Abstract: Systems and methods for monitoring patient vasoactivity are discussed. An exemplary patient monitor system includes a sensor circuit configured to generate a heart sound (HS) metric using a HS signal sensed from a patient, and a vasoactivity monitor configured to monitor vasoactivity, such as degree of vasoconstriction or vasodilation, using the HS metric. The system can provide the monitored vasoactivity to a user to alert patient hemodynamic responses to vasoactive drugs, or initiate or adjust a vasoactive therapy according to the vasoactivity. The system may use the monitored vasoactivity to detect a medical condition such as worsening heart failure, pulmonary edema, or syncope.

Abstract: The present disclosure provides systems and methods for generating burst waveforms. An implantable neurostimulation system includes an implantable stimulation lead including a plurality of contacts, and an implantable pulse generator communicatively coupled to the stimulation lead. The pulse generator is configured to generate a waveform including a burst that includes a leading anodic pulse followed by alternating cathodic pulses and anodic pulses, each cathodic pulse in the burst having a greater amplitude than the previous cathodic pulse.

Abstract: Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a first monitor and a controller. The pulse generator is adapted to generate a neural stimulation signal for a neural stimulation therapy. The neural stimulation signal has at least one adjustable parameter. The first monitor is adapted to detect an undesired effect. In some embodiments, the undesired effect is myocardial infarction. The controller is adapted to respond to the first monitor and automatically adjust the at least one adjustable parameter of the neural stimulation signal to avoid the undesired effect of the neural stimulation therapy. Other aspects are provided herein.

Abstract: An extra-cardiovascular medical device is configured to select a capacitor configuration from a capacitor array and deliver a low voltage, pacing pulse by discharging the selected capacitor configuration across an extra-cardiovascular pacing electrode vector. In some examples, the medical device is configured to determine the capacitor configuration based on a measured impedance of the extra-cardiovascular pacing electrode vector.

Abstract: A system for computational localization of fibrillation sources is provided. In some implementations, the system performs operations comprising generating a representation of electrical activation of a patient's heart and comparing, based on correlation, the generated representation against one or more stored representations of hearts to identify at least one matched representation of a heart. The operations can further comprise generating, based on the at least one matched representation, a computational model for the patient's heart, wherein the computational model includes an illustration of one or more fibrillation sources in the patient's heart. Additionally, the operations can comprise displaying, via a user interface, at least a portion of the computational model. Related systems, methods, and articles of manufacture are also described.

Abstract: A leadless cardiac pacemaker device is configured to provide HIS bundle pacing and contains a housing having a tip, a first electrode arranged on the housing in the vicinity of the tip, the first electrode being configured to engage with intra-cardiac tissue, and a second electrode arranged on the housing at a distance from the tip of the housing. A processor is enclosed in the housing and operatively connected to the first electrode and the second electrode. The processor is configured to process a reception signal received by at least one of the first electrode and the second electrode and to generate a pacing signal to be emitted using at least one of the first electrode and the second electrode.

Abstract: The present technology is generally directed to implantable medical device systems configured to provide cardiac resynchronization therapy. In some embodiments, the implantable medical device system comprises a housing, electrodes carried by the housing, a transducer configured to produce input voltage signals in response to ultrasound energy, and a circuit configured to provide, via an electrical pathway, output voltage signals based on the input voltage signals. The circuit comprises a movable switch, and a slew rate detector configured to detect whether a voltage rate of an individual pulse of the input voltage signals exceeds a predetermined threshold voltage rate. The circuit is configured to move the switch to an open position in response to the detected voltage rate exceeding the predetermined threshold voltage rate.

Abstract: A magnetic resonance apparatus includes a scanner, a patient accommodating region, a patient support apparatus which can be moved within the patient accommodating region and a patient communication device. The patient communication device includes at least one communication element which has a radio-frequency transmitter.

Abstract: A device and method for monitoring a human heart rate to determine whether a bradyarrhythmia event has occurred and if so determined, an electrocardiogram (ECG) rhythm strip is begun to be generated on a continuous basis in real-time and wirelessly communicated to a third party such as the patient's treating physician. The method comprises a pair of sensors for detecting heart rate, each sensor in contact with a respective ear of the patient. If a bradyarrhythmia event is determined; applying an anticholinergic medication to the conjunctiva of at least one eye and releasing ammonia vapor for inhalation by the patient.

Abstract: An input device includes two conductors that are sewn onto a fiber sheet and an output unit configured to determine an impedance variation in a predetermined area on the basis of a voltage value between the two conductors to which a high-frequency current is applied.

Abstract: A variety of methods, medical devices, responder network servers, emergency services interfaces and call center related processes are described that can help improve responder networks designed to get a medical device such as an automated external defibrillator and/or volunteer responders to the scene of a potential medical incident.

Abstract: An implantable lead includes a lead body, electrical conductors, and a lead anchor. The lead body includes an electrode segment configured to be positioned along a pericardial membrane of a heart and including a plurality of electrodes configured to at least one of sense electrical signals from the heart or deliver therapy to the heart. The electrical conductors extend through the lead body between distal and proximal ends of the lead body, and are configured to electrically couple the electrodes to a pulse generator. The lead anchor is configured to be secured to a chest wall. The electrical conductors extend through the lead anchor, and the electrode segment extends from the lead anchor to the pericardial membrane. The electrode segment includes a transition portion that is configured to extend a depth into a mediastinum and a contoured portion to extend alongside and curve about the pericardial membrane.

Abstract: System and methods for delivering defibrillator incident information to a PSAP in real-time during emergency use of an AED are described. Such information is utilized by a telecommunicator at a PSAP to provide better guidance to volunteer caregivers during potential cardiac arrest incidents. In another aspect the AED's current instruction state and optionally the time in that state is provided to the PSAP.

Abstract: A neurostimulation system comprises a sensor and a control system. The sensor is configured to detect a cardiac physiological measure of a patient. The control system is programmed to monitor, via the sensor, the cardiac physiological measure during the treatment. The control system is further programmed to detect a change in the cardiac physiological measure during the treatment. The control system is further programmed to determine, based on the detected change in the cardiac physiological measure, a first transition time in a duty cycle of a neurostimulation signal delivered to the patient where the neurostimulation signal transitions between a stimulation OFF period and a stimulation ON period.

Abstract: The invention provides methods related to improving heart function.

Abstract: The present disclosure concerns a circuit (302) for controlling two switches (210-1, 210-2) electrically in series, including sensors (310-1, 310-2) of voltages across the switches and a circuit (310) of comparison of signals output by said sensors, one at least of said sensors being an active circuit.

Abstract: A method for assessing a patient's suitability for receiving a vagus nerve stimulation therapy includes receiving a criterion regarding the patient's suitability for receiving a vagus nerve stimulation therapy; controlling a stimulation device to provide stimulation to a vagus nerve of the patient; receiving, from a sensor, response data indicative of a physiological response of the patient to the stimulation of the vagus nerve; and determining the patient's suitability for receiving the vagus nerve stimulation therapy based on the criterion and the physiological response of the patient to the stimulation.

Abstract: An image processing apparatus for evaluating cardiac images and a ventricular status identification method are provided. In the method, a region of interest (ROI) is determined from multiple target images, a variation in grayscale values of multiple pixels in the ROIs of each target image is determined, and one or more representative images are obtained according to the variation in the grayscale values. The target image is related to the pixels within an endocardial contour of a left ventricle. A boundary of the ROI is approximately located at two sides of a bottom of the endocardial contour. The ROI corresponds to a mitral valve. The variation in the grayscale values is related to a motion of the mitral valve. The representative image is for evaluating a status of the left ventricle.

Abstract: A method and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a first sensing vector and a second sensing vector, identifying the cardiac event as one of a shockable event and a non-shockable event in response to first processing of a first interval sensed along the first sensing vector during a predetermined sensing window and a second interval simultaneously sensed along the second sensing vector, performing second processing of the first interval and the second interval, different from the first processing, in response to the cardiac event being identified as a shockable event, and determining whether to delay identifying the cardiac event being shockable in response to the second processing of the first interval and the second interval.

Abstract: A method and a system for processing an electroencephalogram (EEG) signal are provided. The method for processing the EEG signal includes: performing a spike detection on the EEG signal to obtain a spike distribution waveform, performing an instantaneous frequency oscillation energy analysis on the EEG signal to obtain multiple energy distribution waveforms; performing a complexity analysis on the EEG signal to obtain a complexity change waveform, obtaining a determination result of a specified neural waveform based on the spike distribution waveform, the energy distribution waveforms, and the complexity change waveform, and outputting the determination result.

Abstract: Implantable medical devices (IMD), such as but not limited to leadless cardiac pacemakers (LCP), subcutaneous implantable cardioverter defibrillators (SICD), transvenous implantable cardioverter defibrillators, neuro-stimulators (NS), implantable monitors (IM), may be configured to communicate with each other. In some cases, a first IMD may transmit instructions to a second IMD. In order to improve the chances of a successfully received transmission, the first IMD may transmit the instructions several times during a particular time frame, such as during a single heartbeat. If the second IMD receives the message more than once, the second IMD recognizes that the messages were redundant and acts accordingly.

Abstract: The present disclosure relates generally to systems, methods, and devices for interpreting neural signals to determine a desired movement of a target, transmitting electrical signals to the target, and dynamically monitoring subsequent neural signals or movement of the target to change the signal being delivered if necessary, so that the desired movement is achieved. In particular, the neural signals are decoded using a feature extractor, decoder(s) and a body state observer to determine the electrical signals that should be sent.

Abstract: A medical device is utilized to monitor physiological parameters of a patient and capture segments of the monitored physiological parameters. The medical device includes circuitry configured to monitor one or more physiological parameters associated with the patient and an analysis module that includes a buffer and a processor. The buffer stores monitored physiological parameters and the processor analyzes the monitored physiological parameters and triggers capture of segments from the buffer in response to a triggering criteria being satisfied. The analysis module selects a pre-trigger duration based at least in part on the triggering criteria.

Abstract: A method of treating a patient having a blood pressure comprises delivering neuromodulation therapy to sustain or increase the blood pressure. The neuromodulation therapy includes placing a sympathetic therapy electrode in a posterior portion of a blood vessel and stimulating at least one extravascular cardiac sympathetic nerve fiber using said electrode.

Abstract: An assembly for placement of a cardiac, aortic or arterial implant. The assembly includes an insertion sheath of an introducer or of a delivery catheter, which is of a size smaller than that of an introducer, intended to be introduced into an artery of a human body. The metal support of an electrode of the external cardiac stimulator being integrated into the insertion sheath of a peripheral venous or arterial accessory catheter, or a sleeve around the accessory catheter, which is introduced into the peripheral vein or artery of a patient. The sheath of the accessory catheter or the sleeve is therefore directly in contact with a peripheral vein or artery of the patient.

Abstract: Provided is a method for displaying electrocardiogram (ECG) data for the detection of myocardial ischemia, wherein a map is configured in the form of concentric circles using ST segments obtained through ECG measurement such that the inner circle consists of a “depression” origin and the outer circle consists of an “elevation” origin so as to display by connecting graphs or dots according to the measured ECG values of limb leads (frontal plane leads; I to aVF) and chest leads (precordial plane leads; V1 to V6), and the intuitive confirmation of the presence of subendocardial ischemia or transmural injury is enabled through the map, thereby making it possible to quickly and accurately recognize the patient's conditions and inducing prompt treatment.

Abstract: A method is provided for treating a patient with an arrhythmia. In some embodiments, the method collects a first patient arrhythmia cardiogram from the patient. The method identifies a first target location and a first ablation pattern associated with a first library arrhythmia cardiogram that is similar to the first patient arrhythmia cardiogram. The method then performs a first ablation near the first target location, factoring in the first ablation pattern, and after the ablation, collects a second patient arrhythmia cardiogram of the patient. The method continues to identify a second target location and a second ablation pattern associated with a second library arrhythmia cardiogram that is similar to the second patient arrhythmia cardiogram. The second library arrhythmia cardiogram is identified, in part, based on ablation characteristics of the first ablation. The method then performs a second ablation near the second target location, factoring in the second ablation pattern.

Abstract: Implantable devices and systems include one or more leads adapted to be emplaced in the internal thoracic vein (ITV) of a patient. The lead may include features to adapt the lead for such placement. An associated device for use with the lead may include operational circuitry adapted for use with a lead having an electrode for sensing and/or therapy purposes coupled thereto. Methods for implantation and use of such devices and systems are disclosed as well.

Abstract: A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.

Abstract: A stretch-measurement probe includes an elongate outer sleeve, expansion feature associated with a distal portion of the outer sleeve, and an elongate inner rod disposed at least partially within the outer sleeve. The expansion feature is configured to allow a longitudinal distance between a proximal end of the outer sleeve and the distal end of the outer sleeve to be varied.

Abstract: Devices, systems and methods are disclosed for treating a variety of diseases and disorders that are primarily or at least partially driven by an imbalance in neurotransmitters in the brain, such as asthma, COPD, depression, anxiety, epilepsy, fibromyalgia, and the like. The invention involves the use of an energy source comprising magnetic and/or electrical energy that is transmitted non-invasively to, or in close proximity to, a selected nerve to temporarily stimulate, block and/or modulate the signals in the selected nerve such that neural pathways are activated to release inhibitory neurotransmitters in the patient's brain.

Abstract: The present invention is directed to transcutaneous electrical nerve stimulation (TENS) devices which utilize novel stimulation waveforms and novel arrangements of TENS electrodes to improve the efficiency of power consumption while enhancing therapeutic effects.

Abstract: One aspect is a system for reception or emission of an electrical signal from or into the human or animal body, comprising at least one insulated electrical conductor; a sleeve-shaped electrode that is electrically connected to the electrical conductor and includes an internal side, an external side, and a channel, wherein the channel defines a longitudinal axis along which the conductor is arranged. According to one embodiment, the conductor extends without interruption along the entire area of the electrode, and the electrode further includes a slit that extends from the internal side to the external side of the electrode and in which the conductor is appropriately arranged in the slit such that the electrode forms a direct durable mechanical and electrical connection to the conductor.

Abstract: In some implementations, a system enables an administrator to customize a set of rules to dynamically adjust the configuration and output of an application provided to users. A configuration interface for setting rules that dynamically adjust output of an application is provided. Data indicating one or more rules are received through the configuration interface. Activity data indicating user interaction with the application or sensor data for at least some of a plurality of users of the application are then received from multiple client devices. A determination relating to the activity data satisfying at least one condition or trigger is then made. Instructions to adjust output of the application according to one or more system actions of the one or more rules are then communicated to client devices associated with the users in the first subset of the plurality of users.

Abstract: The invention relates to an active implantable medical device comprising a processing unit able to be alternately operated during a predetermined period of activity and on standby during a standby period in a cyclical manner, and means for acquiring data relating to physiological and/or physical activity. The device also comprises means for calculating a frequency analysis of the data acquired, said calculating means being capable of successively perform part of the frequency analysis during periods of activity of the processing unit.

Abstract: Systems, devices, and methods for monitoring and assessing immunotherapy toxicity are discussed. An exemplary system receives physiologic information from a patient using an ambulatory medical device. In response to an immunotherapy such as CAR T-cell therapy, the system determines a toxicity indication using the received physiologic information. A therapy can be initiated or adjusted using the toxicity indication.

Abstract: Method for recovering and stabilizing normal heart rate of patients suffering in or being inclined to having atrial fibrillation, comprising the step of sensing primary electrical pulses generated in the right atrium (1), of generating artificial electrical stimulation pulses coordinated with the sensed pulses and stimulating therewith the portion of the left atrium (9) which is remote from the right atrium (1), whereby increasing the areas of the heart muscles that can be reached during a simulation pulse within a predetermined period of time.

Abstract: A device and method for monitoring the heart rate of a patient for a bradyarrhythmia event and thereafter administering medications is disclosed. The method comprises the steps of monitoring heart rate via at least one sensor secured to the neck or head of a patient; and if a bradyarrhythmia event is determined; applying an anticholinergic medication to the conjunctiva of at least one eye and releasing ammonia vapor in close proximity to the nostrils of a patient.

Abstract: Systems, devices, and methods for monitoring for atrial capture are disclosed. Such a method, for use within an implantable system including an atrial leadless pacemaker (aLP) and a ventricular leadless pacemaker (vLP), includes storing within a memory of the vLP a paced atrial activation morphology template corresponding to far-field atrial signal components expected to be present in a vEGM sensed by the vLP when an atrial pacing pulse delivered by the aLP captures atrial tissue. The vLP senses a vEGM and compares a morphology of a portion of the sensed vEGM to the paced atrial activation morphology template to determine whether a match therebetween is detected. Additionally, the vLP determines whether atrial capture occurred or failed to occur (responsive to an atrial pacing pulse), based on whether the vLP detects a match between the morphology of a portion of the sensed vEGM and the paced atrial activation morphology template.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. An embodiment of a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to stimulate a His bundle, and a cardiac event detector to detect a His-bundle activity within a time window following an atrial activity. The cardiac event detector may use a cross-chamber blanking, or an adjustable His-bundle sensing threshold, to avoid or reduce over-sensing of far-field atrial activity and inappropriate inhibition of HBP therapy. The electrostimulation circuit may deliver HBP in the presence of the His-bundle activity. The system may further recognize the detected His-bundle activity as either a FFPW or a valid inhibitory event, and deliver or withhold HBP therapy based on the recognition of the His-bundle activity.

Abstract: Apparatus and methods for determining positioning of a energy delivery element include deploying a energy delivery element at a treatment site proximal to a vessel wall; using a multi-region pressure sensing apparatus to sense pressures applied in a plurality of directions about the energy delivery element; and determining an orientation of the energy delivery element based on the pressures measured in the plurality of directions about the energy delivery element.

Abstract: In an embodiment, an electrogram (EGM) processing system provides, for display by a head-mounted display (HMD) worn by a user, a holographic rendering of intracardiac geometry. The HMD also displays an electrogram waveform. The EGM processing system determines a gaze direction of the user by processing sensor data from the HMD. The HMD displays a marker overlaid on the electrogram waveform at a location based on an intersection point between the gaze direction and the electrogram waveform. The EGM processing system determines a measurement of the electrogram waveform using the location of the marker. The HMD displays the measurement of the electrogram waveform.

Abstract: A medical device includes: a case at least a portion of which functions as a first electrode; a second electrode disposed in a header coupled to the case; a core assembly, the core assembly including operational circuitry enclosed within a core assembly housing, wherein the case includes the core assembly housing; and a battery assembly, the battery assembly including a battery enclosed within a battery housing, where the case further comprises the battery housing; where the operational circuitry is configured to drive a regulated voltage onto the case.

Abstract: A probe generates location signals, and has an electrode at a distal end which acquires from heart chamber surface positions electrical signals due to a conduction wave traversing the surface. A processor derives LATs from the electrical signals, calculates a first time difference between LATs at a first pair of positions and a second time difference between LATs at a second pair of positions. The processor calculates first and second LAT-derived distances as products of the first and second time differences with a conduction wave velocity, identifies an arrhythmia origin at a surface location where a first difference in distances from the location to the first pair of the positions is equal to the first LAT-derived distance, and a second difference in distances from the location to the second pair of the positions is equal to the second LAT-derived distance, and marks the origin on a surface representation.

Abstract: Apparatus and methods are described, including a stent configured to be placed in a lumen. The stent includes a generally cylindrical stent body including a plurality of struts, at least one electrode post protruding from the stent body, and a plurality of antenna posts protruding longitudinally from an end of the stent body. The antenna posts are longitudinally separated from the electrode post. An antenna is disposed annularly on the antenna posts, such that the antenna posts separate the antenna from the end of the stent body, and at least one electrode is coupled to the stent by being placed on the electrode post. Additional embodiments are also described.

Abstract: An implantable medical device implements a special mode of operation, such as a mode of electrical stimulation therapy, during conditions where there may be an increased likelihood that a device reset will occur. The implantable medical device recovers from the device reset by copying values that specify the special mode and that are stored in a non-volatile memory to an operating memory. The special mode is implemented after the device reset has occurred by using the values copied to the operating memory. One version of the special mode is an MRI mode that allows the implantable medical device to safely operate during an MRI scan. The fields of the MRI scan may trigger a device reset, but the MRI mode values are copied from the non-volatile memory to the operating memory, and the MRI mode is implemented after the reset by using the values copied to the operating memory.

Abstract: A method that electrically stimulates a heart muscle to alter the ejection profile of the heart, to control the mechanical function of the heart and reduce the observed blood pressure of the patient. The therapy may be invoked by an implantable blood pressure sensor associated with a pacemaker like device. In some cases, where a measured pretreatment blood pressure exceeds a treatment threshold, a patient's heart may be stimulated with an electrical stimulus timed relative to the patient's cardiac ejection cycle. This is done to cause dyssynchrony between at least two cardiac chambers or within a cardiac chamber, which alters the patient's cardiac ejection profile from a pretreatment cardiac ejection profile. This has the effect of reducing the patient's blood pressure from the measured pretreatment blood pressure.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: An active implantable medical device for neurostimulation therapy is disclosed. The device produces stimulation pulse sequences generated continuously in succession during activity periods separated by intermediate inactivity periods during which no stimulation is issued. An input signal, provided by a physiological sensor, representative of cardiac activity and/or of the patient's hemodynamic status is received by circuitry. The circuitry further provides for dynamic control of the neurostimulation therapy, wherein the length of activity periods is modulated based on the current value level of the control parameter compared to a threshold. The duration of the next period of inactivity is calculated by the circuitry at the end of each activity period to maintain a constant duty cycle ratio between periods of activity and periods of inactivity.

Abstract: A polymerizable unit that yields an electrochemically responsive polymer (advantageously pyrrole) is anchored by polymerization within a polycaprolactone matrix to form an electroactive scaffold upon which cells can be cultured and in which the micro- and nano-topological features of the polycaprolactone matrix are preserved. A scaffold manufactured in accordance with the preferred embodiment can support Schwann cells, which produce nerve growth factor when electrically stimulated. Nerve growth factor has been demonstrated to promote the regeneration of nerve tissue. By implanting the scaffold on which Schwann cells have been cultured into damaged nerve tissue and applying a voltage across the scaffold, nerve growth factor is produced, thereby promoting repair of the damaged nerve tissue.