Abstract: A combination cardiac stimulator for CRT stimulation and CCM stimulation, which is connected to a rhythm evaluation unit which can either detect a sinus rhythm that is present, or classify an atrial arrhythmia, and which comprises an additional therapy selection unit, wherein the therapy selection unit selects the delivery of either CRT therapy or CCM therapy on the basis of the classification of the atrial rhythm such that CRT therapy is preferred in the case of sinus rhythm, and CCM therapy is delivered in the case of atrial arrhythmia.

Abstract: A gene regulatory system detects ischemia events and is capable of delivering a biologic therapy in response to the detection of an ischemic event or the reception of a command. The biologic therapy protects the heart from ischemic damage by regulating the expression of an exogenously introduced gene product. In one embodiment, the gene regulatory system includes an implantable system that emits at least one gene regulatory signal in response to the detection of the ischemic event or the reception of the command. The gene regulatory signal directly or indirectly regulates gene expression of the gene product.

Abstract: One way in which cardiac resynchronization therapy may be delivered is to only deliver paces to the left ventricle. If left ventricular pacing is inhibited during a cardiac cycle, it may be desirable to deliver a right ventricular safety pace to prevent asystole. Methods and devices for implementing right ventricular safety pacing in the context of multi-site left ventricular-only pacing are described.

Abstract: A system and method for identifying patients with asynchronous ventricular contractions due to abnormal electro-mechanical coupling and computing optimal pacing parameters for restoring synchronous contractions is disclosed. Such patients may have normal intra-ventricular and inter-ventricular conduction and cannot be identified from intrinsic conduction data alone such as QRS width. Techniques for computing optimal resynchronization pacing in order to compensate for abnormal electro-mechanical coupling are also described.

Abstract: Various systems, methods, devices and arrangements are implemented for use in pacing of the heart. One implementation is directed to methods and systems for determining a pacing location in the right ventricle of a heart and near the His bundle. A pacing signal is delivered to the location in the right ventricle. The pacing signal produces a capture of a left ventricle. Properties of the capture are monitored. Results of the monitored capture are used to assess the effectiveness of the delivered pacing signal as a function of heart function. The heart function can be, for example, at least one of a QRS width, fractionation and a timing of electrical stimulation of a late activation site of a left ventricle relative to the QRS.

Abstract: A medical system comprises a plurality of electrodes; at least one sensor configured to output at least one signal based on at least one physiological parameter of a patient; and a processor. The processor is configured to control delivery of stimulation to the patient using a plurality of electrode configurations. Each of the electrode configurations comprises at least one of the plurality of electrodes. For each of the electrode configurations, the processor is configured to determine a first response of target tissue to the stimulation based on the signals, and a second response of non-target tissue to the stimulation based on the signals. The processor is also configured to select at least one of the electrode configurations for delivery of stimulation to the patient based on the first and second responses for the electrode configurations. As examples, the target tissue may be a left ventricle or vagus nerve.

Abstract: Cardiac arrhythmias are classified based on the morphology of the arrhythmia episode beats. Templates are formed using morphological features of the cardiac beats of the episode. The arrhythmia episode is classified as a monomorphic tachyarrhythmia or polymorphic tachyarrhythmia based on the one or more templates. The arrhythmia episode may be classified based on a number templates formed from the arrhythmia episode. The templates are formed by determining a measure of similarity between morphological features of a cardiac beat to a template. The similarities can be determined based on a pairing rule that determines which beat morphologies are compared. Selection of therapy for treating the arrhythmia episode may depend on the historical success of a therapy at mitigating previous arrhythmias of the same type as the arrhythmia episode.

Abstract: A method and system of post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by the medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, and determines, in response to the transmitted sensing data, whether one of the sensed ventricular events and the sensed atrial events is initiating conduction of a heart associated with the stored sensing data.

Abstract: An implantable medical device can establish one or more artificial conduction pathways during tachyarrhythmia. Withdrawal of the artificial conduction pathway may help self-terminate the tachyarrhythmia, or may pre-condition the tachyarrhythmia to be more favorable for receiving an anti-tachyarrhythmia therapy, such as anti-tachyarrhythmia pacing, defibrillation shock therapy, or cardioversion. This can help provide enhanced anti-tachyarrhythmia therapy.

Abstract: A medical device containing a device for connecting the medical device to a substrate, for furnishing electrical impulses from the medical device to the substrate, for ceasing the furnishing of electrical impulses to the substrate, for receiving pulsed radio frequency fields, for transmitting and receiving optical signals, and for protecting the substrate and the medical device from currents induced by the pulsed radio frequency fields. The medical device contains a control circuit comprised of a parallel resonant frequency circuit.

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

Abstract: An apparatus example comprises a cardiac signal sensing circuit configured to provide a sensed cardiac signal representative of cardiac depolarization events of a subject, a sampling circuit coupled to the cardiac signal sensing circuit, a therapy circuit, and a controller communicatively coupled to the sampling circuit and the therapy circuit. The controller includes a detection module configured to detect tachyarrhythmia using the cardiac signal and a signal analysis module configured to establish significant points (SPs) of the sampled cardiac signal, estimate heart rate during the tachyarrhythmia using the SPs, and provide an indication of whether noise is present in the cardiac signal using the SPs. The controller is configured to select a therapy for delivery by the therapy circuit in response to the tachyarrhythmia detection and to modify the selected therapy according to the heart rate estimation and the noise indication.

Abstract: A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. One lead includes a telescopic microcable including multiple distinct bare areas that form a network of stimulation electrodes. The microcable includes a diameter providing for insertion of the microcable within smaller portions of the coronary vein system. The diameter may be selected from between 0.5 and 2 French. The microcable includes multiple strands twisted together. At least some strands incorporate either a core of radiopaque material wrapped by a sheath of mechanically durable material, or vice-versa. The bare areas that form the network of stimulation electrodes are provided on outward-facing portions of at least some of the strands.

Abstract: An implantable cardiac stimulation device provides measurement of intrinsic heart activity metrics while sustaining pacing of the heart. The device includes a pulse generator that delivers pacing pulses to a first chamber of corresponding chambers of a heart, and a sensing circuit that senses a conducted evoked response of a second chamber of the corresponding chambers of the heart in response to the pacing pulse to provide an electrical signal representing the conducted evoked response. The device further includes a measuring circuit that measures a metric of the electrical signal to approximate a corresponding metric of an intrinsic electrical feature of the second chamber.

Abstract: A pacing system delivers cardiac protection pacing to protect the heart from injuries. The pacing system receives a set of inputs and calculates parameters for delivering optimized cardiac protection pacing tailored for different stress levels. The system automatically adjusts heart rate to optimize cardiac protection pacing in a closed-loop system. In one embodiment, a method for delivering pacing pulses for cardiac protection is provided. Intrinsic atrioventricular (AV) intervals are sensed. The intrinsic AV interval and a predetermined equation relating the AV interval to an optimal AV delay are used to provide a maximum positive rate of left ventricular pressure change during systole. An AV delay is calculated using a predetermined percentage of the optimal AV delay to deliver ventricular pacing pulses to provide a desired level of stress for cardiac protective pacing therapy (CPPT) to provide a cardiac conditioning therapy to improve autonomic balance.

Abstract: The disclosure described techniques for associating therapy adjustments with intended patient posture states. The techniques may include receiving a patient therapy adjustment to a parameter of a therapy program that defines electrical stimulation therapy delivered to the patient, identifying a posture state of the patient, and associating the patient therapy adjustment with the posture state when the patient therapy adjustment is within a range determined based on stored adjustment information for the identified posture state.

Abstract: Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

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: Methods for treating atrial arrhythmias can involve configuring an implantable arrhythmia treatment device. A device can be configured after implantation when the patient is fully conscious and after any pain suppression medication has worn off. The device is caused to apply a phased unpinning far field therapy to the patient in response to detection of an arrhythmia via a far field configuration of electrodes. An indication of a pain sensation of the patient and the effectiveness of the treatment in response to the therapy can then be received. In response, at least one of a set of therapy parameters is adjusted and the steps are repeated until it is determined that an effective treatment is provide at a pain sensation that is tolerable to the patient. The device is then programmed to automatically treat arrhythmias detected in the patient with the determined set of therapy parameters.

Abstract: Various techniques for delivering atrial pacing and supraventricular stimulation to achieve a desired ventricular rate and/or cardiac output are described. One example method described includes delivering a pacing signal configured to cause an atrial depolarization to a heart of a patient, wherein the atrial depolarization results in an associated refractory period during the cardiac cycle, and delivering a signal to a supraventricular portion of the heart of the patient subsequent to the atrial refractory period and during a ventricular refractory period of the cardiac cycle.

Abstract: A method and system are disclosed for setting the pacing parameters utilized by an implantable cardiac device in delivering cardiac resynchronization therapy. The system may, in different embodiments, be implemented in programming of the implantable device and an external programmer in communication therewith or in the programming of the implantable device by itself. The selection of the pacing parameters is based at least in part upon measurements of intrinsic cardiac conduction parameters. Among the pacing parameters which may be selected in this way are the atrio-ventricular delay interval used in atrial-tracking and AV sequential pacing modes and the biventricular offset interval.

Abstract: Various embodiments of the present invention are directed to, or are for use with, an implantable system including a lead having multiple electrodes implantable in a patient's left ventricular (LV) chamber. In accordance with an embodiment, the patients LV chamber is paced at first and second sites within the LV chamber using a programmed LV1-LV2 delay, wherein the LV1-LV2 delay is a programmed delay between when first and second pacing pulses are to be delivered respectively at the first and second sites within the LV chamber. Evoked responses to the first and second pacing pulses are monitored for, and one or more LV pacing parameter is/are adjusted and/or one or more backup pulse is/are delivered based on results of the monitoring.

Abstract: In an implantable medical device and a method for monitoring ventricular synchronicity of a heart. In particular, impedance signals are measured and an occurrence of a notch is detected in the impedance signal coincident with a period including a change from rapid to slow filling of a ventricle. The notch is indicated by a first positive slope change in a negative slope in a predetermined time window during a diastolic phase of a cardiac cycle. A degree of synchronicity is determined based on the notch feature, wherein a decreasing notch feature indicates an increased degree of synchronicity in the filling phase of the ventricles.

Abstract: An implantable medical device provides ventricular pacing capabilities and optimizes AV intervals for multiple purposes. In general, intrinsic conduction is promoted by determining when electromechanical systole (EMS) ends and setting an AV interval accordingly. EMS is determined utilizing various data including QT interval, sensor input, and algorithmic calculations.

Abstract: A method and apparatus for treating or preventing neurocardiogenic syncope is disclosed. Upon detection of bradycardia or a drop in blood pressure indicating the onset of syncope, electrostimulation pulses are delivered during the heart's refractory period. The pulses are non-excitatory but increase myocardial contractility and thereby increase cardiac output.

Abstract: According to various method embodiments, a person is indicated for a therapy to treat a cardiovascular disease, and the therapy is delivered to the person to treat the cardiovascular disease. Delivering the therapy includes delivering a vagal stimulation therapy (VST) to a vagus nerve of the person at a therapeutically-effective intensity for the cardiovascular disease that is below an upper boundary at which upper boundary the VST would lower an intrinsic heart rate during the VST.

Abstract: An active medical device such as pacemaker, defibrillator and/or resynchronizer with automatic optimization of atrioventricular delay is disclosed. The active medical device is adapted for analyzing a signal delivered by a hemodynamic sensor such as an endocardial acceleration sensor, whose variation according to the AVD is represented by a sigmoid function. An optimal AVD is searched by: applying a reference AVD (XC), at least one left AVD (XL, XLL) and at least one right AVD (XR, XRR); measuring the corresponding hemodynamic parameters (Y1, Y2, Y3, Y4, Y5); evaluating the second derivative of the function at the respective points (XC, Y3; XL, Y2, XR, Y4) of the characteristic corresponding to the reference AVD, to the left AVD and to the right AVD; estimating from these values of second derivatives, the position of an intermediate point of the characteristic for which the second derivative is zero or minimum, and determining the corresponding AVD for that intermediate point as the optimal AVD.

Abstract: A vagus nerve neurostimulator system with multiple patient-selectable modes for treating chronic cardiac dysfunction is provided. An implantable neurostimulator includes a pulse generator coupled to a therapy lead terminated by a pair of helical electrodes positioned over a cervical vagus nerve. The pulse generator is configured to deliver through the helical electrodes continuously-cycling, intermittent and periodic electrical stimulation that is parametrically defined to bi-directionally propagate through nerve fibers in the cervical vagus nerve. The implantable neurostimulator includes a magnetic switch configured to switch the pulse generator between a plurality of operating modes that are each separately selectable in response to a unique and remotely-applied magnetic signal. An external controller includes patient-actuatable controls configured to enable selection of one of the operating modes of the pulse generator.

Abstract: A medical device having a unit in communication with ancillary components wherein the unit and the ancillary components each have a sensory output through which communication with a user of the medical device may be accomplished and to which the user's attention directed. In one aspect, the medical device is an AED unit with associated pads, which are an ancillary component electrically connected to the AED unit. In this illustrative example, the unit has a unit sensory output (e.g., a speaker or a display), and the pads, and/or their associated packaging, have an ancillary sensory output (e.g. a speaker or display). Programming in the AED unit controls output to the sensory outputs such that the user's attention is directed between the unit and the ancillary components.

Abstract: A first fluid status indicator of a pulmonary fluid status associated with pulmonary edema and a second fluid status indicator of a non-pulmonary fluid status can be used to provide an alert or to control a therapy for pulmonary edema. Additionally, intermittent cardiac blood volume redistribution therapy can be used to provide cardiac conditioning in heart failure patients.

Abstract: A pacing system computes optimal cardiac resynchronization pacing parameters using intrinsic conduction intervals. In various embodiments, values for atrio-ventricular delay intervals are each computed as a function of an intrinsic atrio-ventricular interval and a parameter reflective of an interventricular conduction delay. Examples of the parameter reflective of the interventricular conduction delay include QRS width and interval between right and left ventricular senses.

Abstract: At least one of a left intraventricular conduction defect, a right intraventricular conduction defect, or no intraventricular conduction defect can be detected using received intrinsic cardiac information from a subject, and a first atrioventricular (AV) delay can be calculated using a first relationship if the left intraventricular conduction defect or no intraventricular conduction defect is detected, or a second AV delay can be calculated using a second relationship if the right intraventricular conduction defect is detected.

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

Abstract: An embodiment includes a main lead assembly having a proximal portion adapted for connection to a device and a distal portion adapted for placement in a coronary sinus, the distal portion terminating in a distal end for placement proximal a left ventricle. Additionally, the main lead assembly includes a left ventricular electrode located at its distal end which is adapted to deliver cardiac resynchronization therapy to reduce ventricular wall stress. The main lead assembly also includes a fat pad electrode disposed along the main lead assembly a distance from the distal end to position the fat pad electrode proximal to at least one parasympathetic ganglia located in a fat pad bounded by an inferior vena cava and a left atrium. The fat pad electrode is adapted to stimulate the parasympathetic ganglia to reduce ventricular wall stress.

Abstract: This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when pacing is changed from the normal operating mode to a stress augmentation mode. The pacing mode controller suspends the change from the normal operating mode to the stress augmentation mode when a condition to prevent the change is detected.

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

Abstract: Embodiments of the present invention are directed to implantable systems, and methods for use therewith, that monitor and modify a patient's arterial blood pressure without requiring an intravascular pressure transducer. In accordance with an embodiment, for each of a plurality of periods of time, there is a determination one or more metrics indicative of pulse arrival time (PAT), each of which are indicative of how long it takes for the left ventricle to generate a pressure pulsation that travels from the patient's aorta to a location remote from the patient's aorta. Based on the one or more metrics indicative of PAT, the patient's arterial blood pressure is estimated. Changes in the arterial blood pressure are monitored over time. Additionally, the patient's arterial blood pressure can be modified by initiating and/or adjusting pacing and/or other therapy based on the estimates of the patient's arterial blood pressure and/or monitored changes therein.

Abstract: An apparatus comprises an electrostimulation energy storage capacitor, a circuit path that provides pacing stimulation from the capacitor through the load, a constant current neural stimulation circuit that is switchable into the circuit path to provide neural stimulation through the load and switchable out of the circuit path to provide the pacing stimulation through the load, and a control circuit configured to selectively enable delivery of the pacing stimulation or the constant current neural stimulation.

Abstract: Various aspects provide an implantable device. In various embodiments, the device comprises at least one port, where each port is adapted to connect a lead with an electrode to the device. The device further includes a stimulation platform, including a sensing circuit connected to the at least one port to sense an intrinsic cardiac signal and a stimulation circuit connected to the at least one port via a stimulation channel to deliver a stimulation signal through the stimulation channel to the electrode. The stimulation circuit is adapted to deliver stimulation signals through the stimulation channel for both neural stimulation therapy and CRM therapy. The sensing and stimulation circuits are adapted to perform CRM functions. The device further includes a controller connected to the sensing circuit and the stimulation circuit to control the neural stimulation therapy and the CRM therapy. Other aspects and embodiments are provided herein.

Abstract: Refractory period stimulation (RPS) disclosed herein includes apparatus and methods to enhance cardiac performance by delivering monophasic stimulation pulses during the refractory period. The disclosure describes several system level improvements to RPS that include one or more of the following: (i) Delivery of RPS therapy pulses at multiple sites in an automatically alternating way to avoid increasing demand at any one location for prolonged periods of time. (ii) Delivery of RPS therapy pulses at multiple sites to determine one or more optimal electrode configurations for chronic RPS therapy delivery. (iii) Use of separate electrode(s) for sensing ventricular activity to properly time and adjust the application of RPS thereby avoiding limitations associated with electrode polarization that occurs due to the amount of energy delivered during the RPS. (iv) Use of a relatively long active recharge pulse at the RPS stimulation electrodes to remove the undesirable effects of polarization.

Abstract: Methods for timing pacing pulses in an implantable single chamber pacemaker create a simulated, or virtual chamber in order to apply dual chamber-type algorithms and modes. For example, a virtual atrium may be constructed based on information provided by the ventricle, that is, the timing of actual intrinsic ventricular events, and the timing of paced ventricular events, both of which may be sensed as ventricular depolarization by electrodes of the implanted system.

Abstract: Apparatus and methods enable robust, reliable control for implantable medical devices, including cardiac pacemakers, defibrillators and cardiac resynchronization devices. Integrated circuits in the devices have minimized interfaces, can derive power from the interface signals, and have high voltage and latch-up protection. A device lead has a power generation circuit and a switching circuit using cascaded PMOS transistors for operating with a stable voltage despite fluctuations in the supplied voltage. The lead has control electronics that provide a very low impedance between an electrode and a lead conductor during most of the duration of a pacing pulse, but during a brief initial portion of the pacing pulse, provide a very high impedance to permit charging up a power supply that is local to the control electronics. A method of stabilizing the external impedance and a system for fault detection and fault recovery for an implantable device are also provided.

Abstract: A pacemaker comprises an implantable pacemaker housing and a pacemaker electrode provided to transmit stimulation impulses, and a detector for a current which can be induced by an external magnetic field and flowing through the pacemaker electrode. A circuit element is provided to interrupt this inducible current.

Abstract: An implantable cardiac pacing device delivering minimum ventricular pacing and an associated method control intervals timed by the device during sensing and pacing. An atrial-only pacing mode is set in response to sensing intrinsic ventricular events in the ventricular chamber. A first post-ventricular atrial refractory period is set following each of a plurality of ventricular events sensed in the ventricular chamber, and atrial events each being sensed during first post-ventricular atrial refractory periods are detected. A second post-ventricular atrial refractory period is set in response to detecting the atrial events each being sensed during the first post-ventricular atrial refractory period.

Abstract: An implantable medical device (IMD) having a hermetic housing formed from a case and a cover each having an exterior surface and an interior surface. An IMD component is mounted to the interior surface of the cover and has an electrical contact. A hybrid circuit is assembled in the case. The IMD component electrical contact is electrically coupled to the to the hybrid circuit assembled in the case.

Abstract: An implantable device for facilitating control of electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator also includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials.

Abstract: While a cardiac device is in AAI(R) mode, a ventricular channel is monitored for a premature ventricular contraction (PVC). In response to detecting a PVC while the device is in AAI(R) mode, a refractory period is started in an atrial channel to prevent a retrograde atrial event that may occur due to the PVC from resetting an atrial escape interval (AEI). Additionally, during such a relative refractory period in the atrial channel, the atrial channel is monitored for a retrograde atrial event that may occur due to the PVC. If a retrograde atrial event is detected, then the refractory period in the atrial channel is terminated, and an antegrade conduction restoration interval (ACRI) is started. The ACRI is a programmed period that specifies how long to wait after a retrograde atrial event is detected before pacing the atrium.

Abstract: A lead wire and a pacemaker using the lead wire are disclosed. The lead wire, comprising: a lead body and a lead electrode at an end of the lead body, the lead electrode being electrically connected with the lead body, the lead electrode comprising a carbon nanotube structure, the carbon nanotube structure comprising at least one carbon nanotube film, the carbon nanotube structure having an electrode tip away from the lead body, and the electrode tip being in linear contact with an organ, wherein the electrode tip functions as a stimulating electrode, the at least one carbon nanotube film acts as a sensing electrode.

Abstract: The invention relates to a system (100) for visualizing a cardiac parameter at a plurality of positions in a myocardium and at a plurality of stress levels, the system comprising a determination unit (110) for determining a value of the cardiac parameter at a position from the plurality of positions in the myocardium and at a stress level from the plurality of stress levels on the basis of stress level cardiac functional data, and a visualization unit (120) for visualizing the determined value of the cardiac parameter by displaying a point in a viewing plane. The visualized points are defined by their polar coordinates in a polar coordinate system in the viewing plane. A radial coordinate of the point visualizes the determined value of the cardiac parameter. An angular coordinate of the point visualizes an angular coordinate of the position in the myocardium in a cylindrical coordinate system. Thus, the system allows easy numerical comparison of local myocardial contractions at different stress level values.