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: A system and method for controlling cardiac ventricular tachyarrhythmias by acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient. A CVP index is derived based on the pressure signal. The onset of a ventricular tachyarrhythmia episode is detected based on a cardiac rates signal. The CVP index and the rate signal are monitored and, responsive to the rate signal indicating a sustained tachycardia episode during the episode monitoring period, anti-tachycardia therapy selectively withheld and the episode monitoring period is extended based on the CVP index.

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: An analyte measuring system has an implantable medical device having a signal source arranged for generating a current signal and electrodes for applying the current signal to a surrounding tissue in a subject body. The device measures a resulting voltage signal with the electrodes and calculates an impedance signal therefrom. The system comprises a signal processor arranged for generating an estimate of a concentration of an analyte in the tissue based on a spectrum analysis of the determined impedance signal.

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: A method and device are described for delivering cardiac therapy in which an implantable device for delivering such cardiac therapy is additionally configured to detect the presence of inflammation. Upon detection of inflammation, the device may be configured to modify its delivery of therapy in various ways and/or to communicate the information to an external agent for other types of interventions.

Abstract: A system and method for administering a therapeutic treatment to the heart includes a pressure sensor positioned in the pulmonary artery, an implantable medical device located remotely from the sensor, and communication means for communicating pressure data from the pressure sensor to the implantable medical device. The system includes a control module operatively coupled to the implantable medical device. The control module is adapted for comparing the pulmonary arterial pressure data to a pre-programmed value, adjusting an operating parameter of the implantable medical device based on the relationship of the pulmonary arterial pressure to the pre-programmed value, and repeating this process until the relationship between the pulmonary arterial pressure data and the pre-programmed value is such that no adjustment is necessary.

Abstract: A medical device identifies a hemodynamically unstable arrhythmia based upon optical hemodynamic sensor signals. The optical hemodynamic sensor includes a light source for transmitting light corresponding to first and second wavelengths through a blood perfused tissue of a patient and a light detector for generating optical signals corresponding to an intensity of the detected light at the first and second wavelengths. At a low motion period for the patient, optical signals are obtained from the optical hemodynamic sensor and are analyzed to determine a baseline motion level for the patient. Subsequent signals obtained from the optical hemodynamic sensor are compared to the baseline motion levels, with only those signals corresponding to periods where motion does not exceed the baseline level of motion being further analyzed to determine if they are consistent with a hemodynamically unstable arrhythmia.

Abstract: Systems and methods provide for coordinated cardiac pacing with delivery of cardiopulmonary resuscitation (CPR) to a patient. Managing cardiac pacing in a patient during a cardiac arrhythmia involves detecting a cardiac arrhythmia using a patient implantable medical device, prompting a cardiopulmonary resuscitation compression, and delivering, using the patient implantable medical device, a pacing pulse to a heart chamber in coordination with the compression prompt.

Abstract: A technique utilizing an endolymphatically implanted lead having one or more electrodes that may be used for sensing cardiac activity and/or delivering cardiac electrical stimulation by an implantable cardiac device. An electrode disposed in the thoracic duct is in close proximity to the left ventricle and generates an electrogram especially suitable for ischemia detection and/or discriminating between ventricular tachycardias and supraventricular tachycardias.

Abstract: A device for assisting a caregiver in delivering cardiac resuscitation to a patient, the device comprising a user interface configured to deliver prompts to a caregiver to assist the caregiver in delivering cardiac resuscitation to a patient; at least one sensor configured to detect the caregiver's progress in delivering the cardiac resuscitation, wherein the sensor is configured to provide a signal containing information indicative of ventilation; a memory in which a plurality of different prompts are stored, including at least one ventilation progress prompt to guide the rescuer's performance of ventilation; a processor configured to process the output of the sensor to determine a parameter descriptive of ventilation progress and to determine whether the ventilation progress prompt should be selected for delivery. Possible parameters descriptive of ventilation progress include ventilation rate, delivered tidal volume, and flow rate.

Abstract: At least one of a medical device, such as an implantable medical device, and a programming device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.

Abstract: An arrhythmia discrimination device and method involves receiving electrocardiogram signals and non-electrophysiologic signals at subcutaneous locations. Both the electrocardiogram signals and non-electrophysiologic signals are used to discriminate between normal sinus rhythm and an arrhythmia. An arrhythmia may be detected using electrocardiogram signals, and verified using the non-electrophysiologic signals. A detection window may be initiated in response to receiving the electrocardiogram signal, and used to determine whether the non-electrophysiologic signal is received at a time falling within the detection window. Heart rates may be computed based on both the electrocardiogram signals and non-electrophysiologic signals. The rates may be used to discriminate between normal sinus rhythm and an arrhythmia, and used to determine absence of an arrhythmia.

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.

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: A video display coupled to an automatic external defibrillator (AED) and capable of full-motion video can support added functionality of the AED. One advantage of the video display is that it can be used to present standby status information of the AED quickly to an AED operator while the AED is in a low power standby mode or non-operative state. The video display may present status information in response to touching the display or activating a button while the AED is in a non-operative state. When the AED is in an operative state, such as during a rescue, the display may comprise a graphical user interface that may be navigated using touch-screen technology or buttons built into the AED. During a rescue, the video display may present live or stored electrocardiograms (ECGs) and instructions for operating the AED.

Abstract: An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing.

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: The invention is directed techniques for coordinating telemetry of medical devices with magnetic resonance imaging (MRI) techniques. By coordinating telemetry of a medical device with the performance of MRI techniques with, the use of telemetry during MRI may be facilitated. In one example, information indicative of electromagnetic radiation bursts in MRI techniques can be communicated to the medical device prior to execution. In another example, the medical device may identify the electromagnetic radiation bursts, e.g., by measuring for the presence of such bursts. In either case, the medical device can adjust its telemetry to improve communication during MRI.

Abstract: Techniques for processing impedance data to provide an early warning for heart failure decompensation are described. An example device may be configured to measure intrathoracic impedance values, and increment an index when a determined impedance is less than a reference impedance. The incrementing may be based on the difference between the reference impedances and the determined impedance. In some examples, the amount of incrementing is reduced based on a variability of the impedances, or increased over time so long as the index remains above a threshold, e.g., zero. In some examples, the manner is which the reference impedances are determined changes over time to, for example, address rapid changes in impedance after device or system implantation. In some examples, the index is compared to a threshold to determine whether to provide an alert. In some examples, two thresholds are used to provide hysteresis.

Abstract: A device for the determination of at least one compression parameter during administration of cardiopulmonary resuscitation (CPR) on a patient comprising: a field generator, a field detector, and a processor. Position information and the compression parameter are determined from the field detected by the field detector. One of the field generator and the field detector is a position sensor and the other is a reference sensor.

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: The temperature of a patient is a significant predictor of death in heart failure patients. Temperature provides a window into the physiology of the patient's underlying condition and may be used as an early marker for CHF exacerbations. The patient's temperature is taken to form a time series of temperature values. In accordance with some embodiments, the time series of temperature values is converted to the frequency domain by, for example, a discrete Fourier Transform. The frequency domain representation then is analyzed for a marker indicative of the worsening condition of the patient. In accordance with other embodiments, the patient's time series of temperature values is analyzed for a marker using, for example, Cosinor analysis. In yet other embodiments, both the time and frequency domain temperature data is analyzed for markers of the patient's worsening medical condition.

Abstract: This document discusses, among other things, 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: A telemetric sensing system for monitoring physiological parameters for diagnosis and treatment of congestive heart failure in a patient. This system includes one or more implantable sensing devices implanted in a cavity of the patient's cardiovascular system, and a non-implantable reader unit. The implantable sensing device has an inductor and at least one sensor with an option of having electronic components, as well as a mechanism for anchoring the device inside the patient's body. The external readout device has at least one inductor coil with a telemetric device that provides for at least one of electromagnetic telecommunication and wireless powering of the sensing device. This wireless system provides a means for effective monitoring, management and tailoring of treatments for patients suffering from congestive heart failure as well as many other diseases.

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: 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: This document discusses, among other things, an apparatus comprising an implantable hemodynamic sensor circuit that provides a hemodynamic signal representative of mechanical function of a cardiovascular system of a subject and a controller circuit communicatively coupled to the hemodynamic sensor circuit. The controller circuit includes a detection module configured to detect an onset of tachyarrhythmia, a signal analyzer module configured to determine a measure of morphological variability of the hemodynamic signal during the episode of tachyarrhythmia, and a rhythm discrimination module configured to deem whether the tachyarrhythmia episode is indicative of ventricular tachycardia (VT) according to the measure of morphological variability.

Abstract: An implantable system senses a pulmonary artery pressure (PAP) signal using an implantable sensor placed in the pulmonary artery and isolates a plurality of signals from the PAP signal for diagnostic and/or therapeutic use. Each signal is extracted from the PAP signal using its known frequency characteristics and/or timing relationship with one or more detectable events.

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: An implantable cardiac stimulation and rhythm management device includes an impedance measuring circuit which determines a patient's intra-thoracic impedance and the resistance and reactance components of the impedance. The device includes a microcontroller which calculates a ratio (Z/R) which equals the reactance (Z) divided by the resistance (R). The microcontroller is configured to use the calculated ratios to establish a baseline intra-thoracic fluid level, an upper bound relative to the baseline, and a lower bound relative to the baseline, and to monitor the Z/R ratio relative to the baseline and upper and lower bounds. When the Z/R ratios are outside of the established bounds, operating parameters of the stimulation and rhythm management may be altered by the microcontroller.

Abstract: An implantable medical device such as a cardiac pacemaker or implantable cardioverter/defibrillator with the capability of receiving communications in the form of speech spoken by the patient. An acoustic transducer is incorporated within the device which along with associated filtering circuitry enables the voice communication to be used to affect the operation of the device or recorded for later playback.

Abstract: An implantable medical device comprises a hermetically sealed housing having a housing wall with an interior surface, and an ultrasonic acoustic transducer, the transducer comprising one or more piezoelectric discs fixed to the interior surface of the housing wall, such that the housing wall acts as a diaphragm in response to induced movement by the one or more piezoelectric material discs.

Abstract: An exemplary method includes detecting arrhythmia, detecting myocardial ischemia, determining whether the myocardial ischemia comprises local ischemia or global ischemia and, in response to the determining, calling for delivery of either a local ischemic anti-arrhythmia therapy or a global ischemic anti-arrhythmia therapy. Various other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A method of analysis of medical signals is presented which provides useful clinical information concerning the state of the myocardium during cardiopulmonary resuscitation (CPR). The analysis during CPR can be used to (i) identify the underlying rhythm, (ii) provide a measure of the efficacy of CPR, and (iii) to predict the outcome from a defibrillation shock.

Abstract: A method is provided for analyzing the condition of a patient to determine whether or not a defibrillation shock should be applied, without stopping CPR (primarily chest compressions). While chest compressions continue to be applied to the victim, the system differentiates between (1) a perfusing rhythm that has the capability of leading to a beating heart without a shock and (2) ventricular fibrillation (VF) which sometimes occurs in the presence of ventricular tachycardia (VT), in which there is no capability for leading to a beating heart without a shock. Defibrillation shocks should be applied only when needed and that is in the presence of VF and sometimes in the presence of VT.

Abstract: Systems and methods for detecting and measuring cardiac contractile function of a heart using an acceleration sensor unit inserted within the heart, such as within a vein of the cardiac wall are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart by inserting and positioning an implantable lead having an electrode near a cardiac wall as well as detecting mechanical events within the patient's heart by then inserting and positioning a cardiac motion sensor unit through the inner lumen of the implantable lead. Furthermore, the systems and methods do not require dedicated leads and may be used with preexisting implantable leads.

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: 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: Integrated devices for performing external chest compression (ECC) and defibrillation on a person and methods using the devices. Integrated devices can include a backboard, at least one chest compression member operably coupled to the backboard, and a defibrillator module operably coupled to the backboard. The integrated devices can include physiological sensors, electrodes, wheels, controllers, human interface devices, cooling modules, ventilators, cameras, and voice output devices. Methods can include defibrillating, pacing, ventilating, cooling, and performing ECC in an integrated, coordinated, and/or synchronous manner using the full capabilities of the device. Some devices include controllers executing methods for automatically performing the coordinated activities utilizing the device capabilities.

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: Devices and methods to reduce the incidence of both false positive and false negative detection of rhythm anomalies. Implantable devices that measure vascular pressure, vascular blood flow, tissue perfusion, and/or intracardial pressure provide feedback directly to the therapeutic device to improve aberrant rhythm detection.

Abstract: In a method and an apparatus for creating hemodynamic sensor signal templates using an implantable medical device connectable to a patient heart activity of the patient is sensed in order to identify a paste or sensed sequence of events of a heart cycle. Hemodynamic sensor signals for consecutive heart cycles are sensed and the sensed hemodynamic sensor signals for consecutive heart cycles are stored. The sensed sensor signals are classified dependent on at least one predetermined heart event sequence condition. A template may be created using the classified sensor signals.

Abstract: Modular electronic and/or combined electronic/mechanical apparatus for the detection, analysis, transmittal and delivery of tactile stimuli (touch). Sexual application is suggested.

Abstract: An adherent device to monitor and treat a patient comprises an adhesive patch to adhere to a skin of the patient. At least two electrodes are connected to the patch and capable of electrically coupling to the patient. Sensor circuitry is coupled to the at least two electrodes and configured to measure at least two of an electrocardiogram signal of the patient, a respiration signal of the patient or an activity signal of the patient. Therapy circuitry is coupled to the at least two electrodes and configured to deliver a high-energy shock therapy for cardioversion and/or defibrillation. A processor system comprising a tangible medium and coupled to the sensor circuitry and therapy circuitry, the processor is configured to generate a treatment signal to deliver the high-energy shock therapy in response to the at least two of the electrocardiogram signal, the respiration signal or the activity signal.

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: In general, the invention is directed to techniques for using an external defibrillator to detect a presence of an implantable medical device (IMD) implanted within a patient, and providing therapy to the patient through communication between the external defibrillator and the IMD. An external defibrillator provides prompts to a user of the external defibrillator to determine the presence of an IMD implanted within the patient. For example, the external defibrillator may prompt the user to visually inspect the patient's chest for signs that an IMD was implanted, such as a scar or raised portion of skin near the patient's clavicles. As another example, the external defibrillator may prompt the user to place a detection device on the patient's chest. The detection device may be coupled to the external defibrillator, and may employ a magnet to initiate telemetry by the IMD to detect the presence of the IMD.

Abstract: An apparatus for monitoring a patient's blood glucose level. The apparatus includes an implantable medical device having a controller and an implantable heart sounds sensor configured to transmit signals to the controller of the implantable medical device. The controller is configured to determine if a patient is hypoglycemic or hyperglycemic based on the signals from the heart sounds sensor. A method is also disclosed that includes sensing the patient's heart sounds, determining the amplitude of the S2 heart sound, determining the length of the interval from the S1 heart sound to the S2max heart sound, determining the length of the interval from the S1 heart sound to the S2end heart sound, and determining the patient's blood glucose status based on the patient's heart sounds.

Abstract: A method of automatically adjusting an electrode array to the neural characteristics of an individual patient is disclosed. By recording neural response to a predetermined input stimulus, one can alter that input stimulus to the needs of an individual patient. A minimum input stimulus is applied to a patient, followed by recording neural response in the vicinity of the input stimulus. By alternating stimulation and recording at gradually increasing levels, one can determine the minimum input that creates a neural response, thereby identifying the threshold stimulation level. One can further determine a maximum level by increasing stimulus until a predetermined maximum neural response is obtained.

Abstract: Apparatus and method for independently delivering a plurality of therapy programs in an implantable medical device. A therapy controller configures the device to generate independent pulse trains associated with a plurality of therapy programs and dynamically configures the electrodes to deliver the independent pulse trains to the patient. Once configured, the implantable medical device delivers the plurality of therapy programs to the patient wherein the therapy programs may overlap in time.