Abstract: A measurement system, comprises a sensor wire and a transceiver unit. The sensor wire comprises an insertable portion configured to be inserted in a blood vessel of a patient's body and a sensor disposed within the insertable portion at a distal end of the sensor wire. The sensor is configured to measure a variable inside the patient. The transceiver unit comprises: a housing adapted to be connected to a proximal end of the sensor wire; and a first communication module within the housing adapted to wirelessly communicate by a communication signal with an external second communication module in order to transfer information to the external second communication module. The communication signal, including sensor values, is generated by the transceiver unit and transferred as a data stream. The housing is configured to remain external to the patient's body.

Abstract: A method of analyzing myocardial instability includes obtaining a physiological parameter representative of myocardial behavior over a set of cardiac cycles and determining reversal points in the physiological parameter over the set of cardiac cycles. The method also includes identifying myocardial instability based on the reversal points in the physiological parameter. A reversal point may correspond to a value of the physiological parameter, during a current cardiac cycle, that exceeds or is less than the values of the physiological parameter during prior and subsequent cardiac cycles. Optionally, the method includes calculating differences between values of the physiological parameter for consecutive cardiac cycles and detecting the reversal points when a current difference exceeds or is less than differences for prior and subsequent cardiac cycles.

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: An improved method is presented for evaluating the physiological status of a patient diagnosed with congestive heart failure and treating the patient accordingly to alleviate the congestive heart failure. As part of the method, the thoracic or cardiac impedance and ventilation of the particular patient are derived solely from an input consisting of cardiac signals (EKG) generated by electrical energy of the patient's heart as the heart is undergoing its cardiac cycle with a dynamic impedance obtained by subjecting the EKG to alternately high and low input impedances. The derived thoracic impedance and ventilation are used to control the pattern and rate at which stimulating electrical pulses are applied to the patient's vagus nerve by an implanted stimulator, in a manner to deliver therapy to the patient's heart by adjusting the heart rate to a prescribed target rate for alleviating the congestive heart failure.

Abstract: Some embodiments provide a system, comprising a peripheral nerve field modulation (PNFM) therapy delivery system, PNFM electrodes configured to be implanted subcutaneously, and a controller. The PNFM electrodes are electrically connected to the PNFM therapy system. The PNFM therapy delivery system and the PNFM electrodes are configured to deliver current and/or control the field potentials at one or more peripheral nerve fields. The controller is configured to control the PNFM therapy delivery system to deliver a PNFM therapy to the one or more peripheral nerve fields. The controller includes a scheduler configured to control timing of the PNFM therapy.

Abstract: Noncaptured atrial paces can result in long-short cardiac cycles which are proarrhythmic for ventricular tachyarrhythmia. Approaches are described which are directed to avoiding proarrhythmic long-short cycles. For cardiac cycles in which the atrial pace captures the atrium, a first post ventricular refractory period (PVARP) and a first A-A interval are used. For cardiac cycles in which the atrial pace does not capture the atrium, both an extended PVARP and an extended A-A interval are used. The A-A interval following a noncaptured atrial pace is extended from an atrial depolarization sensed during the extended PVARP.

Abstract: A device for detecting cardiac ischemia is disclosed. The device includes a processor that is configured to operate in three different modes according to relative frequency of different beat types. If beats of a first beat type, such as ventricularly paced beats, are predominant, the processor ignores other beat types and performs ischemia detection only on ventricularly paced beats. Conversely, if beats of a second beat type, such as sinus or atrially paced beats, are predominant, the processor ignores ventricularly paced beats and performs ischemia detection only on sinus or atrially paced beats. If there is a mixture of beat types such that neither predominates, the processor performs ischemia detection on both beat types.

Abstract: Medical devices and therapeutic methods for use in the field of cardiology, cardiac rhythm management and interventional cardiology, and more specifically to catheter-based systems for implantation of pacing leads and electrodes, or intramural myocardial reinforcement devices, within the myocardial wall of the heart, such as the ventricles, to provide improved cardiac function.

Abstract: A neural stimulator senses a reference signal indicative of cardiac cycles each including a predetermined type timing reference event using a sensor external to the heart and blood vessels. The delivery of the neural stimulation pulses are synchronized to that timing reference event. Examples of the timing reference event include a predetermined cardiac event such as a P-wave or an R-wave detected from a subcutaneous ECG signal, a predetermined type heart sound detected from an acoustic signal, and a peak detected from a hemodynamic signal related to blood flow or pressure.

Abstract: Cardiac protection pacing is applied to prevent or reduce cardiac injury and/or occurrences of arrhythmia associated with an ischemic event including the occlusion of a blood vessel during a revascularization procedure. Pacing pulses are generated from a pacemaker and delivered through one or more pacing electrodes incorporated onto a percutaneous transluminal vascular intervention (PTVI) device used in the revascularization procedure. The pacemaker generates the pacing pulses according to a predetermined cardiac protection pacing sequence before, during, and/or after the ischemic event.

Abstract: A pacemaker comprises an implantable pacemaker housing and a pacemaker electrode which is provided for the transmission of stimulation pulses. A switching element, in particular a reversibly actuatable switching element, is provided for interrupting, reducing or limiting a current flowing through the pacemaker electrode, said current being inducible by an external magnetic field. Parts of the pacemaker are coated with a material, in particular a nanostructured material, which counteracts magnetic effects.

Abstract: Implantable systems and method for use therewith are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments are for use with an implantable device that includes one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering Atrial Anti-Tachycardia Pacing (AATP) and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.

Abstract: A constant current pacing apparatus and method for pacing uses, for example, H-bridge circuitry and a constant current source connected to the H-bridge circuitry. Further, for example, protection is provided from high voltage pulses applied to the patient via one or more other medical devices.

Abstract: The disclosure includes an electrochemical cell comprising a first cathode and a second cathodes are adjacent one another in a stacked arrangement to form a cathode stack in the electrochemical cell. The first cathode includes a first current collector and a first cathode form of active material covering the first current collector, and the second cathode includes a second current collector and a second cathode form of active material covering the second current collector. The second current collector is in electrical contact with the first current collector. The electrochemical cell further comprises an anode adjacent to the cathode stack, and a separator located between the cathode stack and the anode.

Abstract: Energy is transmitted noninvasively to a patient using electrode-based stimulation devices or magnetic stimulation devices that are designed to non-invasively stimulate nerves selectively. The devices produce impulses that are used to treat atrial fibrillation, by stimulating a vagus nerve of a patient. The devices are also used to forecast the imminent onset of atrial fibrillation and then avert it by stimulating a vagus nerve.

Abstract: The disclosure includes an electrochemical cell comprising a first cathode and a second cathodes are adjacent one another in a stacked arrangement to form a cathode stack in the electrochemical cell. The first cathode includes a first current collector and a first cathode form of active material covering the first current collector, and the second cathode includes a second current collector and a second cathode form of active material covering the second current collector. The second current collector is in electrical contact with the first current collector. The electrochemical cell further comprises an anode adjacent to the cathode stack, and a separator located between the cathode stack and the anode.

Abstract: A medical device and associated method control the delivery of a cardiac pacing therapy by selecting first and second pacing sites along a first ventricle of a patient's heart and delivering the pacing therapy by pacing the first ventricle using the first pacing site during the periods of a first ventricular pacing mode and using the second pacing site during periods of a second ventricular pacing mode. In one embodiment, the device determines activation times at multiple sites along a ventricle in response to pacing pulses being delivered to the opposite ventricle. A first pacing site is selected in response to the activation time determination. The device delivers the pacing therapy by pacing the first ventricle using the first pacing site during periods of the first ventricular pacing mode.

Abstract: A system and method for managing and inhibiting cardiac remodeling in MI patients. Bi-ventricular stimulation is constantly provided with and without sensing to encourage normal pumping of the heart on a consistent basis. Pulses are administered using an anodal pulse followed by a cathodal pulse to stimulate cardiac muscle contraction. Stem cells are administered to MI areas to encourage regeneration of cardiac tissue in the damaged area. Stimulation may be provided to both healthy and compromised cardiac tissue.

Abstract: A system and method for long-term monitoring of cardiac conditions such as arrhythmias is disclosed. The invention includes a pulse generator including means for sensing an arrhythmia. The pulse generator is coupled to at least one subcutaneous electrode or electrode array for providing electrical stimulation such as cardioversion/defibrillation shocks and/or pacing pulses. The electrical stimulation may be provided between multiple subcutaneous electrodes, or between one or more such electrodes and the housing of the pulse generator. In one embodiment, the pulse generator includes one or more electrodes that are isolated from the can. These electrodes may be used to sense cardiac signals.

Abstract: A method and apparatus for affecting the autonomic nervous system of a subject using stimuli based on separate analysis of the sympathetic and/or parasympathetic branches of the subject's autonomic nervous system. The present invention also relates to a method and apparatus for affecting the autonomic nervous system, wherein stimuli is applied in coordination with cyclical activities of the subjects body such as respiration or cardiac cycle.

Abstract: A method discriminates between ventricular arrhythmia and supraventricular arrhythmia by determining the direction of an electrical signal conducted through the atrioventricular node. An implantable cardiac defibrillator provides atrioventricular and ventriculoatrial pacing bursts to determine if an arrhythmia with a 1:1 atrial to ventricular relationship is due to ventricular tachycardia or supraventricular tachycardia. This discrimination capability reduces the incidence of inappropriate shocks from dual-chamber implantable cardiac defibrillators to near zero and provides a method to differentially diagnose supraventricular tachycardia from ventricular tachycardia.

Abstract: A method for monitoring a biological cardiac pacemaker. The method may include stimulating a heart at a region selected for implantation of a biological pacemaker and sensing at least one electrical signal indicative of a cardiac depolarization originating in the region selected for implantation of the biological pacemaker. The method may further include sensing at least one subsequent electrical signal produced by the heart and determining if the subsequent electrical signal originated in the region selected for the biological pacemaker or another region of the heart.

Abstract: A leadless intra-cardiac medical device includes a housing that is configured to be implanted entirely within a single local chamber of the heart. A first electrode is provided on the housing at a first position such that when the housing is implanted in the local chamber, the first electrode engages the local wall tissue at a local activation site within the conduction network of the local chamber. An intra-cardiac extension is coupled to the housing and configured to extend from the local chamber into an adjacent chamber of the heart. A stabilization arm of the intra-cardiac extension engages the adjacent chamber. A second electrode on the intra-cardiac extension engages distal wall tissue at a distal activation site within the conduction network of the adjacent chamber.

Abstract: Method and apparatus for detecting and analyzing heart mechanical activity at a region of interest of a patient's heart are provided. The method comprises acquiring a time sequence of 2-dimensional X-ray images of a region of interest over at least part of a cardiac cycle; detecting coronary vessels in the X-ray images; tracking the coronary vessels through the sequence of images to identify movements of the coronary vessels; and analyzing the movements of the coronary vessels to quantify at least one parameter characterizing heart wall motion in the region of interest.

Abstract: A leadless intra-cardiac medical device (LIMD) configured to be implanted entirely within a heart of a patient includes a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart.

Abstract: A leadless intra-cardiac medical device (LIMD) includes a housing configured to be implanted entirely within a single local chamber of the heart.

Abstract: The disclosure describes techniques for diagnosing premature contractions of a patient's heart. This system may differentiate premature atrial contractions (PACs) and premature ventricular contractions (PVCs) from atrial fibrillation by identifying changes in R-wave intervals, i.e., R-R intervals, on a Lorenz plot, measuring a coupling interval between R-waves, and analyzing a morphology of the premature contractions, e.g., the QRS complex. These techniques may also identify when severe premature contractions, or bigeminy, are present. In response to the type of premature contractions detected, the system may alert a user of the premature contractions and/or deliver cardiac pacing at an increased pacing rate to eliminate the abnormal intrinsic contractions. The system may also adjust the pacing rate and pacing rate duration for persistent premature contractions.

Abstract: An implantable cardioverter/defibrillator (ICD) delivers atrial pacing under several scenarios during a tachyarrhythmia episode that is detected using a ventricular rate. In various embodiments, the atrial pacing terminates the detected tachyarrhythmia and/or enhances the classification of the detected tachyarrhythmia, thus avoiding ineffective and/or unnecessary delivery of a ventricular anti-tachyarrhythmia therapy when the detected tachyarrhythmia has a supraventricular origin.

Abstract: A portable electronic ear light device comprising a support member and an optical radiation source resting on the support member and a light guide for directing optical radiation energy non-invasively at the user's intracranial nerve tissue via the outer auditory canal of the user of the portable electronic device to stimulate the user's intracranial nerve tissue. In the device, the support member is around the light guide at a distance from the radiation guide, thus providing an air gap around the radiation guide. In the device there is a sealing structure between the support member and the light guide for preventing the contamination of the light guide and the air gap.

Abstract: An implantable medical device and associated method assesses T-wave alternans. The method includes sensing a cardiac signal from implanted electrodes subsequent to a premature contraction; measuring a T-wave parameter from the sensed cardiac signal for a plurality of cardiac cycles; and determining a T-wave alternans metric corresponding to the measured T-wave parameter.

Abstract: A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode. The pacemaker further includes a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart. The combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle.

Abstract: A battery comprises a tubular housing. An external surface of the tubular housing comprises a biocompatible material. The battery further comprises a battery header secured to an open end of the tubular housing, and the tubular housing and the battery header combine to form a substantially sealed enclosure. The battery also comprises one or more voltaic cells within the substantially sealed enclosure, and a feedthrough electrically connected to the voltaic cells and extending through the battery header to form a battery terminal. The battery header includes a radial groove opposite the tubular housing, and the radial groove is configured to receive a mating snap-fit electronic component subassembly of an implantable medical device.

Abstract: A lead system for an implantable medical device and applications for the lead system. Also includes therapeutic systems, devices, and processes for detecting and treating disordered breathing and treating cardiac and breathing issues together with an implantable device.

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: Treating the physiological electric conduction of the heart includes methods that involve guiding an electrode to a location, near the His bundle of the heart, that is determined by pacing the heart and sensing signals in response thereto, and electrically bypassing a conduction abnormality of the heart by presenting extrinsic pacing signals to the location near the His bundle of the heart. The pacing electrode may then be fixed at the location, near the His bundle, to provide subsequent pacing of the heart such that the subsequent pacing exhibits electrical bypassing of the conduction abnormality.

Abstract: A method of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. In the event that the AV conduction test reveals an AV conduction block condition then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.

Abstract: A method and apparatus are disclosed for treating a condition of a patient's heart includes placing a first electrode and/or a second electrode in a right ventricle of the heart. In one example, a reference electrode is placed within the patient and internal or external to the heart. A pacing signal is generated including a first signal component, a second signal component and a reference component with the first and second signal components having opposite polarity and with both of the first and second components having a potential relative to the reference component. The pacing signal and the placement of the electrodes are selected to alter a contraction of a left ventricle of the heart.

Abstract: The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data using a probabilistic ventricular oversensing algorithm. The algorithm may look at a plurality of factors weighing for and against a determination of ventricular oversensing. In some examples, the algorithm may also determine whether the cardiac episode includes atrial sensing issues.

Abstract: Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications. One such device is directed to a catheter, and uses thereof, for capturing myocardium of a heart by delivering pacing signals to a location in the heart. The location is near a His Bundle of the heart. The catheter has a proximal end for interfacing with an electrical pacing signal source and a distal end. The distal end includes a fixation mechanism that attaches the catheter to heart tissue. First and second electrodes are also located at the distal end. Each electrode is individually addressable for providing pacing signals to the heart tissue and also arranged to physically contact the heart tissue when the fixation mechanism is attached to the heart tissue.

Abstract: A feedthrough flat-through capacitor includes a capacitor having a first and second set of electrode plates, a first feedthrough passageway through the capacitor, a first lead disposed within the first feedthrough passageway and conductively coupled to the first set of electrode plates, a second feedthrough passageway through the capacitor disposed remote from the first feedthrough passageway, and a second lead disposed within the second feedthrough passageway and conductively coupled to the first set of electrode plates. The second set of electrode plates are typically conductively coupled to a ground. An EMI shield may be provided to electromagnetically isolate the first lead from the second lead.

Abstract: A system and method for detecting and treating symptoms of early decompensation utilizing a cardiac rhythm management. The system applies an electrical stimulus to the patient's heart at a first set of pacing parameters including a lower rate limit (LRL) setting, and acquires a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient. An average coronary venous end diastolic pressure (CV-EDP) value is calculated from the CVP signal. The system monitors the average CV-EDP value over a predetermined interval, and dynamically adjusts the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.

Abstract: An electrotherapy system for stimulating sensory nerves within skin tissue includes a electrode carrier, a pulse generator, an array of skin-penetrating electrodes and surface skin electrodes, a pulse conditioning circuit, and a power source. The system administers biphasic pulsed current at the surface skin electrodes and monophasic pulsed current at each skin-penetrating electrode. The skin-penetrating surfaces and skin contact surfaces of the electrotherapy system may be sterilized or may be replaceable for outpatient reusability.

Abstract: A method and apparatus are used to provide therapy to a patient experiencing ventricular dysfunction or heart failure. At least one electrode is located in a region associated with nervous tissue, such as nerve bundles T1-T4, in a patient's body. Electrical stimulation is applied to the at least one electrode to improve the cardiac efficiency of the patient's heart. One or more predetermined physiologic parameters of the patient are monitored, and the electrical stimulation is adjusted based on the one or more predetermined physiologic parameters.

Abstract: A system and method for pacing rate control in a cardiac rhythm management (CRM) system. The method includes acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient and generating a CVP waveform from the pressure signal. A pacing stimulus is applied to the patient's heart, and the pacing rate is increased in response to increases in patient's metabolic demand. The CVP index is monitored during the pacing rate increase, and the CRM system detects a reduction in the patient's hemodynamic performance based on the CVP index and establishes a maximum rate setting based on the pacing rate corresponding to the reduction in the patient's hemodynamic performance.

Abstract: Methods and systems are described that involve synchronized ventricular pacing that promotes sensing of atrial events. The atrioventricular pacing delay is modified based on characteristics of previously sensed atrial events. The modified AV delay is implemented relative to a first atrial event. A second AV delay is implemented relative to a second atrial event if the second atrial event is sensed during the modified AV delay. A ventricular pacing pulse is delivered following the second AV delay.

Abstract: Embodiments of the invention are related to medical devices and methods for delivery high-energy anti-tachycardia therapy to a subject, amongst other things. In an embodiment, the invention includes a medical device including a controller module configured to administer a plurality of electrical pulses to a patient in response to a detected tachycardia, the electrical pulses comprising an amplitude of greater than 3 Volts and less than 40 Volts, the controller configured to modulate the amplitude of the electrical pulses. In an embodiment, the invention includes a method of treating a tachyarrhythmia including administering a first series of electrical pulses to a patient with an implantable medical device, the electrical pulses including an amplitude of greater than 8 Volts and less than 40 Volts, the first series of electrical pulses having an interval of less than about 600 ms in between individual pulses. Other embodiments are also included herein.

Abstract: A method and device for treating myocardial ischemia are described in which the stress experienced by a myocardial region identified as vulnerable to becoming ischemic is varied with pre-excitation pacing. In an unloading mode, pacing is applied in proximity to the vulnerable region to reduce stress and the metabolic demand of the region. In a loading mode, pacing is applied to a region remote from the vulnerable region in order to produce a conditioning effect.

Abstract: A measurement system may comprise a sensor wire and a transceiver unit. The sensor wire may comprise an insertable portion configured to be inserted in a blood vessel of a patient's body and a sensor disposed within the insertable portion at a distal end of the sensor wire. The sensor is configured to measure a parameter when inserted inside the patient. The transceiver unit may comprise: a housing adapted to be connected to a proximal end of the sensor wire; and a first communication module within the housing adapted to wirelessly communicate by a communication signal with an external second communication module in order to transfer information to the external second communication module.

Abstract: A computer method, employable during an at-rest period of a pacemaker patient, for controlling the operation of the pacemaker so as maximally to support the patient's hemodynamic behavior in a context involving inhibiting fluid overload. The method involves (a) collecting simultaneously occurring ECG and heart-sound information, (b) processing the collected information to obtain at least S3 data, and in certain instances also EMAT and/or % LVST data, (c) utilizing such obtained data, and during the at-rest period, applying (a) pacing rate, (b) pacing intensity, (c) atrio-ventricular delay, and (d) inter-ventricular delay control to the pacemaker.

Abstract: A charge pump is provided in the same integrated circuit chip as a control means which permits selectively connecting any of one or more electrodes with conductors along a lead. The charge pump derives about two volts from a one-volt supply, and becomes stable within a few tens of microseconds. The charge pump may be composed of three doublers—the first generating timing signals for the second and third doublers, with the second and third doublers working out of phase with each other.