as well as a defibrillator allowing to exert a shock upon the patient after having detected the abnormal event. In order to ensure reliable functioning over a longer period of time, the identification device is configured so that the identification device can detect an abnormal event in an interval of not more than 90 seconds or one minute.

Abstract: Methods for evaluating motion of a cardiac tissue location, e.g., heart wall, are provided. In the subject methods, timing of a signal obtain from a strain gauge stably associated with the tissue location of interest is employed to evaluate movement of the cardiac tissue location. Also provided are systems, devices and related compositions for practicing the subject methods. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.

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

Abstract: 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: 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 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: A method for improving the cardiac output of a patient who is suffering from pulseless electrical activity or shock and yet still displays some myocardial wall motion including sensing myocardial activity to determine the presence of residual left ventricular pump function having a contraction or ejection phase and a filling or relaxation phase. In such cases, a compressive force is repeatedly applied to the chest based on the sensed myocardial activity such that the compressive force is applied during at least some of the ejection phases and is ceased during at least some of the relaxation phases to permit residual cardiac filling, thereby enhancing cardiac output and organ perfusion. Also incorporated may be a logic circuit capable of utilizing multiple sensing modalities and optimizing the synchronization pattern between multiple phasic therapeutic modalities and myocardial residual mechanical function.