Cardiac Pacemakers, Inc. Patent applications |
Patent application number | Title | Published |
20160121102 | IMPLANTABLE MEDICAL DEVICES AND METHODS FOR MAKING AND DELIVERING IMPLANTABLE MEDICAL DEVICES - Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an implantable medical device. The implantable medical device may include an implantable pacing member having a housing and a lead input. A lead may be coupled to the lead input. The lead may be designed to extend along a pericardial space, epicardium, or both and engage a heart chamber. A passageway may be defined along a portion of the length of the lead. | 05-05-2016 |
20160114157 | DELIVERY DEVICES AND METHODS FOR LEADLESS CARDIAC DEVICES - Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may an outer tubular member and an inner tubular member slidably disposed within the lumen of the outer tubular member. A distal holding section may extend distally of a distal end of the inner tubular member and define a cavity therein for receiving an implantable leadless pacing device. The device may further include a hub portion including at least a first hub portion affixed adjacent to the proximal end of the outer tubular member and a second hub portion affixed adjacent to the proximal end of the inner tubular member. A first locking mechanism configured to releasably couple the outer tubular member and the inner tubular member may be disposed within the hub portion. | 04-28-2016 |
20160114156 | DELIVERY DEVICES AND METHODS FOR LEADLESS CARDIAC DEVICES - Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may include a proximal section including a deflection mechanism for deflecting the proximal section, and a distal holding section extending distally of a distal end of the proximal section and defining a cavity therein for receiving an implantable leadless pacing device. The distal holding section may be structured to have portions that flex and bend while allowing the implantable device to be recaptured within the distal holding section. | 04-28-2016 |
20150328473 | LEADLESS CARDIAC STIMULATION DEVICE EMPLOYING DISTRIBUTED LOGIC - Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient's heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location. | 11-19-2015 |
20150258345 | MODULAR ANTITACHYARRHYTHMIA THERAPY SYSTEM - This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module. | 09-17-2015 |
20150190638 | MODULAR ANTITACHYARRHYTHMIA THERAPY SYSTEM - This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module. | 07-09-2015 |
20140350425 | THIRD HEART SOUND ACTIVITY INDEX FOR HEART FAILURE MONITORING - A cardiac rhythm management system provides for the trending of a third heart sound (S3) index. The S3 index is a ratio, or an estimate of the ratio, of the number of S3 beats to the number of all heart beats, where the S3 beats are each a heart beat during which an occurrence of S3 is detected. An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including S3. An S3 detector detects occurrences of S3 from the acoustic signal. A heart sound processing system trends the S3 index on a periodic basis to allow continuous monitoring of the S3 activity level, which is indicative of conditions related to heart failure. | 11-27-2014 |
20140343439 | METHODS AND APPARATUS FOR STRATIFYING RISK OF HEART FAILURE DECOMPENSATION - Devices and methods for identifying patient at elevated risk of developing future heart failure (HF) events, such as events indicative of HF decompensation status, are described. The devices and methods can stratify the risk using sensor signals or signal metrics selected in accordance with patient chronic conditions. A medical device can receive a patient status input including at least a first and a second chronic condition indicators, sense one or more physiologic signals from the patient, and generate a plurality of signal metrics from the physiologic signals when the first chronic condition indicator and the second chronic condition indicator meets respective criterion. One or more patient-specific signal metrics can be selected from a group including the signal metrics selected for both the first and the second chronic conditions. A risk stratification algorithm can use the selected one or more patient-specific signal metrics to compute a composite risk index indicative of the probability of the patient later developing an event indicative of worsening of HF. | 11-20-2014 |
20140343438 | METHODS AND APPARATUS FOR DETECTING HEART FAILURE EVENT USING PATIENT CHRONIC CONDITIONS - Devices and methods for detecting physiological target event such as events indicative of HF decompensation status are described. A medical device is configured to receive at least a first and a second chronic condition indictors of a patient, receive one or more physiologic signals from the patient, and generate a plurality of signal metrics when the first and the second chronic condition indicators meet their respective criterion. The medical device can detect the target event or condition using one or more patient-specific signal metrics selected from a group including both the first and the second set of the signal metrics. The medical device and the methods can be configured to detect an event indicative of HF decompensation. | 11-20-2014 |
20140336735 | HEADER CONNECTION WITH REDUCED COMPLEXITY - An apparatus includes an implantable housing, a header mounted to the implantable housing and including a connector block cavity, and a connector block located within the connector block cavity, the connector block including a housing portion, a coil spring, and a metallic conductor connected around the coil spring and extending directly to a feedthrough. | 11-13-2014 |
20140336521 | INTRACARDIAC IMPEDANCE AND ITS APPLICATIONS - A system to measure intracardiac impedance includes implantable electrodes and a medical device. The electrodes sense electrical signals of a heart of a subject. The medical device includes a cardiac signal sensing circuit coupled to the implantable electrodes, an impedance measurement circuit coupled to the same or different implantable electrodes, and a controller circuit coupled to the cardiac signal sensing circuit and the impedance measurement circuit. The cardiac signal sensing circuit provides a sensed cardiac signal. The impedance measurement circuit senses intracardiac impedance between the electrodes to obtain an intracardiac impedance signal. The controller circuit determines cardiac cycles of the subject using the sensed cardiac signal, and detects tachyarrhythmia using cardiac-cycle to cardiac-cycle changes in a plurality of intracardiac impedance parameters obtained from the intracardiac impedance signal. | 11-13-2014 |
20140330347 | METHOD AND APPARATUS FOR STORING UP-TO-DATE INFORMATION ON AN IMPLANTABLE MEDICAL DEVICE - Systems and methods are described for communicating device information and performance information associated with a population of other electrodes to a remote transceiver. The system can include a radio frequency identification (RFID) circuit coupled to an implantable component. The RFID circuit can include a memory circuit configured to store device information associated with at least one implantation-independent attribute of the implantable component. The RFID circuit can communicate the device information and performance parameters associated with the implantable component to at least one programming unit such as a remote transceiver. The programming unit can program the RFID circuit with information associated with the implantable component. | 11-06-2014 |
20140316482 | MEDICAL IMPLANT HAVING A CONDUCTIVE COATING - A coated medical implant and associated method are disclosed. The coated medical implant can include a metallic outer surface. An intermediary layer can be coated on at least a portion of the metallic outer surface. A polyethylene glycol (PEG) self-assembled monolayer (SAM) can be formed on at least a portion of the intermediary layer. The SAM can be configured to be substantially hypoallergenic or conductive. | 10-23-2014 |
20140309941 | SYSTEM AND APPARATUS FOR PROVIDING BASELINE DATA FOR AUTOMATED PATIENT MANAGEMENT - A system and method for providing baseline data for automated patient management is disclosed. A patient is identified for enrollment in automated patient management with information including at least one of treatment profile and medical history. Device measures are collected to provide raw physiometry for the patient regularly recorded by a medical device, beginning with an initial observation period. Derived device measures are determined to provide derivative physiometry based on the collected device measures. Baseline data from the collected and derived device measures are quantified. | 10-16-2014 |
20140277280 | PHRENIC NERVE STIMULATION DETECTION WITH POSTURE SENSING - A method and a system of phrenic nerve stimulation detection in conjunction with posture sensing is disclosed. In an embodiment, the method may include receiving a trigger for conducting a pace-induced phrenic nerve stimulation (PS) search using the IMD within the patient. On receiving the trigger, the IMD may be used for conducting the PS search. A procedure of conducting the PS search may include measuring a posture of the patient using an implantable posture sensor, searching for PS while the patient is in the measured posture and obtaining a PS result from the PS search for the measured posture. The method may include recording both the PS result and the measured posture in a memory of the IMD. | 09-18-2014 |
20140277244 | AMBULATORY PHRENIC NERVE STIMULATION DETECTION - An example of a system includes an implantable medical device (IMD) for implantation in a patient, where the IMD includes a cardiac pace generator, phrenic nerve stimulation (PS) sensor, a memory, and a controller, and where the controller is operably connected to the cardiac pace generator to generate cardiac paces. The controller is configured to provide a trigger for conducting a PS detection procedure and perform the PS detection procedure in response to the trigger. In performing the PS detection procedure the controller is configured to receive a signal from the sensor, detect PS using the signal from the sensor, and record the PS detection in storage within the IMD. | 09-18-2014 |
20140277243 | HEART SOUNDS TEMPLATE COMPARISON TO IDENTIFY TRUE PACING MODE - An apparatus may include an implantable therapy circuit that provides bi-ventricular pacing to a subject, a heart sound signal sensing circuit that produces a sensed heart sound signal that is representative of at least one heart sound associated with mechanical cardiac activity, a memory circuit to store one or more heart sound templates of cardiac capture, and a comparison circuit that compares a segment of the sensed heart sound signal to the one or more heart sound templates of cardiac capture to identify ventricles in which cardiac capture was induced by the bi-ventricular pacing. In some situations, an indication of the ventricles in which cardiac capture was induced may be generated according to the comparison. | 09-18-2014 |
20140277240 | SYSTEM AND METHOD FOR CHANGING DEVICE PARAMETERS TO CONTROL CARDIAC HEMODYNAMICS IN A PATIENT - Pacing parameters may be adjusted to increase the cardiac output of a patient's heart while a patient is awake and/or active and the demand placed on the heart may be greatest, and to decrease or hemodynamic efficiency while a patient is at rest so that the heart itself has time to rest before the next period of higher demand for efficiency begins. This may aid in lessening the strain placed on the heart by making the heart work hard when needed such as when the patient is active, and by permitting the heart to “rest” when the patient is relatively inactive. | 09-18-2014 |
20140277239 | ESTIMATING ELECTROMECHANICAL DELAY TO OPTIMIZE PACING PARAMETERS IN RBBB PATIENTS - Stimulation energy can be provided to stimulate synchronous ventricular contractions. Interval information obtained from a cardiac electrical heart signal and a cardiac mechanical heart signal can be used to determine a right ventricular activation time. The interval information can provide a cardiac stimulation indication. | 09-18-2014 |
20140277238 | SYSTEM AND METHODS FOR IMPROVING DEVICE THERAPY USING HEART SOUNDS - Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can be configured to detect a heart sound signal and generate one or more heart sound metrics, detect a characteristic indicative of cannon waves, and determine a desired value for a device parameter, such as a timing parameter which can be used to control the delivery of CRT pacing to various heart chambers. The desired device parameter value can be determined using the heart sound metrics and the characteristic indicative of the cannon waves. The ambulatory medical device can program stimulation using the desired device parameter value, and deliver the programmed stimulations to one or more target sites to achieve desired therapeutic effects. | 09-18-2014 |
20140277237 | DEVICE BASED OPTIMIZATION OF DEVICE THERAPIES - A system may include an external medical device (e.g., a patch) including one or more physiological sensors configured to sense one or more physiological parameters of a subject when the subject is ambulatory. The external medical device may be configured to communicate information related to the sensed one or more physiological parameters for determining and/or modifying at least one cardiac therapy parameter of an implantable medical device (e.g., pacemaker, implantable cardioverter defibrillators, or cardiac resynchronization therapy device). In some situations, an indication or notification may be generated corresponding to the determined and/modified cardiac therapy parameter. | 09-18-2014 |
20140277236 | PACING AND SENSING VECTORS - A method for allowing cardiac signals to be sensed and pacing pulse vectors to be delivered between two or more electrodes. In one embodiment, cardiac signals are sensed and pacing pulse vectors are delivered between at least one of a first left ventricular electrode and a second left ventricular electrode. Alternatively, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrodes and a first supraventricular electrode. In addition, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrode, the first supraventricular electrode and a conductive housing. In an additional embodiment, a first right ventricular electrode is used to sense cardiac signals and provide pacing pulses with different combinations of the first and second left ventricular electrodes, the first supraventricular electrode and the housing. | 09-18-2014 |
20140277235 | SYSTEM AND METHODS FOR IMPROVING DEVICE THERAPY USING MULTIPLE SENSOR METRICS - Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can receive one or more physiologic signals and generate multiple signal metrics from the physiologic signals. The ambulatory medical device can determine a desired value for a device parameter, such as a timing parameter used for controlling the delivery of CRT pacing to various heart chambers, using information fusion of signal metrics that are selected based on one or more of a signal metric sensitivity to perturbations to the device parameter in response to a stimulation, a signal metric variability in response to a stimulation, or a covariability between two or more signal metrics in response to a stimulation. The ambulatory medical device can program a stimulation using the desired device parameter value, and deliver the programmed stimulation to one or more target sites to achieve desired therapeutic effects. | 09-18-2014 |
20140277234 | IMPLANTABLE MEDICAL DEVICE AND ASSMEBLY THEREOF - This document describes an apparatus including an implantable medical device having a printed circuit board. The apparatus can include a connector block for a lead terminal of the implantable medical device mounted directly to the printed circuit board. | 09-18-2014 |
20140277230 | ELECTRICAL ENERGY DELIVERY TISSUE SITE VALIDATION - Electrical energy delivery tissue site validation systems and methods can determine an indication of a tissue type at a tissue site. This information can be used to enable or inhibit electrical energy delivery to the tissue site. The tissue type at the tissue site can be determined such as by delivering a test electrical energy and sensing a responsive electrical energy. An electrical connectivity to the tissue site can also be determined, such as by using a sensed intrinsic electrical signal at the tissue site. Tissue type information may be communicated externally, such as to allow user confirmation or override of the determined indication of tissue type at the tissue site, such as by a physician, user, or other operator. | 09-18-2014 |
20140276929 | IMPLANTABLE MEDICAL DEVICES WITH SEPARATE FIXATION MECHANISM - Devices or methods such as for stimulating excitable tissue or sensing physiologic response or other signals that can use separate fixation mechanism is described. An implantable apparatus can include a modular electrostimulation electrode assembly that can include a first module and a second module that can be end user-attachable to each other and end user-detached from each other. The first module can include an electrostimulation electrode fixation support member that can be laid flat against or otherwise conform to a surface of a heart, and can define a centrally located open portal such as for permitting electrode access to the surface of the heart. The second module can include an electrostimulation electrode that can be inserted through the portal of the fixation support member such as to contact the surface of the heart such as to deliver chronic electrostimulation to the heart. | 09-18-2014 |
20140276164 | HEART FAILURE MANAGEMENT TO AVOID REHOSPITALIZATION - Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics. Information about relative changes in signal characteristics from multiple sensors can be used to identify particular subject physiologic signals to monitor during subsequent periods. | 09-18-2014 |
20140276163 | DIAGNOSTIC AND OPTIMIZATION USING EXERCISE RECOVERY DATA - An apparatus, such as a cardiac function management system can detect heart sounds following a sensed transition in physical activity level, such as from an elevated physical activity level to rest. A technique can include systems, methods, machine-readable media, or other techniques that can include identifying a physical activity level transition, receiving a heart sound signal, determining characteristics of the heart sound and subject physiologic activity to provide an indication, such as a heart failure status indication. | 09-18-2014 |
20140268499 | FLAT CAPACITOR FOR AN IMPLANTABLE MEDICAL DEVICE - One aspect provides a capacitor feedthrough assembly having an electrically conductive member dimensioned to extend at least partially through a feedthrough hole of a case of the capacitor, the conductive member having a passage therethrough. | 09-18-2014 |
20140257445 | PACING LEADS WITH A STRUCTURED COATING - An implantable medical device includes a lead body having a distal end and a proximal end, a lumen and at least one lead wire extending through the lumen. The lead wire has an outer surface and a polymeric coating on at least a portion of the outer surface of the lead wire. The coating includes a first structure having a first end proximate the outer surface of the lead wire and a second end opposite the first end. The second end is movable relative to the first end and relative to the lead wire. | 09-11-2014 |
20140257426 | METHOD AND APPARATUS FOR CONTROLLING BLOOD PRESSURE USING RESPIRATION-MEDIATED HEART RATE VARIATION - System and methods for programming and delivering electrical stimulation to treat hypertension are described. In various embodiments, an ambulatory stimulator system, such as an implantable medical device, can detect a respiration-mediated heart rate variation (RM-HRV), monitor the efficacy of hypertension therapy and adjust the stimulation parameters using the detected RM-HRV to achieve desired therapy outcome. In some embodiments, the system can be configured to synchronize the detected heart rates to one or more respiration cycles or respiration phases within the respiration cycles, and determine the RM-HRV using the heart rates synchronized with the respiration cycles or the respiration phases. The RM-HRV may be presented to the system operator to monitor the efficacy of the AHT therapy. The ambulatory stimulator system can adjust the stimulation parameters using at least the RM-HRV. | 09-11-2014 |
20140257425 | HYPERTENSION THERAPY DEVICE WITH LONGEVITY MANAGEMENT - System and methods for programming and delivering electrical stimulation to treat hypertension are discussed. In various embodiments, an ambulatory stimulator system, such as an implantable medical device, can receive a power-saving command and deliver the electrical stimulation to a target site in a patient according to one or more simulation parameters including a therapy on-off pattern. In some embodiments, stimulation with therapy on-off pattern can reduce the power consumption while maintaining the anti-hypertension therapy efficacy. In some embodiments, the ambulatory stimulator system can include one or more of a physiologic response detector, a patient status detector, or a battery longevity detector. The power-saving command can be generated using one or more of the detected physiologic signal, the patient status, or the information about the battery longevity. | 09-11-2014 |
20140256184 | CONNECTOR BLOCKS FOR A HEADER OF AN IMPLANTABLE DEVICE - An apparatus includes an implantable housing, a header mounted to the implantable housing and including a connector block cavity, and a connector block located within the connector block cavity, the connector block including a plastic housing portion, a coil spring, and a metallic termination member connected to the coil spring and exposed outside the plastic housing portion. | 09-11-2014 |
20140249604 | METHOD FOR DETECTING AND TREATING VENTRICULAR ARRHYTHMIA - 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. | 09-04-2014 |
20140243946 | IMPLANTABLE MEDICAL DEVICE INCLUDING ASSEMBLY INCORPORATING RADIOPAQUE AGENT AND ELUTABLE DRUG INTO A POLYMERIC LEAD TIP - An assembly for an implantable device can be made from PEEK and can incorporate one or more radiopaque agents and one or more elutable drug components into a polymeric lead tip. The assembly can be machined or injection molded and can be configured, for example, as a housing for an active fixation lead or as an electrode base supporting a foil electrode. | 08-28-2014 |
20140243932 | UNIDIRECTIONAL NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS - An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter. | 08-28-2014 |
20140243930 | FOLDED ANTENNAS FOR IMPLANTABLE MEDICAL DEVICES - In an example, an apparatus can include an implantable medical device comprising a housing, an implantable telemetry circuit carried within the housing, a dielectric compartment mechanically coupled to the housing, the dielectric compartment including first and second substantially parallel face portions and a third face portion extending between the first and second face portions, and an implantable telemetry antenna, located at least partially within the dielectric compartment. The implantable telemetry circuit can be electrically coupled to the implantable telemetry antenna and configured to wirelessly transfer information electromagnetically using the implantable telemetry antenna. In an example the implantable telemetry antenna comprises a spiral conductor portion extending along the first, second, and third face portions. In an example the spiral conductor includes a cross section having a lateral width that can be greater than a sidewall height of the cross section. | 08-28-2014 |
20140243929 | CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY - Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion. | 08-28-2014 |
20140236261 | METHOD AND SYSTEM FOR INDICATING NEUROSTIMULATION DELIVERY - A method and system for providing an indication of delivery of a neural stimulation therapy is disclosed. In an example, a method may include identifying current timing of an intermittent neural stimulation (INS) programmed in an implantable medical device (IMD) where the programmed INS includes alternating stimulation ON and stimulation OFF times and a timing for delivering stimulation bursts of a plurality of stimulation pulses during the stimulation burst ON times. An indication of the current timing of the INS may be provided using an INS indicator of an external device. | 08-21-2014 |
20140236172 | WIRELESS TISSUE ELECTROSTIMULATION - A wireless electrostimulation system can comprise a wireless energy transmission source, and an implantable cardiovascular wireless electrostimulation node. A receiver circuit comprising an inductive antenna can be configured to capture magnetic energy to generate a tissue electrostimulation. A tissue electrostimulation circuit, coupled to the receiver circuit, can be configured to deliver energy captured by the receiver circuit as a tissue electrostimulation waveform. Delivery of tissue electrostimulation can be initiated by a therapy control unit. | 08-21-2014 |
20140236029 | ALGORITHM ADAPTATION TO AN EXTERNAL IMPACT ON THE DATA - Devices and methods for detecting a physiological target event such as events indicative of HF decompensation status are described. An ambulatory medical device is configured to determine the presence and timing of a confounding event, segment a sensed physiological signal into at least two data segments, adjust the physiological signal by removing or lessening the impact of the confounding event on the physiological signal. The adjusted data can be presented to the user, and the ambulatory medical device can detect the target events using the adjusted physiologic signal. In some embodiments, the ambulatory medical device can be configured to detect an event indicative of HF decompensation using a physiological signal and the information of the detected confounding event. | 08-21-2014 |
20140236026 | METHOD AND APPARATUS FOR MULTI-STATE HEART FAILURE DECOMPENSATION DETECTION - Devices and methods for detecting events indicative of heart failure (HF) decompensation status are described. An ambulatory medical device can determine the present physiologic state as being either a drift state or a stable state, and applies an algorithm to detect HF decompensation event according to the physiologic state. In some embodiments, the ambulatory medical device uses the present physiologic state to estimate one ore more expected future signal characteristics, and to detect HF decompensation event using the one or more expected futures signal characteristics. | 08-21-2014 |
20140222115 | REMOTE PACE DETECTION IN AN IMPLANTABLE MEDICAL DEVICE - A system embodiment for stimulating a neural target comprises a neural stimulator, a pace detector, and a controller. The neural stimulator is electrically connected to at least one electrode, and is configured to deliver a neural stimulation signal through the at least one electrode to stimulate the neural target. The pace detector is configured to use at least one electrode to sense cardiac activity and distinguish paced cardiac activity in the sensed cardiac activity from non-paced cardiac activity in the sensed cardiac activity. The controller is configured to control a programmed neural stimulation therapy using the neural stimulator and using detected paced cardiac activity as an input for the neural stimulation therapy. | 08-07-2014 |
20140222100 | SYSTEMS AND METHODS FOR AVOIDING NEURAL STIMULATION HABITUATION - An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter. | 08-07-2014 |
20140221853 | IMPLANTABLE CARDIAC DEVICE WITH DYSPNEA MEASUREMENT - 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. | 08-07-2014 |
20140221809 | LEAD ASSEMBLY INCLUDING A POLYMER INTERCONNECT AND METHODS RELATED THERETO - A lead assembly includes a ring component having mechanical coupling features, and at least one polymer component mechanically coupled with the mechanical coupling features of the ring component. Elongate tubing is disposed over the polymer component and is secured with the polymer component. | 08-07-2014 |
20140221786 | MULTI-SENSOR STRATEGY FOR HEART FAILURE PATIENT MANAGEMENT - An apparatus comprises plurality of sensors and a processor. Each sensor provides a sensor signal that includes physiological information and at least one sensor is implantable. The processor includes a physiological change event detection module that detects a physiological change event from a sensor signal and produces an indication of occurrence of one or more detected physiological change events, and a heart failure (HF) detection module. The HF detection module determines, using a first rule, whether the detected physiological change event is indicative of a change in HF status of a subject, determines whether to override the first rule HF determination using a second rules, and declares whether the change in HF status occurred according to the first and second rules. | 08-07-2014 |
20140214107 | DYNAMIC BATTERY MANAGEMENT IN AN IMPLANTABLE DEVICE - One aspect of this disclosure relates to a system for dynamic battery management in implantable medical devices. An embodiment of the system includes two or more devices for measuring battery capacity for an implantable medical device battery. The embodiment also includes a controller connected to the measuring devices. The controller is adapted to combine the measurements from the measuring devices using a weighted average to determine battery capacity consumed. According to various embodiments, at least one of the measuring devices includes a coulometer. At least one of the measuring devices includes a capacity-by-voltage device, according to an embodiment. The system further includes a display in communication with the controller in various embodiments. The display is adapted to provide a depiction of battery longevity in units of time remaining in the life of the implantable medical device battery, according to various embodiments. Other aspects and embodiments are provided herein. | 07-31-2014 |
20140213859 | SYSTEMS AND METHODS TO IDENTIFY CARDIAC DYSYNCHRONY - The current technology is relevant to a system having an implantable medical device, where the system is configured to identify a patient condition comprising cardiac dysynchrony, configured to notify a clinical user of the identified condition and configured to identify a therapy appropriate for the identified condition. | 07-31-2014 |
20140207222 | HOUSINGS FOR IMPLANTABLE MEDICAL DEVICES AND METHODS FOR FORMING HOUSINGS - Described herein is an implantable medical device and methods for making a device that includes a metal housing a molding process. In one embodiment, the housing includes a header attachment element extends from the housing. In another embodiment, the implantable medical device includes a header attachment surface comprising one or more header retaining features configured to secure a connector header to the header attachment surface. In another embodiment, the housing includes one or more structural elements extending from and integrally molded with the interior surface of the first or second portions of the housing. Also disclosed are methods of making the implantable medical device. | 07-24-2014 |
20140207206 | SYSTEM AND METHOD FOR SYSTOLIC INTERVAL ANALYSIS - According to a system or method, information indicative of a cardiac depolarization signal can be obtained. Information indicative of an acoustic signal from an implantable acoustic sensor included as a portion of an implantable therapy device can be obtained. A feature indicative of an R wave can be identified from the information indicative of the cardiac depolarization signal, and a feature indicative of an S2 heart sound can be identified from the information indicative of the acoustic signal. A time interval between an instant corresponding to the feature indicative of the R wave and an instant corresponding to the feature indicative of the S2 heart sound can be determined. Using information about the determined time interval, an adjusted pacing therapy parameter can be provided for use in a pacing therapy to be provided by the implantable therapy device. | 07-24-2014 |
20140207203 | NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS - Various system embodiments comprise circuitry to determine when an arrhythmia has terminated, and a neural stimulator adapted to temporarily deliver neural stimulation therapy to assist with recovering from the arrhythmia in response to termination of the arrhythmia. | 07-24-2014 |
20140200641 | COIL ELECTRODE FITTING - Various embodiments concern an implantable lead having a coil electrode, configured to deliver defibrillation therapy, made from filars wound in a helical pattern to have a pitch. An end of the coil electrode can be received within a lumen of a tubular fitting, the lumen having threading that corresponds to the pitch of the filars. A wall of a polymer sleeve extending over the coil electrode can be pinched between the threading of the lumen and the filars to mechanically couple the polymer sleeve to the tubular fitting. The polymer sleeve can be porous to permit delivery of the defibrillation through the wall to tissue. Reception of the polymer sleeve within the lumen of the tubular fitting can allow the entire coil electrode to be within the polymer sleeve to prevent direct contact between tissue and the coil electrode. | 07-17-2014 |
20140200634 | INTERMITTENT NEURAL STIMULATION WITH PHYSIOLOGIC RESPONSE MONITOR - 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. | 07-17-2014 |
20140194963 | POLYISOBUTYLENE URETHANE, UREA AND URETHANE/UREA COPOLYMERS AND MEDICAL LEADS CONTAINING THE SAME - The present invention provides medical devices that contain polyisobutylene urethane copolymers, polyisobutylene urea copolymers and polyisobutylene urethane/urea copolymers. More particularly, the present invention provides medical leads that contain such copolymer. | 07-10-2014 |
20140194952 | METHOD AND APPARATUS FOR CONTROLLING AUTONOMIC BALANCE USING NEURAL STIMULATION - A neural stimulation system senses autonomic activities and applies neural stimulation to sympathetic and parasympathetic nerves to control autonomic balance. The neural stimulation system is capable of delivering neural stimulation pulses for sympathetic excitation, sympathetic inhibition, parasympathetic excitation, and parasympathetic inhibition. | 07-10-2014 |
20140194942 | METHOD AND APPARATUS TO PERFORM ELECTRODE COMBINATION SELECTION - Approaches for selecting an electrode combination of multi-electrode pacing devices are described. Electrode combination parameters that support cardiac function consistent with a prescribed therapy are evaluated for each of a plurality of electrode combinations. Electrode combination parameters that do not support cardiac function are evaluated for each of the plurality of electrode combinations. An order is determined for the electrode combinations based on the parameter evaluations. An electrode combination is selected based on the order, and therapy is delivered using the selected electrode combination. | 07-10-2014 |
20140194729 | SYSTEMS AND METHODS FOR SENSING EXTERNAL MAGNETIC FIELDS IN IMPLANTABLE MEDICAL DEVICES - Systems and methods for sensing external magnetic fields in implantable medical devices are provided. One aspect of this disclosure relates to an apparatus for sensing magnetic fields. An apparatus embodiment includes a sensing circuit with at least one inductor having a magnetic core that saturates in the presence of a magnetic field having a prescribed flux density. The apparatus embodiment also includes an impedance measuring circuit connected to the sensing circuit. The impedance measuring circuit is adapted to measure impedance of the sensing circuit and to provide a signal when the impedance changes by a prescribed amount. According to an embodiment, the sensing circuit includes a resistor-inductor-capacitor (RLC) circuit. The impedance measuring circuit includes a transthoracic impedance measurement module (TIMM), according to an embodiment. Other aspects and embodiments are provided herein. | 07-10-2014 |
20140194705 | METHOD AND SYSTEM FOR HEART FAILURE STATUS EVALUATION BASED ON A DISORDERED BREATHING INDEX - An evaluation of heart failure status is provided based on a disordered breathing index. Patient respiration is sensed and a respiration signal is generated. Disordered breathing episodes are detected based on the respiration signal. A disordered breathing index is determined based on the disordered breathing episodes. The disordered breathing index is trended and used to evaluate heart failure status. The disordered breathing index may be combined with additional information and/or may take into account patient activity, posture, sleep stage, or other patient information. | 07-10-2014 |
20140188202 | STIMULATION CUFF AND IMPLANTATION TOOL - Various embodiments concern wrapping a stimulation cuff around a nerve. The cuff can comprise a main body and at least one electrode. The main body can comprise an inner tab, an outer tab, and an intermediate portion extending between the inner tab and the outer tab, the at least one electrode disposed on the intermediate portion, the main body biased such that the cuff assumes the coiled arrangement. The cuff can be uncoiled by pulling on a first elongate element attached to a first tubular member, the first tubular member encircled within the cuff. The nerve can be engaged with an inner surface of the main body along the intermediate portion while the inner tab is releaseably attached to the first elongate element. The first elongate element can be released to allow the cuff to wrap around the nerve. | 07-03-2014 |
20140188184 | SYSTEMS AND METHODS TO OPTIMIZE PACING FUSION WITH NATIVE ACTIVATION - In an example, a pacing therapy can be optimized using information indicative of an offset duration between an intrinsic first atrioventricular delay of a subject at rest and a second atrioventricular delay specified to enhance a cardiac output of the subject heart when the subject is at rest. Optimizing the therapy can include receiving information about a heart rate of the subject and receiving information about an intrinsic, heart rate dependent atrioventricular delay. In an example, a therapy parameter, such as a therapy atrioventricular delay, can be adjusted using information about the received heart rate of the subject, the heart-rate-dependent third AV delay, or the offset duration. | 07-03-2014 |
20140180372 | PRE-LOADED VIBRATION ISOLATOR FOR IMPLANTABLE DEVICE - This document describes an apparatus or an implantable medical device including an implantably biocompatible case. The apparatus can include a component that can be sealed within the case. The apparatus can include a vibration isolator and an at least a portion of the vibration isolator can be situated between and compressively preloaded to bias against the case and the component. | 06-26-2014 |
20140180357 | STIMULATION PATCH WITH ACTIVE ADHESION - System and methods for adhering a patch of stimulation electrode(s) to blood vessels to stimulate a target site on the blood vessel are described. In one embodiment, the system includes an adhesion patch and at least one electrode. The adhesion patch includes an active adhesion mechanism that may produce an adhesive force sufficiently strong to adhere the adhesion patch to the exterior of the blood vessel and to operationally position the at least one electrode for use in electrically stimulating a target site of the blood vessel. The adhesion patch may also include a release mechanism that is configured for a user to disengage the patch from the exterior of the blood vessel without significant trauma to the blood vessel. After being released, the adhesion patch may be re-adhered to a different target site of the blood vessel and stimulate the different target site. | 06-26-2014 |
20140180356 | STIMULATION PATCH WITH PASSIVE ADHESION - System and methods for adhering a patch of stimulation electrode(s) to blood vessels to stimulate a target site on the blood vessel are described. In various embodiments, the system includes an adhesion patch and at least one electrode. The adhesion patch includes a passive adhesion mechanism that may produce an adhesive force sufficiently strong to adhere the adhesion patch to the exterior of the blood vessel and to operationally position the at least one electrode for use in electrically stimulating a target site of the blood vessel. The adhesion patch may also include a release mechanism that is configured for a user to disengage the patch from the exterior of the blood vessel without significant trauma to the blood vessel. After being released, the adhesion patch may be re-adhered to a different target site of the blood vessel and stimulate the different target site. | 06-26-2014 |
20140172038 | CONFIGURATION OF PACING OUTPUT CHANNELS - During auto-threshold, autocapture, or other evoked response sensing, post-pace artifact is reduced by using a smaller coupling capacitor value than what is used when not in such an evoked response sensing configuration. This can be accomplished by borrowing another capacitor for use as the coupling capacitor. The borrowed capacitor can be a backup pacing capacitor from the same or a different pacing channel. The borrowed capacitor can also be a coupling capacitor from a different pacing channel. | 06-19-2014 |
20140172035 | METHOD AND APPARATUS FOR RIGHT VENTRICULAR RESYNCHRONIZATION - An apparatus comprises a cardiac signal sensing circuit and a first implantable electrode pair. At least one electrode of the first implantable electrode pair is configured for placement at a location in a right branch of a His bundle of the subject. The apparatus can include a therapy circuit and a control circuit. The control circuit can include an AH delay calculation circuit configured to calculate an optimal paced AH delay interval. The pacing stimulation location is distal to a location of RV conduction block in a right branch of the His bundle. The control circuit initiates delivery of an electrical stimulation pulse to the stimulation location in the His bundle according to the calculated paced AH delay interval and in response to an intrinsic depolarization event sensed in an atrium of the subject. | 06-19-2014 |
20140172031 | METHODS AND DEVICES FOR DETECTION OF CONTEXT WHEN ADDRESSING A MEDICAL CONDITION OF A PATIENT - Methods and devices detect context related to a patient when monitoring a physiological condition of the patient and/or when applying one or more modes of therapy. The context may be a patient context such as posture or an environmental context such as ambient conditions. The context may be used in various ways in relation to the physiological measurement, such as to control when the physiological measurements are made, to appropriately flag physiological measurements, to be recorded in association with the physiological measurements, and/or to correct the physiological measurements based on a reference context. A device such as a beacon transmitter issued in detecting the context and a measurement device such as an implantable cardiovascular device is used to capture the physiological measurements. | 06-19-2014 |
20140171810 | SYSTEM AND METHOD FOR PRIORITIZING MEDICAL CONDITIONS - The technology disclosed herein generally relates to a method for providing an index disorder in automated patient care. A set of device measures is stored in a database. Quantitative health care data indicators in the database are provided, where the indicators were regularly recorded by a medical device for a patient under automated patient care. Collected device measures are retrieved with a processor. An index disorder is identified through derived measure determination and statistical calculation with a processor. | 06-19-2014 |
20140163631 | METHOD AND APPARATUS TO ENSURE CONSISTENT LEFT VENTRICULAR PACING - A method of operating a cardiac therapy system to deliver cardiac resynchronization therapy (CRT) pacing that includes pacing both ventricles or pacing only the left ventricle is described. Delivery of the CRT pacing to one or both ventricles is scheduled for a cardiac cycle. If an intrinsic depolarization of a ventricle is detected during a pacing delay of the ventricle, then the scheduled CRT pacing to the ventricle is inhibited for the cycle. The intrinsic interval of the ventricle, such as the intrinsic atrioventricular interval concluded by the intrinsic depolarization, is measured. During a subsequent cardiac cycle, the pacing delay of the ventricle is decreased to be less than or equal to the measured intrinsic interval. Capture of the ventricle is verified after pacing is delivered during the subsequent cardiac cycle. | 06-12-2014 |
20140163629 | IMPLANTED LEAD ANALYSIS SYSTEM AND METHOD - The technology disclosed herein relates to a method for lead analysis for an implanted medical device. A summary data record is retrieved associated with one or more episodes from an implanted medical device through a communication module. Episode selection criteria are applied to the summary data record by a processing module. One or more episode data records are retrieved from the implanted medical device for one or more episodes for which the episode selection criteria was satisfied. Noise detection criteria are applied to the episode data record. A notification module is configured to generate an alert if the noise detection criteria are satisfied | 06-12-2014 |
20140163398 | CARDIAC CYCLE SYNCHRONIZED SAMPLING OF IMPEDANCE SIGNAL - A system comprising implantable device, the implantable medical device including an intrinsic cardiac signal sensor, an impedance measurement circuit configured to apply a specified current to a transthoracic region of a subject and to sample a transthoracic voltage resulting from the specified current, and a processor coupled to the intrinsic cardiac signal sensor and the impedance measurement circuit. The processor is configured to initiate sampling of a transthoracic voltage signal in a specified time relation to a fiducial marker in a sensed intrinsic cardiac signal, wherein the sampling attenuates or removes variation with cardiac stroke volume from the transthoracic voltage signal, and determine lung respiration using the sampled transthoracic voltage signal. | 06-12-2014 |
20140155974 | ACTIVE FIXATION LEAD HAVING A ROTATABLE CURVE - Various embodiments concern a lead having a proximal section and a curbed section. The lead can comprise an outer tubular portion having a bias such that the lead assumes a curved shape along the curved section. The lead can further include an inner tubular portion extending within the outer tubular portion, the inner tubular portion comprising an inner coil conductor and an inner polymer jacket over the inner coil conductor along the curved section, the inner tubular member stiffer along the proximal section than the curved section, the outer tubular portion stiffer along the curved section relative to the inner tubular portion along the curved section such that the inner tubular portion can rotate relative to the outer tubular portion while the curved shape is substantially maintained. Relative rotation can extend and rotate and active fixation element. | 06-05-2014 |
20140155972 | MRI CONDITIONALLY SAFE LEAD WITH LOW-PROFILE CONDUCTOR FOR LONGITUDINAL EXPANSION - An implantable electrical lead includes a lead body and a multi-layer coil conductor extending within the lead body. The multi-layer coil conductor includes a first coil layer and a second coil layer disposed about the first coil layer. The first and second coil layers are configured such that the multi-layer coil conductor has an axial stiffness substantially equal to an axial stiffness of the lead body adjacent to the multi-layer coil conductor. | 06-05-2014 |
20140155958 | ADAPTIVE EVENT STORAGE IN IMPLANTABLE DEVICE - Monitoring physiological parameter using an implantable physiological monitor in order to detect a condition predictive of a possible future pathological episode and collecting additional physiological data associated with the condition predictive of a possible future pathological episode. Monitoring another physiological parameter in order to detect a condition indicative of the beginning of a present pathological episode and collecting additional pathological data in response to the condition. Determining that the condition predictive of a future episode and the condition indicative of a present episode are associated and, in response thereto, storing all the collected physiological data. | 06-05-2014 |
20140155766 | SYSTEM AND METHOD FOR EVALUATING A PATIENT STATUS FOR USE IN HEART FAILURE ASSESSMENT - A system and method for evaluating a patient status from sampled physiometry for use in heart failure assessment is presented. Physiological measures, including at least one of direct measures regularly recorded on a substantially continuous basis by a medical device and measures derived from the direct measures are stored. At least one of those of the physiological measures, which relate to a same type of physiometry, and those of the physiological measures, which relate to a different type of physiometry are sampled. A status is determined for a patient through analysis of those sampled measures assembled from a plurality of recordation points. The sampled measures are evaluated. Trends that are indicated by the patient status, including one of a status quo and a change, which might affect cardiac performance of the patient, are identified. Each trend is compared to worsening heart failure indications to generate a notification of parameter violations. | 06-05-2014 |
20140155765 | SYSTEM AND METHOD FOR EVALUATING A PATIENT STATUS FOR USE IN HEART FAILURE ASSESSMENT - A system and method for evaluating a patient status from sampled physiometry for use in heart failure assessment is presented. Physiological measures, including at least one of direct measures regularly recorded on a substantially continuous basis by a medical device and measures derived from the direct measures are stored. At least one of those of the physiological measures, which relate to a same type of physiometry, and those of the physiological measures, which relate to a different type of physiometry are sampled. A status is determined for a patient through analysis of those sampled measures assembled from a plurality of recordation points. The sampled measures are evaluated. Trends that are indicated by the patient status, including one of a status quo and a change, which might affect cardiac performance of the patient, are identified. Each trend is compared to worsening heart failure indications to generate a notification of parameter violations. | 06-05-2014 |
20140155762 | METHOD AND APPARATUS FOR DETECTING SUBAUDIBLE CARDIAC VIBRATIONS - A monitoring system senses a physiological signal indicative of mechanical vibrations including audible and/or subaudible frequency ranges and presents information related to the physiological signal to a user. The presented information includes subaudible components of the physiological signal. In various embodiments, the information can be presented as a visual signal representing the mechanical vibrations including the subaudible components, an audial signal representing the mechanical vibrations having a spectrum shifted to an audible frequency range, and/or an audial signal representing the mechanical vibrations having a spectrum compressed into an audible frequency range. An example of the physiological signal can include a heart sound signal indicative of heart sounds including cardiac mechanical vibrations in audible and subaudible frequency ranges. | 06-05-2014 |
20140148717 | METHOD AND SYSTEM FOR ARRHYTHMIA DISCRIMINATION - A method and system for discriminating ventricular arrhythmia is disclosed. In an embodiment, the method can include implementing an arrhythmia discrimination algorithm that can discriminate between supraventricular tachycardia (SVT) and ventricular tachycardia (VT) using at least one programmable parameter programmed to a first value. The method can include analyzing an SVT event, where analyzing the SVT event can include sensing a physiological signal during the SVT event and identifying characteristics of the sensed physiological signal. The method can further include analyzing a cardiac signal to classify the cardiac signal as either an SVT or a VT using the arrhythmia discrimination algorithm with the programmable parameter (programmed to a second value. The second value can be determined from the identified characteristics of the sensed physiological signal. | 05-29-2014 |
20140147708 | METHOD AND APPARATUS FOR A SMALL POWER SOURCE FOR AN IMPLANTABLE DEVICE - An example includes apparatus including a non-thin-film battery, that can include an implantable housing, electronics disposed in the implantable housing, and a battery disposed in the implantable housing, the battery comprising: a plurality of cells electrically connected to one another, with at least one cell including a stack including at least one substantially planar anode having a thickness greater than 1 micrometer and at least one substantially planar cathode having a thickness greater than 1 micrometer, and a cell housing enclosing the stack of substantially planar anodes and cathodes and displacing less than approximately 0.024 cubic centimeters, wherein the plurality of cells are interconnected in at least one of series and parallel, and terminals interconnecting the battery and the electronics. | 05-29-2014 |
20140144580 | MEDICAL DEVICES INCLUDING POLYISOBUTYLENE BASED POLYMERS AND DERIVATIVES THEREOF - The present invention is directed to a medical electrical lead including an insulative lead body formed, at least in part, from a polyisobutylene urethane, urea or urethane/urea copolymer. In some applications, the lead body can include at least one outer tubular insulator and/or an inner elongated member formed from a polyisobutylene urethane, urea or urethane/urea copolymer. Portions of the lead body formed form the polyisobutylene urethane, urea or urethane/urea copolymer can be either extruded or molded. | 05-29-2014 |
20140142670 | MEDICAL ELECTRODES WITH LAYERED COATINGS - Various embodiments concern an electrode of an implantable medical device for delivering electrical stimulation to tissue. Such an electrode can include a main body formed from a substrate metal comprising one of titanium, stainless steel, a cobalt-chromium alloy, or palladium. The main body may not be radiopaque. The electrode may further include a first coating on at least one side of the main body, the first coating comprising a layer of one of tantalum or iridium metal that is at least about 2 micrometers thick. The first coating can be radiopaque and porous. The porosity of the first coating can increase the electrical performance of the electrode in delivering electrical stimulation to tissue. | 05-22-2014 |
20140142649 | METHODS AND APPARATUS FOR PREDICTING ACUTE RESPONSE TO CARDIAC RESYNCRONIZATION THERAPY AT A GIVEN STIMULATION SITE - Response to cardiac resynchronization therapy is predicted for a given stimulation site so that an atrioventricular delay of an implantable device administering cardiac resynchronization therapy may be set to a proper amount. The first deflection of ventricular depolarization is measured, such as through a surface electrocardiogram or through an intracardiac electrogram measured by a lead positioned in the heart at the stimulation site. The maximum deflection of the ventricular depolarization is then measured by the lead positioned at the stimulation site. The interval of time between the first deflection and the maximum deflection of the ventricular depolarization is compared to a threshold to determine whether the stimulation site is a responder site. If the interval is larger than the threshold, then the site is a responder and the atrioventricular delay of the implantable device may be set to less than the intrinsic atrioventricular delay of the patient. Otherwise, the atrioventricular may be set to approximately equal the intrinsic atrioventricular delay. | 05-22-2014 |
20140142648 | MODULAR ANTITACHYARRHYTHMIA THERAPY SYSTEM - This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as a defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module. | 05-22-2014 |
20140142440 | METHOD AND APPARATUS FOR MANAGEMENT OF HEART FAILURE HOSPITALIZATION - A hospitalization management system including a heart failure analyzer that receives diagnostic data including at least sensor data representative of one or more physiological signals sensed from a hospitalized patient using one or more sensors and assesses risk of rehospitalization for the patient using the diagnostic data. The outcome of the risk assessment is used during and following the patient's hospitalization for reducing the risk of rehospitalization. | 05-22-2014 |
20140135885 | IMPLANTABLE LEAD HAVING A LUMEN WITH A WEAR-RESISTANT LINER - An implantable lead includes a lead body having a proximal end portion and a distal end portion. The lead body includes an insulative member having a lumen extending longitudinally between the proximal end portion and the distal end portion. The lead body also includes a generally tubular liner disposed coaxially with the lumen within the insulative member. The implantable lead also includes an electrode disposed along the lead body in the distal end portion thereof, and a conductor disposed within the lumen and electrically coupled to the electrode. A terminal connector is coupled to the proximal end portion of the lead body and to the conductor. | 05-15-2014 |
20140135861 | SYSTEMS AND METHODS FOR PROVIDING ARRHYTHMIA THERAPY IN MRI ENVIRONMENTS - Systems and methods for arrhythmia therapy in MRI environments are disclosed. Various systems disclosed utilize ATP therapy rather than ventricular shocks when patients are subjected to electromagnetic fields in an MRI scanner bore and shock therapy is not available. As the patient is moved out from within the scanner bore and away from the MRI scanner, the magnetic fields diminish in strength eventually allowing a high voltage capacitor within the IMD to charge if necessary. The system may detect when the electromagnetic fields no longer interfere with the shock therapy and will transition the IMD back to a normal operational mode where shock therapy can be delivered. Then, if the arrhythmia still exists, the system will carry out all of the system's prescribed operations, including the delivery of electric shocks to treat the arrhythmia. | 05-15-2014 |
20140135859 | System And Method For Automated Diagnosis Of Myocardial Ischemia Through Remote Monitoring - A system and method for automated diagnosis of myocardial ischemia through remote monitoring is described. Physiological measures comprising data either recorded on a regular basis by a medical device or derived therefrom is stored. Qualitative measures associated with the physiological measures are matched. Indications of myocardial ischemia are remotely identified. The qualitative measures for both of a reduction in exercise capacity and respiratory distress occurring contemporaneously are examined. The qualitative measures for angina that accompanies the reduction in exercise capacity and the respiratory distress are evaluated. A time course for each of the indications is determined. A patient status is formed comprising an onset of myocardial ischemia conditioned on the time course comprising a short duration. | 05-15-2014 |
20140135789 | GUIDE CATHETER OCCLUSION BALLOON WITH ACTIVE INFLATION - Various embodiments concern a guide catheter for delivery of an implantable lead within the coronary vein. Such a guide catheter can comprise a tubular body having a main lumen and at least one preformed bend. The tubular body can comprise a liner defining an inner surface, braiding circumferentially surrounding the liner, a jacket covering the braiding and defining an exterior surface of the tubular body, and a plurality of inflation tubes embedded within the jacket. The guide catheter can include a balloon mounted on the tubular body, each of the plurality of inflation tubes in communication with the balloon. The guide catheter can further include a hub providing access to the main lumen, the hub comprising a first port for introduction of contrast media into the main lumen and a second port in communication with the plurality of inflation tubes. | 05-15-2014 |
20140135637 | System And Method For Monitoring a Patient Status - A system and method for automated diagnosis of myocardial ischemia through remote monitoring is described. Physiological measures comprising data either recorded on a regular basis by a medical device or derived therefrom is stored. Qualitative measures associated with the physiological measures are matched. Indications of myocardial ischemia are remotely identified. The qualitative measures for both of a reduction in exercise capacity and respiratory distress occurring contemporaneously are examined. The qualitative measures for angina that accompanies the reduction in exercise capacity and the respiratory distress are evaluated. A time course for each of the indications is determined. A patient status is formed comprising an onset of myocardial ischemia conditioned on the time course comprising a short duration. | 05-15-2014 |
20140128953 | SYSTEMS AND METHODS FOR DELIVERING VAGAL NERVE STIMULATION - 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. | 05-08-2014 |
20140128948 | FIXATION AND STRAIN RELIEF ELEMENT FOR TEMPORARY THERAPY DELIVERY DEVICE - A temporary neurostimulation lead may be secured relative to patient using a fixation device. The fixation device may include an attachment portion that is configured to be releasably fixated to the patient and a lead fixation portion that is configured to secure the temporary neurostimulation lead. The fixation device can be adhesively fixated to the patient via the attachment portion and the temporary neurostimulation lead can be fixated to the lead fixation portion of the fixation device. | 05-08-2014 |
20140128933 | METHOD AND APPARATUS FOR PHRENIC STIMULATION DETECTION - Approaches for characterizing a phrenic stimulation threshold, a cardiac capture threshold, a maximum device parameter, and a minimum device parameter are described. A plurality of cardiac pacing pulses can be delivered by using a cardiac pacing device, a pacing parameter of the plurality of cardiac pacing pulses being changed between delivery of at least some of the pulses. One or more sensor signals can be evaluated to detect stimulation of the phrenic nerve by one or more of the plurality of cardiac pacing pluses. The evaluation of the one or more sensor signals and the pacing parameter can be compared to determine if a phrenic stimulation threshold is at least one of higher than a maximum device parameter and lower than a minimum device parameter. | 05-08-2014 |
20140121739 | SUTURE SLEEVES HAVING EXTERIOR SURFACE TEAR RESISTANCE - Various embodiments concern a suture sleeve for securing an implantable lead with a suture. The suture sleeve can comprise a tubular body having a proximal end portion, a distal end portion, an exterior surface, and a lumen, the lumen sized to receive the implantable lead. The suture sleeve can further comprise a suture receiving area along the tubular body, the suture receiving area within a channel that extends around a circumference of the tubular body. An exterior surface of the suture receiving area can comprise a tear resistant feature. The tear resistant feature can be configured to resist initiation of a tear in the exterior surface from the suture. The lumen can comprise an inner surface configured to frictionally engage the implantable lead. | 05-01-2014 |
20140121729 | BAROREFLEX MODULATION TO GRADUALLY CHANGE A PHYSIOLOGICAL PARAMETER - An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein. | 05-01-2014 |
20140121718 | SYSTEMS, DEVICES AND METHODS FOR MODULATING AUTONOMIC TONE - Various embodiments intermittently deliver a sympathetic stimulus, including deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further delivers neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus. | 05-01-2014 |
20140121545 | SYSTEM AND METHOD FOR EVALUATING A PATIENT STATUS FOR USE IN HEART FAILURE ASSESSMENT - A system and method for evaluating a patient status from sampled physiometry for use in heart failure assessment is presented. Physiological measures are stored, including at least one of direct measures regularly recorded on a substantially continuous basis by an implantable medical device for a patient and measures derived from the direct measures. At least one of those of the physiological measures, which each relate to a same type of physiometry, and those of the physiological measures, which each relate to a different type of physiometry are sampled. A status for the patient is determined through analysis of the sampled physiological measures assembled from a plurality of recordation points. The sampled physiological measures are evaluated. Trends that are indicated by the patient status, which might affect cardiac performance of the patient, are identified. Each trend is compared to worsening heart failure indications to generate a notification of parameter violations. | 05-01-2014 |
20140114383 | INDUCTIVE ELEMENT FOR PROVIDING MRI COMPATIBILITY IN AN IMPLANTABLE MEDICAL DEVICE LEAD - A system includes a medical device lead including a connector at a proximal end of the lead, a conductor electrically connected to the connector at a proximal end of the conductor, and at least one electrode coupled to a distal end of the conductor. The system further includes a device securable to the proximal end of the lead including an inductive element. The device includes a port configured to receive the connector and position the inductive element around at least a portion of the connector. | 04-24-2014 |
20140114370 | HEART FAILURE MANAGEMENT - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 04-24-2014 |
20140111353 | MODULAR PATIENT COMMUNICATOR FOR USE IN LIFE CRITICAL NETWORK - A modular patient communicator provides for communications with a patient implantable medical device (PIMD) and connectivity with a central authority (CA) via an unsecured network. Medical firmware and a radio facilitate wireless interrogation of the PIMD and acquisition of PIMD data. A universal communications port facilitates mechanical and signal connectivity with one or a multiplicity of disparate detachable modules, some of which provide the communicator with an external communications facility and have disparate communication protocols. The communicator is devoid of an external communications facility other than the radio and universal communications port. Life critical network software is executed in cooperation with an attached module to cause the communicator to transmit a request to a network access facility for a connection to the unsecured network, authenticate the communicator to the CA, and facilitate secured communication between the communicator and CA upon successful communicator authentication. | 04-24-2014 |
20140107754 | TERMINAL RING CONFIGURATION TO PREVENT IMPROPER IS4 LEAD CONNECTOR ELECTRICAL CONTACT WITH DF4 CONNECTOR PORT - An implantable lead includes a flexible lead body, a plurality of conductor wires and a plurality of electrodes. The implantable lead also includes a terminal connector assembly coupled with a proximal end of the lead body. The terminal connector assembly is sized to be inserted into and received by a connector port of a pulse generator header. The terminal connector assembly includes a plurality of axially spaced terminal ring elements each electrically coupled to at least one of the conductor wires. The terminal ring elements are separated from one another by an electrically insulating material. Each of the terminal ring elements includes an outer surface having a first portion and a second portion, the first portion being electrically conductive and the second portion being electrically non-conductive. | 04-17-2014 |
20140107753 | ACTIVE FIXATION LEADS AND METHOD OF ASSEMBLY - An active fixation lead may have a lead body formed at least in part from an inner member and an outer sheath. The inner member may include a pace/sense lumen and one or more cable lumens. The inner member may include one or more longitudinally extending crumple zones that are configured to reduce stress within the pace/sense lumen that could otherwise be caused by compressive forces applied to the lead. | 04-17-2014 |
20140107724 | METHOD AND APPARATUS FOR SELECTIVE HIS BUNDLE PACING - A cardiac rhythm management system provides for cardiac pacing that is delivered to a target portion of conductive tissue in a heart, such as the His bundle. In various embodiments, the system is configured to verify capture of the target portion and provide for selective pacing of the target portion. In various embodiments, the system is configured to detect responses of the target portion and adjacent myocardial tissue to delivery of pacing pulses and use an outcome of the detection to verify selective capture of the target portion (i.e., without directly exciting the adjacent myocardial tissue. | 04-17-2014 |
20140107506 | AUTONOMIC AROUSAL DETECTION SYSTEM AND METHOD - Various approaches to detecting arousals from sleep involve generating signals modulated by muscle tone, brainwave activity, and/or other nervous system activity associated with a patient's autonomic arousal response. Generating the signals and/or detecting autonomic arousals from sleep may be performed using an implantable device. Arousal information may be useful to identify sleep disorder events associated with arousals from sleep, for diagnostic purposes, and/or for therapy adjustment. | 04-17-2014 |
20140107503 | DIFFERENTIATING DECOMPENSATION DETECTION BASED ON CO-MORBIDITIES IN HEART FAILURE - This document discusses, among other things, a system comprising a sensor signal processor configured to receive a plurality of electrical sensor signals produced by a plurality of sensors and at least one sensor signal produced by an implantable sensor, a memory that includes information indicating a co-morbidity of a subject, a sensor signal selection circuit that selects a sensor signal to monitor from among the plurality of sensor signals, according to an indicated co-morbidity, a threshold adjustment circuit that adjusts a detection threshold of the selected sensor signal according to the indicated co-morbidity, and a decision circuit that applies the adjusted detection threshold to the selected sensor signal to determine whether an event associated with worsening heart failure (HF) occurred in the subject and outputs an indication of whether the event associated with worsening HF occurred to a user or process. | 04-17-2014 |
20140100628 | NEURAL STIMULATION WITH RESPIRATORY RHYTHM MANAGEMENT - A system embodiment comprises at least one respiration sensor, a neural stimulation therapy delivery module, and a controller. The respiration sensor is adapted for use in monitoring respiration of the patient. The neural stimulation therapy delivery module is adapted to generate a neural stimulation signal for use in stimulating the autonomic neural target of the patient for the chronic neural stimulation therapy. The controller is adapted to receive a respiration signal from the at least one respiration sensor indicative of the patient's respiration, and adapted to control the neural stimulation therapy delivery module using a respiratory variability measurement derived using the respiration signal. | 04-10-2014 |
20140100626 | ACTIVITY SENSOR PROCESSING FOR PHRENIC NERVE ACTIVATION DETECTION - An implantable cardiac device includes a sensor for sensing patient activity and detecting phrenic nerve activation. A first filter channel attenuates first frequencies of the sensor signal to produce a first filtered output. A second filter channel attenuates second frequencies of the accelerometer signal to produce a second filtered output. Patient activity is evaluated using the first filtered output and phrenic nerve activation caused by cardiac pacing is detected using the second filtered output. | 04-10-2014 |
20140100625 | LEFT VENTRICULAR PACING PROTECTION IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - In a pacing mode where the left ventricle is paced upon expiration of an escape interval that is reset by a right ventricular sense, there is the risk that the left ventricular pace may be delivered in the so-called vulnerable period that occurs after a depolarization and trigger an arrhythmia. To reduce this risk, a left ventricular protective period (LVPP) may be provided. Methods and devices for implementing an LVPP in the context of multi-site left ventricular pacing are described. | 04-10-2014 |
20140094888 | PINCH TO OPEN CUFF ELECTRODE - The invention describes a cuff electrode assembly that includes a resilient cuff body configured to be disposed about a nerve. The cuff body includes a first end portion and a second end portion. The cuff body can be pre-formed to define a closed configuration having a generally annular cross-sectional shape such that, in the closed configuration, the cuff body extends helically with the first and second end portions overlapping on different planes. The cuff electrode assembly includes a first arm member and a second arm member, each projecting radially outward from the cuff body and spaced from one another along the cuff body. The cuff body can be configured such that force applied to urge the first and second arm members toward one another causes relative deflection of the first end portion and the second end portion to define an open configuration of the cuff body. | 04-03-2014 |
20140094887 | PINCH TO OPEN CUFF ELECTRODE - The present invention provides a cuff electrode assembly for implantation on a target nerve. The cuff electrode assembly can include a resilient cuff body configured to be disposed about the target nerve. The cuff body includes a first end portion having a first free end, and a second end portion having a second free end. The cuff electrode assembly further includes a first arm member and a second arm member each projecting radially outward from the cuff body and spaced from one another along the cuff body. The cuff body can be configured such that a force applied to urge the first and second arm members toward one another defines an open configuration of the cuff body configured to allow the cuff body to be positioned around the target nerve. The cuff electrode assembly further includes an electrode oriented to provide electrical stimuli to the target nerve. | 04-03-2014 |
20140094875 | REMOTE SENSING IN AN IMPLANTABLE MEDICAL DEVICE - An embodiment uses an accelerometer to sense heart sounds, and determines heart rate information using the sensed heart sounds. An embodiment uses an accelerometer to sense respiratory activity. An embodiment delivers a programmed neural stimulation therapy with a programmed duty cycle, where the programmed duty cycle includes a stimulation ON portion followed by a stimulation OFF portion. An electrode electrically connected to the implanted neural stimulation device is used to remotely detect cardiac activity. The remotely detected cardiac activity is used to detect heart rate information during the stimulation ON portion and to detect heart rate information during the stimulation OFF portion. The detected heart rate information and/or the detected respiration information are used to control a neural stimulation therapy performed by the neural stimulator device and/or are used to provide diagnostic information for the patient's condition. | 04-03-2014 |
20140088661 | ELECTRICAL INIBITION OF THE PHRENIC NERVE DURING CARDIAC PACING - According to various method embodiments for pacing a heart and avoiding unwanted stimulation of a phrenic nerve during cardiac pacing, a desired pacing time for delivering a cardiac pace is determined, and a desired nerve traffic inhibition time to inhibit nerve traffic in the phrenic nerve is determined using the desired pace time. The cardiac pace is delivered at the desired pacing time and nerve traffic in the phrenic nerve is inhibited at the desired nerve traffic inhibition time. | 03-27-2014 |
20140088218 | Crosslinkable Polyisobutylene-Based Polymers and Medical Devices Containing the Same - The present invention pertains to crosslinkable and crosslinked polyisobutylene-based polymers, to compositions that contain such polymers, and to medical devices that are formed using such polymers. According to one aspect, the present invention pertains to crosslinkable and crosslinked compositions that comprise a copolymer that comprises a polyisobutylene segment and two or more reactive groups. According to another aspect, the present invention pertains to medical devices that contain such compositions. According to another aspect, the present invention pertains to methods of making medical devices using such compositions. | 03-27-2014 |
20140083762 | FEEDTHROUGH ASSEMBLY FOR AN IMPLANTABLE DEVICE - A feedthrough assembly includes a metallic ferrule, an insulator mounted within the ferrule, a plurality of feedthrough wires mounted within and extending through the insulator, and a ground wire directly attached to the ferrule, wherein the ground wire does not pass through or alongside the insulator. | 03-27-2014 |
20140081363 | FIXATION MECHANISMS FOR TEMPORARY IMPLANTABLE MEDICAL ELECTRICAL STIMULATION LEADS - A temporary implantable medical device lead includes a connector configured to connect the lead to an external control module, a helically coiled conductor including a plurality of insulated filars and having a proximal end mechanically and electrically connected to the connector, and one or more electrodes defined by uninsulated portions of the helically coiled conductor. The temporary implantable medical device lead also includes one or more tine assemblies proximal to the one or more electrodes and configured to inhibit axial migration of the temporary implantable medical device lead, each tine assembly including a base and a plurality of tines extending from the base. | 03-20-2014 |
20140081344 | CARDIAC WAVEFORM TEMPLATE CREATION, MAINTENANCE AND USE - The present disclosure describes methods, devices, and systems for generating, adjusting, and using cardiac waveform morphology templates. The morphology templates include target regions associated with features of cardiac waveforms. The target regions may be adjusted based on relationships between the target regions and features of detected cardiac waveforms associated with the target regions. The templates may be used to analyze cardiac waveforms to classify or monitor various waveform morphologies. Templates may be created or eliminated, for instance, based on a frequency of use. According to one approach, template creation involves providing target regions defined by one or more characteristics. The target regions are adjusted based on detected cardiac waveform features having similar characteristics. A template may be created using the target regions adjusted by this process. | 03-20-2014 |
20140075752 | FEEDTHROUGH SYSTEM FOR IMPLANTABLE DEVICE COMPONENTS - The present subject matter provides feedthrough or interconnect systems for components of an implantable medical device and methods for their manufacture. A feedthrough system includes a wire or nailhead having a protruded tip. The wire or nailhead extends from an aperture in an encasement of a first component and is connected to a terminal conductor adapted to electrically connect to circuitry within the encasement. A ribbon wire has a distal end adapted to electrically connect to a second component and a proximal end having a pattern adapted to fit to the protruded tip of the wire or nailhead to provide for subsequent attachment of the ribbon wire to the nailhead. | 03-20-2014 |
20140074201 | CONFORMAL POROUS THIN LAYER COATING AND METHOD OF MAKING - A method of forming an implantable medical device includes forming a porous layer of a first material on a substrate, extruding or molding a second material over the porous layer and removing the substrate after extruding or molding the second material to form an implantable medical device. | 03-13-2014 |
20140074178 | CARDIAC RHYTHM MANAGEMENT SYSTEM SELECTING BETWEEN MULTIPLE SAME-CHAMBER ELECTRODES FOR DELIVERING CARDIAC THERAPY - A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction evoking stimulation therapy is delivered from the selected electrode. | 03-13-2014 |
20140074177 | METHOD AND APPARATUS TO PERFORM ELECTRODE COMBINATION SELECTION - Approaches for selecting an electrode combination of multi-electrode pacing devices are described. Electrode combination parameters that support cardiac function consistent with a prescribed therapy are evaluated for each of a plurality of electrode combinations. Electrode combination parameters that do not support cardiac function are evaluated for each of the plurality of electrode combinations. An order is determined for the electrode combinations based on the parameter evaluations. An electrode combination is selected based on the order, and therapy is delivered using the selected electrode combination. | 03-13-2014 |
20140073980 | APPARATUS AND METHOD FOR OUTPUTTING HEART SOUNDS - An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output. | 03-13-2014 |
20140073972 | METHODS AND SYSTEMS FOR RECHARGING AN IMPLANTED DEVICE BY DELIVERING A SECTION OF A CHARGING DEVICE ADJACENT THE IMPLANTED DEVICE WITHIN A BODY - Methods, systems, and apparatus for recharging medical devices implanted within the body are disclosed. An illustrative rechargeable system includes a charging device that includes an elongate shaft having a proximal section and a distal section. The distal section is configured to be delivered to a location within the body adjacent to the implanted medical device. The charging device includes a charging element configured to transmit charging energy to a receiver of the implanted medical device. | 03-13-2014 |
20140073971 | MANAGING PRELOAD RESERVE BY TRACKING THE VENTRICULAR OPERATING POINT WITH HEART SOUNDS - A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator. | 03-13-2014 |
20140073194 | TERMINAL CONNECTOR ASSEMBLY FOR A MEDICAL ELECTRICAL LEAD - An IS-4 terminal connector assembly includes three terminal electrodes positioned over an inner tubular member such that they are radially offset from one another. Each of the terminal ring electrodes are configured such that they can withstand both tensile and cyclical bending loads with minimal compromise in their outer geometry. Additionally, each of the terminal electrodes is configured such that they have both an inner and outer geometry that facilitates adequate insulation between a select terminal electrode and an adjacent conductor. Additionally, each of the terminal ring electrodes is configured such that they facilitate an external approach to staking a cable conductor. | 03-13-2014 |
20140067036 | HIS BUNDLE LEAD DELIVERY SYSTEM - Various embodiments concern implanting a lead to directly stimulate the bundle of His. Various embodiments can include introducing a curve of an outer guide catheter into the right ventricle, extending a curve of an inner guide catheter from a lumen of the outer guide catheter, extending a fixation element on a distal tip of an anchor wire from a lumen the inner guide catheter, and anchoring the anchor wire to target tissue within the right ventricle, the target tissue along the septal wall and proximate the tricuspid valve and the bundle of His. A distal tip of an implantable lead with a lumen can then be advanced over the anchor wire to the target tissue as the anchor wire guides the distal tip of the lead to the target tissue. | 03-06-2014 |
20140067031 | LEADS INCORPORATING A LASER PROCESSED ELECTRODE - Medical devices may include an electrode that has been processed to increase its surface area. In some cases, an electrode may be processed using an ultrafast laser to produce an electrode surface that includes macrostructures formed within the electrode surface and nanostructures formed on the macrostructures. The nanostructures may be formed of material that was removed from the electrode surface in forming the macrostructures. | 03-06-2014 |
20140067030 | MRI COMPATIBLE LEAD COIL - Various embodiments concern leads having low peak MRI heating for improved MRI compatibility. Various leads include a lead body having at least one lumen, a proximal end configured to interface with an implantable medical device, and a distal end. Such leads can further include a conductor extending along at least a portion of the lead body within the at least one lumen and a defibrillation coil extending along an exterior portion of the lead body and in electrical connection with the conductor, wherein at least a section of the defibrillation coil is under longitudinal compression. The longitudinal compression can lower peak MRI heating along the defibrillation coil. The longitudinal compression may maintain circumferential contact between adjacent turns of the section of the defibrillation coil. | 03-06-2014 |
20140067028 | ENHANCED LOW FRICTION COATING FOR MEDICAL LEADS AND METHODS OF MAKING - An implantable or insertable medical device can include a silicone substrate and a plasma-enhanced chemical vapor deposition coating on the silicone substrate. The coating may include a silicon-containing compound. A method of forming the coating is also provided. | 03-06-2014 |
20140067002 | SELECTION OF PACING SITES TO ENHANCE CARDIAC PERFORMANCE - Systems and methods for selection of electrodes and related pacing configuration parameters used to pace a heart chamber are described. A change in the hemodynamic state of a patient is detected. Responsive to the detected change, a distribution of an electrical, mechanical, or electromechanical parameter related to contractile function of a heart chamber with respect to locations of multiple electrodes disposed within the heart chamber is determined. A pacing output configuration, including one or more electrodes of the multiple electrodes, is selected and the heart chamber is paced using the selected pacing output configuration. | 03-06-2014 |
20140062718 | MEDICAL DATA TRANSPORT OVER WIRELESS LIFE CRITICAL NETWORK - A communicator facilitates communications with a remote server via a wireless network supporting a plurality of disparate data transport mechanisms having differing characteristics. A processor coupled to memory is disposed in a communicator housing, which is configured for portability. The memory stores wireless radio firmware and data transfer instructions that are executable by the processor for transferring data to the remote server in accordance with a priority level. The priority level is based in part on criticality of the data and the communicator status. A radio disposed in the housing effects communications via the wireless network in accordance with the firmware. A power source in the housing supplies power for communicator components. The processor executes program instructions for selecting a data transport mechanism among the plurality transport mechanisms based on the priority level, and transmits the data via the wireless network via the radio using the selected transport mechanism. | 03-06-2014 |
20140058472 | BIVENTRICULAR-TRIGGERED PACING IN THE CONTEXT OF MULTI-SITE LEFT VENTRICULAR PACING - Biventricular-triggered pacing is a pacing mode that can employ in cardiac resynchronization pacing at elevated heart rates. Described herein are methods and devices for implementing biventricular pacing in the context of multi-site left ventricular pacing. | 02-27-2014 |
20140058471 | MEASURING AUTONOMIC TONE USING ATRIOVENTRICULAR DELAY - An autonomic status indicator representative of a sympathetic/parasympathetic balance of a subject can use atrioventricular (AV) delays measured during recovery from (or in response to) elevated atrial pacing while the subject is at rest. | 02-27-2014 |
20140058468 | USE CASE-BASED SERVICES - An apparatus comprises an external device for communication with an implantable device. The external device includes a communication circuit configured to receive a communication signal from at least a third device separate from the external device and the implantable device, a locating circuit configured to determine a location of the external device using the received communication signal, a port configured to receive user identity information into the external device, and a control circuit electrically coupled to the communication circuit, the locating circuit, and the port. The control circuit is configured to allow user access to an implantable device feature according to the determined location and received user identity information. | 02-27-2014 |
20140058467 | IMPLANTABLE MEDICAL DEVICE WITH CONTROL OF NEURAL STIMULATION BASED ON BATTERY STATUS - An implantable medical device is powered by a battery to deliver one or more therapies including at least one non-life-sustaining therapy such as neural stimulation for enhancing quality of life of a patient. When the battery approaches its end of life, the implantable medical device reduces power consumption of the neural stimulation (e.g., intensity of the neural stimulation) for extending the remaining battery life while maintaining a certain amount of therapeutic benefits for the patient. In one embodiment, the intensity of the neural stimulation is reduced in a tiered manner. In one embodiment in which the implantable medical device also delivers at least one life-sustaining cardiac stimulation therapy, the neural stimulation is disabled or adjusted to reduce its power consumption (e.g., intensity) while the intensity of the cardiac stimulation therapy is maintained when the battery is near its end of life. | 02-27-2014 |
20140058405 | COMPOUND-SHAPED STYLET FOR TORQUE TRANSMISSION - A medical stylet for guiding a lead includes a first elongate member for attachment of the lead to the target tissue, a second elongate member to reshape the lead. The first elongate member of the medical stylet includes a proximal end portion, and a distal end portion wherein the distal end portion of the first elongate member includes a tip feature configured to engage the lead on application of torque externally. The second elongate member defines a lumen along its length. The lumen of the second elongate member can be configured to enclose at least a portion of the first elongate member. The second elongate member can have a pre defined shape. The pre defined shape of the second elongate member allows the lead to be reshaped when inserted into the lead, this reshaped lead now can be guided to an anatomical pass way. | 02-27-2014 |
20140058383 | LOCATION-BASED SERVICES - An apparatus comprises an external device for communication with an implantable device. The external device includes a communication circuit configured to receive a communication signal from at least one other device different from the implantable device, a locating circuit configured to determine a location of the external device using the received communication signal, and a control circuit electrically coupled to the communication circuit and the locating circuit. The control circuit is configured to determine whether the determined location imposes a limit on functionality of an implantable device, and provide user access to an implantable device feature according to the determined location. | 02-27-2014 |
20140055230 | System and Method for Remotely Programming a Patient Medical Device - A system and method for remotely programming a patient medical device (PMD) is presented. Programming instructions specified remotely are translated into commands formatted for a PMD to control functionality thereof. Correctness of the PMD-formatted commands is checked. Patient consent to modify the functionality of the PMD is confirmed. Application of the PMD-formatted commands to the PMD is controlled during a programming session initiated and performed remotely. The application of the PMD-formatted commands is confirmed through interrogation of the PMD to verify the functionality modified. | 02-27-2014 |
20140052226 | LEAD WITH TEXTURED INSULATIVE LAYER - Described is a medical device lead including a lead body having a conductor lumen including an inner surface. The lead also includes a conductor assembly extending through the conductor lumen; the conductor assembly comprising a conductor member and an outer insulative layer; and an electrode coupled to the conductor cable. The outer insulative layer includes a textured external surface that reduces the coefficient of friction between the outer insulative layer and the inner surface of the conductor lumen through which the conductor assembly extends. Methods of forming the conductor assembly are also described. | 02-20-2014 |
20140052209 | PHYSIOLOGICAL VIBRATION DETECTION IN AN IMPLANTED MEDICAL DEVICE - An embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy. | 02-20-2014 |
20140052206 | SYSTEM AND METHOD FOR GRAPHICALLY CONFIGURING LEADS - Systems and methods are provided for graphically configuring leads for a medical device. According to one aspect, the system generally comprises a medical device and a processing device, such as a programmer or computer, adapted to be in communication with the medical device. The medical device has at least one lead with at least one electrode in a configuration that can be changed using the processing device. The processing device provides a graphical display of the configuration, including a representative image of a proposed electrical signal to be applied by the medical device between the at least one electrode of the medical device and at least one other electrode before the medical device applies the electrical signal between the at least one electrode and the at least one other electrode. In one embodiment, the graphical display graphically represents the lead(s), the electrode(s), a pulse polarity, and a vector. | 02-20-2014 |
20140046415 | REINFORCED COIL CREATED FROM POLYMER COATED WIRE FOR IMPROVED TORQUE TRANSFER - An implantable medical device lead includes a lead body including a lumen extending from a proximal end of the lead body to a distal end of the lead body, and a helically coiled conductor including one or more filars extending through the lumen and including a plurality of turns. The implantable medical device lead further includes an insulative coating on at least one of the one or more filars, the insulative coating circumferentially covering the outer surface of the at least one of the one or more filars, and at least one cohesive structure formed between adjacent turns of the helically coiled conductor. The at least one cohesive structure includes portions of the insulative coating on the at least one of the one or more filars and is configured to interconnect adjacent turns of the helically coiled conductor. | 02-13-2014 |
20140046392 | IMPLANTABLE MEDICAL DEVICE RESPONSIVE TO MRI INDUCED CAPTURE THRESHOLD CHANGES - Energy delivered from an implantable medical device to stimulate tissue within a patient's body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue. | 02-13-2014 |
20140046390 | IMPLANTABLE MEDICAL DEVICE WITH AUTOMATIC TACHYCARDIA DETECTION AND CONTROL IN MRI ENVIRONMENTS - An implantable medical device (IMD) includes a lead having one or more sensing electrodes and one or more therapy delivery electrodes, and a sensor configured to detect the presence of static and time-varying scan fields in a magnetic resonance imaging (MRI) environment. A controller, in electrical communication with the lead and the sensor, is configured to process signals related to tachycardia events sensed via the one or more sensing electrodes and to deliver pacing and shock therapy signals via the one or more therapy delivery electrodes. The controller compares the sensed static and time-varying scan fields to static and time-varying scan field thresholds. The controller controls delivery of anti-tachycardia pacing and shock therapy signals as a function of the detected tachycardia events, the comparison of the sensed static scan field to the static scan field threshold, and the comparison of the time-varying scan fields to the time-varying scan field thresholds. | 02-13-2014 |
20140046200 | MONITORING OF HEART SOUNDS - This document discusses, among other things, a system comprising an implantable medical device (IMD) including an implantable heart sound sensor circuit configured to produce an electrical heart sound signal representative of a heart sound of a subject and a processor circuit. The processor circuit is coupled to the heart sound sensor circuit and includes a detection circuit, a heart sound feature circuit and a trending circuit. The detection circuit configured to detect a physiologic perturbation and the heart sound feature circuit is configured to identify a heart sound feature in the electrical signal. The processor circuit is configured to trigger the heart sound feature circuit in relation to a detected physiologic perturbation. The trending circuit is configured to trend the heart sound feature in relation to a recurrence of the physiologic perturbation. The processor circuit is configured to declare a change in a physiologic condition of the patient according to the trending. | 02-13-2014 |
20140039591 | CARDIAC STIMULATION SYSTEM - Some embodiments of pacing systems employ wireless electrode assemblies to provide pacing therapy. The wireless electrode assemblies may wirelessly receive energy via an inductive coupling so as to provide electrical stimulation to the surrounding heart tissue. In certain embodiments, the wireless electrode assembly may include one or more biased tines that shift from a first position to a second position to secure the wireless electrode assembly into the inner wall of the heart chamber. | 02-06-2014 |
20140039327 | SYSTEM AND METHOD FOR EVALUATING A PATIENT STATUS FOR USE IN HEART FAILURE ASSESSMENT - A system and method for evaluating a patient status from sampled physiometry for use in heart failure assessment is presented. Physiological measures are stored, including at least one of direct measures regularly recorded on a substantially continuous basis by an implantable medical device for a patient and measures derived from the direct measures. At least one of those of the physiological measures, which each relate to a same type of physiometry, and those of the physiological measures, which each relate to a different type of physiometry are sampled. A status for the patient is determined through analysis of the sampled physiological measures assembled from a plurality of recordation points. The sampled physiological measures are evaluated. Trends that are indicated by the patient status, which might affect cardiac performance of the patient, are identified. Each trend is compared to worsening heart failure indications to generate a notification of parameter violations. | 02-06-2014 |
20140039312 | PACING-SITE SELECTION FOR LEAD PLACEMENT - Techniques are disclosed for pacing site selection. In one example, a method includes using a sensing element such as an ultrasonic transducer, an optical pressure sensor, a MEMS pressure sensor, a SAW pressure sensor, an accelerometer, a gyroscope, or any other suitable sensing element to sense a measure related to a cardiac strain in a heart resulting from contraction and relaxation of myocardium during a cardiac cycle. Based on the sensed strain, an output may be provided for use by a user of the system to select a segment of the heart for lead placement. | 02-06-2014 |
20140031888 | ELECTRODE DISPLACEMENT DETECTION - Electrode displacement can be detected using a thoracic impedance or conductivity signal. The thoracic impedance or conductivity signal can be filtered to attenuate cardiac contraction (stroke) and respiration components. A fluid status component of the thoracic impedance or conductivity signal can be used to detect a posture-shift related electrode displacement, such as can result from left ventricular/coronary sinus (LV/CS) lead pullback upon a recumbent to upright posture shift. | 01-30-2014 |
20140031887 | IDENTIFYING HEART FAILURE PATIENTS SUITABLE FOR RESYNCHRONIZATION THERAPY USING QRS COMPLEX WIDTH FROM AN INTRACARDIAC ELECTROGRAM - Methods and systems are disclosed for determining whether a patient is a responder to cardiac resynchronization therapy. The beginning and ending of the intrinsic ventricular depolarization are determined through signals measured from one or more electrodes implanted in the patient's heart. An interval between the beginning and ending of the intrinsic ventricular depolarization is computed and is compared to a threshold. The threshold may be determined empirically. The pacing parameters of a heart stimulation device, such as a pacemaker, may then be configured, for example, by setting the paced atrio-ventricular delay based on whether the patient responds positively to cardiac resynchronization therapy. | 01-30-2014 |
20140031886 | VENTRICULAR PACING TO AUGMENT ATRIAL NATRIURETIC HORMONE PRODUCTION - Intermittent delivery of ventricular pacing pulses synchronized to occur during an atrial diastole time period can be used to provide atrial stretch therapy and augment the production and release of atrial natriuretic hormone. | 01-30-2014 |
20140031641 | INTEGRATING DEVICE-BASED SENSORS AND BEDSIDE BIOMARKER ASSAYS TO DETECT WORSENING HEART FAILURE - Devices and methods for improving the sensitivity and specificity of heart failure (HF) detection are described. The devices and methods can detect a HF status such as using physiological sensor data and external biomarker assays. An apparatus can comprise ambulatory physiological sensors that can provide a first HF status indicator and a second HF status indicator to a user. An external biomarker sensor can provide an amount of a biomarker present, such as an assay for B-type natriuretic peptide (BNP), which provides information about HF status. A processor circuit can switch from a first HF detection mode to a second detection mode such as in response to the information from the biomarker sensor. The first detection mode can detect HF status using the first HF status indicator, and the second detection mode can detect HF status using the second HF status indicator. The second detection mode can have a higher specificity than the first detection mode. | 01-30-2014 |
20140025141 | METHOD AND APPARATUS FOR NEURAL STIMULATION WITH RESPIRATORY FEEDBACK - A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder. | 01-23-2014 |
20140018896 | LEADS WITH HIGH SURFACE RESISTANCE - Implantable medical leads having resistance characteristics adapted to dissipate radio frequency (RF) electromagnetic energy during medical procedures such as magnetic resonance imaging (MRI) are disclosed. An illustrative medical device includes a lead having an inner electrical conductor operatively coupled to an electrode and a pulse generator, and one or more outer resistive shields that radially surround the inner conductor and dissipate RF energy into the surrounding body tissue along the length of the lead. | 01-16-2014 |
20140018878 | LOCAL AND NON-LOCAL SENSING FOR CARDIAC PACING - Systems and methods for determining pacing timing intervals based on the temporal relationship between the timing of local and non-local cardiac signal features are described. A device includes a plurality of implantable electrodes electrically coupled to the heart and configured to sense local and non-local cardiac signals. Sense circuitry coupled to first and second electrode pairs senses a local cardiac signal via a first electrode pair and a non-local cardiac signal via a second electrode pair. Detection circuitry is used to detect a feature of the local signal associated with activation of a heart chamber and to detect a feature of the non-local signal associated with activation of the heart chamber. A control processor times delivery of one or more pacing pulses based on a temporal relationship between timing of the local signal feature and timing of the non-local signal feature. | 01-16-2014 |
20140018875 | METHOD AND APPARATUS FOR PACING SAFETY MARGIN - An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture. | 01-16-2014 |
20140018874 | SYSTEMS, DEVICES AND METHODS FOR MONITORING EFFICIENCY OF PACING - 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. | 01-16-2014 |
20140018871 | ENDOCARDIAL PACING DEVICES AND METHODS USEFUL FOR RESYNCHRONIZATION AND DEFIBRILLATION - According to one aspect, various methods and apparatus are used for treating a condition of a patient's heart, and for monitoring cardiac operation. In one approach consistent therewith, an electrode arrangement is placed in a right ventricle of the heart. The electrode arrangement is used to capture the myocardium for re-synchronization of the left and right ventricles by providing first and second signal components having opposite polarity on respective electrodes. The electrode arrangement is connected to an implantable CRM device that has the capability of pacing/sensing atrium, pacing/sensing ventricles, and deliver defibrillation therapy from the right side of the heart. The CRM device captures ventricular contractions to treat conduction abnormalities in one or more of the ventricles. | 01-16-2014 |
20140018870 | MRI OPERATION MODES FOR IMPLANTABLE MEDICAL DEVICES - One embodiment of the present invention relates to an implantable medical device (“IMD”) that can be programmed from one operational mode to another operational mode when in the presence of electro-magnetic interference (“EMI”). In accordance with this particular embodiment, the IMD includes a communication interface for receiving communication signals from an external device, such as a command to switch the IMD from a first operation mode to a second operation mode. The IMD further includes a processor in electrical communication with the communication interface, which is operable to switch or reprogram the IMD from the first operation mode to the second operation mode upon receiving a command to do so. In addition, the IMD includes a timer operable to measure a time period from when the processor switches the IMD to the second operation mode. In accordance with this aspect of the invention, the processor is in electrical communication with the timer, and is further operable to switch the IMD from the second operation mode back to the first operation mode when the measured time period reaches a predetermined time period. | 01-16-2014 |
20140018690 | SENSING RATE OF CHANGE OF PRESSURE IN THE LEFT VENTRICLE WITH AN IMPLANTED DEVICE - An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing. | 01-16-2014 |
20140012345 | CARDIOPULMONARY FUNCTIONAL STATUS ASSESSMENT VIA METABOLIC RESPONSE DETECTION BY IMPLANTABLE CARDIAC DEVICE - An implantable cardiac device is configured and programmed to assess a patient's cardiopulmonary function by evaluating the patient's minute ventilation response. Such evaluation may be performed by computing a minute ventilation response slope, defined as the ratio of an incremental change in minute ventilation to an incremental change in measured activity level. The minute ventilation response slope may then be compared with a normal range to assess the patient's functional status. | 01-09-2014 |
20140012341 | METHODS AND APPARATUSES FOR IMPLANTABLE MEDICAL DEVICE TELEMETRY POWER MANAGEMENT - A method comprises connecting at least one portion of a far-field radio-frequency (RF) first telemetry circuit in an implantable medical device to an energy source through a power connection module, detecting information included in a first predetermined wireless signal, changing a conductivity state of the power connection module when the information in the first predetermined wireless signal is detected to couple power to the at least one portion of the first telemetry circuit, detecting a second predetermined wireless signal, and changing a conductivity state of the power connection module to decouple power to the at least one portion of the first telemetry circuit when the second predetermined wireless signal is detected and the first telemetry circuit enters an idle state. | 01-09-2014 |
20140005503 | SLEEP DETECTION USING AN ADJUSTABLE THRESHOLD | 01-02-2014 |
20140005494 | CONCURRENT THERAPY DETECTION IN IMPLANTABLE MEDICAL DEVICES | 01-02-2014 |
20130345805 | METHODS FOR TREATING OR PREDICTING RISK OF A VENTRICULAR TACHYARRHYTHMIA EVENT - Provided herein are methods that include (i) determining a level of soluble ST2 in a biological sample from a subject, (i) comparing the level of soluble ST2 in the biological sample to a reference level of soluble ST2 (e.g., a level of soluble ST2 in the subject at an earlier time point), and (iii) selecting, implanting, replacing, or reprogramming an implanted cardiac device, e.g., an ICD, CRT, or CRT-D device, for a subject having an elevated level of soluble ST2 in the biological sample compared to the reference level of soluble ST2, or selecting a subject for participation in, or stratifying a subject participating in, a clinical study of a treatment for reducing the risk of a ventricular tachyarrhythmia (VTA) event. Also provided are methods for evaluating the risk of a VTA event in a subject. Also provided are kits for performing any of these methods. | 12-26-2013 |
20130345776 | SYSTEM FOR ABATING NEURAL STIMULATION SIDE EFFECTS - Various system embodiments comprise a neural stimulation delivery system adapted to deliver a neural stimulation signal for use in delivering a neural stimulation therapy, a side effect detector, and a controller. The controller is adapted to control the neural stimulation delivery system, receive a signal indicative of detected side effect, determine whether the detected side effect is attributable to delivered neural stimulation therapy, and automatically titrate the neural stimulation therapy to abate the side effect. In various embodiments, the side effect detector includes a cough detector. In various embodiments, the controller is adapted to independently adjusting at least one stimulation parameter for at least one phase in the biphasic waveform as part of a process to titrate the neural stimulation therapy. Other aspects and embodiments are provided herein. | 12-26-2013 |
20130345591 | METHOD FOR DETECTING VAGUS CAPTURE - Some embodiments provide a system for delivering neurostimulation. Some system embodiments comprise a lead configured to be implanted in the body, a stimulation output circuit configured to deliver neurostimulation pulses to the vagus nerve through the lead, an EMG sensing circuit configured to use the lead to sense EMG signals from laryngeal muscle activity, and an evoked muscular response detection circuit configured to use the EMG signals sensed by the EMG sensing circuit to detect evoked laryngeal muscle activity evoked by the neurostimulation pulse. | 12-26-2013 |
20130338727 | SYSTEMS AND METHODS TO REDUCE SYNCOPE RISK DURING NEURAL STIMULATION THERAPY - Some embodiments, by way of example, provide a system, comprising a posture change detector configured to detect a posture transition indicative of an increased risk of syncope, and a neural stimulator configured to deliver a neural stimulation therapy. The neural stimulator may include a syncope avoidance module configured to respond to a detected posture transition by temporarily overriding the neural stimulation therapy to ameliorate the risk of increased syncope. | 12-19-2013 |
20130338725 | CARDIAC RESPONSE CLASSIFICATION USING MULTISITE SENSING AND PACING - Methods and devices for classifying a cardiac pacing response involve using a first electrode combination for pacing and a second electrode combination for sensing a cardiac signal following pacing. The cardiac response to pacing may be classified using the sensed cardiac signal. One process involves using the sensed cardiac signal to detect the cardiac response as a fusion/pseudofusion beat. Another process involves using the sensed cardiac signal to classify the cardiac response to pacing as one of at least three cardiac response types. | 12-19-2013 |
20130333696 | COORDINATED USE OF RESPIRATORY AND CARDIAC THERAPIES FOR SLEEP DISOREDERED BREATHING - Methods and systems involve coordinating therapies used for treating disordered breathing. Disordered breathing therapies may include cardiac electrical stimulation therapy and external respiratory therapy as well as other therapies for treating disordered breathing in a patient. The therapies delivered to the patient may be coordinated to enhance effectiveness of the therapy, to reduce therapy interactions, to improve patient sleep, or to achieve other therapeutic goals. | 12-19-2013 |
20130331919 | SYSTEM FOR STIMULATING AUTONOMIC TARGETS FROM PULMONARY ARTERY - Various implantable medical device embodiments stimulate an autonomic neural target from within a pulmonary artery, and comprise at least one electrode, a power supply, a neural stimulator connected to the power supply, and an anchor structure. The neural stimulator is configured to generate a neural stimulation signal for delivery to the neural stimulation target through the at least one electrode. The anchor structure is configured to chronically and securely implant the neural stimulator, the power supply and the at least one electrode within the pulmonary artery. The anchor structure, the neural stimulator, the power supply and the at least one electrode are configured to be implanted through a pulmonary valve into the pulmonary artery. In various embodiments, the neural stimulator is configured to be operational to implement a neural stimulation protocol when chronically implanted within the pulmonary artery without a wired connection through the pulmonary valve. | 12-12-2013 |
20130331904 | REMOTE PACE DETECTION IN AN IMPLANTABLE MEDICAL DEVICE - A system embodiment for stimulating a neural target comprises a neural stimulator, a pace detector, and a controller. The neural stimulator is electrically connected to at least one electrode, and is configured to deliver a neural stimulation signal through the at least one electrode to stimulate the neural target. The pace detector is configured to use at least one electrode to sense cardiac activity and distinguish paced cardiac activity in the sensed cardiac activity from non-paced cardiac activity in the sensed cardiac activity. The controller is configured to control a programmed neural stimulation therapy using the neural stimulator and using detected paced cardiac activity as an input for the neural stimulation therapy. | 12-12-2013 |
20130331903 | RATE SMOOTHING CONTROL - A rate smoothing function used in implantable pulse generators uses detected triggering events, which cause the rate smoothing function to be activated or deactivated, and detected parameter adjusting events, which cause parameter(s) of the rate smoothing function to be changed. In one example, the activation/deactivation and/or change to the parameters of the rate smoothing function are temporary, and the pre-event state of the rate smoothing function is set to a post-adjusting state, such as after a first time interval. Rate smoothing may be selected, activated or deactivated, or adjusted based on a cardiac signal state, or based on an activity or other physiological sensor signal. The adjusted rate smoothing parameters may include an up-smoothing percentage to limit a speed of pacing rate increase and a down-smoothing percentage to limit a speed of pacing rate drop. | 12-12-2013 |
20130331902 | IMPLANTABLE CARDIAC DEVICE WITH DYSPNEA MEASUREMENT - 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. | 12-12-2013 |
20130325093 | IMPLANTABLE DEVICE LEAD INCLUDING A DISTAL ELECTRODE ASSEMBLY WITH A COILED COMPONENT - A medical device lead includes an insulative body having a proximal region with a proximal end, and a distal region with a distal end. The medical device lead also includes a connector coupled to the proximal end of the insulative body of the lead to electrically and mechanically connect the lead to an implantable pulse generator. The medical device lead further includes a conductor extending through the insulative body with a proximal end electrically connected to the connector. A distal electrode assembly at a distal end of the insulative body includes a proximal portion electrically coupled to a distal end of the conductor, a distal portion, and an intermediate portion. The intermediate portion comprises a coiled element electrically connecting the proximal portion and distal portion. | 12-05-2013 |
20130324862 | SYSTEM AND METHOD FOR CORRELATION OF PATIENT HEALTH INFORMATION AND IMPLANT DEVICE DATA - A system and method for correlating health related data for display. The system includes a medical device recording data and a display producing device which correlates the data and simultaneously displays different types of data or displays two sets of the same type of data along with the circumstances at which the two sets of data were recorded. Such displays aid a physician in prescribing and ascertaining the efficacy of cardiac therapies. | 12-05-2013 |
20130317561 | SYSTEM AND METHOD TO DELIVER THERAPY IN PRESENCE OF ANOTHER THERAPY - Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein. | 11-28-2013 |
20130317374 | CARDIOVASCULAR PRESSURE ANNOTATIONS AND LOGBOOK - A system comprises an external medical device configured to communicate with a first implantable medical device (IMD). The external medical device includes a communication circuit and a display. The communication circuit is configured to receive information associated with cardiovascular pressure from the IMD. The external medical device is configured to annotate a waveform on the display to indicate one or more events associated with cardiovascular pressure. | 11-28-2013 |
20130316195 | METHOD AND APPARATUS FOR A SMALL POWER SOURCE FOR AN IMPLANTABLE DEVICE - An example includes apparatus including a non-thin-film battery, that can include an implantable housing, electronics disposed in the implantable housing, and a battery disposed in the implantable housing, the battery comprising: a plurality of cells electrically connected to one another, with at least one cell including a stack including at least one substantially planar anode having a thickness greater than 1 micrometer and at least one substantially planar cathode having a thickness greater than 1 micrometer, and a cell housing enclosing the stack of substantially planar anodes and cathodes and displacing less than approximately 0.024 cubic centimeters, wherein the plurality of cells are interconnected in at least one of series and parallel, and terminals interconnecting the battery and the electronics. | 11-28-2013 |
20130310910 | LEAD INCLUDING CONDUCTORS CONFIGURED FOR REDUCED MRI-INDUCED CURRENTS - An implantable medical device lead includes an inner conductor coil comprising one or more generally cylindrically wound filars. The inner conductor coil is configured to have a first inductance value greater than or equal to 0.2 μH/inch when the inner conductor coil is subjected to a range of radio frequencies. The implantable medical device lead also includes a multi-filar outer coil comprising two or more generally cylindrically wound filars. The multi-filar outer coil is configured to have a second inductance value greater than or equal to 0.1 μH/inch when the multi-filar outer coil is subjected to the range of radio frequencies. | 11-21-2013 |
20130310896 | WIRELESS PATIENT COMMUNICATOR FOR USE IN A LIFE CRITICAL NETWORK - A portable housing supports a processor coupled to memory for storing medical firmware and wireless radio firmware, first and second radios, a processor, and a power source. Communications are effected between an implantable medical device and the first radio in accordance with program instructions of the medical firmware, and between the second radio and the wireless network in accordance with program instructions of the wireless radio firmware. The first and second radios are configured to operate cooperatively in a first testing configuration, by which the first radio operates as a transmitter and the second radio operates as a receiver, and cooperatively in a second testing configuration, by which the second radio operates as a transmitter and the first radio operates as a receiver. Functional testing of the first and second radios is implemented using one or both of the first and second testing configurations. | 11-21-2013 |
20130310893 | SPATIALLY SELECTIVE VAGUS NERVE STIMULATION - By targeting on selected branches or fascicles of a vagus nerve using electrode placement and/or selection, one or more target branches of the vagus nerve are substantially activated by electrical stimulation pulses delivered to a branch without substantially activating one or more non-target branches. In one embodiment, vagus nerve stimulation is delivered through an electrode placed on a thoracic vagus nerve that is separated from a recurrent laryngeal nerve, such that the vagus nerve is stimulated without causing laryngeal muscle contractions. In another embodiment, vagus nerve stimulation is delivered through a multi-contact electrode with one or more contacts selected for delivering the electrical stimulation pulses to stimulate the vagus nerve without causing laryngeal muscle contractions. | 11-21-2013 |
20130310891 | AUTOMATIC PACING CONFIGURATION SWITCHER - A system or apparatus can provide electrostimulations via an electrode configuration that can be selected from multiple electrode configurations, the electrostimulations of the type for inducing a desired heart contraction, or a neurostimulation response. The system or apparatus can allow communicating with an external device to receive an input indicating a degree of patient discomfort with an electrostimulation delivered using a first electrode configuration, and can associate information about the degree of discomfort with information about the corresponding first electrode configuration for use by a controller circuit in determining a second electrode configuration for delivering a subsequent electrostimulation. | 11-21-2013 |
20130310889 | SYMPATHETIC STIMULATION FOR IMPROVED MYOCARDIAL RELAXATION - Described are methods and devices for improving diastolic function with electrostimulation in heart failure patients who exhibit relatively normal systolic function. Such patients are characterized by impaired myocardial relaxation during diastole that prevents adequate filling of the ventricles during diastole to thereby reduce cardiac output. An implantable device is described for effecting strategic and periodic stimulation of the sympathetic nervous system to elicit myocardial adrenergic activation for improved myocardial relaxation. | 11-21-2013 |
20130304170 | MULTIPOLAR CONDUCTOR FOR AN IMPLANTABLE MEDICAL DEVICE - A medical device lead includes a flexible body having a proximal region with a proximal end, and a distal region with a distal end. A connector is coupled to the proximal end of the flexible body of the lead to electrically and mechanically connect the lead to an implantable pulse generator. A composite wire having a proximal end is electrically coupled to the connector. The composite wire includes an inner conductor element and a plurality of outer conductor elements adjacent to and radially spaced from the inner conductor element. A distal end of each of the inner conductor element and the plurality of outer conductor elements is connected to one of a plurality of electrodes in the distal region of the flexible body. | 11-14-2013 |
20130296988 | PACING LEADS WITH ULTRATHIN ISOLATION LAYER BY ATOMIC LAYER DEPOSITION - A medical implant includes a polymer material and a ceramic material. In one embodiment, the medical implant includes a nanolaminate comprising at least one ceramic layer and at least one polymer layer. Each ceramic layer is less than or equal to about 30 nanometers thick. | 11-07-2013 |
20130296965 | METHOD FOR BLOOD PRESSURE MODULATION USING ELECTRICAL STIMULATION OF THE CORONARY BARORECEPTORS - An apparatus comprises a first stimulation circuit and a control circuit. The stimulation circuit is configured to be electrically coupled to a first electrode assembly that is configured to deliver electrical sub-myocardial activation stimulation to a coronary baroreceptor from a location within a left atrial appendage of a heart. The stimulation circuit is further configured to generate the electrical stimulation for delivery to the coronary baroreceptor via the first electrode assembly. The control circuit is wirelessly or conductively coupled to the first stimulation circuit and is configured to control delivery of the electrical stimulation. | 11-07-2013 |
20130289476 | MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE - The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed. | 10-31-2013 |
20130282093 | IMPLANTABLE MEDICAL DEVICE LEAD INCLUDING A UNIFILAR COILED CABLE - A medical device lead includes a flexible body having a proximal region with a proximal end, and a distal region with a distal end. A connector is coupled to the proximal end of the flexible body of the lead to electrically and mechanically connect the lead to an implantable pulse generator. The medical device lead also includes an electrode in the distal region of the flexible body, and a cable conductor having a proximal end electrically coupled to the connector and a distal end electrically coupled to the electrode. The cable conductor consists of a single helically coiled filar including a plurality of co-radial turns and having an outer diameter of less than about 0.020 inch (0.508 mm). | 10-24-2013 |
20130274624 | METHOD AND APPARATUS FOR AUTOMATIC ARRHYTHMIA CLASSIFICATION WITH CONFIDENCE ESTIMATION - An arrhythmia classification system receives cardiac data from an implantable medical device, performs automatic adjudication of each cardiac arrhythmia episode indicated by the cardiac data, and generates episode data representative of information associated with the episode. The episode data include at least an episode classification resulting from the automatic adjudication of the episode and a confidence level in the episode classification. In one embodiment, the episode data further include key features rationalizing the automatic adjudication of the episode. | 10-17-2013 |
20130271279 | SYSTEM AND METHOD PROVIDING DATA EXCHANGE WITH A MEDICAL DEVICE FOR REMOTE PATIENT CARE - A system for relaying data to a repository from a medical device is disclosed. A receiver is configured to receive data from a medical device, where the data can be an indication of a problem with the medical device. A memory is configured to maintain the data once it has been received. A transmission device is configured to send the data to a data repository over a communication medium. A detector is configured to detect conditions of the communication medium that could affect data exchange and send the data based at least in part on the conditions. A processor is configured to send at least a portion of the data based at least in part on a degree of urgency. | 10-17-2013 |
20130261714 | STEROID ELUTING COLLAR UNDERMOLD - Methods of manufacturing implantable medical devices with one or more undermolded features are disclosed. An example method includes injection molding an annular-shaped member onto an inner surface of a sacrificial mold insert, and then undermolding an elongate medical device body directly to the member. The member is directly coupled to the device body without the use of adhesives or bonding agents, thus eliminating the presence of gaps or surface irregularities that can affect device performance. | 10-03-2013 |
20130261690 | APPARATUS FOR TREATING THE PHYSIOLOGICAL ELECTRIC CONDUCTION OF THE HEART - 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. | 10-03-2013 |
20130261689 | METHODS, DEVICES AND SYSTEMS FOR CARDIAC RHYTHM MANAGEMENT USING AN ELECTRODE ARRANGEMENT - 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. | 10-03-2013 |
20130261688 | DETERMINATION OF PHRENIC NERVE STIMULATION THRESHOLD - In an example of a method, the method includes testing for phrenic nerve stimulation (PS) threshold. If PS beats are detected at the pacing output level, analyzing the detected PS beats using criteria to determine if the pacing output level can be declared to be the PS threshold. If the pacing output level cannot be declared to be the PS threshold based on the analysis of the PS beat at the pacing output level, performing a PS beat confirmation procedure. The PS beat confirmation procedure may include delivering additional cardiac paces at the pacing output level to generate additional PS beats, and analyzing the detected PS beats using other criteria to determine if the pacing output level can be confirmed as the PS threshold. | 10-03-2013 |
20130261476 | PHRENIC NERVE STIMULATION DETECTION - In an example, a system includes a cardiac pulse generator configured to generate cardiac paces to pace the heart, a sensor configured to sense a physiological signal for use in detecting pace-induced phrenic nerve stimulation where the pace-induced phrenic nerve stimulation is phrenic nerve stimulation induced by electrical cardiac pace signals, and a phrenic nerve stimulation detector configured to analyze the sensed physiological signal to detect PS beats where the PS beats are cardiac paces that induce phrenic nerve stimulation. The detector may be configured to correlate signal data for sensed beat signals to a PS template to detect PS beats, or may be configured to analyze morphological features of sensed beat signals to detect PS beats, or may be configured to detect PS beats using a combination that both correlates signal data for sensed beat signals to a PS template and analyzes morphological features of sensed beat signals. | 10-03-2013 |
20130261471 | BASELINE DETERMINATION FOR PHRENIC NERVE STIMULATION DETECTION - Some method examples may include pacing a heart with cardiac paces, sensing a physiological signal for use in detecting pace-induced phrenic nerve stimulation, performing a baseline level determination process to identify a baseline level for the sensed physiological signal, and detecting pace-induced phrenic nerve stimulation using the sensed physiological signal and the calculated baseline level. Detecting pace-induced phrenic nerve stimulation may include sampling the sensed physiological signal during each of a plurality of cardiac cycles to provide sampled signals and calculating the baseline level for the physiological signal using the sampled signals. Sampling the sensed physiological signal may include sampling the signal during a time window defined using a pace time with each of the cardiac cycles to avoid cardiac components and phrenic nerve stimulation components in the sampled signal. | 10-03-2013 |
20130254348 | REGULATORY COMPLIANT TRANSMISSION OF MEDICAL DATA EMPLOYING A PATIENT IMPLANTABLE MEDICAL DEVICE AND A GENERIC NETWORK ACCESS DEVICE - An interface device for facilitating transfer of medical information between a patient implantable medical device (PIMD) and a remote network server via public network infrastructure is disclosed, the interface device using any of a plurality of generic network access devices having disparate communication protocols. First communication circuitry is configured to receive medical information from a patient implantable medical device (PIMD), and second communication circuitry configured to effect communication with the first communication circuitry and a generic network access device. A processor is coupled the first communication circuitry and the second communication circuitry. The processor is configured to control transmission of the medical information to the generic network access device and condition the medical device data in compliance with a predetermined medical information regulatory standard governing the PIMD. A method is also disclosed. | 09-26-2013 |
20130253624 | SYSTEMS AND METHODS FOR STIMULATION OF VAGUS NERVE - Described is a system for stimulating a target region of a vagus nerve from a location within an internal jugular vein. The system comprises a medical lead and an insulating element. The insulating element is formed from a flexible sheet of electrically insulative material, and is to be implanted within the internal jugular vein to insulate nerve structures proximate the vagus nerve from stimulation. The insulating sheath includes at least one window through which the electrical stimuli can be delivered to the target region of the vagus nerve. | 09-26-2013 |
20130253616 | METHOD AND APPARATUS FOR SYNCHRONIZING NEURAL STIMULATION TO CARDIAC CYCLES - 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. | 09-26-2013 |
20130253615 | AUTOMATIC SELECTION OF LEAD CONFIGURATION FOR A NEURAL STIMULATION LEAD - A neurostimulation system includes a neural stimulation lead having a proximal portion and a distal portion and including a plurality of electrodes along the distal portion. The plurality of electrodes are configured for positioning proximate a portion of the autonomic nervous system. A neural stimulation circuit, coupled to the plurality of electrodes, delivers neural stimulation pulses to the plurality of electrodes. A processor and controller is configured to control the neural stimulation circuit to deliver first neural stimulation pulses to each of a plurality of electrode configurations. Each electrode configuration includes one or more of the plurality of electrodes. The processor and controller is further configured to receive information related to motor fiber activity that is induced in response to delivery of the first neural stimulation pulses to each of the plurality of electrode configurations and to identify the electrode configurations that induce the motor fiber activity. | 09-26-2013 |
20130253350 | METHOD AND APPARATUS FOR RECOGNIZING SENSED CARDIAC EVENTS USING DIFFERENT ELECTRODE CONFIGURATIONS - A system senses a cardiac signal for diagnostic and/or therapy control purposes using a first set of electrodes and switches to a different second set of electrodes for recognizing cardiac events in the cardiac signal. In various embodiments, the cardiac signal sensed using the second set of electrodes is compared to the cardiac signal sensed using the first set of electrodes, and the cardiac events in the cardiac signal are each recognized using an outcome of the comparison. | 09-26-2013 |